Neural control properties of the external anal sphincter in young and elderly women

AIMS

The prevalence of fecal incontinence (FI) increases with age and affects more than 15% of the elderly population. Sarcopenia, skeletal muscle structural, and functional decline with aging, is known to be caused by neuromuscular dysfunction. However, age-related alterations of the neuromuscular function of the external anal sphincter (EAS) have not been studied. This study aims to quantitatively characterize the effect of aging on the EAS by assessing the firing patterns and size of motor unit action potential (MUAP) using high-density surface electromyography (HD-sEMG) recording and analysis techniques.

METHODS

Thirteen young (31.0 ± 3.6 years) and 14 elderly (64.3 ± 6.2 years) healthy women were recruited for this study. EMG activity of the EAS during maximal voluntary contraction was recorded by a 64-Channel, HD-sEMG intra-rectal probe. HD-sEMG signals were decomposed into MUAP spike trains to extract the firing rate and amplitudes thereof.

RESULTS

HD-sEMG decomposition was successfully performed. For the young and elderly groups, mean motor unit (MU) firing rates of 11.4 ± 2.1 pulses per second (PPS) and 9.6 ± 2.3 PPS, and mean MUAP amplitudes of 45.2 ± 14.3 µV and 61.9 ± 21.2 µV were respectively obtained. Both the MU firing rate and MUAP amplitude were significantly different between two groups (P < .05). Moreover, the MUAP firing rate and amplitude correlated with age with a linear regression model (P < .05).

CONCLUSIONS

This study represents the first effort to examine the effect of aging on the neuromuscular function of EAS. Results suggest an age-related impairment of lower motor neuron descending excitation to the EAS with a compensatory increase in mean MU size.

Motor Unit Properties of the First Dorsal Interosseous in Chronic Stroke Subjects: Concentric Needle and Single Fiber EMG Analysis

The purpose of this study was to better understand changes in motor unit electrophysiological properties in people with chronic stroke based on concentric needle electromyography (EMG) and single fiber EMG recordings. The first dorsal interosseous (FDI) muscle was studied bilaterally in eleven hemiparetic stroke subjects. A significant increase in mean fiber density (FD) was found in the paretic muscle compared with the contralateral side based on single fiber EMG (1.6 ± 0.2 vs. 1.3 ± 0.1, respectively, P = 0.003). There was no statistically significant difference between the paretic and contralateral sides in most concentric needle motor unit action potential (MUAP) parameters, such as amplitude (768.7 ± 441.7 vs. 855.0 ± 289.9 μV), duration (8.9 ± 1.8 vs. 8.68 ± 0.9 ms) and size index (1.2 ± 0.5 vs. 1.1 ± 0.3) (P > 0.18), nor was there a significant difference in single fiber EMG recorded jitter (37.0 ± 9.6 vs. 39.9 ± 10.6 μs, P = 0.45). The increase in FD suggests motor units of the paretic FDI have enlarged due to collateral reinnervation. However, sprouting might be insufficient to result in a statistically significant change in the concentric needle MUAP parameters. Single fiber EMG appears more sensitive than concentric needle EMG to reflect electrophysiological changes in motor units after stroke. Both single fiber and concentric needle EMG recordings may be necessary to better understand muscle changes after stroke, which is important for development of appropriate rehabilitation strategies. The results provide further evidence that motor units are remodeled after stroke, possibly in response to a loss of motoneurons.

Motor Unit Activity during Fatiguing Isometric Muscle Contraction in Hemispheric Stroke Survivors

Enhanced muscle weakness is commonly experienced following stroke and may be accompanied by increased susceptibility to fatigue. To examine the contributions of central and peripheral factors to isometric muscle fatigue in stroke survivors, this study investigates changes in motor unit (MU) mean firing rate, and action potential duration during, and directly following, a sustained submaximal fatiguing contraction at 30% maximum voluntary contraction (MVC). A series of short contractions of the first dorsal interosseous muscle were performed pre- and post-fatigue at 20% MVC, and again following a 10-min recovery period, by 12 chronic stroke survivors. Individual MU firing times were extracted using surface EMG decomposition and used to obtain the spike-triggered average MU action potential waveforms. During the sustained fatiguing contraction, the mean rate of change in firing rate across all detected MUs was greater on the affected side (-0.02 ± 0.03 Hz/s) than on the less-affected side (-0.004 ± 0.003 Hz/s, p = 0.045). The change in firing rate immediately post-fatigue was also greater on the affected side than less-affected side (-13.5 ± 20 and 0.1 ± 19%, p = 0.04). Mean MU firing rates increased following the recovery period on the less-affected side when compared to the affected side (19.3 ± 17 and 0.5 ± 20%, respectively, p = 0.03). MU action potential duration increased post-fatigue on both sides (10.3 ± 1.2 to 11.2 ± 1.3 ms on the affected side and 9.9 ± 1.7 to 11.2 ± 1.9 ms on the less-affected side, p = 0.001 and p = 0.02, respectively), and changes in action potential duration tended to be smaller in subjects with greater impairment (p = 0.04). This study presents evidence of both central and peripheral fatigue at the MU level during isometric fatiguing contraction for the first time in stroke survivors. Together, these preliminary observations indicate that the response to an isometric fatiguing contraction differs between the affected and less-affected side post-stroke, and may suggest that central mechanisms observed here as changes in firing rate are the dominant processes leading to task failure on the affected side.

