Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.
Department of Neurology, Aizen Hospital, Sapporo, Hokkaido, Japan.
Muscle Nerve. 2024 Nov;70(5):944-953. doi: 10.1002/mus.28226. Epub 2024 Aug 12.
INTRODUCTION/AIMS: Concentric needle electromyography (CNEMG) is an essential examination for evaluating neuromuscular disorders, although pain is a drawback. Clustering Index (CI) method is a non-invasive quantitative analysis for surface electromyography (SEMG) that evaluates whether the signal area is clustered into the few large motor unit potentials (MUPs) or is evenly distributed. However, the diagnostic yield of the CI method in comparison with CNEMG is not known. In this study, we aimed to compare the sensitivity of the CI method with MUP parameters in CNEMG for diagnosing neurogenic or myogenic disorders.
We retrospectively identified patients for whom both SEMG and CNEMG were performed on the same tibialis anterior (TA) muscle. In CNEMG, seven MUP parameters were evaluated, including size index (SI) and revised size indices for neurogenic (rSIn) and myogenic (rSIm) disorders.
Identified were 21 patients with neurogenic and 21 patients with myogenic disorders. Control data were constructed from 30 control subjects. The sensitivities of the CI method for the neurogenic and myogenic groups were 76% and 62%, respectively, which were not significantly different from MUP parameters, except for being significantly higher than those of amplitude and duration for myopathy (24%). Among MUP parameters, the sensitivities of rSIn (62%) and rSIm (57%) for myopathy were significantly higher than those of amplitude and duration. The CI method significantly correlated with the strength of the TA muscle in myopathy.
The CI method, having comparable diagnostic yields to MUP parameters, is promising as a non-invasive diagnostic measure.
简介/目的：同心针肌电图（CNEMG）是评估神经肌肉疾病的重要检查方法，尽管存在疼痛这一缺点。聚类指数（CI）方法是一种用于表面肌电图（SEMG）的非侵入性定量分析方法，用于评估信号区域是否聚类成少数几个大运动单位电位（MUP），还是均匀分布。然而，CI 方法与 CNEMG 的诊断效果比较尚不清楚。本研究旨在比较 CI 方法与 CNEMG 中 MUP 参数在诊断神经源性或肌源性疾病方面的敏感性。
我们回顾性地确定了同时对同一胫骨前肌（TA）进行 SEMG 和 CNEMG 的患者。在 CNEMG 中，评估了七个 MUP 参数，包括大小指数（SI）和神经源性（rSIn）和肌源性（rSIm）疾病的修正大小指数。
确定了 21 例神经源性和 21 例肌源性疾病患者。对照组数据来自 30 名对照者。CI 方法对神经源性和肌源性组的敏感性分别为 76%和 62%，与 MUP 参数相比无显著差异，除了对肌病的振幅和持续时间的敏感性明显高于 MUP 参数（24%）。在 MUP 参数中，肌病的 rSIn（62%）和 rSIm（57%）的敏感性明显高于振幅和持续时间。CI 方法与肌病 TA 肌肉的强度显著相关。
CI 方法与 MUP 参数具有相当的诊断效果，有望成为一种非侵入性的诊断手段。
