肯尼迪病的EMG特点及其诊断价值OA

Objective To investigate the EMG characteristics of Kennedy's disease and the diagnostic value of the EMG specificity.Methods Twenty-nine patients with varying degrees of muscle atrophy who visited our hospital between June 2018 and May 2024 were selected as the study subjects.Seven patients diagnosed with Kennedy's disease via genetic testing served as the observation group(KD group),and compared with the remaining 12 patients with cervical spondylotic myelopathy(CS group)and 10 patients with motor neuron disease(MND group).The motor nerve conduction velocity,amplitude(CMAP),sensory nerve conduction velocity,amplitude(SNAP),and the latency of F wave and the appearance rate of giant F-waves of the median,ulnar,tibial,peroneal,sural and superficial peroneal nerves were tested in all recruited patients,respectively.The needle electrode EMG was used to detect nine groups of muscles including the hyoid muscle,trapezius muscle,etc.,which were dominated by bulbar,cervical,thoracic and lumbar segments,respectively.The EMG-related parameters of the three groups were compared and statistically analyzed.Results The differences of the rates of muscle weakness,limb numbness,decreased sexual function,hyponasality,muscle twitching,dysphagia,gynecomastia,spinal MRI abnormalities,and abnormal muscle enzymes among KD group,CS group and MND group were statistically significant(all P＜0.05).The SNAP of median,ulnar,superficial peroneal and sural nerves in KD group were significantly lower than those in CS and MND groups,and the SNAP of sural nerve in MND group was significantly higher than that in CS group(all P＜0.05).The CMAP of the median nerve in MND group was significantly lower than those in KD and CS groups(both P＜0.05).The CMAP of the ulnar nerve in KD group was significantly lower than those in CS and MND groups(both P＜0.05).The CMAP of the tibial,peroneal nerves in KD and MND groups were significantly lower than those in the CS group(all P＜0.05).The motor nerve conduction velocity of the peroneal nerve in KD group was significantly lower than those in CS and MND groups(both P＜0.05).The incidence of giant F-waves in the motor nerves of KD group was significantly higher than that in CS group(P＜0.05).The normal rates of needle electrode EMG of the bulbar,thoracic and lumbar segments in CS group were significantly higher than those in KD group(all P＜0.05).The active damage rates of needle electrode EMG of the bulbar and thoracic segments in MND group were significantly higher than those in KD group(all P＜0.05).The chronic damage rates of needle electrode EMG of cervical,thoracic and lumbar segments in KD group were 100%,respectively.The chronic damage rates of needle electrode EMG of bulbar,thoracic and lumbar segments in KD group were significantly higher than those in CS group(all P＜0.05).The chronic damage rate of needle electrode EMG of thoracic segment in KD group was significantly higher than that in MND group(P＜0.05).Conclusion The EMG of Kennedy's disease has its specificity,and its specificity has a certain screening,diagnostic and differential diagnostic significance for Kennedy's disease.