Global Innervation Zone Identification with High-Density Surface Electromyography

Objective: The aim of this study is to compare the performance of three strategies in determining the global innervation zone (IZ) distribution. Methods: High-density surface electromyography was recorded from the biceps brachii muscle of seven healthy subjects under isometric voluntary contractions at 20%, 50%, and 100% of the maximal voluntary contraction and supramaximal musculocutaneous nerve stimulations. IZs were detected: first, by visual identification in a column-specific manner (IZ-1D); second, based on decomposed bipolar mapping of motor unit action potentials (IZ-2D); and third, by source imaging in the three-dimensional muscle space (IZ-3D). Results: All three IZ detection approaches have exhibited excellent trial-to-trial repeatability. Consistent IZ results were found in the axial direction of the arm across all three approaches, yet a difference was observed in the mediolateral direction. Conclusions: Among all three approaches, IZ-3D is capable of providing the most comprehensive information regarding the global IZ distribution, while maintaining high consistency with IZ-1D and IZ-2D results. Significance: IZ-3D approach can be a potential tool for global IZ imaging, which is critical to the clinical diagnosis and treatment of neuromuscular disorders.