Normalization procedures using maximum voluntary isometric contractions for the serratus anterior and trapezius muscles during surface EMG analysis.

The serratus anterior and trapezius muscles are considered to be the only upward rotators of the scapula and are very important for normal shoulder function. A variety of methods have been used to produce a maximum voluntary isometric contraction (MVIC) of these muscles for normalization of EMG data. The purpose of this study was to quantify the surface EMG activity of the serratus anterior muscle and the upper, middle, and lower parts of the trapezius during 9 manual muscle tests performed with maximum effort in 30 subjects. It was found that no one muscle test produced a MVIC for all individuals. Therefore, to perform normalization within each subject, it is suggested that the 2 or 3 tests identified in this study that produce high levels of EMG activity for each muscle be performed. The scapular protraction muscle test that is often used to normalize data for the serratus anterior muscle produced relatively low levels of EMG activity and was not found to be an optimal test. Muscle tests in which an attempt was made to de-rotate the scapula from an upwardly rotated position produced much higher levels of EMG activity in the serratus anterior muscle.     

Motor responses to positive-pressure breathing in the developing opossum

The suckling opossum exhibits an expiration-phased discharge in abdominal muscles during positive-pressure breathing (PPB); the response becomes apparent, however, only after the 3rd-5th wk of postnatal life. The purpose of this study was to determine whether the early lack of activation represented a deficiency of segmental outflow to abdominal muscles or whether comparable effects were observed in cranial outflows to muscles of the upper airways due to immaturity of afferent and/or supraspinal pathways. Anesthetized suckling opossums between 15 and 50 days of age were exposed to PPB; electromyogram (EMG) responses in diaphragm and abdominal muscles were measured, along with EMG of larynx dilator muscles and/or upper airway resistance. In animals older than approximately 30 days of age, the onset of PPB was associated with a prolonged expiration-phased EMG activation of larynx dilator muscles and/or decreased upper airway resistance, along with expiratory recruitment of the abdominal muscle EMG. These effects persisted as long as the load was maintained. Younger animals showed only those responses related to the upper airway; in fact, activation of upper airway muscles during PPB could be associated with suppression of the abdominal motor outflow. After unilateral vagotomy, abdominal and upper airway motor responses to PPB were reduced. The balance between PPB-induced excitatory and inhibitory or disfacilitory influences from the supraspinal level on abdominal motoneurons and/or spinal processing of information from higher centers may shift toward net excitation as the opossum matures.     

Lumbar spinal muscle activation synergies predicted by multi-criteria cost function

The hypothesis that control of lumbar spinal muscle synergies is biomechanically optimized was studied by comparing EMG data with an analytical model with a multi-component cost function that could include (1) trunk displacements, (2) intervertebral displacements, (3) intervertebral forces; (4) sum of cubed muscle stresses, and (5) eigenvalues for the first two spinal buckling modes. The model's independent variables were 180 muscle forces. The 36 displacements of 6 vertebrae were calculated from muscle forces and the spinal stiffness. Calculated muscle activation was compared with EMG data from 14 healthy human subjects who performed isometric voluntary ramped maximum efforts at angles of 0 degrees, 45 degrees, 90 degrees, 135 degrees and 180 degrees to the right from the anterior direction. Muscle activation at each angle was quantified as the linear regression slope of the RMS EMG versus external force relationship, normalized by the maximum observed EMG.There was good agreement between the analytical model and EMG data for the dorsal muscles when the model included either minimization of intervertebral displacements or minimization of intervertebral forces in its cost function, but the model did not predict a realistic level of abdominal muscles activation. Agreement with EMG data was improved with the sum of the cubed muscle stresses added to the cost function. Addition of a cost function component to maximize the trunk stability produced higher levels of antagonistic muscle activation at low efforts than at greater efforts. It was concluded that the muscle activation strategy efficiently limits intervertebral forces and displacements, and that costs of higher muscle stresses are taken into account, but stability does not appear to be maximized. Trunk muscles are apparently not controlled solely to optimize any one of the biomechanical costs considered here.     

