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Hamtaei Pour Shirazi F, Parsaei H, Ashraf A. A clinical decision support system for diagnosis and severity quantification of lumbosacral radiculopathy using intramuscular electromyography signals. Med Biol Eng Comput 2024:10.1007/s11517-024-03196-8. [PMID: 39298073 DOI: 10.1007/s11517-024-03196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 09/03/2024] [Indexed: 09/21/2024]
Abstract
Interpreting intramuscular electromyography (iEMG) signals for diagnosing and quantifying the severity of lumbosacral radiculopathy is challenging due to the subjective evaluation of signals. To address this limitation, a clinical decision support system (CDSS) was developed for the diagnosis and quantification of the severity of lumbosacral radiculopathy based on intramuscular electromyography (iEMG) signals. The CDSS uses the EMG interference pattern method (QEMG IP) to directly extract features from the iEMG signal and provide a quantitative expression of injury severity for each muscle and overall radiculopathy severity. From 126 time and frequency domain features, a set of five features, including the crest factor, mean absolute value, peak frequency, zero crossing count, and intensity, were selected. These features were derived from raw iEMG signals, empirical mode decomposition, and discrete wavelet transform, and the wrapper method was utilized to determine the most significant features. The CDSS was trained and tested on a dataset of 75 patients, achieving an accuracy of 93.3%, sensitivity of 93.3%, and specificity of 96.6%. The system shows promise in assisting physicians in diagnosing lumbosacral radiculopathy with high accuracy and consistency using iEMG data. The CDSS's objective and standardized diagnostic process, along with its potential to reduce the time and effort required by physicians to interpret EMG signals, makes it a potentially valuable tool for clinicians in the diagnosis and management of lumbosacral radiculopathy. Future work should focus on validating the system's performance in diverse clinical settings and patient populations.
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Affiliation(s)
- Farshid Hamtaei Pour Shirazi
- Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Parsaei
- Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Ashraf
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
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Montaner-Cuello A, Caudevilla-Polo S, Rodríguez-Mena D, Ciuffreda G, Pardos-Aguilella P, Albarova-Corral I, Pérez-Rey J, Bueno-Gracia E. Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy. Diagnostics (Basel) 2024; 14:1258. [PMID: 38928673 PMCID: PMC11202655 DOI: 10.3390/diagnostics14121258] [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: 04/29/2024] [Revised: 06/03/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, an assessment of sensitivity and strength, diagnostic imaging-usually magnetic resonance imaging (MRI)-and electrodiagnostic testing (EDX), typically electromyography (EMG), and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.
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Affiliation(s)
- Alberto Montaner-Cuello
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (S.C.-P.); (G.C.); (P.P.-A.); (I.A.-C.); (E.B.-G.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (D.R.-M.); (J.P.-R.)
| | - Santos Caudevilla-Polo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (S.C.-P.); (G.C.); (P.P.-A.); (I.A.-C.); (E.B.-G.)
| | - Diego Rodríguez-Mena
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (D.R.-M.); (J.P.-R.)
- Department of Neurophysiology, University Clinical Hospital “Lozano Blesa”, 50009 Zaragoza, Spain
| | - Gianluca Ciuffreda
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (S.C.-P.); (G.C.); (P.P.-A.); (I.A.-C.); (E.B.-G.)
| | - Pilar Pardos-Aguilella
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (S.C.-P.); (G.C.); (P.P.-A.); (I.A.-C.); (E.B.-G.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (D.R.-M.); (J.P.-R.)
| | - Isabel Albarova-Corral
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (S.C.-P.); (G.C.); (P.P.-A.); (I.A.-C.); (E.B.-G.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (D.R.-M.); (J.P.-R.)
| | - Jorge Pérez-Rey
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (D.R.-M.); (J.P.-R.)
| | - Elena Bueno-Gracia
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (S.C.-P.); (G.C.); (P.P.-A.); (I.A.-C.); (E.B.-G.)
- PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain; (D.R.-M.); (J.P.-R.)
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Electrodiagnostic Studies in Degenerative Cervical Myelopathy. Clin Spine Surg 2022; 35:403-409. [PMID: 36447344 DOI: 10.1097/bsd.0000000000001413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/03/2022] [Indexed: 12/05/2022]
Abstract
The diagnosis of degenerative cervical myelopathy can generally be made with a thorough history, physical examination, and spinal imaging. Electrodiagnostic studies, consisting of nerve conduction studies and electromyography, are a useful adjunct when the clinical picture is inconsistent or there is concern for overlapping pathology. Electrodiagnostic studies may be particularly helpful in identifying cases of myeloradiculopathy, when there is combined nerve root and spinal cord injury, both with regards to prognosis and guiding surgical treatment. Electrodiagnostic studies are a useful adjunct for the spine surgeon and should be used when there are features atypical for degenerative cervical myelopathy or when there is suspicion for a concomitant disease process.
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Ercan M, Kuruoglu H. Significance of pure sensory manifestations in estimating electromyography results in cervical radiculopathy. NEUROL SCI NEUROPHYS 2022. [DOI: 10.4103/nsn.nsn_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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