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Baumgartner NW, Hill JP, Bhatnagar S, Roos R, Soliven B, Rezania K, Issa NP. Added load increases the peak frequency of intermuscular coherence. J Electromyogr Kinesiol 2024; 76:102881. [PMID: 38574588 PMCID: PMC11111328 DOI: 10.1016/j.jelekin.2024.102881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/15/2024] [Accepted: 03/30/2024] [Indexed: 04/06/2024] Open
Abstract
Cortical motor neuron activity appears to drive lower motor neurons through two distinct frequency bands: the β range (15-30 Hz) during weak muscle contractions and γ range (30-50 Hz) during strong contractions. It is unknown whether the frequency of cortical drive shifts continuously or abruptly between the β and γ frequency bands as contraction strength changes. Intermuscular coherence (IMC) between synergistic arm muscles was used to assess how the frequency of common neuronal drive shifts with increasing contraction strength. Muscle activity was recorded by surface electromyography (EMG) from the biceps and brachioradialis in nine healthy adults performing 30-second isometric holds with added loads. IMC was calculated across the two muscle groups during the isometric contraction. Significant IMC was present in the 20 to 50 Hz range with all loads. Repeated measures ANOVA show the peak frequency of IMC increased significantly when load was added, from a peak of 32.7 Hz with no added load, to 35.3 Hz, 35.7 Hz, and 36.3 Hz with three-, five-, and ten-pound loads respectively. An increase in IMC frequency occurs in response to added load, suggesting that cortical drive functions over a range of frequencies as a function of an isometric contraction against load.
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Affiliation(s)
- Nicholas W Baumgartner
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Jacquelyn P Hill
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Shail Bhatnagar
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Raymond Roos
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Betty Soliven
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Kourosh Rezania
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Naoum P Issa
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA.
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Issa NP, Aydin S, Polley E, Carberry N, Garret MA, Smith S, Habib AA, Baumgartner NW, Soliven B, Rezania K. Intermuscular coherence as an early biomarker for amyotrophic lateral sclerosis: The protocol for a prospective, multicenter study. PLoS One 2024; 19:e0303053. [PMID: 38776297 PMCID: PMC11111088 DOI: 10.1371/journal.pone.0303053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/18/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE To describe the protocol of a prospective study to test the validity of intermuscular coherence (IMC) as a diagnostic tool and biomarker of upper motor neuron degeneration in amyotrophic lateral sclerosis (ALS). METHODS This is a multicenter, prospective study. IMC of muscle pairs in the upper and lower limbs is gathered in ∼650 subjects across three groups using surface electrodes and conventional electromyography (EMG) machines. The following subjects will be tested: 1) neurotypical controls; 2) patients with symptomatology suggestive for early ALS but not meeting probable or definite ALS by Awaji Criteria; 3) patients with a known ALS mimic. The recruitment period is between 3/31/2021 and 12/31/2025. Written consent will be sought from the subject or the subject's legally authorized representative during enrollment. RESULTS The endpoints of this study include: 1) whether adding IMC to the Awaji ALS criteria improve its sensitivity in early ALS and can allow for diagnosis earlier; 2) constructing a database of IMC across different ages, genders, and ethnicities. SIGNIFICANCE This study may validate a new inexpensive, painless, and widely available tool for the diagnosis of ALS.