Temporalis and masseter muscle function during incision in macaques and humans

Most previously published electromyographic (EMG) studies have indicated that the temporalis muscles in humans become almost electrically quiet during incisai biting. These data have led various workers to conclude that these muscles may contribute little to the incisai bite force. The feeding behavior and comparative anatomy of the incisors and temporalis muscles of certain catarrhine primates, however, suggest that the temporalis muscle is an important and powerful contributor to the bite force during incision. One purpose of this study is to analyze the EMG activity of the masseter and temporalis muscles in both humans and macaques with the intention of focusing on the conflict between published EMG data on humans and inferences of muscle function based on the comparative anatomy and behavior of catarrhine primates. The EMG data collected from humans in the present study indicate that, in five of seven subjects, the masseter,anterior temporalis, and posterior temporalis muscles are very active during apple incision (i.e., relative to EMG activity levels during apple and almond mastication). In the other two human subjects the EMG levels of these muscles are lower during incision than during mastication, but in no instance are these muscles ever close to becoming electrically quiet. The EMG data on macaques indicate that, in all six subjects, the masseter, anterior temporalis, and posterior temporalis muscles are very active during incision. These data are in general agreement with inferences on muscle function that have been drawn from the comparative anatomy and behavior of primates, but they do not agree with previous experimental data. The reason for this disagreement is probably due to differences in the experimental procedure. In previous studies subjects simply bit isometrically on their incisors and the resulting EMG pattern was compared to the pattern associated with powerful clenching in centric occlusion. In the present study the subjects incised into actual food objects, and the resulting EMG pattern was compared to the pattern associated with mastication of various foods. It is not surprising that these two procedures result in markedly different EMG patterns, which in turn result in markedly different interpretations of jaw-muscle function. In an attempt to explain the evolution of the postorbital septum in anthropoids, it has been suggested that the anterior temporalis is more active than the masseter during incision (Cachel, 1979). The human and macaque EMG data do not support this hypothesis; during incision, the two muscles show no consistent differences in humans and the masseter appears to be in fact more active than the anterior temporalis in macaques.     

Electromagnetic interference on pacemakers

External sources, either within or outside the hospital environment, may interfere with the appropriate function of pacemakers which are being implanted all around the world in current medical practice. The patient and the physician who is responsible for follow-up of the pacing systems may be confronted with some specific problems regarding the various types of electromagnetic interference (EMI). To avoid these unwanted EMI effects one must be aware of this potential problem and need to take some precautions. The effects of EMI on pacemaker function and precautions to overcome some specific problems were discussed in this review article. There are many sources of EMI interacting with pacemakers. Magnetic resonance imaging creates real problem and should be avoided in pacemaker patients. Cellular phones might be responsible for EMI when they were held on the same side with the pacemaker. Otherwise they don't cause any specific type of interaction with pacemakers. Sale security systems are not a problem if one walks through it without lingering in or near it. Patients having unipolar pacemaker systems are prone to develop EMI because of pectoral muscle artifacts during vigorous active physical exercise.     

Reliability and precision of EMG in leg,torso, and arm muscles during running

Changes in electromyographic (EMG) parameters are used to evaluate timing, amplitude, and fatigue of muscle actions during movement. Little published data describe the reliability and precision of multiple EMG parameters, how these parameters compare to one another, and how these parameters vary between muscles. The purpose of this study was to determine the reliability and precision of four EMG parameters recorded from the legs, torso, and arm muscles during running. Fifteen well-trained male runners performed moderate-intensity treadmill running while EMG data were collected from thirteen muscles. Integrated EMG (iEMG), root mean square EMG (RMS), maximum M-wave, and median power frequency (MPF) were calculated for 25 consecutive strides. Intra-class correlation coefficients (ICC) and standard error of measurement (SEM) for each parameter were calculated for each muscle. Seven muscles displayed good reliability (ICC > 0.80) for all parameters studied. MPF was the most reliable variable, with 12 muscles having ICC > 0.80 and <6% normalized SEM. Reliability and precision differed between muscles of similar function and anatomic region. These data emphasize the need for researchers and clinicians to have reliability and precision measures for all parameters of each muscle, and demonstrates that generalizations must be used cautiously when interpreting EMG data collected during running.     

