臨床神経学

<シンポジウム(3)―4―3>電気診断の復権

非侵襲的な定量筋電図検査法:Clustering Index法の創案

上杉 春雄1), 園生 雅弘2), 東原 真奈3), Erik Stalberg4), 斉藤 久寿5)

1)札幌麻生脳神経外科病院神経内科〔〒065―0022 札幌市東区東22条北1丁目1―40〕
2)帝京大学神経内科
3)防衛医科大学内科3
4)ウプサラ大学臨床神経生理部門
5)札幌麻生脳神経外科病院脳神経外科

There have been few previous studies trying to evaluate neuromuscular disorders using surface electro myography (SEMG). The greatest obstacle to such an approach must be the difficulty in identifying individual motor unit potentials (MUPs) on the SEMG signal under voluntary contraction because of their dense overlap. We tried to solve this problem by reducing the overlap of MUPs using appropriate electrode setting, as well as by developing a new method of interference pattern analysis. The tibialis anterior muscle was examined in our first study. A new method to analyse SEMG signal, the Clustering Index (CI) method, achieved 100% and 61% sensitivities for neurogenic and myopathic patients, and 97% specificity for control subjects. In the second study, the abductor digiti minimi muscle was examined. Subjects were 29 spinal and bulbar muscular atrophy patients and 27 controls. The CI method was compared with the motor unit number estimation, and the amplitude of compound muscle action potential. As results, the CI method achieved the best sensitivity and among these three techniques. The CI method is a novel, simple, and quantitative analysis method without using any special equipments, and is promising as a non-invasive complement to needle EMG.
Full Text of this Article in Japanese PDF (291K)

(臨床神経, 52:1249−1251, 2012)
key words:Clustering Index,表面筋電図,針筋電図,定量筋電図,運動単位数推定

(受付日:2012年5月25日)