Dispersion of mean consecutive differences in single‐fiber electromyography increases diagnostic sensitivity for myasthenia gravis
Introduction In this study we aimed to investigate the dispersion of mean consecutive difference (MCD) of concentric needle jitter studies of patients with myasthenia gravis (MG) and its effect on diagnostic sensitivity for MG. Methods One hundred fifty‐three patients, including 76 patients with MG...
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| Veröffentlicht in: | Muscle & nerve 2021-06, Vol.63 (6), p.885-889 |
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| creator | Kojima, Yuta Shibuya, Kazumoto Uzawa, Akiyuki Kano, Hiroki Nakamura, Keigo Yasuda, Manato Suzuki, Yo‐ichi Tsuneyama, Atsuko Suichi, Tomoki Ozawa, Yukiko Misawa, Sonoko Noto, Yu‐ichi Mizuno, Toshiki Kuwabara, Satoshi |
| description | Introduction
In this study we aimed to investigate the dispersion of mean consecutive difference (MCD) of concentric needle jitter studies of patients with myasthenia gravis (MG) and its effect on diagnostic sensitivity for MG.
Methods
One hundred fifty‐three patients, including 76 patients with MG and 77 controls with possible MG who later received another diagnosis, underwent stimulated concentric needle jitter studies of the frontalis muscle. MCD mean, standard deviation (SD), and coefficient of variation (CV) were calculated. Diagnostic sensitivity and specificity were determined using receiver operating characteristic (ROC) analyses.
Results
MG patients showed a significantly greater MCD mean (MG: control, 26.3 μs; 13.5 μs [median]; P |
| doi_str_mv | 10.1002/mus.27236 |
| format | Article |
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In this study we aimed to investigate the dispersion of mean consecutive difference (MCD) of concentric needle jitter studies of patients with myasthenia gravis (MG) and its effect on diagnostic sensitivity for MG.
Methods
One hundred fifty‐three patients, including 76 patients with MG and 77 controls with possible MG who later received another diagnosis, underwent stimulated concentric needle jitter studies of the frontalis muscle. MCD mean, standard deviation (SD), and coefficient of variation (CV) were calculated. Diagnostic sensitivity and specificity were determined using receiver operating characteristic (ROC) analyses.
Results
MG patients showed a significantly greater MCD mean (MG: control, 26.3 μs; 13.5 μs [median]; P < .0001), MCD SD (MG: control, 12.8 μs; 5.1 μs [median]; P < .0001), and MCD CV (MG: control, 46.1; 37.5 [median]; P < .001) than those without MG. An ROC curve of SD showed a large area under the curve (0.88), and a cut‐off value of 7.2 μs, which was calculated by maximum Youden index, exhibited high diagnostic sensitivity (86%) for MG. Combined MCD mean, outliers, and SD criteria showed higher sensitivity (88%) than conventional criteria alone (82%), at the expense of lower specificity. Five MG patients with normal MCD mean and abnormal MCD SD had only ocular symptoms.