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Affiliation(s)
- Naoum P. Issa
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Serdar Aydin
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Eric Polley
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Nathan Carberry
- University of Miami, Coral Gables, FL, United States of America
| | - Mark A. Garret
- Massachusetts General Hospital, Boston, MA, United States of America
| | - Sean Smith
- Washington University, St. Louis, MO, United States of America
| | - Ali A. Habib
- University of California, Irvine, Irvine, CA, United States of America
| | | | - Betty Soliven
- University of Chicago Medical Center, Chicago, IL, United States of America
| | - Kourosh Rezania
- University of Chicago Medical Center, Chicago, IL, United States of America
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Rong P, Heidrick L, Pattee GL. A multimodal approach to automated hierarchical assessment of bulbar involvement in amyotrophic lateral sclerosis. Front Neurol 2024; 15:1396002. [PMID: 38836001 PMCID: PMC11148322 DOI: 10.3389/fneur.2024.1396002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/01/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction As a hallmark feature of amyotrophic lateral sclerosis (ALS), bulbar involvement leads to progressive declines of speech and swallowing functions, significantly impacting social, emotional, and physical health, and quality of life. Standard clinical tools for bulbar assessment focus primarily on clinical symptoms and functional outcomes. However, ALS is known to have a long, clinically silent prodromal stage characterized by complex subclinical changes at various levels of the bulbar motor system. These changes accumulate over time and eventually culminate in clinical symptoms and functional declines. Detection of these subclinical changes is critical, both for mechanistic understanding of bulbar neuromuscular pathology and for optimal clinical management of bulbar dysfunction in ALS. To this end, we developed a novel multimodal measurement tool based on two clinically readily available, noninvasive instruments-facial surface electromyography (sEMG) and acoustic techniques-to hierarchically assess seven constructs of bulbar/speech motor control at the neuromuscular and acoustic levels. These constructs, including prosody, pause, functional connectivity, amplitude, rhythm, complexity, and regularity, are both mechanically and clinically relevant to bulbar involvement. Methods Using a custom-developed, fully automated data analytic algorithm, a variety of features were extracted from the sEMG and acoustic recordings of a speech task performed by 13 individuals with ALS and 10 neurologically healthy controls. These features were then factorized into 10 composite outcome measures using confirmatory factor analysis. Statistical and machine learning techniques were applied to these composite outcome measures to evaluate their reliability (internal consistency), validity (concurrent and construct), and efficacy for early detection and progress monitoring of bulbar involvement in ALS. Results The composite outcome measures were demonstrated to (1) be internally consistent and structurally valid in measuring the targeted constructs; (2) hold concurrent validity with the existing clinical and functional criteria for bulbar assessment; and (3) outperform the outcome measures obtained from each constituent modality in differentiating individuals with ALS from healthy controls. Moreover, the composite outcome measures combined demonstrated high efficacy for detecting subclinical changes in the targeted constructs, both during the prodromal stage and during the transition from prodromal to symptomatic stages. Discussion The findings provided compelling initial evidence for the utility of the multimodal measurement tool for improving early detection and progress monitoring of bulbar involvement in ALS, which have important implications in facilitating timely access to and delivery of optimal clinical care of bulbar dysfunction.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, United States
| | - Lindsey Heidrick
- Department of Hearing and Speech, University of Kansas Medical Center, Kansas City, KS, United States
| | - Gary L Pattee
- Neurology Associate P.C., Lincoln, NE, United States
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Lemon R. The Corticospinal System and Amyotrophic Lateral Sclerosis: IFCN handbook chapter. Clin Neurophysiol 2024; 160:56-67. [PMID: 38401191 DOI: 10.1016/j.clinph.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/23/2023] [Accepted: 02/03/2024] [Indexed: 02/26/2024]
Abstract
Corticospinal neurons located in motor areas of the cerebral neocortex project corticospinal axons which synapse with the spinal network; a parallel corticobulbar system projects to the cranial motor network and to brainstem motor pathways. The primate corticospinal system has a widespread cortical origin and an extensive range of different fibre diameters, including thick, fast-conducting axons. Direct cortico-motoneuronal (CM) projections from the motor cortex to arm and hand alpha motoneurons are a recent evolutionary feature, that is well developed in dexterous primates and particularly in humans. Many of these projections originate from the caudal subdivision of area 4 ('new' M1: primary motor cortex). They arise from corticospinal neurons of varied soma size, including those with fast- and relatively slow-conducting axons. This CM system has been shown to be involved in the control of skilled movements, carried out with fractionation of the distal extremities and at low force levels. During movement, corticospinal neurons are activated quite differently from 'lower' motoneurons, and there is no simple or fixed functional relationship between a so-called 'upper' motoneuron and its target lower motoneuron. There are key differences in the organisation and function of the corticospinal and CM system in primates versus non-primates, such as rodents. These differences need to be recognized when making the choice of animal model for understanding disorders such as amyotrophic lateral sclerosis (ALS). In this neurodegenerative brain disease there is a selective loss of fast-conducting corticospinal axons, and their synaptic connections, and this is reflected in responses to non-invasive cortical stimuli and measures of cortico-muscular coherence. The loss of CM connections influencing distal limb muscles results in a differential loss of muscle strength or 'split-hand' phenotype. Importantly, there is also a unique impairment in the coordination of skilled hand tasks that require fractionation of digit movement. Scores on validated tests of skilled hand function could be used to assess disease progression.
