Simulation of concentric needle EMG motor unit action potentials

Computer simulations of motor unit action potentials (MUAPs) as measured by a concentric needle (CN) electromyography (EMG) electrode in normal motor units (MUs) indicated that the MUAP amplitude is determined mainly by the proximity of the electrode to the closest muscle fiber. The area and duration of the simulated MUAPs were affected by all muscle fibers in front of the active recording surface but mainly by those that were less than 2 and 2.5 mm, respectively, from the active recording surface. The MUAP area was also affected by the proximity of the electrode to the closest muscle fiber. The number of phases of the simulated MUAPs increased when the dispersion of the arrival times of individual muscle fiber APs at the electrode was increased. Increased temporal dispersion of APs decreased the MUAP amplitude and area slightly but did not affect the MUAP duration. It is inferred that different features of the CN MUAP are determined by the distribution of muscle fibers within different portions of the MU territory and thus provide complementary information about the MU architecture.     

Simulation of myopathic motor unit action potentials

Normal motor units (MUs) were simulated and their architecture altered to simulate the changes produced by myopathy. The concentric needle electromyographic recordings of motor unit action potentials (MUAPs) from the MUs were then also simulated. These simulated MUAPs showed features that are seen in myopathy: normal amplitude and slightly reduced area, MUAPs with simple waveform and reduced duration, and complex MUAPs with normal or increased duration. The MUAP waveforms were complex because of increased variability of fiber diameter and not because of loss of muscle fibers. The MUAP duration increased when the variability of fiber diameter increased. Finally, MUAPs similar to those seen in neurogenic diseases were produced from MUs in which the only abnormality was increased variability of fiber diameter.     

Fiber density of the motor units recruited at high and low force output

Motor units (MUs) are recruited according to the size principle. At low force output, macro‐motor unit potentials (macro‐MUPs) with small amplitude and area are recorded; MUs with large electrical size fire at high force output. Our objective was to elucidate whether this difference is caused by a higher fiber density (FD) of the MUs recruited at high force output. We measured the FD and respectively the amplitude and the area of the macro‐MUPs via single‐fiber macro electromyography (EMG) recorded at low and high force output in 48 healthy subjects. The macro‐MUPs were significantly larger at high force output than at low force. The FD did not differ at the two force levels. Our findings suggest that the larger electrical size of the high recruitment threshold MUs is due not to a higher FD, but to a larger territory. FD is a robust EMG parameter, independent of the level of the force output. Muscle Nerve 40: 112–114, 2009     

Simulation and analysis of the electromyographic interference pattern in normal muscle. Part I: Turns and amplitude measurements

The electromyographic (EMG) interference pattern (IP) was simulated by adding together motor unit action potentials (MUAPs) of different sizes that had been recorded by a concentric needle EMG electrode. The number of turns (NT) of the simulated IP increased with the number of MUAP discharges. The mean amplitude (MA) difference between successive turns in the IP increased when large amplitude MUAPs were added. Our analysis demonstrates that the MA of the IP is determined mainly by the amplitude of large MUAPs in the signal and that large amplitude spikes are more likely to be generated by single large amplitude MUAPs than by summation of several small amplitude MUAPs.     

Motor unit properties of biceps brachii during dynamic contractions in chronic stroke patients

The aim of this study was to investigate motor unit (MU) characteristics of the biceps brachii during sinusoidal contractions in chronic stroke patients using high-density surface electromyography. Ten sinusoidal elbow flexion and extension movements were performed both passively and actively by 18 stroke patients and 20 healthy subjects. Motor unit action potentials (MUAPs) were extracted, and their root-mean-square value (RMS(MUAP)) was calculated. RMS(MUAP) was significantly larger in stroke than in healthy subjects. In both groups RMS(MUAP) was smaller during the stretch phase of passive movement than during active movement. The larger MUAPs indicate enlarged MUs, possibly as a result of reinnervation. The lower RMS(MUAP) values during passive stretch than during active movement indicates that the stretch reflex mainly activates smaller MUs, while a larger part of the MU pool can be recruited voluntarily. RMS(MUAP) may have added value for monitoring changes in peripheral MU properties after stroke.     

