表面肌电与运动诱发电位在脊髓运动完全性损伤评估中的比较

Comparison of surface electromyography and motor evoked potential in assessment of complete spinal cord motor injury

目的比较基于表面肌电图(sEMG)的脑运动控制方案和基于经颅磁刺激(TMS)的运动诱发电位在脊髓运动完全性损伤患者评估中的敏感性。方法纳入中国康复研究中心2021年3月—2023年4月收治的31例临床诊断为脊髓运动完全性损伤的患者,分别进行基于表面肌电的运动控制检测和基于TMS的运动诱发电位检测。结果31例患者中,27个(87%)至少有一个通道排名4或5。31例患者共测试了248块肌肉(每一例患者共测8块肌肉,分别是左右两侧的股直肌、股二头肌、胫前肌和腓肠肌),其中有79块(32%)肌肉可测量出通道排名4或5。62个肢体中的40个(64%)至少有一个通道排名4或5。31例患者中有21例(68%)有最高排名5的通道。然而,31例患者无一例能检测出运动诱发电位。结论sEMG在脊髓运动完全性损伤患者评估中的敏感性明显高于运动诱发电位。

Objective To compare the sensitivity of surface electromyography(sEMG)based brain motor control protocol and transcranial magnetic stimulation(TMS)based motor evoked potentials in the evaluation of patients with complete spinal cord motor injury.Methods 31 patients diagnosed complete spinal cord motor injury were admitted to the China Rehabilitation Research Center from March 2021 to April 2023 underwent sEMG based motor control detection and TMS based motor evoked potential detection,respectively.Results 27 of 31 patients(87%)had at least one channel ranked 4 or 5,and a total of 248 muscles were tested in 31 patients(8 muscles per patient,rectus femoris,biceps femoris,anterior tibialis and gastrocnemius on the right and left sides),of which 79(32%)muscles could be measured with a channel ranked 4 or 5.40 of 62 limbs(64%)had at least one channel rank 4 or 5,and 21 of 31 patients(68%)had the highest rank 5 channel.However,none of the 31 patients were positive in TMS-based motor evoked potential testing.Conclusion SEMG is significantly more sensitive than motor evoked potentials in the evaluation of patients with complete spinal cord motor injury.