Shoulder and elbow muscle activity during fully supported trajectory tracking in people who have had a stroke

An inability to perform tasks involving reaching is a common problem for stroke patients. This paper provides an insight into mechanisms associated with recovery of upper limb function by examining how stroke participants’ upper limb muscle activation patterns differ from those of neurologically intact participants, and how they change in response to an intervention.In this study, five chronic stroke participants undertook nine tracking tasks in which trajectory (orientation and length), speed and resistance to movement were varied. During these tasks, EMG signals were recorded from triceps, biceps, anterior deltoid, upper, middle and lower trapezius and pectoralis major. Data collection was performed in sessions both before, and after, an intervention in which participants performed a similar range of tracking tasks with the addition of responsive electrical stimulation applied to their triceps muscle. The intervention consisted of eighteen one hour treatment sessions, with two participants attending an additional seven sessions. During all sessions, each participant’s arm was supported by a hinged arm-holder which constrained their hand to move in a two dimensional plane.Analysis of the pre intervention EMG data showed that timing and amplitude of peak EMG activity for all stroke participants differed from neurologically intact participants. Analysis of post intervention EMG data revealed that statistically significant changes in these quantities had occurred towards those of neurologically intact participants.     

Role of triangularis sterni during coughing and sneezing in dogs

Studies in mammals have found that during breathing the triangularis sterni (TS) muscle regulates expiratory airflow and the end-expiratory position of the rib cage and furthermore that the respiratory activity of this muscle is influenced by a variety of chemical and mechanical stimuli. To assess the role of the TS during coughing and sneezing, electromyograms (EMGs) recorded from the TS were compared with EMGs of the transversus abdominis (TA) in eight pentobarbital-anesthetized dogs. During coughing induced by mechanically stimulating the trachea or larynx (n = 7 dogs), peak EMGs increased from 23 +/- 2 to 74 +/- 5 U (P less than 0.00002) for the TS and from 21 +/- 6 to 66 +/- 4 U (P less than 0.0002) for the TA. During sneezing induced by mechanically stimulating the nasal mucosa (n = 3 dogs), peak EMG of the TS increased from 10 +/- 3 to 66 +/- 7 U (P less than 0.005) and peak EMG of the TA increased from 10 +/- 2 to 73 +/- 7 U (P less than 0.02). For both muscles the shape of the EMG changed to an early peaking form during coughs and sneezes. Peak expiratory airflow during coughs of different intensity correlated more closely with peak TS EMG in three dogs and with peak TA EMG in four dogs; peak expiratory airflow during sneezes of different intensity correlated more closely with peak TS than TA EMG in all three animals. These results suggest that the TS is actively recruited during coughing and sneezing and that different neuromuscular strategies may be utilized to augment expiratory airflow.     

Shoulder muscle recruitment patterns during a kayak stroke performed on a paddling ergometer.

Precise muscle co-ordination is required to maintain normal shoulder function and alterations in synchrony between shoulder muscles can result in loss of full range of movement and pain. Although shoulder pain in kayakers is high with 53% of elite international paddlers reporting shoulder injuries, little information is available regarding the pattern of shoulder muscle recruitment during paddling. The aim of this study was to investigate the normal recruitment pattern of shoulder muscles during the kayak stroke. Nine recreational paddlers without shoulder pain were examined. EMG data from eight shoulder muscles of the dominant arm were collected simultaneously with video data during simulated paddling on an ergometer. EMG data was normalized to time and peak amplitude. Intersubject consistency was evaluated using Pearson correlation analysis. The results of this study indicated a fair to high correlation in at least one phase of the kayak stroke in five of the muscles examined: upper trapezius, supraspinatus, latissimus dorsi, serratus anterior and rhomboid major. This normative data will enable comparisons with the shoulder muscle recruitment patterns in kayakers with shoulder pain in order to determine the role of altered motor control in the painful kayaking shoulder.     

