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Abstract
Although the past two decades have produced exciting discoveries in the genetics and pathology of amyotrophic lateral sclerosis (ALS), progress in developing an effective therapy remains slow. This review summarizes the critical discoveries and outlines the advances in disease characterization, diagnosis, imaging, and biomarkers, along with the current status of approaches to ALS care and treatment. Additional knowledge of the factors driving disease progression and heterogeneity will hopefully soon transform the care for patients with ALS into an individualized, multi-prong approach able to prevent disease progression sufficiently to allow for a dignified life with limited disability.
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Affiliation(s)
- Hristelina Ilieva
- Jefferson Weinberg ALS Center, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Justin Kwan
- National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA
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2
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Mandeville R, Sanchez B, Johnston B, Bazarek S, Thum JA, Birmingham A, See RHB, Leochico CFD, Kumar V, Dowlatshahi AS, Brown J, Stashuk D, Rutkove SB. A scoping review of current and emerging techniques for evaluation of peripheral nerve health, degeneration, and regeneration: part 1, neurophysiology. J Neural Eng 2023; 20:041001. [PMID: 37279730 DOI: 10.1088/1741-2552/acdbeb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/06/2023] [Indexed: 06/08/2023]
Abstract
Peripheral neuroregeneration research and therapeutic options are expanding exponentially. With this expansion comes an increasing need to reliably evaluate and quantify nerve health. Valid and responsive measures that can serve as biomarkers of the nerve status are essential for both clinical and research purposes for diagnosis, longitudinal follow-up, and monitoring the impact of any intervention. Furthermore, such biomarkers can elucidate regeneration mechanisms and open new avenues for research. Without these measures, clinical decision-making falls short, and research becomes more costly, time-consuming, and sometimes infeasible. As a companion to Part 2, which is focused on non-invasive imaging, Part 1 of this two-part scoping review systematically identifies and critically examines many current and emerging neurophysiological techniques that have the potential to evaluate peripheral nerve health, particularly from the perspective of regenerative therapies and research.
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Affiliation(s)
- Ross Mandeville
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States of America
| | - Benjamin Sanchez
- Department Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112, United States of America
| | - Benjamin Johnston
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, United States of America
| | - Stanley Bazarek
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA 02115, United States of America
| | - Jasmine A Thum
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, United States of America
| | - Austin Birmingham
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, United States of America
| | - Reiner Henson B See
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, United States of America
| | - Carl Froilan D Leochico
- Department of Physical Medicine and Rehabilitation, St. Luke's Medical Center, Global City, Taguig, The Philippines
- Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, The Philippines
| | - Viksit Kumar
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States of America
| | - Arriyan S Dowlatshahi
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States of America
| | - Justin Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, United States of America
| | - Daniel Stashuk
- Department of Systems Design Engineering, University of Waterloo, Ontario N2L 3G1, Canada
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States of America
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3
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Wong EWY, Pandeya S, Crandall H, Smart T, Dixon M, Boucher KM, Florell SR, Grossman D, Sanchez B. Electrical impedance dermography differentiates squamous cell carcinoma in situ from inflamed seborrheic keratoses. JID INNOVATIONS 2023; 3:100194. [PMID: 37066115 PMCID: PMC10090659 DOI: 10.1016/j.xjidi.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 02/22/2023] Open
Abstract
There are no currently available low-cost, noninvasive methods for discerning the depth of squamous cell carcinoma (SCC) invasion or distinguishing SCC from its benign mimics, such as inflamed seborrheic keratosis (SK). We studied 35 subjects with subsequently confirmed SCC or SK. Subjects underwent electrical impedance dermography measurements at six frequencies to assess the electrical properties of the lesion. Averaged greatest intrasession reproducibility values were 0.630 for invasive SCC at 128 kHz, 0.444 for SCC in situ at 16 kHz, and 0.460 for SK at 128 kHz. Electrical impedance dermography modeling revealed significant differences between SCC and inflamed SK in normal skin (P < 0.001) and also between invasive SCC and SCC in situ (P < 0.001), invasive SCC and inflamed SK (P < 0.001), and SCC in situ and inflamed SK (P < 0.001). A diagnostic algorithm classified SCC in situ from inflamed SK with an accuracy of 0.958, a sensitivity of 94.6%, and a specificity of 96.9%; it also classified SCC in situ from normal skin with an accuracy of 0.796, a sensitivity of 90.2%, and a specificity of 51.2%. This study provides preliminary data and a methodology that can be used in future studies to further advance the value of electrical impedance dermography and inform biopsy decision making in patients with lesions suspicious of SCC.
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Malyško-Ptašinskė V, Staigvila G, Novickij V. Invasive and non-invasive electrodes for successful drug and gene delivery in electroporation-based treatments. Front Bioeng Biotechnol 2023; 10:1094968. [PMID: 36727038 PMCID: PMC9885012 DOI: 10.3389/fbioe.2022.1094968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Electroporation is an effective physical method for irreversible or reversible permeabilization of plasma membranes of biological cells and is typically used for tissue ablation or targeted drug/DNA delivery into living cells. In the context of cancer treatment, full recovery from an electroporation-based procedure is frequently dependent on the spatial distribution/homogeneity of the electric field in the tissue; therefore, the structure of electrodes/applicators plays an important role. This review focuses on the analysis of electrodes and in silico models used for electroporation in cancer treatment and gene therapy. We have reviewed various invasive and non-invasive electrodes; analyzed the spatial electric field distribution using finite element method analysis; evaluated parametric compatibility, and the pros and cons of application; and summarized options for improvement. Additionally, this review highlights the importance of tissue bioimpedance for accurate treatment planning using numerical modeling and the effects of pulse frequency on tissue conductivity and relative permittivity values.
