1
|
Vieira TM, Cerone GL, Botter A, Watanabe K, Vigotsky AD. The Sensitivity of Bipolar Electromyograms to Muscle Excitation Scales With the Inter-Electrode Distance. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4245-4255. [PMID: 37844006 DOI: 10.1109/tnsre.2023.3325132] [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] [Indexed: 10/18/2023]
Abstract
The value of surface electromyograms (EMGs) lies in their potential to non-invasively probe the neuromuscular system. Whether muscle excitation may be accurately inferred from bipolar EMGs depends on how much the detected signal is both sensitive and specific to the excitation of the target muscle. While both are known to be a function of the inter-electrode distance (IED), specificity has been of long concern in the physiological literature. In contrast, sensitivity, at best, has been implicitly assumed. Here we provide evidence that the IED imposes a biophysical constraint on the sensitivity of surface EMG. From 20 healthy subjects, we tested the hypothesis that excessively reducing the IED limits EMGs' physiological content. We detected bipolar EMGs with IEDs varying from 5 mm to 50 mm from two skeletal muscles with distinct architectures, gastrocnemius and biceps brachii. Non-parametric statistics and Bayesian hierarchical modelling were used to evaluate the dependence of the onset of muscle excitation and signal-to-noise ratio (SNR) on the IED. Experimental results revealed that IED critically affects the sensitivity of bipolar EMGs for both muscles-indeliberately reducing the IED yields EMGs that are not representative of the whole muscle, hampering validity. Simulation results substantiate the generalization of experimental results to small and large electrodes. Based on current and previous findings, we discuss a potentially valid procedure for defining the most appropriate IED for a single bipolar, surface recording-i.e., the distance from the electrode to the target muscle boundary may heuristically serve as a lower bound when choosing an IED.
Collapse
|
2
|
Cavalcanti Garcia MA, Lindolfo-Almas J, Hiroshi Matsuda R, Labiapari Pinto V, Aparecida Nogueira-Campos A, Hugo Souza V. The surface electrode placement determines the magnitude of motor potential evoked by transcranial magnetic stimulation. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
|
3
|
García-Bernal MI, González-García P, Madeleine P, Casuso-Holgado MJ, Heredia-Rizo AM. Characterization of the Structural and Mechanical Changes of the Biceps Brachii and Gastrocnemius Muscles in the Subacute and Chronic Stage after Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1405. [PMID: 36674159 PMCID: PMC9864550 DOI: 10.3390/ijerph20021405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
The objective of this study was to characterize the changes of muscle tone, stiffness, and thickness of upper and lower limb muscles in stroke survivors. Forty patients with subacute or chronic stroke and 31 controls were included and measured using myotonometry (MyotonPRO), with multiple site assessments at muscle belly (MB) and musculotendinous (MT) locations of the biceps brachii and gastrocnemius muscles. Muscle thickness (ultrasonography) was obtained for each muscle. Upper and lower limb motor performance was evaluated with the Fugl−Meyer Assessment for Upper Extremity and the Functional Ambulance Category. Overall, muscle tone and stiffness were significantly higher at MT than at MB sites. Among stroke patients, differences between the paretic and nonparetic limb were found for the biceps brachii, with lower muscle tone, stiffness, and thickness of the paretic side (all, p < 0.05). There were weak to moderate correlations between mechanical (myotonometry) and structural (ultrasound) muscular changes, regardless of the post-stroke stage. This suggests that myotonometry and ultrasonography assess similar, although different, constructs and can be combined in the clinical setting. Their discriminative ability between the paretic and nonparetic sides and between participants with and without stroke differs depending on the muscle, the functional level, and the stroke stage.
Collapse
Affiliation(s)
- María Isabel García-Bernal
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain
| | - Paula González-García
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain
| | - Pascal Madeleine
- Sport Sciences—Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - María Jesús Casuso-Holgado
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, 41009 Sevilla, Spain
| | - Alberto Marcos Heredia-Rizo
- Departmento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Universidad de Sevilla, 41009 Sevilla, Spain
| |
Collapse
|
4
|
Castoldi V, Rossi E, Marenna S, Comi G, Leocani L. Improving reproducibility of motor evoked potentials in mice. J Neurosci Methods 2022; 367:109444. [PMID: 34921842 DOI: 10.1016/j.jneumeth.2021.109444] [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: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND In preclinical research involving murine models of neurological diseases, Motor Evoked Potentials (MEPs) can detect pathological alterations in nerve conduction throughout the cortico-spinal tract. In mice, MEPs elicited by electrical stimulation of the motor cortex can be performed with epicranial or subdermal electrodes such as implanted screws or removable needles, which are associated with invasive surgery and variability in placement of the stimulating electrodes, respectively. METHODS We compared MEPs induced by epicranial or subcutaneous stimulation with a non-invasive surface cup electrode over five recording sessions, in healthy C57BL/6 mice. Additionally, using surface stimulation, we examined the recordings obtained with intramuscular needles or surface electrodes to understand if MEP reproducibility could be improved. RESULTS Resting motor threshold (RMT), MEP latency and amplitude were comparable among the different stimulation methods. Epicranial, subcutaneous and surface stimulation techniques presented good repeatability over time, with surface stimulation showing a significantly reduced inter-session variability. Compared with intramuscular needles, MEPs recorded with surface electrode showed reduced peak-to-peak amplitude at all timepoints. RMT and MEP latency were comparable with both recording methods. On the other hand, amplitudes recorded with the surface electrode presented a significantly lower inter-session variance, resulting in improved repeatability. CONCLUSION Overall, there is evidence for highly reproducible results using different stimulating methods, with indication for reduced inter-session variability for surface stimulation. Moreover, MEP recording with surface electrode provided a decrease in amplitude variability over time, indicating improved measurement stability when considering amplitude as functional outcome in longitudinal studies.