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Affiliation(s)
- Roger Lemon
- Department of Clinical and Movement Sciences, Queen Square Institute of Neurology, UCL, London WC1N 3BG, UK.
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Issa NP, Aydin S, Bhatnagar S, Baumgartner NW, Hill J, Aluri S, Valentic CS, Polley E, Gomez CM, Rezania K. Intermuscular Coherence in Spinocerebellar Ataxias 3 and 6: a Preliminary Study. CEREBELLUM (LONDON, ENGLAND) 2024; 23:601-608. [PMID: 37428409 PMCID: PMC10776817 DOI: 10.1007/s12311-023-01585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 07/11/2023]
Abstract
Spinocerebellar ataxias (SCAs) are familial neurodegenerative diseases involving the cerebellum and spinocerebellar tracts. While there is variable involvement of corticospinal tracts (CST), dorsal root ganglia, and motor neurons in SCA3, SCA6 is characterized by a pure, late-onset ataxia. Abnormal intermuscular coherence in the beta-gamma frequency range (IMCβγ) implies a lack of integrity of CST or the afferent input from the acting muscles. We test the hypothesis that IMCβγ has the potential to be a biomarker of disease activity in SCA3 but not SCA6. Intermuscular coherence between biceps brachii and brachioradialis muscles was measured from surface EMG waveforms in SCA3 (N = 16) and SCA6 (N = 20) patients and in neurotypical subjects (N = 23). IMC peak frequencies were present in the β range in SCA patients and in the γ range in neurotypical subjects. The difference between IMC amplitudes in the γ and β ranges was significant when comparing neurotypical control subjects to SCA3 (p < 0.01) and SCA6 (p = 0.01) patients. IMCβγ amplitude was smaller in SCA3 patients compared to neurotypical subjects (p < 0.05), but not different between SCA3 and SCA6 patients or between SCA6 and neurotypical subjects. IMC metrics can differentiate SCA patients from normal controls.
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Affiliation(s)
- Naoum P Issa
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA.
| | - Serdar Aydin
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Shail Bhatnagar
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | | | - Jacquelyn Hill
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Sravya Aluri
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | | | - Eric Polley
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Christopher M Gomez
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
| | - Kourosh Rezania
- Department of Neurology, University of Chicago, 5841 S. Maryland Ave., MC2030, Chicago, IL, 60637, USA
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Issa NP, Aydin S, Bhatnagar S, Baumgartner NW, Hill J, Aluri S, Valentic CS, Gomez CM, Rezania K. Intermuscular coherence in spinocerebellar ataxias 3 and 6: a preliminary study. RESEARCH SQUARE 2023:rs.3.rs-2782070. [PMID: 37131794 PMCID: PMC10153384 DOI: 10.21203/rs.3.rs-2782070/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Objective : Spinocerebellar ataxias (SCAs) are familial neurodegenerative diseases involving the cerebellum and spinocerebellar tracts. While there is variable involvement of corticospinal tracts (CST), dorsal root ganglia, and motor neurons in SCA3, SCA6 is characterized by a pure, late-onset ataxia. Abnormal intermuscular coherence in the beta-gamma frequency range (IMCbg) implies lack of integrity of CST or the afferent input from the acting muscles. We test the hypothesis that IMCbg has the potential to be a biomarker of disease activity in SCA3 but not SCA6. Methods: Intermuscular coherence between biceps and brachioradialis muscles was measured from surface EMG waveforms in SCA3 (N=16) and SCA6 (N=20) patients, and in neurotypical subjects (N=23). Results: IMC peak frequencies were present in the b range in SCA patients and in the g range in neurotypical subjects. The difference between IMC amplitudes in the g and b ranges was significant when comparing neurotypical control subjects to SCA3 (p < 0.01) and SCA6 (p = 0.01) patients. IMCbg amplitude was smaller in SCA3 patients compared to neurotypical subjects (p<0.05), but not different between SCA3 and SCA6 patients or between SCA6 and neurotypical subjects. Conclusion/significance: IMC metrics can differentiate SCA patients from normal controls.
