Assessing the immediate impact of botulinum toxin injection on impedance of spastic muscle

Li, Xiaoyan; Shin, Henry; Li, Le; Magat, Elaine; Li, Sheng; Zhou, Ping

doi:10.1016/j.medengphy.2017.01.018

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…Increased fluids in the muscle can lead to impedance changes, particularly, a decrease in muscle resistance. In a previous study, a significant reduction of muscle resistance was observed shortly after injection of Botulinum toxin, indicating high sensitivity of the EIM system in detection of local water accumulation [38]. In the current study, muscle resistance in the paretic side is similar or slightly larger than that in the contralateral side.…”

Section: Discussionsupporting

confidence: 66%

Electrical Impedance Myography for Evaluating Paretic Muscle Changes After Stroke

Shin

et al. 2017

IEEE Trans. Neural Syst. Rehabil. Eng.

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Electrical impedance myography (EIM) was used to assess the paretic muscle intrinsic electrical properties post stroke. Twenty-seven subjects with chronic hemiparesis participated in this study. Muscle impedance was measured by applying high-frequency, low-intensity alternating current to biceps brachii muscles. Major EIM parameters, resistance ( ), reactance ( ), phase angle ( ), and electrical anisotropy ratios (AR) of the three parameters, were examined at 50 kHz. Statistical analysis demonstrated significant reduction of reactance, phase angle, AR of resistance, and AR of reactance in the paretic muscle compared with the contralateral side (Paretic X: , contralateral X: , and p < 0.001; Paretic : , contralateral : 14.5 ± 0.82°, and p < 0.001; Paretic AR of R: 0.969 ± 0.013, contralateral AR of R: 1.008 ± 0.011, and p < 0.02; and Paretic AR of X: 0.981 ± 0.066, contralateral AR of X: 1.114 ± 0.041, and p < 0.02). Correlation analysis, however, did not show any significant relationship between EIM parameters and clinical assessments. Findings of this paper indicated significant changes in the muscular intrinsic electrical properties after stroke, possibly related to structural modifications induced by loss of muscle fibers or fat infiltration as well as changes in the quality of cell membranes post stroke.

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Section: Discussionsupporting

confidence: 66%

Electrical Impedance Myography for Evaluating Paretic Muscle Changes After Stroke

Shin

et al. 2017

IEEE Trans. Neural Syst. Rehabil. Eng.

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“…There are a number of limitations in the study. To match the muscle size, this study used the electrode array with relative smaller inter-electrode distance compared with previous studies ( 37 , 38 ). When current electrodes are closer to the voltage electrodes, a larger proportion of the current will pass through the subcutaneous layer rather than deeper through the muscle.…”

Section: Discussionmentioning

confidence: 99%

Assessing Hand Muscle Structural Modifications in Chronic Stroke

et al. 2018

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The purpose of the study is to assess poststroke muscle structural alterations by examining muscular electrical conductivity and inherent electrophysiological properties. In particular, muscle impedance and compound muscle action potentials (CMAP) were measured from the hypothenar muscle bilaterally using the electrical impedance myography and the electrophysiological techniques, respectively. Significant changes of muscle impedance were observed in the paretic muscle compared with the contralateral side (resistance: paretic: 27.54 ± 0.97 Ω, contralateral: 25.46 ± 0.91 Ω, p < 0.05; phase angle: paretic: 8.81 ± 0.61°, contralateral: 10.79 ± 0.69°, p < 0.05). In addition, impedance changes correlated moderately with the CMAP amplitude in the paretic hand (phase angle: r = 0.66, p < 0.05; reactance: r = 0.58, p < 0.05). The study discloses significant muscle rearrangements as a result of fiber loss or atrophy, fat infiltration or impaired membrane integrity in chronic stroke.

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“…It follows that EIM has the potential to establish the relationship between muscle function and microstructural properties, providing physiological evidence for muscle evaluation. Furthermore, our team also demonstrated excellent sensitivity of EIM technique in the measurement of alterations on muscle composition in stroke patients ( Li et al, 2017d ). Coupled with excellent robustness and convenience, EIM holds a high potential for clinical assessment of muscle function ( Martinez-Gonzalez et al, 2020 ; Rutkove et al, 2021 ).…”

Section: Introductionmentioning

confidence: 88%

Electrical impedance myography combined with quantitative assessment techniques in paretic muscle of stroke survivors: Insights and challenges

Gong

Wang

et al. 2023

Front. Aging Neurosci.

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Aging is a non-modifiable risk factor for stroke and the global burden of stroke is continuing to increase due to the aging society. Muscle dysfunction, common sequela of stroke, has long been of research interests. Therefore, how to accurately assess muscle function is particularly important. Electrical impedance myography (EIM) has proven to be feasible to assess muscle impairment in patients with stroke in terms of micro structures, such as muscle membrane integrity, extracellular and intracellular fluids. However, EIM alone is not sufficient to assess muscle function comprehensively given the complex contributors to paretic muscle after an insult. This article discusses the potential to combine EIM and other common quantitative methods as ways to improve the assessment of muscle function in stroke survivors. Clinically, these combined assessments provide not only a distinct advantage for greater accuracy of muscle assessment through cross-validation, but also the physiological explanation on muscle dysfunction at the micro level. Different combinations of assessments are discussed with insights for different purposes. The assessments of morphological, mechanical and contractile properties combined with EIM are focused since changes in muscle structures, tone and strength directly reflect the muscle function of stroke survivors. With advances in computational technology, finite element model and machine learning model that incorporate multi-modal evaluation parameters to enable the establishment of predictive or diagnostic model will be the next step forward to assess muscle function for individual with stroke.

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Assessing the immediate impact of botulinum toxin injection on impedance of spastic muscle

Cited by 8 publications

References 30 publications

Electrical Impedance Myography for Evaluating Paretic Muscle Changes After Stroke

Electrical Impedance Myography for Evaluating Paretic Muscle Changes After Stroke

Assessing Hand Muscle Structural Modifications in Chronic Stroke

Electrical impedance myography combined with quantitative assessment techniques in paretic muscle of stroke survivors: Insights and challenges

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