A multidimensional facial surface EMG analysis for objective assessment of bulbar involvement in amyotrophic lateral sclerosis.

Objective: To develop a multidimensional facial surface electromyographic (EMG) analysis for assessing bulbar involvement in amyotrophic lateral sclerosis (ALS).
Methods: Fifty-four linear and nonlinear features were extracted from the surface EMG recordings for masseter, temporalis, and anterior belly of digastric in 13 patients with ALS and 10 healthy controls, each performed a speech task three times. The features were factor analyzed and then evaluated in terms of internal consistency, relation to functional speech outcomes, and efficacy for patient-control classification.
Results: Five internally consistent, interpretable factors were derived, representing the functioning of masseter, temporalis, digastric, antagonists, and agonists, respectively. These factors explained 40-43% of the variance in the functional speech outcomes and were ≥90% accurate in patient-control classification. The jaw muscle performance of individuals with ALS was characterized by (1) reduced complexity and coherence of antagonist muscle activities, and (2) increased complexity and irregularity of temporalis activity.
Conclusions: Two important bulbar muscular changes were identified in ALS, related to both upper and lower motor neuron pathologies. These changes reflected (1) decreased motor unit recruitment and synchronization for jaw antagonists, and (2) a potential neuromuscular adaptation for temporalis.
Significance: The surface EMG-based framework shows promise as an objective bulbar assessment tool.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)