복합근육활동전위의 시작잠복기와 진폭에 대한 기준전극의 영향
The Influence of the Reference Electrode on Compound Muscle Action Potential Onset Latency and Amplitude
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Background: In belly-tendon (bipolar) montage, reference (R2) electrode placed on muscle’s tendon has traditionally been considered to be electrically inactive. However, recent studies have revealed that R2 electrode is not simply referential, but actively contributes to compound muscle action potential (CMAP) waveform morphology. These findings suggest that CMAP onset latency and amplitude may also be influenced by the position of R2 electrode. This study was performed in order to evaluate the effect of R2 electrode position on CMAP onset latency and amplitude. Methods: We performed motor nerve conduction studies of median, ulnar, tibial and peroneal nerves on bilateral limbs of 20 normal subjects. We used traditional bipolar and monopolar montage and compared their CMAP onset latencies and amplitudes. In bipolar montage, recording (R1) electrode was placed on mid-belly of muscle with R2 electrode on the tendon of the muscle. In monopolar montage, R1 electrode was placed on the same site of bipolar montage, while R2 electrode was placed on the contralateral limb. Results: The mean CMAP onset latencies of median and peroneal nerves in bipolar montage were significantly different (p<0.05) with those in monopolar montage. And those of ulnar and tibial nerves were not significantly different (p>0.05). The mean CMAP amplitudes of all the tested nerves except ulnar nerve were significantly different (p<0.05). Conclusions: This study shows that change in R2 electrode position can affect the CMAP onset latency and amplitude, and these differences seem to be related to the generation of far field potential by CMAP.
Abstract
Background: Background: In belly-tendon (bipolar) montage, reference (R2) electrode placed on muscle’s tendon has traditionally been considered to be electrically inactive. However, recent studies have revealed that R2 electrode is not simply referential, but actively contributes to compound muscle action potential (CMAP) waveform morphology. These findings suggest that CMAP onset latency and amplitude may also be influenced by the position of R2 electrode. This study was performed in order to evaluate the effect of R2 electrode position on CMAP onset latency and amplitude. Methods: We performed motor nerve conduction studies of median, ulnar, tibial and peroneal nerves on bilateral limbs of 20 normal subjects. We used traditional bipolar and monopolar montage and compared their CMAP onset latencies and amplitudes. In bipolar montage, recording (R1) electrode was placed on mid-belly of muscle with R2 electrode on the tendon of the muscle. In monopolar montage, R1 electrode was placed on the same site of bipolar montage, while R2 electrode was placed on the contralateral limb. Results: The mean CMAP onset latencies of median and peroneal nerves in bipolar montage were significantly different (p<0.05) with those in monopolar montage. And those of ulnar and tibial nerves were not significantly different (p>0.05). The mean CMAP amplitudes of all the tested nerves except ulnar nerve were significantly different (p<0.05). Conclusions: This study shows that change in R2 electrode position can affect the CMAP onset latency and amplitude, and these differences seem to be related to the generation of far field potential by CMAP.
참고문헌 (19)
- Oh SJ, "Nerve conduction techniques. In: Oh SJ. Clinical electromyography: nerve conduction studies, 2nd ed", Williams & Wilins, pp.41~45 (1993)
- Olney RK, "Ulnar nerve conduction study of the first dorsal interosseous muscle", Am J Phys Med Rehabil, 66, pp.16~18 (1985)
- Nandedkar SD, "Contribution of reference electrode to the compound muscle action potential", Muscle Nerve, 36, pp.87~92 (2007)
- Kincaid JC, "The influence of the reference electrode on CMAP configuration", Muscle Nerve, 16, pp.392~396 (1993)
- Barkaus PE, "Recording characteristics of surface EMG electrodes", Muscle Nerve, 17, pp.1317~1323 (1994)
- Bromberg MB, "The influence of active electrode placement on CMAP amplitude", Electroencephalogr Clin Neurophysiol, 105, pp.385~389 (1997)
- van Dijk JG, "Influence of recording site on CMAP amplitude and on its variation over a length of nerve", Muscle Nerve, 17, pp.1286~1292 (1994)
- van Dijk JG, "CMAP variability as a function of electrode site and size", Muscle Nerve, 18, pp.68~73 (1995)
- Slomić A, "Electrical and mechanical responses of normal and myasthenic muscle", Brain res, 10, pp.1~78 (1968)
- Wertsch JJ, "Effect of reference electrode position on deep ulnar nerve conduction studies", Muscle Nerve, 13, pp.862~ (1990)
- Dumitru D, "Nerve conduction studies. In:Dumitru D. Electrodiagnostic medicine", pp.127~130 (1995), Hanley & Belfus
- Falck B, "Motor nerve conduction studies:measurement principles and interpretation of findings", J Clin Neurophysiol, 12, pp.254~279 (1995)
- Phongsamart G, "Effect of reference electrode position on the compound muscle action potential (CMAP) onset latency", Muscle Nerve, 25, pp.816~821 (2002)
- Al-Shekhlee A, "Optimal recording electrode placement in the lumbrical-interossei comparison study", Muscle Nerve, 33, pp.289~293 (2006)
- McGill KC, "The contribution of the interosseous muscle to the hypothenar compound muscle action potential", Muscle Nerve, 22, pp.6~15 (1999)
- Dumitru D, "Far field potentials in muscle", Muscle Nerve, 14, pp.981~999 (1991)
- Dumitru D, "Far-field potential", Muscle Nerve, 16, pp.237~254 (1993)
- Van Dijk JG, "CMAP amplitude cartography of muscles innervated by the median, ulnar, peroneal, and tibial nerves", Muscle Nerve, 22, pp.378~389 (1999)
- Stegeman DF, "Near-and far-fields: source characteristics and the conducting medium in neurophysiology", J Clin Neurophysiol, 14, pp.429~442 (1997)