Monitoring of free calcium in the neuronal endoplasmic reticulum: an overview of modern approaches

This paper describes an improved spike triggered averaging technique for the assessment of control properties and conduction velocity (CV) of single motor units (MUs) of the tibialis anterior muscle during voluntary muscle contractions. The method is based on the detection of multi-channel surface EMG signals (with linear electrode arrays) and intramuscularly recorded single MU action potentials (MUAPs). Intramuscular electrodes were inserted in the muscle taking into account the MU structural properties (innervation zone, tendon locations, length of the fibers), assessed by the linear array surface EMG detection technique. An algorithm for intramuscular EMG signal decomposition is used to identify single MUAP trains. The MUAPs detected by the intramuscular EMG decomposition algorithm were used to trigger and average the multi-channel EMG signals. CV of single averaged surface MUAPs was estimated by the use of advanced signal processing methods based on multi-channel recordings which allow to consistently reduce the variance of CV estimates compared with traditional two channel delay estimators. The number of averaged potentials can thus be limited, resulting in high temporal resolution CV estimates. The developed technique was tested on recordings from the tibialis anterior muscle in 11 volunteers during fatigue. It was shown that the method allows the assessment of single MU CV changes (fatigue) as small as 0.1 m/s with less than 2 s data epochs. The method allows reliable assessment of firing rate and conduction properties of single MUs with applications for the investigation of central and peripheral fatigue mechanisms.     

Age effects on properties of motor unit action potentials: ADEMG analysis

We have measured the configurational and firing properties of 13,206 motor unit action potentials (MUAPs) from the brachial biceps, brachial triceps, and anterior tibial muscles in 10 young (20-40 years), 10 middle-aged (40-60 years), and 10 elderly (60-80 years) normal individuals, using an automatic method for decomposition of the electromyographic (EMG) interference pattern (ADEMG). Recording were made during stable isometric contractions at threshold, 10%, and 30% of maximum voluntary contraction using standard concentric needle electrodes. At supra-threshold forces, an average of 5.9 simultaneously active MUAPs were identified at each recording site. Mean amplitudes, durations, and numbers of turns all increased linearly with age in both low-threshold and high-threshold MUAPs (p less than 0.01), suggesting an ongoing process of progressive denervation and compensatory reinnervation. Mean MUAP firing rates decreased with age (p = 0.01) when force was measured proportionately, but not when measured absolutely. In a subgroup of 12 age-matched gender pairs, men had larger mean MUAP amplitudes, rise rates, and numbers of turns (p less than 0.05), probably reflecting larger muscle fiber diameters. These findings amplify previous observations from traditional analysis of lowest-threshold single MUAPs; establish a base of normative adult data for ADEMG; and further validate the clinical applicability of rapid, automatic EMG decomposition.     

Comparison between concentric needle EMG and macro EMG in patients with a history of polio.

OBJECTIVES: Acute poliomyelitis causes degeneration of anterior horn cells, followed by denervation. Reinnervation and muscle fibre hypertrophy are mechanisms that compensate this loss of neurones. Concentric needle EMG (CNEMG) and macro EMG are two methods to assess the magnitude of initial involvement and the compensatory reinnervation. The aim of this study is to explore the difference between CNEMG and macro EMG describing the status of the motor unit in patients previously affected by polio. METHODS: Macro and concentric needle EMG investigations were performed in 261 muscles in 121 patients with a remote history of polio. RESULTS: CNEMG was abnormal in 211 muscles, macro EMG was abnormal in 246 muscles. The macro amplitude was 3-4 times 'more abnormal' than CNEMG amplitude relative to the reference values. CNEMG duration was less abnormal and showed only weak correlation with macro amplitudes. The most likely explanation for the difference in magnitude of deviation from reference values for CNEMG and macro EMG, is a more pronounced 'phase cancellation' between single fibre action potentials in CNEMG. This is supported by simulation studies reported here. CONCLUSIONS: In conclusion macro EMG better reflects the size of the motor unit than the CNEMG. For detection of concomitant disorders, CNEMG is the method of choice.     

