Reliability of the diaphragmatic compound muscle action potential evoked by cervical magnetic stimulation and recorded via chest wall surface EMG

Welch, Joseph F.; Mildren, Robyn L.; Zaback, Martin; Archiza, Bruno; Allen, Grayson P.; Sheel, A. William

doi:10.1016/j.resp.2017.05.011

Cited by 23 publications

(31 citation statements)

References 28 publications

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“…Diaphragm electrical activity was bilaterally recorded following both cortical and posterior CEMS according to current guidelines and previous studies . Surface EMG was recorded using a Dantec 2000 EMG device (Dantec Medical, Skovlunde, Denmark).…”

Section: Methodsmentioning

confidence: 99%

“…Surface EMG was recorded using a Dantec 2000 EMG device (Dantec Medical, Skovlunde, Denmark). Electrodes were placed in the seventh intercostal space approximately on the anterior axillary line with the reference electrodes positioned cranially to the xiphoid process (16‐cm inter‐electrode distance) . The ground electrode was placed around the right wrist …”

Section: Methodsmentioning

confidence: 99%

“…After a 20‐minute resting period with quiet breathing and no speaking, stimuli were delivered using a MagPro Compact magnetic stimulator equipped with a 12 cm C‐100 circular coil (MagVenture, Willich, Germany). Square‐pulse stimuli were 0.1 ms in duration . Stimulus conditions were standardized by using maximum magnetic flux density (2 Tesla) for all stimulations .…”

Section: Methodsmentioning

confidence: 99%

“…Square‐pulse stimuli were 0.1 ms in duration . Stimulus conditions were standardized by using maximum magnetic flux density (2 Tesla) for all stimulations . For COMS, the magnetic coil was placed over Cz´ .…”

Section: Methodsmentioning

confidence: 99%

“…Electrophysiological evaluation of phrenic nerve and inspiratory pathway function can be performed using surface electromyography (EMG) for recording of diaphragm motor evoked potentials (dMEP) following cortical magnetic stimulation (COMS), and compound action potentials (dCMAP) following cervical magnetic stimulation (CEMS) …”

Section: Introductionmentioning

confidence: 99%

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Phrenic nerve involvement and respiratory muscle weakness in patients with Charcot‐Marie‐Tooth disease 1A

Spießhoefer

Henke

Kabitz

et al. 2019

J Peripheral Nervous Sys

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Diaphragm weakness in Charcot‐Marie‐Tooth disease 1A (CMT1A) is usually associated with severe disease manifestation. This study comprehensively investigated phrenic nerve conductivity, inspiratory and expiratory muscle function in ambulatory CMT1A patients. Nineteen adults with CMT1A (13 females, 47 ± 12 years) underwent spiromanometry, diaphragm ultrasound, and magnetic stimulation of the phrenic nerves and the lower thoracic nerve roots, with recording of diaphragm compound muscle action potentials (dCMAP, n = 15), transdiaphragmatic and gastric pressures (twPdi and twPgas, n = 12). Diaphragm motor evoked potentials (dMEP, n = 15) were recorded following cortical magnetic stimulation. Patients had not been selected for respiratory complaints. Disease severity was assessed using the CMT Neuropathy Scale version 2 (CMT‐NSv2). Healthy control subjects were matched for age, sex, and body mass index. The following parameters were significantly lower in CMT1A patients than in controls (all P < .05): forced vital capacity (91 ± 16 vs 110 ± 15% predicted), maximum inspiratory pressure (68 ± 22 vs 88 ± 29 cmH2O), maximum expiratory pressure (91 ± 23 vs 123 ± 24 cmH2O), and peak cough flow (377 ± 135 vs 492 ± 130 L/min). In CMT1A patients, dMEP and dCMAP were delayed. Patients vs controls showed lower diaphragm excursion (5 ± 2 vs 8 ± 2 cm), diaphragm thickening ratio (DTR, 1.9 [1.6‐2.2] vs 2.5 [2.1‐3.1]), and twPdi (8 ± 6 vs 19 ± 7 cmH2O; all P < .05). DTR inversely correlated with the CMT‐NSv2 score (r = −.59, P = .02). There was no group difference in twPgas following abdominal muscle stimulation. Ambulatory CMT1A patients may show phrenic nerve involvement and reduced respiratory muscle strength. Respiratory muscle weakness can be attributed to diaphragm dysfunction alone. It relates to neurological impairment and likely reflects a disease continuum.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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