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Antunes M, Folgado D, Barandas M, Carreiro A, Quintão C, de Carvalho M, Gamboa H. A morphology-based feature set for automated Amyotrophic Lateral Sclerosis diagnosis on surface electromyography. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rong P, Hansen O, Heidrick L. Relationship between rate-elicited changes in muscular-kinematic control strategies and acoustic performance in individuals with ALS-A multimodal investigation. JOURNAL OF COMMUNICATION DISORDERS 2022; 99:106253. [PMID: 36007484 DOI: 10.1016/j.jcomdis.2022.106253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION As a key control variable, duration has been long suspected to mediate the organization of speech motor control strategies, which has management implications for neuromotor speech disorders. This study aimed to experimentally delineate the role of duration in organizing speech motor control in neurologically healthy and impaired speakers using a voluntary speaking rate manipulation paradigm. METHODS Thirteen individuals with amyotrophic lateral sclerosis (ALS) and 10 healthy controls performed a sentence reading task three times, first at their habitual rate, then at a slower rate. A multimodal approach combining surface electromyography, kinematic, and acoustic technologies was used to record jaw muscle activities, jaw kinematics, and speech acoustics. Six muscular-kinematic features were extracted and factor-analyzed to characterize the organization of the mandibular control hierarchy. Five acoustic features were extracted, measuring the spectrotemporal properties of the diphthong /ɑɪ/ and the plosives /t/ and /k/. RESULTS The muscular-kinematic features converged into two interpretable latent factors, reflecting the level and cohesiveness/flexibility of mandibular control, respectively. Voluntary rate reduction led to a trend toward (1) finer, less cohesive, and more flexible mandibular control, and (2) increased range and decreased transition slope of the diphthong formants, across neurologically healthy and impaired groups. Differential correlations were found between the rate-elicited changes in mandibular control and acoustic performance for neurologically healthy and impaired speakers. CONCLUSIONS The results provided empirical evidence for the long-suspected but previously unsubstantiated role of duration in (re)organizing speech motor control strategies. The rate-elicited reorganization of muscular-kinematic control contributed to the acoustic performance of healthy speakers, in ways consistent with theoretical predictions. Such contributions were less consistent in impaired speakers, implying the complex nature of speaking rate reduction in ALS, possibly reflecting an interplay of disease-related constraints and volitional duration control. This information may help to stratify and identify candidates for the rate manipulation therapy.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence KS, USA.
| | - Olivia Hansen
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence KS, USA; Department of Hearing & Speech, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lindsey Heidrick
- Department of Hearing & Speech, University of Kansas Medical Center, Kansas City, KS, USA
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De Oliveira HM, Silsby M, Jaiser SR, Lai HM, Pavey N, Kiernan MC, Williams TL, Vucic S, Baker MR. Electrodiagnostic findings in facial onset sensory motor neuronopathy (FOSMN). Clin Neurophysiol 2022; 140:228-238. [DOI: 10.1016/j.clinph.2022.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 01/08/2023]
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Rong P, Pattee GL. A multidimensional facial surface EMG analysis for objective assessment of bulbar involvement in amyotrophic lateral sclerosis. Clin Neurophysiol 2022; 135:74-84. [DOI: 10.1016/j.clinph.2021.11.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/01/2021] [Accepted: 11/07/2021] [Indexed: 11/03/2022]
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Merlo A, Bò MC, Campanini I. Electrode Size and Placement for Surface EMG Bipolar Detection from the Brachioradialis Muscle: A Scoping Review. SENSORS 2021; 21:s21217322. [PMID: 34770627 PMCID: PMC8587451 DOI: 10.3390/s21217322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022]
Abstract
The brachioradialis muscle (BRD) is one of the main elbow flexors and is often assessed by surface electromyography (sEMG) in physiology, clinical, sports, ergonomics, and bioengineering applications. The reliability of the sEMG measurement strongly relies on the characteristics of the detection system used, because of possible crosstalk from the surrounding forearm muscles. We conducted a scoping review of the main databases to explore available guidelines of electrode placement on BRD and to map the electrode configurations used and authors’ awareness on the issues of crosstalk. One hundred and thirty-four studies were included in the review. The crosstalk was mentioned in 29 studies, although two studies only were specifically designed to assess it. One hundred and six studies (79%) did not even address the issue by generically placing the sensors above BRD, usually choosing large disposable ECG electrodes. The analysis of the literature highlights a general lack of awareness on the issues of crosstalk and the need for adequate training in the sEMG field. Three guidelines were found, whose recommendations have been compared and summarized to promote reliability in further studies. In particular, it is crucial to use miniaturized electrodes placed on a specific area over the muscle, especially when BRD activity is recorded for clinical applications.
