Multichannel EMG-based estimation of fiber conduction velocity during isometric contraction of patients with different stages of diabetic neuropathy.

This study compares muscle fiber conduction velocities estimated using surface electromyography during isometric maximal voluntary contraction in different stages of diabetic neuropathy. Eighty-five adults were studied: 16 non-diabetic individuals and 69 diabetic patients classified into four neuropathy stages, defined by a fuzzy expert system: absent (n=26), mild (n=21), moderate (n=11) and severe (n=11). Average muscle fiber conduction velocities of gastrocnemius medialis, tibialis anterior, vastus lateralis and biceps femoris were assessed using linear array electrodes, and were compared by ANOVA. Conduction velocities were significantly decreased in the moderate neuropathy group for the vastus lateralis compared to other groups (from 18% to 21% decrease), and were also decreased in all diabetic groups for the tibialis anterior (from 15% to 20% from control group). Not only the distal anatomical localization of the muscle affects the conduction velocity, but also the proportion of muscle fiber type, where the tibialis anterior with greater type I fiber proportion is affected earlier while the vastus lateralis with greater type II fiber proportion is affected in later stages of the disease. Generally, the muscles of the lower limb have different responsiveness to the effects of diabetes mellitus and show a reduction in the conduction velocity as neuropathy progresses.

[1]  Roberto Merletti,et al.  Atlas of Muscle Innervation Zones , 2012 .

[2]  Dario Farina,et al.  Estimation of average muscle fiber conduction velocity from simulated surface EMG in pinnate muscles , 2007, Journal of Neuroscience Methods.

[3]  G. Gronseth,et al.  Distal symmetric polyneuropathy: A definition for clinical research , 2005, Neurology.

[4]  Ricky Watari,et al.  Effect of diabetic neuropathy severity classified by a fuzzy model in muscle dynamics during gait , 2014, Journal of NeuroEngineering and Rehabilitation.

[5]  T. Hawke,et al.  Effects of type 1 diabetes mellitus on skeletal muscle: clinical observations and physiological mechanisms , 2011, Pediatric diabetes.

[6]  J. Meijer,et al.  Muscle fiber conduction abnormalities in early diabetic polyneuropathy , 2008, Clinical Neurophysiology.

[7]  U. Rajendra Acharya,et al.  Entropy analysis of muscular near-infrared spectroscopy (NIRS) signals during exercise programme of type 2 diabetic patients: Quantitative assessment of muscle metabolic pattern , 2013, Comput. Methods Programs Biomed..

[8]  D. Farina,et al.  The linear electrode array: a useful tool with many applications. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[9]  Isabel CN Sacco,et al.  A comparison of lower limb EMG and ground reaction forces between barefoot and shod gait in participants with diabetic neuropathic and healthy controls , 2010, BMC musculoskeletal disorders.

[10]  Roberto Merletti,et al.  Do surface electromyograms provide physiological estimates of conduction velocity from the medial gastrocnemius muscle? , 2013, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[11]  D. Armstrong,et al.  Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration. , 1998, Archives of internal medicine.

[12]  B. Taksande,et al.  The Diagnostic Sensitivity, Specificity and Reproducibility of the Clinical Physical Examination Signs in Patients of Diabetes Mellitus for Making Diagnosis of Peripheral Neuropathy , 2011 .

[13]  K. Zou,et al.  Correlation and simple linear regression. , 2003, Radiology.

[14]  J. Jakobsen,et al.  Muscle weakness: a progressive late complication in diabetic distal symmetric polyneuropathy. , 2006, Diabetes.

[15]  Dustyn P. Roberts,et al.  Optimal pennation angle of the primary ankle plantar and dorsiflexors: variations with sex, contraction intensity, and limb. , 2006, Journal of applied biomechanics.

[16]  D. Greene,et al.  Single‐fiber electromyography in diabetic peripheral polyneuropathy , 1996, Muscle & nerve.

[17]  M J Zwarts,et al.  Muscle fiber conduction velocity in amyotrophic lateral sclerosis and traumatic lesions of the plexus brachialis. , 1993, Electroencephalography and clinical neurophysiology.

[18]  S. Kobayashi,et al.  Diabetic state-induced modification of Ca, Mg, Fe and Zn content of skeletal, cardiac and smooth muscles. , 1989, Endocrinologia japonica.

[19]  E. Hennig,et al.  The effect of diabetic neuropathy and previous foot ulceration in EMG and ground reaction forces during gait. , 2008, Clinical biomechanics.

[20]  A. Amadio,et al.  Influence of the diabetic neuropathy on the behavior of electromyographic and sensorial responses in treadmill gait. , 2003, Clinical biomechanics.

[21]  R. Paschke,et al.  Altered fiber distribution and fiber-specific glycolytic and oxidative enzyme activity in skeletal muscle of patients with type 2 diabetes. , 2006, Diabetes care.

