1. The evolving role of surface electromyography in amyotrophic lateral sclerosis: A systematic review
- Author
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Christopher Shaw, Kerry R. Mills, and James Bashford
- Subjects
MU, motor unit ,FMF, fine motor function ,IZ, innervation zone ,Action Potentials ,Electromyography ,MUNIX, motor unit number index ,ALS-FRS, ALS-Functional Rating Scale ,0302 clinical medicine ,FP, fasciculation potential ,SDTC, strength-duration time constant ,Motor unit number estimation ,Surface electromyography ,Amyotrophic lateral sclerosis ,Motor Neurons ,CMAP, compound muscle action potential ,medicine.diagnostic_test ,05 social sciences ,ADM, abductor digiti minimi ,ALS, amyotrophic lateral sclerosis ,Prognosis ,Sensory Systems ,3. Good health ,TEd, depolarizing threshold electrotonus ,Neurology ,Disease Progression ,biomarker ,Biomarker (medicine) ,MMN, multifocal motor neuropathy ,MFCV, muscle fibre conduction velocity ,medicine.medical_specialty ,MUNE, motor unit number estimate ,ComputerApplications_COMPUTERSINOTHERSYSTEMS ,IQR, inter-quartile range ,surface electromyography ,motor neuron disorders ,Article ,050105 experimental psychology ,SPiQE, surface potential quantification engine ,MD, multiplet discharge ,(HD)SEMG, (high-density) surface electromyography ,MUSIX, motor unit size index ,03 medical and health sciences ,Physical medicine and rehabilitation ,Physiology (medical) ,medicine ,Humans ,NEMG, needle electromyography ,0501 psychology and cognitive sciences ,Muscle, Skeletal ,Motor neuron disorders ,BFS, benign fasciculation syndrome ,business.industry ,TMS, transcranial magnetic stimulation ,Amyotrophic Lateral Sclerosis ,Role ,Motor unit number ,Biomarker ,IFI, inter-FP interval ,SVC, slow vital capacity ,Neurophysiology ,medicine.disease ,Clinical trial ,Motor unit ,MUAP, motor unit action potential ,APB, abductor pollicis brevis ,CI, clustering index ,Neurology (clinical) ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Highlights • Surface EMG offers significant practical advantages over invasive methods in ALS patients. • A variety of techniques exist to harness the superior spatial resolution of high-density surface EMG. • Multi-disciplinary collaboration is required to combat analytical and technical challenges., Objective Amyotrophic lateral sclerosis (ALS) is an adult-onset neurodegenerative disease that leads to inexorable motor decline and a median survival of three years from symptom onset. Surface EMG represents a major technological advance that has been harnessed in the development of novel neurophysiological biomarkers. We have systematically reviewed the current application of surface EMG techniques in ALS. Methods We searched PubMed to identify 42 studies focusing on surface EMG and its associated analytical methods in the diagnosis, prognosis and monitoring of ALS patients. Results A wide variety of analytical techniques were identified, involving motor unit decomposition from high-density grids, motor unit number estimation and measurements of neuronal hyperexcitability or neuromuscular architecture. Some studies have proposed specific diagnostic and prognostic criteria however clinical calibration in large ALS cohorts is currently lacking. The most validated method to monitor disease is the motor unit number index (MUNIX), which has been implemented as an outcome measure in two ALS clinical trials. Conclusion Surface EMG offers significant practical and analytical flexibility compared to invasive techniques. To capitalise on this fully, emphasis must be placed upon the multi-disciplinary collaboration of clinicians, bioengineers, mathematicians and biostatisticians. Significance Surface EMG techniques can enrich effective biomarker development in ALS.
- Published
- 2020