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"Clustering Index method": a new technique for differentiation between neurogenic and myopathic changes using surface EMG

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Uesugi H, Sonoo M, Stålberg E, Matsumoto K, Higashihara M, Murashima H, Ugawa Y, Nagashima Y, Shimizu T, Saito H, Kanazawa I. "Clustering Index method": a new technique for differentiation between neurogenic and myopathic changes using surface EMG. Clin Neurophysiol. 2011 May;122(5):1032-41. doi: 10.1016/j.clinph.2010.08.012. PMID: 20869308.

Objective: To establish a non-invasive and quantitative analysis method using single-channel surface EMG (SEMG) for diagnosing neurogenic and myopathic changes.
Methods: The subjects consisted of 66 healthy controls, 12 patients with neurogenic diseases, and 18 patients with myopathic diseases. The tibialis anterior muscle was examined using a belly to the adjacent bone lead. From each subject, 20–40 signals of 1 s length were collected of various strengths. A new parameter, the ‘‘Clustering Index (CI)”, was developed to quantify the uneven distribution of the SEMG signal and was plotted against the SEMG area. The results were expressed as the Z-score of each subject calculated using linear regression from the normative data.
Results: When ±2.5 was used as the cut-off value of the Z-score, the specificity was 95%, whereas the sensitivity was 92% (11/12) and 61% (11/18) for the neurogenic and myopathic patients, respectively. There was no overlap of the Z-score values between the neurogenic and myopathic groups.
Conclusions: The CI method achieved a reasonably high diagnostic yield in detecting neurogenic or myopathic changes.
Significance: This is a new simple and quantitative analysis method using SEMG with good reproducibility and is promising as a non-invasive complement to needle EMG.

September 15, 2023