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Affiliation(s)
| | - Gediminas Staigvila
- Faculty of Electronics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Vitalij Novickij
- Faculty of Electronics, Vilnius Gediminas Technical University, Vilnius, Lithuania
- Department of Immunology, State Research Institute Centre of Innovative Medicine, Vilnius, Lithuania
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5
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Mueller M, Thompson R, Osman KL, Andel E, Dejonge C, Kington S, Stephenson Z, Hamad A, Bunyak F, Nichols NL, Lever TE. Impact of Limb Phenotype on Tongue Denervation Atrophy, Dysphagia Penetrance, and Survival Time in a Mouse Model of ALS. Dysphagia 2022; 37:1777-1795. [PMID: 35426522 PMCID: PMC9568622 DOI: 10.1007/s00455-022-10442-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/28/2022] [Indexed: 12/16/2022]
Abstract
Current treatments for dysphagia in ALS do not target the underlying tongue weakness and denervation atrophy that is prevalent in spinal and bulbar ALS cases. To address this clinical gap, we studied the low copy number SOD1-G93A (LCN-SOD1) mouse model of ALS to quantify the impact of limb phenotype on tongue denervation atrophy, dysphagia penetrance, and survival time in preparation for future treatment-based studies. Two male LCN-SOD1 breeders and 125 offspring were followed for limb phenotype inheritance, of which 52 (30 LCN-SOD1 and 22 wild-type/WT, both sexes) underwent characterization of dysphagia penetrance (via videofluoroscopic swallow study; VFSS) and survival time at disease end-stage (15-20% body weight loss). From these, 16 mice (8/genotype) underwent postmortem histological analysis of the genioglossus for evidence of denervation atrophy. Results revealed that both breeders displayed a mixed (hindlimb and forelimb) ALS phenotype and sired equal proportions of hindlimb vs. mixed phenotype offspring. Dysphagia penetrance was complete for mixed (100%) versus incomplete for hindlimb (64%) phenotype mice; yet survival times were similar. Regardless of limb phenotype, LCN-SOD1 mice had significantly smaller genioglossus myofibers and more centralized myonuclei compared to WT mice (p < 0.05). These biomarkers of denervation atrophy were significantly correlated with VFSS metrics (lick and swallow rates, p < 0.05) but not survival time. In conclusion, both LCN-SOD1 phenotypes had significant tongue denervation atrophy, even hindlimb phenotype mice without dysphagia. This finding recapitulates human ALS, providing robust rationale for using this preclinical model to explore targeted treatments for tongue denervation atrophy and ensuing dysphagia.
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Affiliation(s)
| | | | - Kate L. Osman
- Department of Otolaryngology – Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO, USA
| | - Ellyn Andel
- University of Missouri Students, Columbia, MO, USA
| | | | | | | | - Ali Hamad
- University of Missouri Students, Columbia, MO, USA
| | - Filiz Bunyak
- Department of Electrical Engineering and Computer Science, University of Missouri College of Engineering, Columbia, MO, USA
| | - Nicole L. Nichols
- Department of Biomedical Sciences, University of Missouri College of Veterinary Medicine, Columbia, MO, USA
| | - Teresa E. Lever
- Department of Otolaryngology – Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO, USA,Department of Biomedical Sciences, University of Missouri College of Veterinary Medicine, Columbia, MO, USA
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6
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Kangasmaa O, Laakso I. Estimation method for the anisotropic electrical conductivity of in vivo human muscles and fat between 10 kHz and 1 MHz. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac9a1e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Abstract
Objective. In low frequency dosimetry the variability in the electrical conductivity values assigned to body model tissues represents a major source of uncertainty. The aim of this study is to propose a method for estimating the conductivity of human anisotropic skeletal muscle and fat in vivo in the frequency range from 10 kHz to 1 MHz. Approach. A method based on bounded electrical impedance tomography was used. Bioimpedance measurements were performed on the legs of ten subjects. Anatomically realistic models of the legs were then created using magnetic resonance images. The inverse problem of the tissue conductivities was solved using the finite element method. The results were validated using resampling techniques. These findings were also used to study the effects of muscle anisotropy on magnetic field exposure. Main results. The estimated conductivities for anisotropic muscle were found to be in good agreement with values found in existing literature and the anisotropy was shown to decrease with increasing frequency, with the ratio of lateral to longitudinal conductivity increasing from 37% to 64%. The conductivity of fat was found to be almost a constant 0.07 S m−1 in the frequency range considered. Significance. The proposed method was shown to be a viable option when estimating in vivo conductivity of human tissue. The results can be used in numerical dosimetry calculations or as limits in future investigations studying conductivity with bioimpedance measurements.
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Goryachev I, Tresansky AP, Ely GT, Chrzanowski SM, Nagy JA, Rutkove SB, Anthony BW. Comparison of Quantitative Ultrasound Methods to Classify Dystrophic and Obese Models of Skeletal Muscle. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:1918-1932. [PMID: 35811236 DOI: 10.1016/j.ultrasmedbio.2022.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
In this study, we compared multiple quantitative ultrasound metrics for the purpose of differentiating muscle in 20 healthy, 10 dystrophic and 10 obese mice. High-frequency ultrasound scans were acquired on dystrophic (D2-mdx), obese (db/db) and control mouse hindlimbs. A total of 248 image features were extracted from each scan, using brightness-mode statistics, Canny edge detection metrics, Haralick features, envelope statistics and radiofrequency statistics. Naïve Bayes and other classifiers were trained on single and pairs of features. The a parameter from the Homodyned K distribution at 40 MHz achieved the best univariate classification (accuracy = 85.3%). Maximum classification accuracy of 97.7% was achieved using a logistic regression classifier on the feature pair of a2 (K distribution) at 30 MHz and brightness-mode variance at 40MHz. Dystrophic and obese mice have muscle with distinct acoustic properties and can be classified to a high level of accuracy using a combination of multiple features.