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Affiliation(s)
- Andrea Merlo
- LAM-Motion Analysis Laboratory, S. Sebastiano Hospital, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Via Circondaria 29, 42015 Correggio, Italy;
- Merlo Bioengineering, 43100 Parma, Italy;
| | | | - Isabella Campanini
- LAM-Motion Analysis Laboratory, S. Sebastiano Hospital, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Via Circondaria 29, 42015 Correggio, Italy;
- Correspondence:
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Rong P. A Novel Hierarchical Framework for Measuring the Complexity and Irregularity of Multimodal Speech Signals and Its Application in the Assessment of Speech Impairment in Amyotrophic Lateral Sclerosis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2996-3014. [PMID: 34293265 DOI: 10.1044/2021_jslhr-20-00743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The purposes of this study are to develop a novel multimodal framework for measuring variability at the muscular, kinematic, and acoustic levels of the motor speech hierarchy and evaluate the utility of this framework in detecting speech impairment in amyotrophic lateral sclerosis (ALS). Method The myoelectric activities of three bilateral jaw muscle pairs (masseter, anterior temporalis, and anterior belly of digastric), jaw kinematics, and speech acoustics were recorded in 13 individuals with ALS and 10 neurologically healthy controls during sentence reading. Thirteen novel measures (six muscular, three kinematic, four acoustic), which characterized two different but interrelated aspects of variability-complexity and irregularity-were derived using linear and nonlinear methods. Exploratory factor analysis was applied to identify the latent factors underlying these measures. Based on the latent factors, three supervised classifiers-support vector machine (SVM), random forest (RF), and logistic regression (Logit)-were used to differentiate between the speech samples for patients and controls. Results Four interpretable latent factors were identified, representing the complexity of jaw kinematics, the irregularity of jaw antagonists functioning, the irregularity of jaw agonists functioning, and the irregularity of subband acoustic signals, respectively. Based on these latent factors, the speech samples for patients and controls were classified with high accuracy (> 96% for SVM and RF; 88.64% for Logit), outperforming the unimodal measures. Two factors showed significant between-groups differences, as characterized by decreased complexity of jaw kinematics and increased irregularity of jaw antagonists functioning in patients versus controls. Conclusions Decreased complexity of jaw kinematics presumably reflects impaired fine control of jaw movement, while increased irregularity of jaw antagonists functioning could be attributed to reduced synchronization of motor unit firing in ALS. The findings provide preliminary evidence for the utility of the multimodal framework as a novel quantitative assessment tool for detecting speech impairment in ALS and (potentially) in other neuromotor disorders.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences & Disorders, University of Kansas, Lawrence
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13
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Quintão C, Vigário R, Santos MM, Gomes AL, de Carvalho M, Pinto S, Gamboa H. Surface electromyography for testing motor dysfunction in amyotrophic lateral sclerosis. Neurophysiol Clin 2021; 51:454-465. [PMID: 34172377 DOI: 10.1016/j.neucli.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To investigate the use of a set of dynamical features, extracted from surface electromyography, to study upper motor neuron (UMN) degeneration in amyotrophic lateral sclerosis (ALS). METHODS We acquired surface EMG signals from the upper limb muscles of 13 ALS patients and 20 control subjects and classified them according to a novel set of muscle activity features, describing the temporal and frequency dynamic behavior of the signals, as well as measures of its complexity. Using a battery of classification approaches, we searched for the most discriminating combination of those features, as well as a suitable strategy to identify ALS. RESULTS We observed significant differences between ALS patients and controls, in particular when considering features highlighting differences between forearm and hand recordings, for which classification accuracies of up to 94% were achieved. The most robust discriminations were achieved using features based on detrended fluctuation analysis and peak frequency, and classifiers such as decision trees, random forest and Adaboost. CONCLUSION The current work shows that it is possible to achieve good identification of UMN changes in ALS by taking into consideration the dynamical behavior of surface electromyographic (sEMG) data.
