Electrical impedance myography (EIM) refers to the specific application of electrical bioimpedance techniques for the assessment of neuromuscular disorders. In EIM, a weak, high-frequency electrical current is applied to a muscle or muscle group of interest and the resulting voltages measured. Among its advantages, the technique can be used noninvasively across a variety of disorders and requires limited subject cooperation and evaluator training to obtain accurate and repeatable data. Studies in both animals and human subjects support its potential utility as a primary diagnostic tool, as well as a biomarker for clinical trial or individual patient use. This review begins by providing an overview of the current state and technological advances in electrical impedance myography and its specific application to the study of muscle. We then provide a summary of the clinical and preclinical applications of EIM for neuromuscular conditions, and conclude with an evaluation of ongoing research efforts and future developments.

Measuring the impedance frequency response of systems by means of frequency sweep electrical impedance spectroscopy (EIS) takes time. An alternative based on broadband signals enables the user to acquire simultaneous impedance response data collection. This is directly reflected in a short measuring time compared to the frequency sweep approach. As a result of this increase in the measuring speed, the accuracy of the impedance spectrum is compromised. The aim of this paper is to study how the choice of the broadband signal can contribute to mitigate this accuracy loss. A review of the major advantages and pitfalls of four different periodic broadband excitations suitable to be used in EIS applications is presented. Their influence on the instrumentation and impedance spectrum accuracy is analyzed. Additionally, the signal processing tools to objectively evaluate the quality of the impedance spectrum are described. In view of the experimental results reported, the impedance spectrum signal-to-noise ratio (SNRZ) obtained with multisine or discrete interval binary sequence signals is about 20–30 dB more accurate than maximum length binary sequence or chirp signals.

The bioimpedance measurement/identification of time-varying biological systems Z(ω, t) by means of electrical impedance spectroscopy (EIS) is still a challenge today. This paper presents a novel measurement and identification approach, the so-called parametric-in-time approach, valid for time-varying (bio-)impedance systems with a (quasi) periodic character. The technique is based on multisine EIS. Contrary to the widely used nonparametric-in-time strategy, the (bio-)impedance Z(ω, t) is assumed to be time-variant during the measurement interval. Therefore, time-varying spectral analysis tools are required. This new parametric-in-time measuring/identification technique has experimentally been validated through three independent sets of in situ measurements of in vivo myocardial impedance. We show that the time-varying myocardial impedance Z(ω, t) is dominantly periodically time varying (PTV), denoted as ZPTV(ω, t). From the temporal analysis of ZPTV(ω, t), we demonstrate that it is possible to decompose ZPTV(ω, t) into a(n) (in)finite sum of fundamental (bio-)impedance spectra, the so-called harmonic impedance spectra (HIS) Zk(ω)s with [Formula: see text]. This is similar to the well-known Fourier series of a periodic signal, but now understood at the level of a periodic system's frequency response. The HIS Zk(ω)s for [Formula: see text] actually summarize in the bi-frequency (ω, k) domain all the temporal in-cycle information about the periodic changes of Z(ω, t). For the particular case k = 0 (i.e. on the ω-axis), Z0(ω) reflects the mean in-cycle behavior of the time-varying bioimpedance. Finally, the HIS Zk(ω)s are directly identified from noisy current and voltage myocardium measurements at the multisine measurement frequencies (i.e. nonparametric-in-frequency).

EIM has been used as a disease severity biomarker in a variety of disorders affecting the muscle, ranging from amyotrophic lateral sclerosis (ALS) to muscular dystrophies to disuse atrophy due to the weightlessness of space. In ALS, studies have demonstrated that major reductions in sample size in clinical trials can be achieved. Similarly, in the Duchenne muscular dystrophy, the technique tracks disease progression and is sensitive to the beneficial effect of steroids. More basic work has demonstrated that EIM can provide a non-invasive means of tracking muscle fiber size. Ongoing innovations include the development of techniques for assessing muscle contraction. EIM is gradually being adopted as a useful, practical, and convenient tool for the assessment of neuromuscular conditions.

Electrical impedance methods have been used as evaluation tools in biological and medical science for well over 100 years. However, only recently have these techniques been applied specifically to the evaluation of conditions affecting nerve and muscle. This specific application, termed electrical impedance myography (EIM), is finding wide application as it can provide a quantitative index of muscle condition that can assist with diagnosis, track disease progression, and assess the beneficial impact of therapy. Using noninvasive surface methods, EIM has been studied in a number of conditions ranging from amyotrophic lateral sclerosis to muscular dystrophy to disuse atrophy. Data support that the technique is sensitive to disease status and can offer the possibility of performing clinical trials with fewer subjects than would otherwise be possible. Recent advances in the field include improved approaches for using EIM as a "virtual biopsy" and the development of combined needle impedance-electromyography technology.

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Classical measurements of myocardium tissue electrical impedance for characterizing the morphology of myocardium cells, as well as cell membranes integrity and intra/extra cellular spaces, are based on the frequency-sweep electrical impedance spectroscopy (EIS) technique. In contrast to the frequency-sweep EIS approach, measuring with broadband signals, i.e., multisine excitations, enables to collect, simultaneously, multiple myocardium tissue impedance data in a short measuring time. However, reducing the measuring time makes the measurements to be prone to the influence of the transients introduced by noise and the dynamic time-varying properties of tissue. This paper presents a novel approach for the impedance-frequency-response estimation based on the local polynomial method (LPM). The fast LPM version presented rejects the leakage error's influence on the impedance frequency response when measuring electrical bioimpedance in a short time. The theory is supported by a set of validation measurements. Novel preliminary experimental results obtained from real-time in vivo healthy myocardium tissue impedance characterization within the cardiac cycle using multisine excitation are reported.

Multisine signal with a low crest factor (CF) can bring a high signal-to-noise ratio for fast frequency response function (FRF) estimation. Synthesis of a low CF multisine with the given amplitude spectrum depends on optimum selection of the initial phases of its cosinusoidal components. The solutions investigated can be generally divided into two branches: (1) the analytical method based on direct formula calculation; and (2) the numerical method based on iterative computations. The analytical method works well only for an equidistant and flat amplitude spectrum, while the numerical method can generally output better results, even for a sparse or non-flat spectrum, but the number of iterations might be huge. This paper presents an improved CF minimization algorithm to synthesize multisine signals based on the combination of the previous Schroeder analytical method and the Van der Ouderaa (VDO) iteration procedure. The improved algorithm adopts the Schroder phases as the iterative initial phases, and employs a logarithmic clip function of the iterative index i in the VDO iteration procedure. Comprehensive experiments of multisine synthesis on three types of cosinusoidal amplitude spectra are performed, and the resulting CFs remain the lowest level in all cases compared with the earlier methods. The proposed algorithm provides a fast and efficient solution to synthesize multisine with the lowest CF for an arbitrary user-prescribed spectrum.