Yang Xiong-Gang, Guo Hong-Yang, Peng Zhi, Luo Hao-Tian, Lu Sheng
Department of Orthopedics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming City, Yunnan Province, China; The Key Laboratory of Digital Orthopedics of Yunnan Province, Kunming City, Yunnan Province, China.
Department of Rehabilitation, Affiliated Hospital of Hebei University of Technology, Handan, China.
World Neurosurg. 2024 Nov;191:165-171. doi: 10.1016/j.wneu.2024.08.076. Epub 2024 Aug 17.
This review aims to comprehensively summarize the application of electrophysiological methods, specifically repetitive nerve stimulation (RNS) and single fiber electromyography (SFEMG), in the diagnosis of neuromuscular junction (NMJ) disorders, including myasthenia gravis, Lambert-Eaton syndrome, and sarcopenia in the elderly. Both RNS and SFEMG have demonstrated high sensitivity and specificity in detecting NMJ abnormalities. RNS aids in distinguishing presynaptic from postsynaptic lesions, while SFEMG provides direct evidence of NMJ function by assessing single motor unit action potentials. Key parameters in SFEMG, such as fiber density, jitter, and pulse blocking, are crucial for evaluating NMJ function. Increased fiber density and jitter value, along with pulse blocking, are often observed in patients with NMJ disorders. However, despite the extensive application of these techniques in various NMJ-related diseases, their role in aging, particularly in sarcopenic patients, remains underexplored, highlighting the need for future research.
本综述旨在全面总结电生理方法，特别是重复神经刺激（RNS）和单纤维肌电图（SFEMG）在神经肌肉接头（NMJ）疾病诊断中的应用，这些疾病包括重症肌无力、兰伯特-伊顿综合征以及老年人的肌肉减少症。RNS和SFEMG在检测NMJ异常方面均显示出高灵敏度和特异性。RNS有助于区分突触前病变和突触后病变，而SFEMG通过评估单个运动单位动作电位提供NMJ功能的直接证据。SFEMG中的关键参数，如纤维密度、颤抖和脉冲阻滞，对于评估NMJ功能至关重要。在NMJ疾病患者中经常观察到纤维密度增加、颤抖值增加以及脉冲阻滞。然而，尽管这些技术在各种与NMJ相关的疾病中得到了广泛应用，但它们在衰老过程中的作用，特别是在肌肉减少症患者中的作用，仍未得到充分探索，这凸显了未来研究的必要性。