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Affiliation(s)
- Ivan Goryachev
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Anne Pigula Tresansky
- Harvard-MIT Program in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Gregory Tsiang Ely
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Stephen M Chrzanowski
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Janice A Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian W Anthony
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
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8
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Cooper RL, Thomas MA, McLetchie DN. Impedance Measures for Detecting Electrical Responses during Acute Injury and Exposure of Compounds to Roots of Plants. Methods Protoc 2022; 5:mps5040056. [PMID: 35893582 PMCID: PMC9351684 DOI: 10.3390/mps5040056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Electrical activity is widely used for assessing a plant's response to an injury or environmental stimulus. Commonly, a differential electrode recording between silver wire leads with the reference wire connected to the soil, or a part of the plant, is used. One method uses KCl-filled glass electrodes placed into the plant, similar to recording membrane/cell potentials in animal tissues. This method is more susceptible to artifacts of equipment noise and photoelectric effects than an impedance measure. An impedance measure using stainless steel wires is not as susceptible to electrically induced noises. Impedance measurements are able to detect injury in plants as well as exposure of the roots to environmental compounds (glutamate). The impedance measures were performed in 5 different plants (tomato, eggplant, pepper, liverwort, and Coleus scutellarioides), and responses to mechanical movement of the plant, as well as injury, were recorded. Monitoring electrical activity in a plant that arises in a distant plant was also demonstrated using the impedance method. The purpose of this report is to illustrate the ease in using impedance measures for monitoring electrical signals from individual plants or aggregates of plants for potentially scaling for high throughput and monitoring controlled culturing and outdoor field environments.
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9
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Kwon H, Park HC, Barrera AC, Rutkove SB, Sanchez B. On the measurement of skeletal muscle anisotropic permittivity property with a single cross-shaped needle insertion. Sci Rep 2022; 12:8494. [PMID: 35589764 PMCID: PMC9120124 DOI: 10.1038/s41598-022-12289-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/09/2022] [Indexed: 11/10/2022] Open
Abstract
Application of minimally invasive methods to enable the measurement of tissue permittivity in the neuromuscular clinic remain elusive. This paper provides a theoretical and modeling study on the measurement of the permittivity of two-dimensional anisotropic tissues such as skeletal muscle with a multi-electrode cross-shaped needle. For this, we design a novel cross-shaped needle with multiple-electrodes and analyse apparent impedance corresponding to the measured impedance. In addition, we propose three methods of estimate anisotropic muscle permittivity. Compared to existing electrical impedance-based needle methods that we have developed, the new needle design and numerical methods associated enable estimating in vivo muscle permittivity values with only a single needle insertion. Being able to measure muscle permittivity directly with a single needle insertion could open up an entirely new area of research with direct clinical application, including using these values to assist in neuromuscular diagnosis and to assess subtle effects of therapeutic intervention on muscle health.
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Affiliation(s)
- Hyeuknam Kwon
- Division of Software, Yonsei University, Wonju, Republic of Korea.
| | - Hyoung Churl Park
- Department of Mathematics, Yonsei University, Wonju, Republic of Korea
| | - Albert Cheto Barrera
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT, 84112, USA.
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10
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Altered electrical properties in skeletal muscle of mice with glycogen storage disease type II. Sci Rep 2022; 12:5327. [PMID: 35351934 PMCID: PMC8964715 DOI: 10.1038/s41598-022-09328-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/14/2022] [Indexed: 01/15/2023] Open
Abstract
Electrical impedance methods, including electrical impedance myography, are increasingly being used as biomarkers of muscle health since they measure passive electrical properties of muscle that alter in disease. One disorder, Pompe Disease (Glycogen storage disease type II (GSDII)), remains relatively unstudied. This disease is marked by dramatic accumulation of intracellular myofiber glycogen. Here we assessed the electrical properties of skeletal muscle in a model of GSDII, the Pompe6neo/6neo (Pompe) mouse. Ex vivo impedance measurements of gastrocnemius (GA) were obtained using a dielectric measuring cell in 30-week-old female Pompe (N = 10) and WT (N = 10) mice. Longitudinal and transverse conductivity, σ, and the relative permittivity, εr, and Cole–Cole complex resistivity parameters at 0 Hz and infinite frequency, ρo and ρ∞, respectively, and the intracellular resistivity, ρintracellular were determined from the impedance data. Glycogen content (GC) was visualized histologically and quantified biochemically. At frequencies > 1 MHz, Pompe mice demonstrated significantly decreased longitudinal and transverse conductivity, increased Cole–Cole parameters, ρo and ρo-ρ∞, and decreased ρintracellular. Changes in longitudinal conductivity and ρintracellular correlated with increased GC in Pompe animals. Ex vivo high frequency impedance measures are sensitive to alterations in intracellular myofiber features considered characteristic of GSDII, making them potentially useful measures of disease status.