Estimating motor-unit architectural properties by analyzing motor-unit action potential morphology.

OBJECTIVE: We investigated the architectural organization of groups of neighboring motor units (MUs) in normal brachial biceps and tibialis anterior muscles by analyzing morphological landmarks of their MU action potentials (MUAPs). METHODS: EMG signals containing multiple MUAPs were recorded using a monopolar needle electrode during moderate isometric voluntary contractions. The MUAPs were identified using computer-aided decomposition, and averaged. For each MUAP the onset, spike, terminal wave, and slow afterwave were identified; then the location of the MU's endplate and muscle/tendon junction were estimated from the latencies of the spike and terminal wave with respect to the MUAP onset. RESULTS: The analysis revealed a variety of architectural organizations, including single and multiple endplate zones, MU fractions, pennation, intramuscular aponeuroses, and centrally and non-centrally located endplates. CONCLUSIONS: This type of morphological analysis of the MUAP promises to be informative for studying normal MU properties as well as evaluating MU reorganization in disease.     

Concentric macro electromyography

Concentric EMG electrodes can record from a few (10 to 15) muscle fibers of a motor unit (MU). Macro EMG, is able to record from the majority of muscle fibers in the MU. The macro EMG electrode uses a single fiber action potential (SFAP) on one channel to trigger the time locked cannula (macro) response on the other channel. To study the concentric motor unit action potential (MUAP), alongside the macro potential, we built a needle electrode combining concentric and macro recording surfaces. The study of 240 motor units in 10 healthy subjects with the single fiber (SF macro) and concentric macro (conmac) electrodes revealed no significant differences between macro potentials areas and amplitudes obtained with either electrode. The ability to study a small and a large section of the motor unit simultaneously offers insights into the local or global nature of motor unit changes not otherwise available to the electromyographer. It also reveals which concentric parameters correlate best with the macro potential and, can even be of great help with the newer EMG signal decomposition techniques; by identifying each motor unit by its concentric and macro waveform simultaneously, it will allow for the "marking" of these motor units helping to reduce the risk of their misclassification when the concentric MUAP is used alone.     

A comparison of turns analysis and motor unit analysis in electromyography.

We compared the results of turns analysis and motor unit analysis on 4056 electromyographic interference patterns (IPs) from normal subjects and patients with neuromuscular disorders. The motor unit analysis involved decomposing the IPs into their component motor unit action potentials (MUAPs) using automatic decomposition electromyography (ADEMG). We checked the accuracy of the decompositions by attempting to reconstruct some of the IPs from their identified MUAPs using computer simulations. The simulations revealed that ADEMG typically identified more than 60% (but not all) of the MUAPs in a given IP. Both turns and MUAP properties showed regular and related changes with force, age, muscle, and recording electrode type. The number of turns in each IP was highly correlated with the number of active MUAPs (r = 0.65), the mean MUAP firing rate (r = 0.72), the mean number of turns per MUAP (r = 0.34), and the product of these 3 properties (r = 0.83). The mean amplitude change per turn was highly correlated with the mean MUAP amplitude (r = 0.82), but also depended on the number of turns per MUAP. Due to the lack of a one-to-one relationship between the turns analysis properties and the MUAP properties, the turns analysis properties by themselves did not provide sufficient information to infer unambiguous physiological information about motor unit morphology or firing behavior.     

Principal component analysis of the features of concentric needle EMG motor unit action potentials

Motor unit action potentials (MUAPs) were recorded from the biceps muscle of normal subjects and of patients with nerve or muscle diseases. Principal component analysis of the MUAP amplitude, area, area/amplitude ratio, duration, and the number of turns and phases produced three components that among them contained 90% of the variance of the data set. Thus the dimensionality of data was reduced from six to three. The first component reflected changes in the size of the MU, whereas the second reflected variations in the arrival time at the recording electrode of the action potentials of muscle fibers in the motor unit. The third factor reflected local loss of muscle fibers within the MU territory. Patterns of variations in the three components were different in patients with neuropathy and myopathy.     

Can standard surface EMG processing parameters be used to estimate motor unit global firing rate?

