A rare type of fibrillation-like EMG activity

Non peer reviewe

Muscle Pain and Muscle Spindles

Muscle pain is a common symptom associated with, for example, myofascial syndrome, fibromyalgia and polymyalgia rheumatica. Many diseases of the muscle tissue are, however, completely or nearly painless such as polymyositis and inclusion body myositis. Thus, a mere inflammation cannot be the cause of muscle pain. In needle electromyography (EMG), the insertion of a needle electrode causes pain but further advancement is usually painless. However, there are small spots of muscle tissue where sudden pain is elicited with the needle. In EMG, these ‘active spots’ are observed to produce spontaneous activity in the form of end plate noise and spikes (EPSs). End plate noise is elicited at the neuromuscular junction of α, β or γ motor neuron. EPSs are action potentials of γ or β motor units. Muscle spindles are the main nociceptors in muscle tissue, both in healthy muscle and in diseases with muscle pain by inflammation of the muscle spindles. Multiple possible mechanisms of muscle pain exist. Polymyalgia rheumatica may have interstitial pain and possibly pain associated with muscle spindle capsules. Delayed onset muscle soreness may reflect both interstitial muscle pain caused by minor injuries and pain generated in mildly inflamed muscle spindles

Electromyography of the muscle spindle

In needle electromyography, there are two spontaneous waveforms, miniature end plate potentials and "end plate spikes", appearing usually together. Miniature end plate potentials are local, non-propagating postsynaptic waves, caused by spontaneous exocytosis of acetylcholine in the neuromuscular junction. The prevailing hypothesis states that "end plate spikes" are propagated postsynaptic action potentials of muscle fibers, caused by presynaptic irritation of the motor nerve or nerve terminal. Using several small concentric needle electrodes in parallel with the muscle fibers, most "end plate spikes" are strictly local or propagating for 2-4 mm. At the end plate zone, there are miniature end plate potentials without "end plate spikes". Local "end plate spikes" are junctional potentials of intrafusal gamma neuromuscular junctions of the nuclear bag fibers, and propagated "end plate spikes" are potentials of nuclear chain muscle fibers of muscle spindles. Miniature end plate potentials without "end plate spikes" at the end plate zone derive from alpha neuromuscular junctions. These findings contrast with the prevailing hypothesis. The history of observations and different hypotheses of the origin of end plate spikes are described.Peer reviewe

Optimal digital filters for analyzing the mid-latency auditory P50 event-related potential in patients with Alzheimer's disease

Background: Filtering is an effective pre-processing technique for improving the signal-to-noise ratio of ERP waveforms. Filters can, however, introduce substantial distortions into the time-domain representations of ERP waveforms. Inappropriate filter parameters may lead to the presence of statistically significant but artificial effects, whereas true effects may appear as insignificant. New method: The present study aimed to determine the optimal digital filters for analyzing the auditory P50 component in patients with Alzheimer's disease. To provide evidence of the optimal filter settings, different high-pass and low-pass filters were applied to ERP waveforms obtained from a conditioning testing paradigm. The results facilitate practical recommendations for selection of filters that maximize the signal-to-noise ratio of the P50 components without introducing significant distortions. Results: The present study confirms that filter parameters have a significant effect on the amplitude and gating measures of the P50 component. Setting the high-pass cut-off at 0.1 Hz and the low-pass cut-off at 90Hz (or above) is recommended for P50 component analyses. Comparison with existing methods: The majority of ERP studies on sensory gating report using high-pass filters with 10-Hz cut-offs to measure P50 suppression. Such a high cut-off appeared to induce significant distortions into the ERP waveforms; thus, the authors advise against using these excessive high-pass cut-offs. Conclusions: Filtering broadband signals, such as ERP signals, necessary results in time-domain distortions. However, by adjusting the filter parameters carefully according to the components of interest, it is possible to minimize filter artifacts and obtain more easily interpretable ERP waveforms. (C) 2016 Elsevier B.V. All rights reserved.Peer reviewe

Muscle activity and acute stress in fibromyalgia

Background: Fibromyalgia (FM) patients are likely to differ from healthy controls in muscle activity and in reactivity to experimental stress. Methods: We compared psychophysiological reactivity to cognitive stress between 51 female FM patients aged 18 to 65 years and 31 age- and sex-matched healthy controls. They underwent a 20-minute protocol consisting of three phases of relaxation and two phases of cognitive stress. We recorded surface electromyography normalized to maximum voluntary muscle contraction (%EMG), the percentage of time with no muscle activity (EMG rest time), and subjective pain and stress intensities. We compared group reactivity using linear modelling and adjusted for psychological and life-style factors. Results: The FM patients had a significantly higher mean %EMG (2.2 % vs. 1.0 %, p <0.001), pain intensity (3.6 vs. 0.2, p <0.001), and perceived stress (3.5 vs. 1.4, p <0.001) and lower mean EMG rest time (26.7 % vs. 47.2 %, p <0.001). In the FM patients, compared with controls, the pain intensity increased more during the second stress phase (0.71, p = 0.028), and the %EMG decreased more during the final relaxation phase (-0.29, p = 0.036). Within the FM patients, higher BMI predicted higher %EMG but lower stress. Leisure time physical activity predicted lower %EMG and stress and higher EMG rest time. Higher perceived stress predicted lower EMG rest time, and higher trait anxiety predicted higher pain and stress overall. Conclusions: Our results suggest that repeated cognitive stress increases pain intensity in FM patients. FM patients also had higher resting muscle activity, but their muscle activity did not increase with pain. Management of stress and anxiety might help control FM flare-ups.Peer reviewe

FinnGen provides genetic insights from a well-phenotyped isolated population.

Population isolates such as those in Finland benefit genetic research because deleterious alleles are often concentrated on a small number of low-frequency variants (0.1% ≤ minor allele frequency < 5%). These variants survived the founding bottleneck rather than being distributed over a large number of ultrarare variants. Although this effect is well established in Mendelian genetics, its value in common disease genetics is less explored1,2. FinnGen aims to study the genome and national health register data of 500,000 Finnish individuals. Given the relatively high median age of participants (63 years) and the substantial fraction of hospital-based recruitment, FinnGen is enriched for disease end points. Here we analyse data from 224,737 participants from FinnGen and study 15 diseases that have previously been investigated in large genome-wide association studies (GWASs). We also include meta-analyses of biobank data from Estonia and the United Kingdom. We identified 30 new associations, primarily low-frequency variants, enriched in the Finnish population. A GWAS of 1,932 diseases also identified 2,733 genome-wide significant associations (893 phenome-wide significant (PWS), P < 2.6 × 10-11) at 2,496 (771 PWS) independent loci with 807 (247 PWS) end points. Among these, fine-mapping implicated 148 (73 PWS) coding variants associated with 83 (42 PWS) end points. Moreover, 91 (47 PWS) had an allele frequency of <5% in non-Finnish European individuals, of which 62 (32 PWS) were enriched by more than twofold in Finland. These findings demonstrate the power of bottlenecked populations to find entry points into the biology of common diseases through low-frequency, high impact variants