Automatic decomposition electromyography in idiopathic inflammatory myopathies

Automatic decomposition electromyography (ADEMG) is a commercially available software package with installed reference values that enables the objective measurement of motor unit action potentials (MUAPs). To assess the diagnostic yield of this package in idiopathic inflammatory myopathies (IIM) we performed biceps brachii ADEMG in 17 patients with polymyositis, dermatomyositis and inclusion body myositis. Results were compared with those in 12 controls, and with the results of conventional EMG of the biceps and other muscles. Decreased mean values for MUAP duration occurred significantly more frequently in IIM patients than in controls; other MUAP characteristics did not differ. In IIM patients, decreased mean amplitude and increased mean number of turns occurred significantly less frequently on ADEMG than did corresponding abnormalities on conventional biceps EMG. Decreased mean values for duration and amplitude, and increased mean values for number of turns were seen significantly less often on ADEMG than corresponding abnormalities on conventional EMG of four different, individually chosen muscles. Overall evaluation of ADEMG resulted in a diagnosis of possible myopathy in 1 and probable myopathy in 8 patients, whereas overall evaluation of conventional EMG led to a diagnosis suggestive of IIM in 13 patients. We conclude that, although measurement of mean MUAP duration might be valuable in IIM diagnosis, our results do not favour the use of biceps brachii ADEMG and the installed reference values for the diagnosis of IIM. We suggest modifications to improve ADEMG's applicability.     

The vestibulo-collic reflex

Until now there has no been no simple, reliable clinical test that assesses the function of the otolith organs. However, recent work has suggested the occurrence of an easily identifiable electromyographic (EMG) waveform in isometrically contracting sternomastoid muscles in response to loud clicks. This is thought to represent an otolith evoked disynaptic reflex. Equipment routinely used for evoked response audiometry (ERA) has been adapted to investigate this response. A short latency (8 ms) positive-negative EMG waveform has been recorded in 31 of 32 normal subjects. The latency of the positive peak (P1) is 11.7 ms ( sd = 0.89), and the negative peak (N1) is 20.5 ms ( sd = 1.89). It is predominantly ipsilateral, although a contralateral response was present in 35.5%. The response has also been recorded in three patients with a severe unilateral sensorineural hearing loss and normal caloric responses, and in a patient undergoing cochlear implantation for profound bilateral sensorineural hearing loss. Further work is required to delineate the value of this technique in investigating vestibular lesions.     

带状疱疹节段性轻瘫的电生理特点分析

目的 分析带状疱疹节段性轻瘫的电生理特点。方法 回顾分析2017年10月至2022年10月肌电图室接诊的11例带状疱疹节段性轻瘫患者神经电生理检查结果。结果 11例患者的电生理结果均异常,神经传导异常率为20.9%（41/196）。运动神经异常率为26.0%（26/100）,感觉神经异常率为15.6%（15/96）,以受累神经波幅降低为主。与健侧对比,神经传导波幅异常率为18.4%（36/196）,其中运动传导波幅异常率为23.0%（23/100）,感觉传导波幅异常率为13.5%（13/96）。炎性神经病病因和治疗量表（Inflammatory Neuropathy Cause and Treatment,INCAT）评分与复合肌肉动作电位（compound muscle action potential,CMAP）波幅下降比例最大值呈正相关（P<0.05）。针极肌电图显示受累肌肉呈神经源性损害改变。结论 带状疱疹节段性轻瘫患者的电生理结果分为神经丛型、神经根型、单神经型,以轴索损害为主。神经传导联合针极肌电图检测对带状疱疹节段性轻瘫的早期诊断、肌肉定位、病情的严重程度评估有重要价值。     

手臂静态姿势负荷的肌电实验研究

目的利用表面肌电术和Borg量表来测定、评价手臂静态姿势负荷,为工效学设计提供参考。方法14名男性大学生志愿者为对象,右臂以不同角度和距离做上抬、外展和前伸静态姿势,测定此间肱桡肌、肱二头肌、三角肌和斜方肌的表面肌电信号。肌电幅度以最大自主收缩肌电百分比(MVE%)来表示。用Borg量表对不同姿势的主观疲劳程度评分。对肌电幅度与Borg量表评分进行Pearson相关分析。结果各肌群的肌电幅度、疲劳评分随上抬和外展角度以及前伸距离的增大呈上升趋势。表面肌电MVE%与Borg量表评分之间相关性显著。结论表面肌电和Borg量表评分能够反映肌肉的静态姿势负荷与应激,两者有明显的相关性。在所测定的肌肉中,以三角肌和斜方肌受累最为显著。     

运动神经元病患者胸锁乳突肌肌电图的特征

目的探讨运动神经元病(MND)患者胸锁乳突肌(SCM)肌电图的特征。方法回顾性分析461例MND患者及349例非MND患者的临床和肌电图资料。结果MND组SCM肌电图异常率(60.3%)显著高于非MND组(4.6%)(P<0.01);确诊级MND患者SCM肌电图的异常率(77.4%)明显高于其他诊断级(均P<0.01);MND组中,SCM肌电图的异常率(60.3%)低于上、下肢体肌肉的肌电图(93.2%、84.4%)(均P<0.001);MND患者SCM肌电图异常以自发电位(42.5%)和轻收缩时运动单位电位时限增宽(43.2%)最为常见;MND组有延髓症状者SCM肌电图的异常率(71.7%)明显高于无延髓症状者(54.3%)(P<0.05)。结论MND患者SCM肌电图异常率及其特异性高,为延髓肌受累的指征,有助于MND的诊断与鉴别诊断。     

Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Dysphagia associated with upper esophageal sphincter (UES) dysfunction remarkably affects the quality of life of patients. UES injection of botulinum toxin is an effective treatment for dysphagia. In comparison with skeletal muscles of the limb and trunk, the UES is a special therapeutic target of botulinum toxin injection, owing to its several anatomical, physiological, and pathophysiological features. This review focuses on (1) the anatomy and function of the UES and the pathophysiology of UES dysfunction in dysphagia and why the entire UES rather than the cricopharyngeal muscle before/during botulinum toxin injection should be examined and targeted; (2) the therapeutic mechanisms of botulinum toxin for UES dysfunction, including the choice of injection sites, dose, and volume; (3) the strengths and weaknesses of guiding techniques, including electromyography, ultrasound, computed tomography, and balloon catheter dilation for botulinum toxin injection of the UES.     

膝骨关节炎患者肌电标准化方法的信度研究

目的 评估标准等长收缩(standard isometric contraction, SIC)与最大随意等长收缩(maximum voluntary isometric contraction, MVIC)应用于膝骨关节炎(knee osteoarthritis, KOA)患者肌电标准化的重测信度。方法 采用无线肌电测试系统收集KOA患者患侧腿在慢跑、SIC测试和MVIC测试时臀大肌、半腱肌、股直肌、股外侧肌、胫骨前肌、外侧腓肠肌和比目鱼肌的肌电数据。使用组内相关系数和95%置信区间评估重测信度。结果 KOA患者执行SIC测试时7块肌肉的重测信度均较好,执行MVIC测试时5块肌肉重测信度一般,2块肌肉重测信度较好,7块肌肉在SIC测试中的重测信度均高于MVIC测试;KOA患者慢跑时7块肌肉经SIC标准化后的重测信度均高于经MVIC标准化的重测信度,且股直肌经SIC标准化后的重测信度显著高于经MVIC标准化的重测信度。结论 对于KOA患者,SIC是一种比MVIC更为可靠的表面肌电标准化方案,具有较好的临床推广潜力。     

表面肌电图在儿童吞咽障碍疾病中的应用

目的 探讨表面肌电图在儿童吞咽障碍疾病中的应用价值。方法 选取吞咽障碍患儿20例为观察组,招募性别及年龄相匹配的健康儿童20例为对照组。采用表面肌电图记录两组儿童静息状态及吞水状态颏下肌群和舌骨下肌群肌电积分值。比较两组儿童静息状态下及吞水5 mL后颏下肌群和舌骨下肌群肌电积分值的差异。记录观察组患儿康复治疗1个月后颏下肌群和舌骨下肌群肌电积分值的变化。采用Spearman相关分析法评估观察组患儿吞咽障碍程度与颏下肌群及舌骨下肌群肌电积分值的相关性。结果 静息状态下两组儿童颏下肌群和舌骨下肌群肌电积分差异无统计学意义（P > 0.05）,但在吞水后观察组的肌电积分值明显高于对照组（P < 0.05）。治疗后观察组吞咽障碍临床症状改善,颏下肌群和舌骨下肌群肌电积分值较前明显降低（P < 0.05）。吞咽障碍严重程度与颏下肌群和舌骨下肌群肌电积分值呈正相关（P < 0.01）。结论 表面肌电图检查可以作为儿童吞咽障碍诊断及疗效评估的方法之一。     

舌三针为主治疗脑卒中后吞咽功能障碍的临床研究

目的观察舌三针为主治疗脑卒中后吞咽功能障碍的临床疗效及其对脑神经机制的影响。方法将130例脑卒中后吞咽功能障碍患者随机分为治疗组和对照组,每组65例。对照组采用康复训练配合低频脉冲电刺激治疗,治疗组在对照组基础上采用舌三针治疗。观察两组治疗前后吞咽功能(洼田饮水试验评分)、精神状态[汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分]及表面肌电图各项指标[平均振幅值(AEMG)、持续时间(t)]的变化情况。结果两组治疗后洼田饮水试验评分、HAMA评分及HAMD评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后洼田饮水试验评分、HAMA评分及HAMD评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗后空吞咽时及吞咽5 mL水时sEMG各项指标(颏下肌群及舌骨下肌群的AEMG和t)与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后空吞咽时及吞咽5 mL水时sEMG各项指标与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗后误吸及肺部感染的发生率分别为16.1%和17.7%,对照组分别为36.2%和32.8%,两组比较差异均具有统计学意义(P<0.05)。结论舌三针配合康复训练及低频脉冲电刺激能有效改善脑卒中患者的吞咽功能。     

微电子肌电桥技术对颈脊髓损伤患者桡侧腕长伸肌运动功能康复的效果

目的 观察微电子肌电桥(EMGB)技术对C5完全性脊髓损伤患者桡侧腕长伸肌运动功能的康复疗效.方法 2016年3月至2017年3月,选择本院C5完全性脊髓损伤患者20例,随机分为对照组(n=10)和试验组(n=10).对照组进行常规腕背伸训练,试验组在此基础上增加EMGB训练,共180 d.以桡侧腕长伸肌表面肌电图(s...