Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Edif. 8B, Camino de Vera SN, Valencia 46022, Spain.
Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain.
J Electromyogr Kinesiol. 2024 Dec;79:102940. doi: 10.1016/j.jelekin.2024.102940. Epub 2024 Oct 11.
This study aimed to assess the electrical coupling between both pelvic floor muscle (PFM) sides (two-sided coupling) and within individual PFM sides (one-sided coupling) in chronic pelvic pain (CPP) before and after botulinum neurotoxin type A (BoNT/A) treatment. Surface electromyographic (sEMG) signals were recorded from the left and right PFM of 24 patients (P) with CPP before and after being treated with BoNT/A (Weeks 0,8,12,24). Recordings were also made in 24 healthy women (H). PFM two-sided and one-sided coupling was evaluated during contractions by the cross-correlation (CC) and the imaginary part of coherency (iCOH) of their sEMG signals. Significant differences between their values were assessed comparing P(0) vs. P(8,12,24) and H vs. P(0,8,12,24). This study showed that PFM two-sided coupling is similar across groups before treatment, while PFM one-sided coupling on the patients' most painful side is deranged before and also after BoNT/A treatment: amplitude coupling is lower (<CC) and phase difference is greater (>iCOH) than healthy women's. This could be justified by altered neuromotor control strategies developed as an adaptation to muscle pain, structural and electrical changes in PFM, and alterations in their innervation pattern, which may influence the onset, perpetuation, or recurrence of CPP after treatment.
本研究旨在评估慢性盆腔疼痛（CPP）患者在接受肉毒杆菌毒素 A（BoNT/A）治疗前后双侧（双侧耦合）和单侧（单侧耦合）盆底肌（PFM）之间的电耦合。在接受 BoNT/A 治疗前（第 0 周）和治疗后（第 8、12、24 周），我们记录了 24 名 CPP 患者（P）的左侧和右侧 PFM 的表面肌电图（sEMG）信号，并记录了 24 名健康女性（H）的 sEMG 信号。通过交叉相关（CC）和相干虚部（iCOH）评估收缩时 PFM 的双侧和单侧耦合。通过比较 P(0)与 P(8、12、24)和 H 与 P(0、8、12、24)之间的数值，评估它们之间的差异是否具有统计学意义。本研究表明，治疗前，PFM 双侧耦合在各组之间相似，而患者最痛侧的 PFM 单侧耦合在治疗前和治疗后均出现紊乱：振幅耦合较低（<CC），相位差较大（>iCOH），与健康女性不同。这可能是由于肌肉疼痛、PFM 的结构和电变化以及其神经支配模式的改变导致的神经运动控制策略发生改变，这些改变可能会影响治疗后 CPP 的发生、持续或复发。
