Surface electromyography for characterizing neuromuscular changes in diabetic peripheral neuropathy

Area of Science:

• Biomedical Engineering
• Neurology
• Diabetology

Background:

• Distal symmetric polyneuropathy (DSP) is the most prevalent complication of diabetes, accounting for 75% of diabetic neuropathies.
• DSP can lead to severe consequences such as plantar ulcers and lower limb amputation.
• Early detection is crucial for timely therapeutic interventions and improved patient outcomes.

Purpose of the Study:

• To investigate the utility of surface electromyography (sEMG) parameters derived from isometric and dynamic exercises as potential biomarkers for early DSP detection.
• To assess the effectiveness of sEMG in identifying individuals at risk for DSP and monitoring disease progression.
• To evaluate changes in muscle electrical activity associated with DSP.

Main Methods:

• The study included 61 participants: 34 controls and 27 patients with varying DSP severity.
• sEMG signals were recorded from four lower limb muscles: tibialis anterior, medial gastrocnemius, extensor digitorum brevis, and flexor digitorum brevis.
• Recorded sEMG signals were analyzed for amplitude, frequency, complexity, and shape characteristics during isometric and dynamic exercises.

Main Results:

• Significant differences in sEMG parameters were observed between control and diabetic groups, particularly in the extensor and flexor digitorum muscles.
• Diabetic patients exhibited reduced sEMG amplitude and complexity, alongside increased frequency, peakedness, and asymmetry.
• These alterations were evident during both isometric and dynamic exercise protocols, indicating compromised neuromuscular function.

Conclusions:

• Specific sEMG parameters, including root mean square and sample entropy, demonstrated efficacy in distinguishing between control and DSP groups.
• The findings suggest alterations in motor unit recruitment and muscle quality in individuals with DSP.
• sEMG serves as a promising non-invasive tool for monitoring neuromuscular changes in diabetes, with both isometric and dynamic exercises offering complementary insights.