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Luo X, Wang S, Rutkove SB, Sanchez B. Nonhomogeneous volume conduction effects affecting needle electromyography: an analytical and simulation study. Physiol Meas 2021; 42:10.1088/1361-6579/ac38c0. [PMID: 34763321 PMCID: PMC8744488 DOI: 10.1088/1361-6579/ac38c0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/11/2021] [Indexed: 12/30/2022]
Abstract
Objective.Needle electromyography (EMG) is used to study the electrical behavior of myofiber properties in patients with neuromuscular disorders. However, due to the complexity of electrical potential spatial propagation in nonhomogeneous diseased muscle, a comprehensive understanding of volume conduction effects remains elusive. Here, we develop a framework to study the conduction effect of extracellular abnormalities and electrode positioning on extracellular local field potential (LFP) recordings.Methods.The framework describes the macroscopic conduction of electrical potential in an isotropic, nonhomogeneous (i.e. two tissue) model. Numerical and finite element model simulations are provided to study the conduction effect in prototypical monopolar EMG measurements.Results.LFPs recorded are influenced in amplitude, phase and duration by the electrode position in regards to the vicinity of tissue with different electrical properties.Conclusion.The framework reveals the influence of multiple mechanisms affecting LFPs including changes in the distance between the source-electrode and tissue electrical properties.Clinical significance.Our modeled predictions may lead to new ways for interpreting volume conduction effects on recorded EMG activity, for example in neuromuscular diseases that cause structural and compositional changes in muscle tissue. These change will manifest itself by changing the electric properties of the conductor media and will impact recorded potentials in the area of affected tissue.
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Affiliation(s)
- Xuesong Luo
- Department of Automation Science and Electric Engineering, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100083, China
- Sanchez Research Lab, Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112-9206, USA
| | - Shaoping Wang
- Department of Automation Science and Electric Engineering, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100083, China
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Benjamin Sanchez
- Sanchez Research Lab, Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112-9206, USA
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Pandeya SR, Nagy JA, Riveros D, Semple C, Taylor RS, Sanchez B, Rutkove SB. Relationships between in vivo surface and ex vivo electrical impedance myography measurements in three different neuromuscular disorder mouse models. PLoS One 2021; 16:e0259071. [PMID: 34714853 PMCID: PMC8555802 DOI: 10.1371/journal.pone.0259071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
Electrical impedance myography (EIM) using surface techniques has shown promise as a means of diagnosing and tracking disorders affecting muscle and assessing treatment efficacy. However, the relationship between such surface-obtained impedance values and pure muscle impedance values has not been established. Here we studied three groups of diseased and wild-type (WT) animals, including a Duchenne muscular dystrophy model (the D2-mdx mouse), an amyotrophic lateral sclerosis (ALS) model (the SOD1 G93A mouse), and a model of fat-related atrophy (the db/db diabetic obese mouse), performing hind limb measurements using a standard surface array and ex vivo measurements on freshly excised gastrocnemius muscle. A total of 101 animals (23 D2-mdx, 43 ALS mice, 12 db/db mice, and corresponding 30 WT mice) were studied with EIM across a frequency range of 8 kHz to 1 MHz. For both D2-mdx and ALS models, moderate strength correlations (Spearman rho values generally ranging from 0.3-0.7, depending on the impedance parameter (i.e., resistance, reactance and phase) were obtained. In these groups of animals, there was an offset in frequency with impedance values obtained at higher surface frequencies correlating more strongly to impedance values obtained at lower ex vivo frequencies. For the db/db model, correlations were comparatively weaker and strongest at very high and very low frequencies. When combining impedance data from all three disease models together, moderate correlations persisted (with maximal Spearman rho values of 0.45). These data support that surface EIM data reflect ex vivo muscle tissue EIM values to a moderate degree across several different diseases, with the highest correlations occurring in the 10-200 kHz frequency range. Understanding these relationships will prove useful for future applications of the technique of EIM in the assessment of neuromuscular disorders.
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Affiliation(s)
- Sarbesh R. Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Janice A. Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Daniela Riveros
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Carson Semple
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Rebecca S. Taylor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah, United States of America
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
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13
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Luo X, Sanchez B. In silicomuscle volume conduction study validates in vivomeasurement of tongue volume conduction properties using a user tongue array depressor. Physiol Meas 2021; 42. [PMID: 33690188 DOI: 10.1088/1361-6579/abed36] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/09/2021] [Indexed: 01/24/2023]
Abstract
Objective.Electrophysiological assessment of the tongue volume conduction properties (VCPs) using our novel multi-electrode user tongue array (UTA) depressor has the promise to serve as a biomarker in patients with bulbar dysfunction. However, whetherin vivodata collected using the UTA depressor accurately reflect the tongue VCPs remains unknown.Approach.To address this question, we performedin silicosimulations of the depressor with an accurate anatomical tongue finite element model (FEM) using healthy human tongue VCP values, namely the conductivity and the relative permittivity, in the sagittal plane (i.e. longitudinal direction) and axial and coronal planes (i.e. transverse directions). We then established the relationship between tongue VCP values simulated from our model to measured human data.Main results.Experimental versus simulated tongue VCP values including their spatial variation were in good agreement with differences well within the variability of the experimental results. Tongue FEM simulations corroborate the feasibility of our UTA depressor in assessing tongue VCPs.Significance.The UTA depressor is a new non-invasive and safe tool to measure tongue VCPs. These electrical properties reflect the tongue's ionic composition and cellular membrane integrity and could serve as a novel electrophysiological biomarker in neurological disorders affecting the tongue.