Hybrid neuromusculoskeletal modeling to best track joint moments using a balance between muscle excitations derived from electromyograms and optimization

Current electromyography (EMG)-driven musculoskeletal models are used to estimate joint moments measured from an individual?s extremities during dynamic movement with varying levels of accuracy. The main benefit is the underlying musculoskeletal dynamics is simulated as a function of realistic, subject-specific, neural-excitation patterns provided by the EMG data. The main disadvantage is surface EMG cannot provide information on deeply located muscles. Furthermore, EMG data may be affected by cross-talk, recording and post-processing artifacts that could adversely influence the EMG?s information content. This limits the EMG-driven model?s ability to calculate the multi-muscle dynamics and the resulting joint moments about multiple degrees of freedom. We present a hybrid neuromusculoskeletal model that combines calibration, subject-specificity, EMG-driven and static optimization methods together. In this, the joint moment tracking errors are minimized by balancing the information content extracted from the experimental EMG data and from that generated by a static optimization method. Using movement data from five healthy male subjects during walking and running we explored the hybrid model?s best configuration to minimally adjust recorded EMGs and predict missing EMGs while attaining the best tracking of joint moments. Minimally adjusted and predicted excitations substantially improved the experimental joint moment tracking accuracy than current EMG-driven models. The ability of the hybrid model to predict missing muscle EMGs was also examined. The proposed hybrid model enables muscle-driven simulations of human movement while enforcing physiological constraints on muscle excitation patterns. This might have important implications for studying pathological movement for which EMG recordings are limited.     

Special problems of pacing in children

The number of children suffering from congenital or acquired rhythm disorders, and therefore being pacemaker dependent, is very small. This is one of the reasons why a special hardware has never been developed for this cohort. Pacemaker implantation into children does not differ substantially from operations in adults. But there are several important points which have to be fulfilled in these small patients in order to guarantee a complication free function. As most of these children remain pacemaker dependent a lifetime, it is of tremendous importance to minimize all revisions regarding the implanted systems and to enable our small patients a high and therefore nearly normal quality of life. Pros and cons of different surgical approaches, implantation sites and the problem of growth after pacemaker implantation in children are considered.     

A systematic method to quantify the presence of cross-talk in stimulus-evoked EMG responses: implications for TMS studies

Surface electromyography (EMG) responses to noninvasive nerve and brain stimulation are routinely used to provide insight into neural function in humans. However, this could lead to erroneous conclusions if evoked EMG responses contain significant contributions from neighboring muscles (i.e., due to "cross-talk"). We addressed this issue with a simple nerve stimulation method to provide quantitative information regarding the size of EMG cross-talk between muscles of the forearm and hand. Peak to peak amplitude of EMG responses to electrical stimulation of the radial, median, and ulnar nerves (i.e., M-waves) were plotted against stimulation intensity for four wrist muscles and two hand muscles (n = 12). Since electrical stimulation can selectively activate specific groups of muscles, the method can differentiate between evoked EMG arising from target muscles and EMG cross-talk arising from nontarget muscles. Intramuscular EMG responses to nerve stimulation and root mean square EMG produced during maximal voluntary contractions (MVC) of the wrist were recorded for comparison. Cross-talk was present in evoked surface EMG responses recorded from all nontarget wrist (5.05-39.38% Mmax) and hand muscles (1.50-24.25% Mmax) and to a lesser degree in intramuscular EMG signals (～3.7% Mmax). The degree of cross-talk was comparable for stimulus-evoked responses and voluntary activity recorded during MVC. Since cross-talk can make a considerable contribution to EMG responses in forearm and hand muscles, care is required to avoid misinterpretation of EMG data. The multiple nerve stimulation method described here can be used to quantify the potential contribution of EMG cross-talk in transcranial magnetic stimulation and reflex studies.     