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Affiliation(s)
- Carla Quintão
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics, NOVA University of Lisbon, 2829-516 Caparica, Portugal; Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal.
| | - Ricardo Vigário
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics, NOVA University of Lisbon, 2829-516 Caparica, Portugal; Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal
| | - Maria Marta Santos
- Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal
| | - Ana Luísa Gomes
- PLUX - Wireless Biosignals, Avenida 5 de Outubro 70, 1050-059 Lisboa, Portugal
| | - Mamede de Carvalho
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, 1179-056 Lisboa, Portugal
| | - Susana Pinto
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, 1179-056 Lisboa, Portugal
| | - Hugo Gamboa
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics, NOVA University of Lisbon, 2829-516 Caparica, Portugal; Department of Physics, Nova School of Science and Technology, 2829-516 Caparica, Portugal
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de Carvalho M, Kiernan MC, Pullman SL, Rezania K, Turner MR, Simmons Z. Neurophysiological features of primary lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2021; 21:11-17. [DOI: 10.1080/21678421.2020.1837174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Mamede de Carvalho
- Instituto de Fisiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal
| | - Matthew C. Kiernan
- Brain and Mind Centre, University of Sydney, and Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Seth L Pullman
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Kourosh Rezania
- Department of Neurology, The University of Chicago, Chicago, IL, USA
| | - MR Turner
- Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford, UK, and
| | - Zachary Simmons
- Department of Neurology, Pennsylvania State University, Hershey, PA, US
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Rong P, Pattee GL. A potential upper motor neuron measure of bulbar involvement in amyotrophic lateral sclerosis using jaw muscle coherence. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22:368-379. [PMID: 33522298 DOI: 10.1080/21678421.2021.1874993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify a novel, quantitative bulbar measure in amyotrophic lateral sclerosis (ALS) based on jaw muscle coherence. Methods: The myoelectric activities of masseter, anterior temporalis, and anterior belly of digastric were recorded bilaterally during a speech task in 12 individuals with ALS and 10 neurologically healthy controls, using surface electromyography. Coherence and directed coherence were calculated for all muscle pairs. The muscle pairs showing significant coherence and directed coherence in the beta-band (15-35 Hz) were identified and their mean beta-band coherence were (1) correlated with the kinematic (i.e. jaw acceleration time) and functional speech (i.e. speaking rate) measures that have been previously identified to be affected by bulbar ALS, across all participants, and (2) evaluated in terms of their efficacy in differentiating individuals with ALS from healthy controls. Results: Beta-band coherence was in general reduced in ALS relative to healthy controls, with the antagonistic and homologous muscle pairs being more affected than the agonistic pairs. Among all muscle pairs, the coherence between masseter and digastric (1) showed the strongest correlations with jaw acceleration time and speaking rate, and (2) differentiated individuals with ALS from healthy controls with the highest sensitivity (i.e. 0.92) and specificity (i.e. 0.90). Conclusions: Reduced beta-band coherence between masseter and digastric in ALS reflects weakened neural linkage between these muscles resulting from the disrupted cortical drive to the bulbar musculature. These findings provide preliminary evidence for jaw muscle coherence as a novel, quantitative measure of corticobulbar involvement, designed to improve bulbar assessment in ALS.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA
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Rong P, Jawdat O. A novel physiologic marker of bulbar motor involvement in amyotrophic lateral sclerosis: Jaw muscle synergy. Clin Neurophysiol 2021; 132:94-103. [DOI: 10.1016/j.clinph.2020.09.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/07/2020] [Accepted: 09/26/2020] [Indexed: 10/23/2022]