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Affiliation(s)
- Xuesong Luo
- Sanchez Research Lab, Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112-9206, United States of America
| | - Benjamin Sanchez
- Sanchez Research Lab, Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112-9206, United States of America
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Mabrouk S, Whittingslow D, Inan OT. Robust Method for Mid-Activity Tracking and Evaluation of Ankle Health Post-Injury. IEEE Trans Biomed Eng 2021; 68:1341-1350. [PMID: 32997618 DOI: 10.1109/tbme.2020.3027477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To present a robust methodology for evaluating ankle health during ambulation using a wearable device. Methods: We developed a novel data capture system that leverages changes within the ankle during ambulation for real-time tracking of bioimpedance. The novel analysis compares the range of reactance at 5 kHz to the range of reactance at 100 kHz; which removes the technique's previous reliance on a known baseline. To aid in interpretation of the measurements, we developed a quantitative simulation model based on a literature review of the effects on joint bioimpedance of variations in edematous fluid volume, muscle fiber tears, and blood flow changes. Results: The results of the simulation predicted a significant difference in the ratio of the range of the reactance from 5 kHz to 100 kHz between the healthy and injured ankles. These results were validated in 15 subjects - with 11 healthy ankles and 7 injured ankles measured. The injured subjects had lateral ankle sprains 2-4 weeks prior to the measurement. The analysis technique differentiated between the healthy and the injured population (p<<0.01), and a correlation (R = 0.8) with a static protocol previously validated for its sensitivity to edema. Conclusion: The technology presented can detect variations in ankle edema and structural integrity of ankles, and thus could provide valuable feedback to clinicians and patients during the rehabilitation of an ankle injury. Significance: This technology could lead to better-informed decision making regarding a patient's readiness to return to activity and / or tailoring rehabilitation activities to an individual's changing needs.
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Cardoner MMDM, Kwon H, Pulido HVG, Nagy J, Rutkove S, Sanchez B. Modeling and Reproducibility of Twin Concentric Electrical Impedance Myography. IEEE Trans Biomed Eng 2021; 68:3068-3077. [PMID: 33661730 DOI: 10.1109/tbme.2021.3063724] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Electrical impedance myography (EIM) is a recent technology to assess muscle health. As of today, the clinical application of EIM has been applied only to evaluate muscle condition using non-invasive surface electrodes in contact with the skin; however, intermediate tissues at the recording site introduce confounding artifacts which reduce the technique's performance as a biomarker of neuromuscular disorders (NMD). Here, we develop and test in humans a new approach using two concentric needles for intramuscular EIM recordings. METHODS First, we study the recording characteristics of dual concentric needle EIM via analytical models and finite element models (FEMs). Next, the validity of the models is verified by performing experiments on saline and agar phantoms. Finally, 8 subjects with various neuromuscular diseases were studied measuring tibialis anterior, biceps, deltoid, adductor pollicis brevis, first dorsal interosseous and flexor carpi radialis muscles. RESULTS Analytical and FEM simulations are in good agreement with a maximum experimental discrepancy 8% and 9% using gauge needles 26 and 30, respectively. The inter-session reproducibility, as measured by the intraclass correlation coefficients for all muscles studied, was 0.926, which is comparable or exceeds the reproducibility of other well-established electrophysiological tests to assess muscle health. CONCLUSION The reproducibility of the technique support future clinical validation of needle EIM for assessment of disease status, either as part of standard patient care or as biomarker measure in clinical trials. SIGNIFICANCE Needle EIM has the potential of becoming a valuable diagnostic tool to evaluate NMD in adult population.
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Bachasson D, Ayaz AC, Mosso J, Canal A, Boisserie JM, Araujo ECA, Benveniste O, Reyngoudt H, Marty B, Carlier PG, Hogrel JY. Lean regional muscle volume estimates using explanatory bioelectrical models in healthy subjects and patients with muscle wasting. J Cachexia Sarcopenia Muscle 2021; 12:39-51. [PMID: 33377299 PMCID: PMC7890267 DOI: 10.1002/jcsm.12656] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/22/2020] [Accepted: 11/05/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The availability of non-invasive, accessible, and reliable methods for estimating regional skeletal muscle volume is paramount in conditions involving primary and/or secondary muscle wasting. This work aimed at (i) optimizing serial bioelectrical impedance analysis (SBIA ) by computing a conductivity constant based on quantitative magnetic resonance imaging (MRI) data and (ii) investigating the potential of SBIA for estimating lean regional thigh muscle volume in patients with severe muscle disorders. METHODS Twenty healthy participants with variable body mass index and 20 patients with idiopathic inflammatory myopathies underwent quantitative MRI. Anatomical images and fat fraction maps were acquired in thighs. After manual muscle segmentation, lean thigh muscle volume (lVMRI ) was computed. Subsequently, multifrequency (50 to 350 kHz) serial resistance profiles were acquired between current skin electrodes (i.e. ankle and hand) and voltage electrodes placed on the anterior thigh. In vivo values of the muscle electrical conductivity constant were computed using data from SBIA and MRI gathered in the right thigh of 10 healthy participants. Lean muscle volume (lVBIA ) was derived from SBIA measurements using this newly computed constant. Between-day reproducibility of lVBIA was studied in six healthy participants. RESULTS Electrical conductivity constant values ranged from 0.82 S/m at 50 kHz to 1.16 S/m at 350 kHz. The absolute percentage difference between lVBIA and lVMRI was greater at frequencies >270 kHz (P < 0.0001). The standard error of measurement and the intra-class correlation coefficient for lVBIA computed from measurements performed at 155 kHz (i.e. frequency with minimal difference) against lVMRI were 6.1% and 0.95 in healthy participants and 9.4% and 0.93 in patients, respectively. Between-day reproducibility of lVBIA was as follows: standard error of measurement = 4.6% (95% confidence interval [3.2, 7.8] %), intra-class correlation coefficient = 0.98 (95% confidence interval [0.95, 0.99]). CONCLUSIONS These findings demonstrate a strong agreement of lean muscle volume estimated using SBIA against quantitative MRI in humans, including in patients with severe muscle wasting and fatty degeneration. SBIA shows promises for non-invasive, fast, and accessible estimation and follow-up of lean regional skeletal muscle volume for transversal and longitudinal studies.