The relations between motor unit global firing rates and established quantitative measures for processing the surface electromyogram (EMG) signals were explored using a simulation approach. Surface EMG signals were simulated using the reported properties of the first dorsal interosseous muscle in man, and the models were varied systematically, using several hypothetical relations between motor unit electrical and force output, and also using different motor unit firing rate strategies. The utility of using different EMG processing parameters to help estimate global motor unit firing rate was evaluated based on their relations to the number of motor unit action potentials (MUAPs) in the simulated surface EMG signals. Our results indicate that the relation between motor unit electrical and mechanical properties, and the motor unit firing rate scheme are all important factors determining the form of the relation between surface EMG amplitude and motor unit global firing rate. Conversely, these factors have less impact on the relations between turn or zero-crossing point counts and the number of MUAPs in surface EMG. We observed that the number of turn or zero-crossing points tends to saturate with the increase in the MUAP number in surface EMG, limiting the utility of these measures as estimates of MUAP number. The simulation results also indicate that the mean or median frequency of the surface EMG power spectrum is a poor indicator of the global motor unit firing rate.     

Influence of contractile force on properties of motor unit action potentials: ADEMG analysis

We have used automatic decomposition electromyography (ADEMG) to measure the configurational and firing properties of 13,206 motor unit action potentials (MUAPs) in the brachial biceps, brachial triceps and anterior tibial muscles of 30 healthy adults (22 men, 8 women; mean age 48.6 +/- 16.9 years, range 20-76) at three levels of isometric contractile force: threshold, 10% of maximum voluntary contraction (MVC), and 30% MVC. In all muscles, the increment in contractile force from threshold to 10% MVC was associated with a significant (P less than 0.05, paired t-test) increase in mean MUAP firing rate and number of turns per MUAP. The increment from 10% to 30% MVC led to highly significant (P less than 0.005) increase in mean firing rate, number of turns, amplitude and rise rate. Each force increment was associated with an increase in the number of simultaneously-active MUAPs per recording site; and with a significant decrease in mean MUAP duration in all muscles, due to noise-dependency of the duration measurement. Quantitatively, the changes in MUAP properties with force were comparable to or exceeded the effects of age, gender differences, or intermuscular variability. Test-retest measurements 2 years apart in a subgroup of young adults showed good correspondence of mean MUAP properties with force standardization. These results demonstrate that contractile force is a major determinant of MUAP shape and behavior properties, and so must be precisely measured or controlled in clinical EMG studies.     

Simulation and analysis of the electromyographic interference pattern in normal muscle. Part II: Activity, upper centile amplitude, and number of small segments

We have defined three new features of the electromyographic (EMG) interference pattern (IP): activity, upper centile amplitude (UCA), and number of small segments (NSS). These parameters were measured in simulated IPs constructed by adding together motor unit action potentials (MUAPs) recorded with a concentric needle EMG electrode. The activity increases linearly with the number of MUAP discharges to approximately 80% of its theoretical maximum value. The UCA correlates strongly with the peak-to-peak amplitude of the largest MUAP in the IP and the mean segment amplitude and does not depend on the discharge rate of the largest MUAPs. We infer that the UCA defines the upper limit of the peak-to-peak amplitude of the MUAPs contained in the IP. The NSS increases with the number of MUAP discharges, but reaches a constant value at higher MUAP discharge rates, probably because small amplitude MUAPs are masked by the large amplitude MUAPs. The potential value of these parameters in automated IP analysis is discussed.     

Quantitative EMG in inflammatory myopathy

Fifty-four quantitative electromyographic (EMG) studies were made in 37 patients with inflammatory myopathy (IM) at different points in their clinical course and treatment. All studies were performed in the biceps brachii which varied in clinical strength. Motor unit action potentials (MUAPs) in 45 studies and EMG interference pattern (IP) in 48 studies were recorded using a concentric needle electrode. Macroelectromyographic (Macro-EMG) MUAPs were recorded from 10 patients in 14 studies. MUAP analysis revealed a myopathic pattern (decreased duration and/or area: amplitude ratio) in 69% of studies. IP analysis was more sensitive than MUAP analysis, demonstrating a myopathic pattern in 83% of studies. Macro-EMG MUAP amplitudes were reduced in two studies, minimally increased in one study and normal in the remainder; in 6 (40%) studies, fiber density was slightly increased. Thus, reinnervation does not seem to play an important role in motor unit remodeling in IM.     

