MP26-12 MOTOR UNIT NUMBER ESTIMATION OF THE PUBORECTALIS MUSCLE

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology I1 Apr 2017MP26-12 MOTOR UNIT NUMBER ESTIMATION OF THE PUBORECTALIS MUSCLE Nicholas Dias, Yun Peng, Jinbao He, Charles Popeney, and Yingchun Zhang Nicholas DiasNicholas Dias More articles by this author , Yun PengYun Peng More articles by this author , Jinbao HeJinbao He More articles by this author , Charles PopeneyCharles Popeney More articles by this author , and Yingchun ZhangYingchun Zhang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.783AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Motor unit number estimation (MUNE) techniques estimate the number of functioning motor units (MUs) in a muscle, and serve as a biomarker for neuromuscular and muscular atrophy. Application of current MUNE techniques to the pelvic floor is impractical because of the need for either multiple stimulations or invasive needle electrodes. The objective is to propose a novel MUNE technique applicable to pelvic floor muscles, by combining a high-density surface EMG (HD-sEMG) decomposition approach with pudendal nerve stimulation, negating the need for invasive needles or multiple stimulations. METHODS All procedures were approved by UH IRB. The pudendal nerve was stimulated transrectally with a St. Mark′s electrode mounted on the operator′s glove. HD-sEMG recordings were acquired from the puborectalis muscle with a vaginal EMG probe (Figure 1b) during supramaximal stimulation and three maximal voluntary contractions of pelvic floor muscles. Firstly, single motor unit action potentials (SMUPs) were decomposed from EMG recordings during muscle contraction using our recently developed K-Means Clustering Convolution Kernel Compensation (KmCKC) Algorithm. All SMUPs were grouped into left or right side by visually checking their innervation zone locations following an established procedure. Next, mean SMUPs were derived for both sides by averaging all HD-sEMG profiles of grouped SMUPs. Last, MUNE was calculated as the weighted average of compound muscle action potential (CMAP) size to mean SMUP size ratios for both sides. RESULTS Left and right branches of the pudendal nerve were simulated. Four SMUPs were decomposed from HD-sEMG signals (left: 3 and right: 1). MUNE for the left and right sides were 22.8 and 27.0, respectively. CONCLUSIONS This pilot study proves the feasibility of a novel MUNE technique for muscles in the pelvic floor region. The KmCKC algorithm enables a non-invasive collection of SMUPs, negating the need for repeated electrical stimulation or invasive needle electrodes. Results from more subjects will be available from our ongoing subject recruitment. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e324 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Nicholas Dias More articles by this author Yun Peng More articles by this author Jinbao He More articles by this author Charles Popeney More articles by this author Yingchun Zhang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...