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Affiliation(s)
- Damien Bachasson
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Alper Carras Ayaz
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Jessie Mosso
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Aurélie Canal
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Jean-Marc Boisserie
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Ericky C A Araujo
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology and Inflammation-Immunopathology-Biotherapy Department (I2B), Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris, East Paris Neuromuscular Diseases Reference Center, Inserm U974, Sorbonne Université, Paris, France
| | - Harmen Reyngoudt
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Benjamin Marty
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Pierre G Carlier
- Institute of Myology, Neuromuscular Investigation Center, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Jean-Yves Hogrel
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
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Luo X, Victoria Gutierrez Pulido H, Rutkove S, Sanchez B. A Bioimpedance-Based Device to Assess the Volume Conduction Properties of the Tongue in Neurological Disorders Affecting Bulbar function. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2021; 2:278-285. [PMID: 35402988 PMCID: PMC8940204 DOI: 10.1109/ojemb.2021.3117871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 12/03/2022] Open
Abstract
Goal: Current instruments for bulbar assessment exhibit technical limitations that hinder the execution of clinical studies. The volume conduction properties (VCP) of the tongue reflect ionic content and myofiber integrity and they can serve as a new biomarker for evaluating neurological disorders with bulbar dysfunction. Methods: We designed a standalone bioimpedance measurement system that enables accurate, multi-frequency measurement of tongue anisotropic VCP including conductivity and relative permittivity. The system includes a tongue depressor with 16 non-invasive surface sensors for electrical contact with the tongue at directions 0\documentclass[12pt]{minimal}
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}{}$^{\circ }$\end{document}. The depressor is interfaced with the tongue electronic system with Bluetooth connectivity, and a smartphone application. De-identified patient data is sent by email. Results: We first determined the accuracy of the hardware performing phantom measurements mimicking a broad range of tongue values and determined the error to be \documentclass[12pt]{minimal}
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}{}$< $\end{document}1%. We then validated our new technology measuring a cohort of 7 healthy human subjects under Institutional Review Board approval. Conclusions: None of the subjects who participated suffered discomfort or gag reflexes. The novel technique presented for intra-oral assessment of tongue VCP provides standard, objective and quantitative data potentially sensitive to alterations in tongue internal structure and composition.
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Affiliation(s)
- Xuesong Luo
- Sanchez Research Lab, Department of Electrical and Computer EngineeringUniversity of Utah Salt Lake City UT 84112 USA
| | | | - Seward Rutkove
- Department of Neurology, Beth Israel Deaconess Medical CenterHarvard Medical School Boston MA 02115 USA
| | - Benjamin Sanchez
- Sanchez Research Lab, Department of Electrical and Computer EngineeringUniversity of Utah Salt Lake City UT 84112 USA
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Pandeya SR, Nagy JA, Riveros D, Semple C, Taylor RS, Mortreux M, Sanchez B, Kapur K, Rutkove SB. Predicting myofiber cross-sectional area and triglyceride content with electrical impedance myography: A study in db/db mice. Muscle Nerve 2021; 63:127-140. [PMID: 33063867 PMCID: PMC8891989 DOI: 10.1002/mus.27095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/02/2020] [Accepted: 10/11/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Electrical impedance myography (EIM) provides insight into muscle composition and structure. We sought to evaluate its use in a mouse obesity model characterized by myofiber atrophy. METHODS We applied a prediction algorithm, ie, the least absolute shrinkage and selection operator (LASSO), to surface, needle array, and ex vivo EIM data from db/db and wild-type mice and assessed myofiber cross-sectional area (CSA) histologically and triglyceride (TG) content biochemically. RESULTS EIM data from all three modalities provided acceptable predictions of myofiber CSA with average root mean square error (RMSE) of 15% in CSA (ie, ±209 μm2 for a mean CSA of 1439 μm2 ) and TG content with RMSE of 30% in TG content (ie, ±7.3 nmol TG/mg muscle for a mean TG content of 25.4 nmol TG/mg muscle). CONCLUSIONS EIM combined with a predictive algorithm provides reasonable estimates of myofiber CSA and TG content without the need for biopsy.
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Affiliation(s)
- Sarbesh R. Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Janice A. Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Daniela Riveros
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Carson Semple
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Rebecca S. Taylor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Marie Mortreux
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Benjamin Sanchez
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, Utah
| | - Kush Kapur
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seward B. Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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In vivo muscle conduction study of the tongue using a multi-electrode tongue depressor. Clin Neurophysiol 2020; 132:683-687. [PMID: 33309468 DOI: 10.1016/j.clinph.2020.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/08/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To test a novel technology for assessment of the volume conduction properties (VCPs) of the tongue. These properties are electrophysiological data that might reflect alterations in patients with tongue involvement. METHODS Seven healthy individuals were self-measured. The depressor was placed on the surface of the anterior tongue. Directional differences of VCPs were determined with standard descriptive statistics. RESULTS Conductivity in longitudinal direction was larger than in transverse direction at 16 (p < 0.05), 32 (p < 0.05), 64 (p < 0.01), and 128 kHz (p < 0.01). No differences were found in relative permittivity. The intraclass correlation was 0.778 and 0.771, respectively. CONCLUSIONS Our technology provides, for the first time, VCPs of the healthy human tongue. SIGNIFICANCE Tongue VCPs are standard electrophysiological, quantitative and objective data reflecting ionic content and membrane integrity which could find value for diagnostic purposes and treatment monitoring.