EMG activity in hyoid muscles during pig suckling

Infant suckling is a complex behavior that includes cycles of rhythmic sucking as well as intermittent swallows. This behavior has three cycle types: 1) suck cycles, when milk is obtained from the teat and moved posteriorly into the valleculae in the oropharynx; 2) suck-swallow cycles, which include both a rhythmic suck and a pharyngeal swallow, where milk is moved out of the valleculae, past the larynx, and into the esophagus; and 3) postswallow suck cycles, immediately following the suck-swallow cycles. Because muscles controlling these behaviors are active in all three types of cycles, we tested the hypothesis that different patterns of electromyographic (EMG) activity in the mylohyoid, hyoglossus, stylohyoid, and thyrohyoid muscles of the pig characterized each cycle type. Anterior mylohyoid EMG activity occurred regularly in every cycle and was used as a cycle marker. Thyrohyoid activity, indicating the pharyngeal swallow, was immediately preceded by increased stylohyoid and hyoglossus activity; it divided the suck-swallow cycle into two phases. Timed from the onset of the suck-swallow cycle, the first phase had a relatively fixed duration while the duration of the second phase, timed from the thyrohyoid, varied directly with cycle duration. In short-duration cycles, the second phase could have a zero duration so that thyrohyoid activity extended into the postswallow cycle. In such cycles, all swallowing activity that occurred after the thyrohyoid EMG and was associated with bolus passage through the pharynx fell into the postswallow cycle. These data suggest that while the activity of some muscles, innervated by trigeminal and cervical plexus nerves, may be time locked to the cycle onset in swallowing, the cycle period itself is not. The postswallow cycle consequently contains variable amounts of pharyngeal swallowing EMG activity. The results exemplify the complexity of the relationship between rhythmic sucking and the swallow.     

Comparisons of the variability of three markers of the human circadian pacemaker

A circadian pacemaker within the central nervous system regulates the approximately 24-h physiologic rhythms in sleep cycles, hormone secretion, and other physiologic functions. Because the pacemaker cannot be examined directly in humans, markers of pacemaker function must be used to study the pacemaker and its response to environmental stimuli. Core body temperature (CBT), plasma cortisol, and plasma melatonin are three marker variables frequently used to estimate the phase of the human pacemaker. Measurements of circadian phase using markers can contain variability due to the circadian pacemaker itself, the intrinsic variability of the marker relative to the pacemaker, the method of analysis of the marker, and the marker assay. For this report, we compared the mathematical variability of a number of methods of identifying circadian phase from CBT, plasma cortisol, and plasma melatonin data collected in a protocol in which pacemaker variability was minimized using low light levels and regular timing of both the light pattern and the rest/activity schedule. We hoped to assess the relative variabilities of the different physiological markers and the analysis methods. Methods were based on the crossing of an absolute threshold, on the crossing of a relative threshold, or on fitting a curve to all data points. All methods of calculating circadian phase from plasma melatonin data were less variable than those calculated using CBT or cortisol data. The standard deviation for the phase estimates using CBT data was 0.78 h, using cortisol data was 0.65 h, and for the eight analysis methods using melatonin data was 0.23 to 0.35 h. While the variability for these markers might be different for other subject populations and/or less stringent study conditions, assessment of the intrinsic variability of the different calculations of circadian phase can be applied to allow inference of the statistical significance of phase and phase shift calculations, as well as estimation of sample size or statistical power for the number of subjects within an experimental protocol.     