Collapse
Affiliation(s)
- Valerio Castoldi
- Experimental Neurophysiology Unit, INSPE - Institute of Experimental Neurology, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
| | - Elena Rossi
- Experimental Neurophysiology Unit, INSPE - Institute of Experimental Neurology, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
| | - Silvia Marenna
- Experimental Neurophysiology Unit, INSPE - Institute of Experimental Neurology, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
| | - Giancarlo Comi
- Vita-Salute San Raffaele University, via Olgettina 58, 20132 Milan, Italy; Casa di Cura del Policlinico, via Giuseppe Dezza, 48, 20144 Milan, Italy
| | - Letizia Leocani
- Experimental Neurophysiology Unit, INSPE - Institute of Experimental Neurology, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy; Vita-Salute San Raffaele University, via Olgettina 58, 20132 Milan, Italy.
| |
Collapse
|
5
|
Bakker CD, Massa M, Daffertshofer A, Pasman JW, van Kuijk AA, Kwakkel G, Stegeman DF. The addition of the MEP amplitude of finger extension muscles to clinical predictors of hand function after stroke: A prospective cohort study. Restor Neurol Neurosci 2020; 37:445-456. [PMID: 31322583 DOI: 10.3233/rnn-180890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Within the first 72 hours after stroke, active finger extension is a strong predictor of long-term dexterity. Transcranial magnetic stimulation may add prognostic value to clinical assessment, which is especially relevant for patients unable to follow instructions. OBJECTIVE The current prospective cohort study aims at determining whether amplitude of motor evoked potentials of the extensor digitorum communis (EDC) can improve clinical prediction after stroke when added to clinical tests. METHODS the amplitude of motor evoked potentials of the affected EDC muscle at rest was measured in 18 participants within 4 weeks after stroke, as were the ability to perform finger extension and the Fugl-Meyer Motor Assessment of the upper extremity (FMA_UE). These three determinants were related to the FMA_UE at 26 weeks after stroke (FMA_UE26), both directly, and via the proportional recovery prediction model. The relation between amplitude of the motor evoked potentials and FMA_UE26 was evaluated for EDC. For comparison, also the MEP amplitudes of biceps brachii and adductor digiti minimi muscles were recorded. RESULTS Patients' ability to voluntarily extend the fingers was strongly related to FMA_UE26, in our cohort there were no false negative results for this predictor. Our data revealed that the relation between amplitude of motor evoked potential of EDC and FMA_UE26 was significant, but moderate (rs = 0.58) without added clinical value. The other tested muscles did not correlate significantly to FMA_UE26. CONCLUSIONS Our study demonstrates no additional value of motor evoked potential amplitude of the affected EDC muscle to the clinical test of finger extension, the latter being more strongly related to FMA_UE26.
Collapse
Affiliation(s)
- C D Bakker
- Department of Rehabilitation, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands.,Department of Rehabilitation Medicine, Máxima Medical Center, Veldhoven, the Netherlands
| | - M Massa
- Department of Neurology/Clinical Neurophysiology, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam Movement Sciences and Institute for Brain and Behaviour Amsterdam, the Netherlands
| | - J W Pasman
- Department of Neurology/Clinical Neurophysiology, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A A van Kuijk
- Department of Rehabilitation, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands.,Tolbrug Rehabilitation Centre, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - G Kwakkel
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, location VU University Medical Center, MOVE Research Institute Amsterdam and Amsterdam NeuroScience, the Netherlands
| | - D F Stegeman
- Department of Neurology/Clinical Neurophysiology, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam Movement Sciences and Institute for Brain and Behaviour Amsterdam, the Netherlands
| |
Collapse
|