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Sanchez B, Martinsen OG, Freeborn TJ, Furse CM. Electrical impedance myography: A critical review and outlook. Clin Neurophysiol 2020; 132:338-344. [PMID: 33450556 DOI: 10.1016/j.clinph.2020.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/31/2020] [Accepted: 11/18/2020] [Indexed: 12/30/2022]
Abstract
Electrical impedance myography (EIM) technology is finding application in neuromuscular disease research as a tool to assess muscle health. Correlations between EIM outcomes, functional, imaging and histological data have been established in a variety of neuromuscular disorders; however, an analytical discussion of EIM is lacking. This review presents an explanation for clinicians and others who are applying EIM and interpreting impedance outcomes. The background of EIM is presented, including the relation between EIM, volume conduction properties, tissue structure, electrode configuration and conductor volume. Also discussed are technical considerations to guide the reader to critically evaluate EIM and understand its limitations and strengths.
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Affiliation(s)
- Benjamin Sanchez
- Sanchez Research Lab, Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112, USA.
| | - Orjan G Martinsen
- Department of Physics, University of Oslo, 0371 Oslo, Norway; Department of Clinical and Biomedical Engineering, Oslo University Hospital, Oslo 0372, Norway
| | - Todd J Freeborn
- Department of Electrical and Computer Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA
| | - Cynthia M Furse
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT 84112, USA
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Wu M, Pu K, Jiang T, Zhai Q, Ma Z, Ma H, Xu F, Zhang Z, Wang Q. Early label-free analysis of mitochondrial redox states by Raman spectroscopy predicts septic outcomes. J Adv Res 2020; 28:209-219. [PMID: 33364057 PMCID: PMC7753238 DOI: 10.1016/j.jare.2020.06.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/10/2020] [Accepted: 06/29/2020] [Indexed: 12/20/2022] Open
Abstract
Resonance Raman spectroscopy was applied to in vivo detection of the mitochondrial redox state in septic mice for the first time. Monitoring mitochondrial redox states using resonance Raman spectroscopy had higher prognostic accuracy for mortality than the lactate level during sepsis and could be a novel diagnostic marker for predicting septic outcomes at an early time point. Resonance Raman spectroscopy could detect mitochondrial dysfunction in sepsis and provide a biomarker that can be a specific target of adjunctive treatment.
Background Sepsis remains an unacceptably high mortality due to the lack of biomarkers for predicting septic outcomes in the early period. Mitochondrial redox states play a pivotal role in this condition and are disturbed early in the development of sepsis. Here, we hypothesized that visualizing mitochondrial redox states via resonance Raman spectroscopy (RRS) could identify septic outcomes at an early time point. Sepsis was induced by cecal ligation and puncture (CLP). We applied RRS analysis at baseline and 30 min, 1 h, 2 h, 4 h, and 6 h after CLP, and the mitochondrial redox states were identified. The levels of blood lactate as a predictor in sepsis were assessed. Our study is the first to reveal the possibility of in vivo detection of the mitochondrial redox state by using RRS in septic mice. The peak area for the Raman reduced mitochondrial fraction, the indicator of mitochondrial redox states, fluctuated significantly at 2 h after CLP. This fluctuation occurred earlier than the change in lactate level. Moreover, this fluctuation had higher prognostic accuracy for mortality than the lactate level during sepsis and could be a novel diagnostic marker for predicting septic outcomes according to the cutoff value of 1.059, which had a sensitivity of 80% and a specificity of 90%. Objectives To explore an effective indicator concerning mitochondrial redox states in the early stage of sepsis and to predict septic outcomes accurately in vivo using non-invasive and label-free Resonance Raman spectroscopy (RRS) analysis. Methods Mitochondria, primary skeletal muscle cells andex-vivo muscles harvested from gastrocnemius were detected mitochondrial redox states respectively by using RRS. Sepsis was induced by cecal ligation and puncture (CLP). We applied RRS analysis at baseline and 30 min, 1 h, 2 h, 4 h, and 6 h after CLP, and the mitochondrial redox states were identified. The levels of blood lactate as a predictor in sepsis were assessed. The predictive correlation of mitochondrial redox states on mortality, inflammation and organ dysfunction was further assessed. Results Mitochondrial redox states were clearly recognized in ex-vivo gastrocnemius muscles as well as purified mitochondria and primary skeletal muscle cells by using RRS. The peak area for the Raman reduced mitochondrial fraction, the indicator of mitochondrial redox states, fluctuated significantly at 2 h after CLP. This fluctuation occurred earlier than the change in lactate level. Moreover, this fluctuation had higher prognostic accuracy for mortality than the lactate level during sepsis and could be a novel diagnostic marker for predicting septic outcomes according to the cutoff value of 1.059, which had a sensitivity of 80% and a specificity of 90%. Conclusions This study demonstrated that monitoring mitochondrial redox states using RRS as early as 2 h could indicate outcomes in septic mice. These data may contribute to developing a non-invasive clinical device concerning mitochondrial redox states by using bedside-RRS.
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Affiliation(s)
- Meiyan Wu
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Kairui Pu
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Tao Jiang
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Qian Zhai
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Zhi Ma
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Hongli Ma
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Fuxing Xu
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Zhanqin Zhang
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Qiang Wang
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
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Impedance Measures and a Mounting Technique for Drosophila: Larval Movements, Heart Rate, Imaging, and Electrophysiology. Methods Protoc 2020; 3:mps3010012. [PMID: 31991683 PMCID: PMC7189670 DOI: 10.3390/mps3010012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 12/12/2022] Open
Abstract
Monitoring movements of larval Drosophila with electrical detection allows one to record the behaviors without the use of lights and cameras. This is a suitable technique when studying the use of light-sensitive proteins in optogenetic studies. Electrical measures are feasible to use in determining when a larva starts to move or continues to move after a light induced activation of channelrhodopsin. We have developed a technique using an electrical measure of the media as an index of larval movement. As a proof of concept, recordings with an infrared camera of the larval movement were simultaneous made with electrical measures. The two techniques parallel each other in their ability to index larval movements. Bright light-emitting diode (LED) lights used in optogenetic experiments tend to saturate the detectors of the camera unless filters are used and different filters maybe necessary depending on the LED spectrum and sensitivity of the camera. Impedance measures are independent of the type of LED or brightness. We also assessed the use of a non-solvent based glue (3M Vetbond) to hold larvae in place while measuring synaptic function of neuromuscular junctions, cardiac function and influence of modulators, or activation of light-sensitive channels.