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Clinical and Electrophysiological Hints to TMS in De Novo Patients with Parkinson's Disease and Progressive Supranuclear Palsy. J Pers Med 2020. [PMID: 33322688 DOI: 10.3390/jpm10040274.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) can non-invasively probe cortical excitability in movement disorders, although clinical significance is still controversial, especially at early stages. We compare single-pulse TMS in two prototypic synucleinopathy and tauopathy-i.e., Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP), respectively-to find neurophysiological differences and identify early measures associated with cognitive impairment. METHODS 28 PD and 23 PSP de novo patients were age-matched with 28 healthy controls, all right-handed and drug-free. Amplitude and latency of motor evoked potentials (MEP), central motor conduction time, resting motor threshold (rMT), and cortical silent period (CSP) were recorded through a figure-of-eight coil from the First Dorsal Interosseous muscle (FDI), bilaterally. RESULTS Mini Mental Examination and Frontal Assessment Battery (FAB) scored worse in PSP; PD had worse FAB than controls. Higher MEP amplitude from right FDI in PD and PSP than controls was found, without difference between them. CSP was bilaterally longer in patients than controls, but similar between patient groups. A positive correlation between FAB and rMT was observed in PSP, bilaterally. CONCLUSIONS Despite the small sample size, PD and PSP might share, at early stage, a similar global electrocortical asset. rMT might detect and possibly predict cognitive deterioration in PSP.
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Fisicaro F, Lanza G, Cantone M, Ferri R, Pennisi G, Nicoletti A, Zappia M, Bella R, Pennisi M. Clinical and Electrophysiological Hints to TMS in De Novo Patients with Parkinson's Disease and Progressive Supranuclear Palsy. J Pers Med 2020; 10:jpm10040274. [PMID: 33322688 PMCID: PMC7768400 DOI: 10.3390/jpm10040274] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/06/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) can non-invasively probe cortical excitability in movement disorders, although clinical significance is still controversial, especially at early stages. We compare single-pulse TMS in two prototypic synucleinopathy and tauopathy-i.e., Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP), respectively-to find neurophysiological differences and identify early measures associated with cognitive impairment. METHODS 28 PD and 23 PSP de novo patients were age-matched with 28 healthy controls, all right-handed and drug-free. Amplitude and latency of motor evoked potentials (MEP), central motor conduction time, resting motor threshold (rMT), and cortical silent period (CSP) were recorded through a figure-of-eight coil from the First Dorsal Interosseous muscle (FDI), bilaterally. RESULTS Mini Mental Examination and Frontal Assessment Battery (FAB) scored worse in PSP; PD had worse FAB than controls. Higher MEP amplitude from right FDI in PD and PSP than controls was found, without difference between them. CSP was bilaterally longer in patients than controls, but similar between patient groups. A positive correlation between FAB and rMT was observed in PSP, bilaterally. CONCLUSIONS Despite the small sample size, PD and PSP might share, at early stage, a similar global electrocortical asset. rMT might detect and possibly predict cognitive deterioration in PSP.
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Affiliation(s)
- Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 97-95123 Catania, Italy; (F.F.); (M.P.)
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy;
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero, 73-94018 Troina, Italy;
- Correspondence: ; Tel.: +39-095-3782448
| | - Mariagiovanna Cantone
- Department of Neurology, Sant’Elia Hospital, ASP Caltanissetta, Via Luigi Russo, 6-93100 Caltanissetta, Italy;
| | - Raffaele Ferri
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero, 73-94018 Troina, Italy;
| | - Giovanni Pennisi
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia, 78-95123 Catania, Italy;
| | - Alessandra Nicoletti
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia, 87-95123 Catania, Italy; (A.N.); (M.Z.); (R.B.)
| | - Mario Zappia
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia, 87-95123 Catania, Italy; (A.N.); (M.Z.); (R.B.)