Magnetic stimulation-induced modulations of motor unit firings extracted from multi-channel surface EMG

The noninvasive assessment of motor unit (MU) firing patterns on the basis of topographical information from 128-channel high-density surface electromyography (SEMG) is reported. First, multi-channel MU action potential (MUAP) templates are obtained by clustering detected firing events according to the surface topography of the MUAP. Second, a template-matching algorithm is used to find all firings of a MU, including the superimpositions of MUAPs. From a single recording, the firing pattern of up to five MUs could be derived. The modulation of MU firing by transcranial magnetic stimulation was analyzed in peri-stimulus time histograms. The results are similar to previous results of transcranial magnetic stimulation (TMS) obtained by needle electromyographic (EMG) recordings. The method can be used to investigate MU firing patterns in patients with central motor disorders. An additional advantage of the technique, apart from its noninvasiveness, is the structural and functional information that it provides on the MUs, which is not obtained by needle EMG.     

A special kind of anterior horn cell involvement in juvenile myoclonic epilepsy demonstrated by macro electromyography

Juvenile myoclonic epilepsy (JME) is not an uncommon seizure disorder, occurring in 5–10% of epileptic patients. A subclinical anterior horn cell involvement has been suggested in some JME patients by concentric needle electromyography (EMG) and turn/amplitude analysis. In this study, 22 JME patients and 17 normal control subjects have been studied with macro EMG, which is a sensitive method to assess the size of motor units. Most JME patients (19 of 22) had a pathologically increased number of individual large macro motor unit action potentials (MUAPs) compared to control subjects. For both biceps brachii and tibialis anterior muscles, means of median macro MUAP amplitudes were significantly greater than those of normal controls, whereas the fiber density values were only slightly increased. This suggested another kind of anterior horn cell involvement in JME than seen in motor neuron diseases. © 1997 John Wiley & Sons, Inc. Muscle Nerve, 20, 148–152, 1997.     

Evaluation of an automatic method of measuring features of motor unit action potentials

This study was performed to evaluate an automatic method of motor unit action potential (MUAP) analysis developed in our laboratory. MUAPs were recorded from the biceps brachii muscle of 68 normal subjects and 122 patients with nerve or muscle disease. The values of mean MUAP durations from normal subjects obtained by automatic analysis were similar to those reported in the literature. However, the normal range of MUAP amplitude and the incidence of polyphasic MUAPs were much higher. Normal ranges of mean MUAP area, area/amplitude ratio, and the number of turns were also defined. Automatic analysis demonstrated an abnormality of at least one MUAP feature in 70% of patients. There was concordance between automated analysis and visual assessment of MUAPs in 76% of patients with neuropathy but in only 50% of patients with myopathy. The relationships between different MUAP features seen in neuropathy and myopathy are explained in physiologic terms.     

The use of a neural network system in the identification of motor unit characteristics from surface detected action potentials: a simulation study

The surface detected motor unit action potential (MUAP) morphology depends on many physiological and anatomical characteristics of the contracting muscle that are not directly accessible to measurement. In this paper, a neural network based approach is proposed to estimate the motor unit (MU) parameters from a simulated single surface MUAP. We have developed an estimation system that is composed of the following stages: conduction velocity estimation, signal dimension reduction, MU parameters estimation, and number of MU fibres estimation. The parameter estimation stage employs four multilayer neural networks trained on simulated MUAPs corresponding to various ranges of MU parameters. In the estimation mode, this module produces four MU parameters sets. The selected set of the five muscle characteristics is that which minimises an error criterion on a signal reconstructed from the estimated parameters. The proposed system is tested with several simulated MUAPs signals with additive white noise in order to evaluate its performance. It is shown that the technique performs well when the signal to noise ratio is greater than 20 dB.