The diagnostic power of motor unit potential analysis: An objective Bayesian approach

Authors
Citation
G. Pfeiffer, The diagnostic power of motor unit potential analysis: An objective Bayesian approach, MUSCLE NERV, 22(5), 1999, pp. 584-591
Citations number
37
Categorie Soggetti
da verificare
Journal title
MUSCLE & NERVE
ISSN journal
0148639X → ACNP
Volume
22
Issue
5
Year of publication
1999
Pages
584 - 591
Database
ISI
SICI code
0148-639X(199905)22:5<584:TDPOMU>2.0.ZU;2-W
Abstract
The notion of a "myopathic" or "neuropathic" electromyogram (EMG) is usuall y based on qualitative visual and acoustical impressions. Conventional quan tification defines abnormality but not diagnosis, which requires interpreta tion of patterns of change, Discriminant analysis is a model for this multi variate decision. It tells how probable it is that a motor unit potential ( MUP) comes from a normal, myopathic, or neuropathic muscle. Accumulation of single MUP information by a sequential Bayesian algorithm produced diagnos tic probabilities above 0.95 in 91% of all muscles (223 biceps brachii musc les from 80 patients with motoneuron disorders, 56 patients with neuropathi es, 71 patients with myopathies, and 34 controls). Two muscles from patient s with neurogenic disorders were misclassified as "myopathic." Misclassific ation was more frequent only in myositis (4 of 28 muscles) and in oculophar yngeal muscular dystrophy (2 of 4 muscles). MUP discriminant classification was as sensitive as, and more specific than, conventional quantitative EMG , which discriminated between myopathic and neuropathic in only 22% of the muscles. This rate was 59% for discriminant analysis. As a knowledge-based expert system, MUP discriminant analysis successfully distinguishes between myopathic, neuropathic, and unclassifiable MUP samples. It discloses more information than conventional quantitative MUP analysis. (C) 1999 John Wile y & Sons, Inc.