On the electrode positioning for bipolar EMG recording of forearm extensor and flexor muscle activity after transcranial magnetic stimulation

Munneke, M.A.M.; Bakker, C.D.; Goverde, Eline A.; Pasman, J.W.; Stegeman, Dick F.

doi:10.1016/j.jelekin.2018.02.010

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…This observed increase post-TMS suggests potential bene ts of TMS therapy for stroke rehabilitation, indicating a positive impact on the recovery of muscle function. Consistent with existing research ndings(Munneke et al, 2018;Young et al, 2022), this supports the effectiveness of TMS as a neurorehabilitation tool, emphasizing its role in enhancing muscle activity in stroke patients. TMS is known to modulate cortical excitability by inducing electrical currents in the brain.…”

supporting

confidence: 88%

Effect of repetitive transcranial magnetic stimulation on upper limb motor function in stroke patients with right hemiplegia based on EEG microstates and EMG

Xin,

Zhao,

et al. 2023

Preprint

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Stroke is a neurological disorder that profoundly affects patients' neural function and daily life. Although rehabilitation methods have made significant progress, there is still a need for innovative treatment strategies to improve the recovery outcomes of stroke patients. In this study, we employed electroencephalography (EEG) microstate analysis to investigate the influence of transcranial magnetic stimulation (TMS) on upper limb functional Rehabilitation in stroke patients with right hemiplegia, while also exploring the relationship between microstate patterns and improvements in muscle strength. The study involved 20 stroke patients with right-sided hemiparesis and 20 healthy right-handed control subjects recruited. All subjects underwent EEG and EMG data collection in a resting state. Before and after treatments，using the Upper Extremity Section of the Fugl-Meyer Assessment(FMA-UE) and the Action Research Arm Test (ARAT) to assess the upper extremity function of stroke patients. After one week of TMS treatment, data collection was repeated for patients. After TMS intervention, the FMA-UE scores and ARAT scores of stroke patients were significantly improved compared to the pre-treatment period (p < 0.05). Microstate B exhibited reduced time coverage and occurrence frequency in stroke patients (p < 0.05), but following TMS treatment, there was a significant increase in time coverage, approaching levels seen in the healthy control group (p < 0.05). Furthermore, we observed a significant reduction in the duration and time coverage of Microstate C and Microstate D following TMS treatment (p < 0.05). Encouragingly, the improvement in time coverage and occurrence frequency of Microstate B was positively correlated with the enhanced abilities of specific muscle groups, including upper limb muscles such as the flexor carpi ulnaris and extensor carpi ulnaris, highlighting the close relationship between Microstate B and improvements in motor control and muscle coordination. Changes in Microstate C were positively correlated with increased upper limb muscle strength, suggesting that Microstate C may play a crucial role in motor control and muscle coordination. This suggests that TMS may have a positive impact on neurorehabilitation in stroke patients, particularly concerning rehabilitation goals associated with Microstate B. In conclusion, our study underscores TMS can effectively promote upper limb motor function in stroke patients with right-sided hemiplegia and the critical link between microstate analysis and motor function recovery in stroke patients. Microstate B and Microstate C may serve as physiological indicators for assessing the progress of motor rehabilitation, providing valuable insights for developing more effective rehabilitation strategies and personalized rehabilitation plans.

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supporting

confidence: 88%

Effect of repetitive transcranial magnetic stimulation on upper limb motor function in stroke patients with right hemiplegia based on EEG microstates and EMG

Xin,

Zhao,

et al. 2023

Preprint

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“…The results reported here support our hypothesis: bipolar EMGs detected with greater IEDs are more sensitive to muscle excitation. Evidence favoring the increased sensitivity of EMGs detected with greater IEDs, as recently documented in other studies [3], [14], can be summarized by the changes we observed in the EMG surrogates for the timing and degree of excitation of the two muscles assessed. As IED increased, from 5 mm to 50 mm: (i) the variability of EMG-Torque onset decreased, with IEDs greater than 30 mm providing onset values converging to tenths of a ms earlier in relation to the average torque onset (Fig.…”

Section: B the Dependence Of Bipolar Emg Descriptors On The Iedsupporting

confidence: 76%

“…Short IEDs are more likely to provide more specific and less sensitive EMGs, whereas the opposite holds true for large IEDs [14]- [16]. While specificity is generally acknowledged in the EMG literature, with recommendations tending to favor the use of short IEDs [13], only recently has the sensitivity issue been systematically studied [3], [14]. Although the existence of Type II errors in surface EMG has been formalized [9], its practical importance has not yet been documented.…”

Section: Introductionmentioning

confidence: 99%

The Sensitivity of Bipolar Electromyograms to Muscle Excitation Scales With the Inter-Electrode Distance

Vieira,

Cerone,

Botter

et al. 2023

IEEE Trans. Neural Syst. Rehabil. Eng.