Organization of the motor-unit pool for different directions of isometric contraction of the first dorsal interosseous muscle

INTRODUCTION

Muscle force generation involves recruitment and firing rate modulation of motor units (MUs). The control of MUs in producing multidirectional forces remains unclear.

METHODS

We studied MU recruitment and firing properties, recorded from the first dorsal interosseous muscle, for 3 different directions of contraction: abduction; abduction/flexion combination; and flexion.

RESULTS

MUs were recruited systematically at higher threshold force during flexion. Larger MUs were recruited and firing rates of MUs were lower during abduction. There was an orderly recruitment of MUs according to MU size regardless of contraction direction, obeying the "size principle." Firing rates of earlier-recruited MUs were consistently higher than later-recruited MUs, affirming the "onion-skin" property.

DISCUSSION

Our findings suggest that the size principle and onion-skin organization together provide a general description of MU recruitment patterns and firing properties. The directional alternations of MU control properties likely reflect changes in neural drive to the muscle. Muscle Nerve 57: E85-E93, 2018.

Zebrafish needle EMG: a new tool for high-throughput drug screens

Zebrafish models have recently been highlighted as a valuable tool in studying the molecular basis of neuromuscular diseases and developing new pharmacological treatments. Needle electromyography (EMG) is needed not only for validating transgenic zebrafish models with muscular dystrophies (MD), but also for assessing the efficacy of therapeutics. However, performing needle EMG on larval zebrafish has not been feasible due to the lack of proper EMG sensors and systems for such small animals. We introduce a new type of EMG needle electrode to measure intramuscular activities of larval zebrafish, together with a method to hold the animal in position during EMG, without anesthetization. The silicon-based needle electrode was found to be sufficiently strong and sharp to penetrate the skin and muscles of zebrafish larvae, and its shape and performance did not change after multiple insertions. With the use of the proposed needle electrode and measurement system, EMG was successfully performed on zebrafish at 30 days postfertilization (dpf) and at 5 dpf. Burst patterns and spike morphology of the recorded EMG signals were analyzed. The measured single spikes were triphasic with an initial positive deflection, which is typical for motor unit action potentials, with durations of ∼10 ms, whereas the muscle activity was silent during the anesthetized condition. These findings confirmed the capability of this system of detecting EMG signals from very small animals such as 5 dpf zebrafish. The developed EMG sensor and system are expected to become a helpful tool in validating zebrafish MD models and further developing therapeutics.

Changes in motor unit behavior following isometric fatigue of the first dorsal interosseous muscle

The neuromuscular strategies employed to compensate for fatigue-induced muscle force deficits are not clearly understood. This study utilizes surface electromyography (sEMG) together with recordings of a population of individual motor unit action potentials (MUAPs) to investigate potential compensatory alterations in motor unit (MU) behavior immediately following a sustained fatiguing contraction and after a recovery period. EMG activity was recorded during abduction of the first dorsal interosseous in 12 subjects at 20% maximum voluntary contraction (MVC), before and directly after a 30% MVC fatiguing contraction to task failure, with additional 20% MVC contractions following a 10-min rest. The amplitude, duration and mean firing rate (MFR) of MUAPs extracted with a sEMG decomposition system were analyzed, together with sEMG root-mean-square (RMS) amplitude and median frequency (MPF). MUAP duration and amplitude increased immediately postfatigue and were correlated with changes to sEMG MPF and RMS, respectively. After 10 min, MUAP duration and sEMG MPF recovered to prefatigue values but MUAP amplitude and sEMG RMS remained elevated. MU MFR and recruitment thresholds decreased postfatigue and recovered following rest. The increase in MUAP and sEMG amplitude likely reflects recruitment of larger MUs, while recruitment compression is an additional compensatory strategy directly postfatigue. Recovery of MU MFR in parallel with MUAP duration suggests a possible role for metabolically sensitive afferents in MFR depression postfatigue. This study provides insight into fatigue-induced neuromuscular changes by examining the properties of a large population of concurrently recorded single MUs and outlines possible compensatory strategies involving alterations in MU recruitment and MFR.

DCT domain feature extraction scheme based on motor unit action potential of EMG signal for neuromuscular disease classification

A feature extraction scheme based on discrete cosine transform (DCT) of electromyography (EMG) signals is proposed for the classification of normal event and a neuromuscular disease, namely the amyotrophic lateral sclerosis. Instead of employing DCT directly on EMG data, it is employed on the motor unit action potentials (MUAPs) extracted from the EMG signal via a template matching-based decomposition technique. Unlike conventional MUAP-based methods, only one MUAP with maximum dynamic range is selected for DCT-based feature extraction. Magnitude and frequency values of a few high-energy DCT coefficients corresponding to the selected MUAP are used as the desired feature which not only reduces computational burden, but also offers better feature quality with high within-class compactness and between-class separation. For the purpose of classification, the K-nearest neighbourhood classifier is employed. Extensive analysis is performed on clinical EMG database and it is found that the proposed method provides a very satisfactory performance in terms of specificity, sensitivity and overall classification accuracy.