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia, 87-95123 Catania, Italy; (A.N.); (M.Z.); (R.B.)
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 97-95123 Catania, Italy; (F.F.); (M.P.)
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Proudfoot M, van Ede F, Quinn A, Colclough GL, Wuu J, Talbot K, Benatar M, Woolrich MW, Nobre AC, Turner MR. Impaired corticomuscular and interhemispheric cortical beta oscillation coupling in amyotrophic lateral sclerosis. Clin Neurophysiol 2018; 129:1479-1489. [DOI: 10.1016/j.clinph.2018.03.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 03/02/2018] [Accepted: 03/13/2018] [Indexed: 01/01/2023]
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Baker MR, Dharmadasa T, Jaiser SR, Kiernan MC. Amyotrophic lateral sclerosis - Time for beta testing? Clin Neurophysiol 2018; 129:1455-1456. [PMID: 29754830 DOI: 10.1016/j.clinph.2018.04.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 04/18/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M R Baker
- Institute of Neuroscience, The Medical School, Newcastle University, NE2 4HH, UK; Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK; Department of Clinical Neurophysiology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
| | - T Dharmadasa
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - S R Jaiser
- Institute of Neuroscience, The Medical School, Newcastle University, NE2 4HH, UK; Department of Clinical Neurophysiology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - M C Kiernan
- Brain and Mind Centre, The University of Sydney, Sydney, Australia; Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia
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Souza VH, Baffa O, Garcia MAC. Lateralized asymmetries in distribution of muscular evoked responses: An evidence of specialized motor control over an intrinsic hand muscle. Brain Res 2018; 1684:60-66. [PMID: 29408387 DOI: 10.1016/j.brainres.2018.01.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/05/2018] [Accepted: 01/23/2018] [Indexed: 12/14/2022]
Abstract
Lateralized neural control over hand muscles has been associated with anatomical and physiological asymmetries in the central nervous system. Some studies suggested that the dominant cerebral hemisphere exhibit larger cortical representation areas with lower excitability, while others reported higher cortical excitability in dominant side compared to the contralateral, or even could not find any differences. Thus, neurophysiological lateral asymmetries are still controversial. This study aimed to evaluate differences in dominant and non-dominant sides in motor evoked potentials (MEPs) distribution and investigate whether conventional montages and high-density surface electromyography (HD-sEMG) provide reliable measurements of corticospinal excitability. MEPs elicited by transcranial magnetic stimulation (TMS) were recorded from dominant and non-dominant sides of healthy right-handed participants with an electrode grid over the abductor pollicis brevis muscle. MEPs amplitude distribution, amplitude, latency and resting motor threshold (MT) were evaluated. MEPs distribution significantly shifted towards the lateral direction on the dominant side. MT, amplitude, and latency did not reveal any asymmetries in functional cortical excitability. MEPs amplitude and latency were different for conventional montages and HD-sEMG. Our results suggest that laterality asymmetries manifest in both levels of cortical representation and muscle recruitment, possibly leading to a more pronounced abduction movement on dominant hemisphere compared to the non-dominant side in right-handers. Furthermore, the use of HD-sEMG provided additional insights over conventional electrode montages. A better understanding of laterality asymmetries in fine motor control may help to establish specialized treatments in sensory motor disorders patients.
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Affiliation(s)
- Victor Hugo Souza
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes, 3900, CEP: 14040-901, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Oswaldo Baffa
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes, 3900, CEP: 14040-901, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Marco A C Garcia
- Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes, 3900, CEP: 14040-901, Monte Alegre, Ribeirão Preto, SP, Brazil; Departamento de Biociências e Atividades Físicas, Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho, 540, CEP: 21941-599, Cidade Universitária, Rio de Janeiro, RJ, Brazil; Laboratório de Neurobiologia II, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho, 373, CEP: 21941-902, Cidade Universitária, Rio de Janeiro, RJ, Brazil.
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