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The value of surface electromyograms (EMGs) lies in their potential to non-invasively probe the neuromuscular system. Whether muscle excitation may be accurately inferred from bipolar EMGs depends on how much the detected signal is both sensitive and specific to the excitation of the target muscle. While both are known to be a function of inter-electrode distance (IED), specificity has been of long concern in the physiological literature. In contrast, sensitivity, at best, has been implicitly assumed. Here we provide evidence that IED imposes a biophysical constraint on the sensitivity of surface EMG. From 20 healthy subjects, we tested the hypothesis that excessively reducing IED provides EMGs with limited physiological content. We detected bipolar EMGs with IEDs varying from 5 mm to 50 mm from two skeletal muscles with distinct architectures, gastrocnemius and biceps brachii. Nonparametric statistics and Bayesian hierarchical modelling were used to evaluate the dependence of the onset of muscle excitation and signal-to-noise ratio (SNR) on the IED. Experimental results revealed that IED critically affects the sensitivity of bipolar EMGs for both muscles-indeliberately reducing IED provides EMGs that are not representative of the whole muscle, hampering validity. Simulation results substantiate the generalization of experimental results to small and large electrodes. Based on current and previous findings, we discuss a potentially valid procedure for defining the most appropriate IED for a single bipolar, surface recording-i.e., the distance from the electrode to the target muscle boundary may heuristically serve as a lower bound when choosing an IED.

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“…Current literature has characterized the muscle adaptations after stroke with SEMG [ 14 ], mechanomyography [ 24 ], and ultrasonography [ 6 , 8 ]. Myotonometry uses superficial mechanical deformation and represents a convenient approach that is considerably less costly than elastography [ 25 ] and has good psychometric properties [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been recommended to measure several spots within the muscle and tendon to better characterize PSS [ 13 ]. Topographical mapping, based on multiple site assessments within an area of interest, has been used extensively for surface electromyography (SEMG) [ 14 ] and quantitative sensory testing [ 15 ] and, more recently, to report the spatial distribution of muscle stiffness in people with chronic pain [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Characterization of the Structural and Mechanical Changes of the Biceps Brachii and Gastrocnemius Muscles in the Subacute and Chronic Stage after Stroke

García-Bernal

González-García

Madeleine

et al. 2023

IJERPH

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The objective of this study was to characterize the changes of muscle tone, stiffness, and thickness of upper and lower limb muscles in stroke survivors. Forty patients with subacute or chronic stroke and 31 controls were included and measured using myotonometry (MyotonPRO), with multiple site assessments at muscle belly (MB) and musculotendinous (MT) locations of the biceps brachii and gastrocnemius muscles. Muscle thickness (ultrasonography) was obtained for each muscle. Upper and lower limb motor performance was evaluated with the Fugl–Meyer Assessment for Upper Extremity and the Functional Ambulance Category. Overall, muscle tone and stiffness were significantly higher at MT than at MB sites. Among stroke patients, differences between the paretic and nonparetic limb were found for the biceps brachii, with lower muscle tone, stiffness, and thickness of the paretic side (all, p < 0.05). There were weak to moderate correlations between mechanical (myotonometry) and structural (ultrasound) muscular changes, regardless of the post-stroke stage. This suggests that myotonometry and ultrasonography assess similar, although different, constructs and can be combined in the clinical setting. Their discriminative ability between the paretic and nonparetic sides and between participants with and without stroke differs depending on the muscle, the functional level, and the stroke stage.

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On the electrode positioning for bipolar EMG recording of forearm extensor and flexor muscle activity after transcranial magnetic stimulation

Cited by 8 publications

References 19 publications

Effect of repetitive transcranial magnetic stimulation on upper limb motor function in stroke patients with right hemiplegia based on EEG microstates and EMG

Effect of repetitive transcranial magnetic stimulation on upper limb motor function in stroke patients with right hemiplegia based on EEG microstates and EMG

The Sensitivity of Bipolar Electromyograms to Muscle Excitation Scales With the Inter-Electrode Distance

Characterization of the Structural and Mechanical Changes of the Biceps Brachii and Gastrocnemius Muscles in the Subacute and Chronic Stage after Stroke

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