[22]  I. W. Hunter,et al.  Estimation of the conduction velocity of muscle action potentials using phase and impulse response function techniques , 1987, Medical and Biological Engineering and Computing.

[23]  Toshio Moritani,et al.  Type 2 diabetes mellitus patients manifest characteristic spatial EMG potential distribution pattern during sustained isometric contraction. , 2012, Diabetes research and clinical practice.

[24]  J. Jakobsen,et al.  Accelerated atrophy of lower leg and foot muscles—a follow-up study of long-term diabetic polyneuropathy using magnetic resonance imaging (MRI) , 2009, Diabetologia.

[25]  M. Johnson,et al.  Data on the distribution of fibre types in thirty-six human muscles. An autopsy study. , 1973, Journal of the neurological sciences.

[26]  Ricky Watari,et al.  Classification of the severity of diabetic neuropathy: a new approach taking uncertainties into account using fuzzy logic , 2012, Clinics.

[27]  Douglas W. Zochodne,et al.  Does diabetes mellitus target motor neurons? , 2007, Neurobiology of Disease.

[28]  K. Meijer,et al.  Lower extremity muscle strength is reduced in people with type 2 diabetes, with and without polyneuropathy, and is associated with impaired mobility and reduced quality of life. , 2012, Diabetes research and clinical practice.

[29]  Henning Andersen,et al.  Muscle strength in type 2 diabetes. , 2004, Diabetes.

[30]  D. Zochodne,et al.  Neuronal Targeting in Diabetes Mellitus: A Story of Sensory Neurons and Motor Neurons , 2008, The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry.

[31]  E. Stålberg,et al.  Association of muscle strength and electrophysiological measures of reinnervation in diabetic neuropathy , 1998, Muscle & nerve.

[32]  E. Reske‐Nielsen,et al.  ULTRASTRUCTURE OF MUSCLE BIOPSIES IN RECENT, SHORT‐TERM AND LONG‐TERM JUVENILE DIABETES , 1977, Acta neurologica Scandinavica.

[33]  Henning Andersen,et al.  Atrophy of foot muscles: a measure of diabetic neuropathy. , 2004, Diabetes care.

[34]  D. Gabriel,et al.  Reliability of a simple method for determining muscle fiber conduction velocity , 2012, Muscle & nerve.

[35]  W. Litchy,et al.  Signs and symptoms versus nerve conduction studies to diagnose diabetic sensorimotor polyneuropathy: Cl vs. NPhys trial , 2010, Muscle & nerve.

[36]  J. Arezzo,et al.  Diabetic somatic neuropathies. , 2004, Diabetes care.

[37]  D. Farina,et al.  Surface Electromyography for Noninvasive Characterization of Muscle , 2001, Exercise and sport sciences reviews.

[38]  R. Ruff,et al.  Ca‐, Sr‐tension relationships and contraction velocities of human muscle fibers , 1991, Muscle & nerve.

[39]  E. H. Mamdani,et al.  An Experiment in Linguistic Synthesis with a Fuzzy Logic Controller , 1999, Int. J. Man Mach. Stud..

[40]  M. Cooper,et al.  Mechanisms of diabetic complications. , 2013, Physiological reviews.

[41]  R. Fitts,et al.  Isometric force and maximal shortening velocity of single muscle fibers from elite master runners. , 1996, The American journal of physiology.

[42]  R J Abboud,et al.  Lower limb muscle dysfunction may contribute to foot ulceration in diabetic patients. , 2000, Clinical biomechanics.

[43]  T. Masuda,et al.  Innervation zones of the upper and lower limb muscles estimated by using multichannel surface EMG. , 2000, Journal of human ergology.

[44]  H. Andersen.  Reliability of isokinetic measurements of ankle dorsal and plantar flexors in normal subjects and in patients with peripheral neuropathy. , 1996, Archives of physical medicine and rehabilitation.

[45]  S. Hansen,et al.  Axonal dysfunction in the neuropathy of diabetes mellitus: a quantitative electrophysiological study. , 1977, Journal of neurology, neurosurgery, and psychiatry.

[46]  M. Blüher,et al.  Metabolic profile and nitric oxide synthase expression of skeletal muscle fibers are altered in patients with type 1 diabetes. , 2008, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[47]  Toshio Moritani,et al.  Motor unit firing pattern of vastus lateralis muscle in type 2 diabetes mellitus patients , 2013, Muscle & nerve.

[48]  Dario Farina,et al.  Assessment of average muscle fiber conduction velocity from surface EMG signals during fatiguing dynamic contractions , 2004, IEEE Transactions on Biomedical Engineering.

[49]  A. N. Onodera,et al.  Lower limb electromygraphy and kinematics of neuropathic diabetic patients during real‐life activities: Stair negotiation , 2011, Muscle & nerve.