Electromyography of back muscles during quadrupedal and bipedal walking in primates

Despite the extensive electromyographic research that has addressed limb muscle function during primate quadrupedalism, the role of the back muscles in this locomotor behavior has remained undocumented. We report here the results of an electromyographic (EMG) analysis of three intrinsic back muscles (multifidus, longissimus, and iliocostalis) in the baboon (Papio anubis), chimpanzee (Pan troglodytes), and orangutan (Pongo pygmaeus) during quadrupedal walking. The recruitment patterns of these three back muscles are compared to those reported for the same muscles during nonprimate quadrupedalism. In addition, the function of the back muscles during quadrupedalism and bipedalism in the two hominoids is compared. Results indicate that the back muscles restrict trunk movements during quadrupedalism by contracting with the touchdown of one or both feet, with more consistent activity associated with touchdown of the contralateral foot. Moreover, despite reported differences in their gait preferences and forelimb muscle EMG patterns, primates and nonprimate mammals recruit their back muscles in an essentially similar fashion during quadrupedal walking. These quadrupedal EMG patterns also resemble those reported for chimpanzees, gibbons and humans (but not orangutans) walking bipedally. The fundamental similarity in back muscle function across species and locomotor behaviors is consistent with other data pointing to conservatism in the evolution of the neural control of tetrapod limb movement, but does not preclude the suggestion (based on forelimb muscle EMG and spinal lesion studies) that some aspects of primate neural circuitry are unique. © 1994 Wiley-Liss, Inc.     

Developmental changes in sequential activation of laryngeal abductor muscle and diaphragm in infants.

In animals and human adults, upper airway muscle activity usually precedes inspiratory diaphragm activity. We examined the interaction of the posterior cricoarytenoid muscle (PCA), which abducts the larynx, and the diaphragm (DIA) in the control of airflow in newborn infants to assess the effect of maturation on respiratory muscle sequence. We recorded tidal volume, airflow, and DIA and PCA electromyograms (EMG) in 12 full-term, 14 premature, and 10 premature infants with apnea treated with aminophylline. In most breaths, onset of PCA EMG activity preceded onset of DIA EMG activity (lead breaths). In all subjects, we also observed breaths (range 6-61%) in which PCA EMG onset followed DIA EMG onset (lag breaths). DIA neural inspiratory duration and the neuromechanical delay between DIA EMG onset and inspiratory flow were longer in lag than in lead breaths (P < 0.05 and P < 0.01, respectively). The frequency of lag breaths was greater in the premature infants [33 +/- 4% (SE)] than in either the full-term infants (21 +/- 3%, P < 0.03) or the premature infants with apnea treated with aminophylline (16 +/- 2%, P < 0.01). We conclude that the expected sequence of onset of PCA and DIA EMG activity is frequently disrupted in newborn infants. Both maturation and respiratory stimulation with aminophylline improve the coordination of the PCA and DIA.     

EMG scanning norms: caveat emptor

Questions are raised as to the appropriateness of applying static normative data to EMG muscle scanning and whether currently available normative data meet standards prescribed by the principles of measurement. Potential sources of systematic measurement error emanating from hardware differences, the practitioner, and the standardization sample are also discussed. An alternative to the fixed normative approach is presented. Specifically it is suggested that raw EMG data values be scaled using a nonlinear data transformation which would result in a derived standard scan score scale. This would also allow for intermuscular and interindividual comparisons, which are not appropriate with the currently used fixed normative approach. Further, the alternative approach adheres to the principle that EMG data must be interpreted relatively and not absolutely. It is argued that this alternative would eliminate systematic error problems with regard to hardware differentials and preclude the necessity of, and the problems endemic to, norms development. Finally there is an explanation on how one could develop a muscle scanning profile similar to that in current use by many personality inventories. The profiles could then be used as normative.     

