Publicación: JitterAnalyzer: aplicación para el estudio del jitter neuromuscular
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2024-08
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El “jiiter” es un parámetro que está relacionado con la dispersión temporal existente entre los instantes de disparo de los potenciales de fibra muscular de un conjunto de fibras enervadas de la misma unidad motora y que puede verse aumentado cuando existen patologías que afectan a la unión neuromuscular o a la motoneurona. Su estudio se realiza aplicando algoritmos automáticos o de forma manual por los especialistas encargados de obtener los registros de electromiografía y consiste en medir el desfase medio entre los disparos de un tren de potenciales de acción de la unidad motora. El jitter se puede cuantificar utilizando diferentes figuras de mérito, siendo la media de las diferencias consecutivas (MCD) la más común. Los estudios de jitter se pueden realizar en dos escenarios distintos: uno mediante estimulación axonal y otro con contracción muscular voluntaria, y para realizarlos se pueden utilizar varios tipos de electrodos.
El trabajo tiene tres objetivos principales: desarrollar una aplicación que permita medir el jitter, evaluar su precisión en comparación con equipos comerciales de electromiografía (EMG) y compararlo con los dos métodos manuales utilizados para medir el jitter: el método pico-pico y el método flanco-flanco. La aplicación se ha desarrollado en Matlab usando el modelo de arquitectura Modelo-Vista-Controlador (MVC) y se evaluó utilizando datos de 41 registros de pacientes obtenidos en el Hospital Universitario de Navarra. Los resultados muestran que, aunque existen diferencias estadísticamente significativas entre las medidas obtenidas con la aplicación y los equipos comerciales, estas no son clínicamente relevantes. Para el estudio comparativo entre los métodos pico-pico y flanco-flanco se utilizó un banco de 238 señales procedentes del Hospital Universitario Fundación Jiménez Díaz. Este mostró diferencias en las medidas de jitter obtenidas, lo que sugiere que el método elegido puede influir en el diagnóstico clínico en algunos casos, aunque estas diferencias pueden corregirse mediante modelos de regresión.
Jitter is a parameter related to the temporal dispersion between the instants of firing of the muscle fiber potentials of a set of innervated fibers of the same motor unit and which can be increased when there are pathologies that affect the neuromuscular junction or the motor neuron. Jitter studies are carried out by applying automatic algorithms or manually by the specialists and consist of measuring the average phase shift between the firings of a train of action potentials of the motor unit. Jitter can be quantified using different figures of merit, the most common being the mean consecutive differences (MCD). Jitter studies can be carried out in two different scenarios: by means of axonal stimulation and another with voluntary muscle contraction, and various types of electrodes can be used. This work has three main objectives: to develop an application that allows measuring jitter, to evaluate its accuracy in comparison with commercial electromyography (EMG) equipment and to compare it with the two manual methods used to measure jitter: the peak-peak method and the flank-flank method. The application has been developed in Matlab using the Model-View-Controller (MVC) architecture model and was evaluated using data from 41 patient records obtained at the University Hospital of Navarra. The results show that, although there are statistically significant differences between the measurements obtained with the application and the commercial equipment, these are not clinically relevant. For the comparative study between the peak-peak and flank-flank methods, a bank of 238 signals from the Fundación Jiménez Díaz University Hospital was used. This showed differences in the jitter measurements obtained, suggesting that the chosen method may influence the clinical diagnosis in some cases, although these differences can be corrected by regression models.
Jitter is a parameter related to the temporal dispersion between the instants of firing of the muscle fiber potentials of a set of innervated fibers of the same motor unit and which can be increased when there are pathologies that affect the neuromuscular junction or the motor neuron. Jitter studies are carried out by applying automatic algorithms or manually by the specialists and consist of measuring the average phase shift between the firings of a train of action potentials of the motor unit. Jitter can be quantified using different figures of merit, the most common being the mean consecutive differences (MCD). Jitter studies can be carried out in two different scenarios: by means of axonal stimulation and another with voluntary muscle contraction, and various types of electrodes can be used. This work has three main objectives: to develop an application that allows measuring jitter, to evaluate its accuracy in comparison with commercial electromyography (EMG) equipment and to compare it with the two manual methods used to measure jitter: the peak-peak method and the flank-flank method. The application has been developed in Matlab using the Model-View-Controller (MVC) architecture model and was evaluated using data from 41 patient records obtained at the University Hospital of Navarra. The results show that, although there are statistically significant differences between the measurements obtained with the application and the commercial equipment, these are not clinically relevant. For the comparative study between the peak-peak and flank-flank methods, a bank of 238 signals from the Fundación Jiménez Díaz University Hospital was used. This showed differences in the jitter measurements obtained, suggesting that the chosen method may influence the clinical diagnosis in some cases, although these differences can be corrected by regression models.
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Valle Morgado, César (2024) JitterAnalyzer: aplicación para el estudio del jitter neuromuscular. Trabajo Fin de Máster. Universidad de Educación a Distancia (UNED)
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Facultades y escuelas::Facultad de Ciencias
Departamento
Física Matemática y de Fluídos