Electrophysiologic correlations and diagnostic accuracy of quantitative surface electromyography in median neuropathy.
Keywords:
surface electromyography, electrodiagnosis, Quantitative evaluation, Median neuropathyAbstract
Introduction
Quantitative electromyography (QEMG) is an objective methodology for analyzing maximum effort phase of an electromyography (EMG) recording. The signal is decomposed in time domain and frequency domain variables that offer numerical values for analyzing. QEMG using surface electrodes may be useful in distinguishing abnormal patterns in peripheral nerve diseases.
Objective: Describe the diagnostic accuracy using ROC curve analysis of the quantitative variables of surface EMG interference pattern (IP) in patients with carpal tunnel syndrome (CTS).
Material and Methods: 32 patients (50 hands) with electrophysiological diagnosis of CTS were compared with 14 patients (17 hands) without CTS. The IP of abductor pollicis brevis (APB) was obtained with a 10 second contraction, QEMG analysis was performed using time domain variables and frequency domain variables.
Results. Mean amplitude of turns was lower and T/M ratio was higher in CTS group compared with non-CTS (p<.001). On frequency domain, RMS (p<.001)and power of peak frequency (p<.05)was lower on CTS group . Differences remained significant when an analysis matched by age was performed. ROC curve analysis showed an AUC of 0.96 for RMS and 0.93 for mean amplitude of turns.
Conclusion: Maximum effort in EMG can be described with quantitative variables of the IP using superficial electrodes. Mean amplitude of turns and RMS obtained through surface EMG have high diagnostic accuracy for distinguishing between neuropathic and non neuropathic patterrns.
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