EMG scanning norms: Caveat emptor

Questions are raised as to the appropriateness of applying static normative data to EMG muscle scanning and whether currently available normative data meet standards prescribed by the principles of measurement. Potential sources of systematic measurement error emanating from hardware differences, the practitioner, and the standardization sample are also discussed. An alternative to the fixed normative approach is presented. Specifically it is suggested that raw EMG data values be scaled using a nonlinear data transformation which would result in a derived standard scan score scale. This would also allow for intermuscular and interindividual comparisons, which are not appropriate with the currently used fixed normative approach. Further, the alternative approach adheres to the principle that EMG data must be interpreted relatively and not absolutely. It is argued that this alternative would eliminate systematic error problems with regard to hardware differentials and preclude the necessity of, and the problems endemic to, norms development. Finally there is an explanation on how one could develop a muscle scanning profile similar to that in current use by many personality inventories. The profiles could then be used as normative.     

Electromyographic normalization procedures for determining exercise intensity of closed chain exercises for strengthening the quadriceps femoris muscles

The purpose of this study was to compare the electromyographic (EMG) amplitudes of the quadriceps femoris (QF) muscles during a maximum voluntary isometric contraction (MVIC) to submaximal and maximal dynamic concentric contractions during active exercises. A secondary purpose was to provide information about the type of contraction that may be most appropriate for normalization of EMG data if one wants to determine if a lower extremity closed chain exercise is of sufficient intensity to produce a strengthening response for the QF muscles. Sixty-eight young healthy volunteers (39 female, 29 male) with no lower extremity pain or injury participated in the study. Surface electrodes recorded EMG amplitudes from the vastus medialis obliquus (VMO), rectus femoris (RF), and vastus lateralis (VL) muscles during 5 different isometric and dynamic concentric exercises. The last 27 subjects performed an additional 4 exercises from which a second data set could be analyzed. Maximum isokinetic knee extension and moderate to maximum closed chain exercises activated the QF significantly more than a MVIC. A 40-cm. lateral step-up exercise produced EMG amplitudes of the QF muscles of similar magnitude as the maximum isokinetic knee extension exercises and would be an exercise that could be considered for strengthening the QF muscles. Most published EMG studies of exercises for the QF have been performed by comparing EMG amplitudes during dynamic exercises to a MVIC. This procedure can lead one to overestimate the value of a dynamic exercise for strengthening the QF muscles. We suggest that when studying the efficacy of a dynamic closed chain exercise for strengthening the QF muscles, the exercise be normalized to a dynamic maximum muscle contraction such as that obtained with knee extension during isokinetic testing.     

Modeling Magnetomyograms of Uterine Contractions during Pregnancy Using a Multiscale Forward Electromagnetic Approach

Understanding the mechanisms of uterine contractions during pregnancy is especially important in predicting the onset of labor and thus in forecasting preterm deliveries. Preterm birth can cause serious health problems in newborns, as well as large financial burdens to society. Various techniques such as electromyography (EMG) and magnetomyography (MMG) have been developed to quantify uterine contractions. However, no widely accepted method to predict labor based on electromagnetic measurement is available. Therefore, developing a biophysical model of EMG and MMG could help better understand uterine contractions, interpret real measurements, and detect labor. In this work, we propose a multiscale realistic model of uterine contractions during pregnancy. At the cellular level, building on bifurcation theory, we apply generalized FitzHugh-Nagumo (FHN) equations that produces both plateau-type and bursting-type action potentials. At the tissue level, we introduce a random fiber orientation model applicable to an arbitrary uterine shape. We also develop an analytical expression for the propagation speed of transmembrane potential. At the organ level, a realistic volume conductor geometry model is provided based on magnetic resonance images of a pregnant woman. To simulate the measurements from the SQUID Array for Reproductive Assessment (SARA) device, we propose a sensor array model. Our model is able to reproduce the characteristics of action potentials. Additionally, we investigate the sensitivity of MMG to model configuration aspects such as volume geometry, fiber orientation, and pacemaker location. Our numerical results show that fiber orientation and pacemaker location are the key aspects that greatly affect the MMG as measured by the SARA device. We conclude that sphere is appropriate as an approximation of the volume geometry. The initial step towards validating the model against real MMG measurement is also presented. Our results show that the model is flexible to mimic the limited-propagation magnetic signature during the emergence and decay of a uterine contraction.