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Leitner ML, Kapur K, Darras BT, Yang M, Wong B, Dalle Pazze L, Florence J, Buck M, Freedman L, Bohorquez J, Rutkove S, Zaidman C. Electrical impedance myography for reducing sample size in Duchenne muscular dystrophy trials. Ann Clin Transl Neurol 2019; 7:4-14. [PMID: 31876124 PMCID: PMC6952321 DOI: 10.1002/acn3.50958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 01/16/2023] Open
Abstract
Objective To evaluate the sensitivity of electrical impedance myography (EIM) to disease progression in both ambulatory and non‐ambulatory boys with DMD. Methods and Participants A non‐blinded, longitudinal cohort study of 29 ambulatory and 15 non‐ambulatory boys with DMD and age‐similar healthy boys. Subjects were followed for up to 1 year and assessed using the Myolex® mViewTM EIM system as part of a multicenter study. Results In the ambulatory group, EIM 100 kHz resistance values showed significant change compared to the healthy boys. For example, in lower extremity muscles, the average change in EIM 100 kHz resistance values over 12 months led to an estimated effect size of 1.58. Based on these results, 26 DMD patients/arm would be needed for a 12‐month clinical trial assuming a 50% treatment effect. In non‐ambulatory boys, EIM changes were greater in upper limb muscles. For example, biceps at 100kHz resistance gave an estimated effect size of 1.92 at 12 months. Based on these results, 18 non‐ambulatory DMD patients/arm would be needed for a 12‐month clinical trial assuming a 50% treatment effect. Longitudinal changes in the 100 kHz resistance values for the ambulatory boys correlated with the longitudinal changes in the timed supine‐to‐stand test. EIM was well‐tolerated throughout the study. Interpretation This study supports that EIM 100 kHz resistance is sensitive to DMD progression in both ambulatory and non‐ambulatory boys. Given the technology’s ease of use and broad age range of utility it should be employed as an exploratory endpoint in future clinical therapeutic trials in DMD. Trial Registration: Clincialtrials.gov registration #NCT02340923
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Affiliation(s)
| | - Kush Kapur
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Basil T Darras
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Michele Yang
- Department of Neurology, Children's Hospital Colorado, Denver, Colorado
| | - Brenda Wong
- Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Julaine Florence
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
| | | | | | | | | | - Craig Zaidman
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
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Clark-Matott J, Nagy JA, Sanchez B, Taylor R, Riveros D, Abraham NA, Simon DK, Rutkove SB. Altered muscle electrical tissue properties in a mouse model of premature aging. Muscle Nerve 2019; 60:801-810. [PMID: 31531861 DOI: 10.1002/mus.26714] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/07/2019] [Accepted: 09/11/2019] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Improved methods are needed to detect and quantify age-related muscle change. In this study we assessed the electrical properties of muscle impacted by acquired mitochondrial DNA mutations via the PolG mouse, which exhibits typical age-associated features, and the impact of a potential therapy, nicotinamide mononucleotide (NMN). METHODS The gastrocnemii of 24 PolG and 30 wild-type (WT) mice (8 PolG and 17 WT treated with NMN) were studied in an electrical impedance-measuring cell. Conductivity and relative permittivity were determined from the impedance data. Myofiber cross-sectional area (CSA) was quantified histologically. RESULTS Untreated PolG mice demonstrated alterations in several impedance features, including 50-kHz relative permittivity and center frequency. A potential effect of NMN was also observed in these parameters in PolG but not WT animals. Impedance values correlated with myofiber CSA. DISCUSSION Electrical impedance is sensitive to myofiber features considered characteristic of aging and to the impact of a potential therapy.
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Affiliation(s)
- Joanne Clark-Matott
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Janice A Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Benjamin Sanchez
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Rebecca Taylor
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Daniela Riveros
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Neeta A Abraham
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - David K Simon
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Kwon H, de Morentin MM, Nagy JA, Rutkove SB, Sanchez B. Approximate complex electrical potential distribution in the monodomain model with unequal conductivity and relative permittivity anisotropy ratios. Physiol Meas 2019; 40:085008. [PMID: 31408853 DOI: 10.1088/1361-6579/ab3aa1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Electrical conductivity and relative permittivity are properties that indicate muscle health and they have different values parallel and perpendicular to the direction of the myofiber, a concept known as anisotropy. When the intrinsic electrical properties of muscle have ratios of anisotropy that are different then there is no analytical solution that can describe the electrical potential distribution in the tissue. APPROACH Here, we present approximate analytical solutions to monodomain equations with unequal anisotropy ratios. For this, we base our analysis on perturbation theory where the electrical potential is approximated by the sum of the zeroth- and first-order terms of an infinite series. MAIN RESULTS The validity of the approach is confirmed using experimental data for healthy and diseased muscle available online. SIGNIFICANCE A better understanding of electrical potential distribution in anisotropic skeletal muscle tissue will allow the development of improved diagnostic tools for neuromuscular diseases.
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Affiliation(s)
- H Kwon
- College of Science and Technology, Yonsei University, Wonju 26493, Republic of Korea
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