Discussion
The dispersion of MCD as measured by MCD SD greater than 7.2 μs is significantly increased in patients with MG and may be a useful measure of abnormal jitter in the diagnosis of MG, especially for identifying patients with mild disease.</description><identifier>ISSN: 0148-639X</identifier><identifier>EISSN: 1097-4598</identifier><identifier>DOI: 10.1002/mus.27236</identifier><identifier>PMID: 33748989</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Coefficient of variation ; concentric needle electrode ; Criteria ; Diagnosis ; diagnostic criteria ; Diagnostic systems ; Dispersion ; Electromyography ; Mathematical analysis ; Mean ; mean consecutive difference ; Medical diagnosis ; Muscles ; Myasthenia ; Myasthenia gravis ; Neuromuscular junctions ; Outliers (statistics) ; Signs and symptoms ; Vibration</subject><ispartof>Muscle & nerve, 2021-06, Vol.63 (6), p.885-889</ispartof><rights>2021 Wiley Periodicals LLC.</rights><rights>2021 Wiley Periodicals, LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4196-fae49b63f06a3f7e893e90983fe70a1449c8f8722a6ec0149d36df5314ab2ae53</citedby><cites>FETCH-LOGICAL-c4196-fae49b63f06a3f7e893e90983fe70a1449c8f8722a6ec0149d36df5314ab2ae53</cites><orcidid>0000-0003-1169-8574</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmus.27236$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmus.27236$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33748989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kojima, Yuta</creatorcontrib><creatorcontrib>Shibuya, Kazumoto</creatorcontrib><creatorcontrib>Uzawa, Akiyuki</creatorcontrib><creatorcontrib>Kano, Hiroki</creatorcontrib><creatorcontrib>Nakamura, Keigo</creatorcontrib><creatorcontrib>Yasuda, Manato</creatorcontrib><creatorcontrib>Suzuki, Yo‐ichi</creatorcontrib><creatorcontrib>Tsuneyama, Atsuko</creatorcontrib><creatorcontrib>Suichi, Tomoki</creatorcontrib><creatorcontrib>Ozawa, Yukiko</creatorcontrib><creatorcontrib>Misawa, Sonoko</creatorcontrib><creatorcontrib>Noto, Yu‐ichi</creatorcontrib><creatorcontrib>Mizuno, Toshiki</creatorcontrib><creatorcontrib>Kuwabara, Satoshi</creatorcontrib><title>Dispersion of mean consecutive differences in single‐fiber electromyography increases diagnostic sensitivity for myasthenia gravis</title><title>Muscle & nerve</title><addtitle>Muscle Nerve</addtitle><description>Introduction
In this study we aimed to investigate the dispersion of mean consecutive difference (MCD) of concentric needle jitter studies of patients with myasthenia gravis (MG) and its effect on diagnostic sensitivity for MG.
Methods
One hundred fifty‐three patients, including 76 patients with MG and 77 controls with possible MG who later received another diagnosis, underwent stimulated concentric needle jitter studies of the frontalis muscle. MCD mean, standard deviation (SD), and coefficient of variation (CV) were calculated. Diagnostic sensitivity and specificity were determined using receiver operating characteristic (ROC) analyses.
Results
MG patients showed a significantly greater MCD mean (MG: control, 26.3 μs; 13.5 μs [median]; P < .0001), MCD SD (MG: control, 12.8 μs; 5.1 μs [median]; P < .0001), and MCD CV (MG: control, 46.1; 37.5 [median]; P < .001) than those without MG. An ROC curve of SD showed a large area under the curve (0.88), and a cut‐off value of 7.2 μs, which was calculated by maximum Youden index, exhibited high diagnostic sensitivity (86%) for MG. Combined MCD mean, outliers, and SD criteria showed higher sensitivity (88%) than conventional criteria alone (82%), at the expense of lower specificity. Five MG patients with normal MCD mean and abnormal MCD SD had only ocular symptoms.
Discussion
The dispersion of MCD as measured by MCD SD greater than 7.2 μs is significantly increased in patients with MG and may be a useful measure of abnormal jitter in the diagnosis of MG, especially for identifying patients with mild disease.</description><subject>Coefficient of variation</subject><subject>concentric needle electrode</subject><subject>Criteria</subject><subject>Diagnosis</subject><subject>diagnostic criteria</subject><subject>Diagnostic systems</subject><subject>Dispersion</subject><subject>Electromyography</subject><subject>Mathematical analysis</subject><subject>Mean</subject><subject>mean consecutive difference</subject><subject>Medical diagnosis</subject><subject>Muscles</subject><subject>Myasthenia</subject><subject>Myasthenia gravis</subject><subject>Neuromuscular junctions</subject><subject>Outliers (statistics)</subject><subject>Signs and symptoms</subject><subject>Vibration</subject><issn>0148-639X</issn><issn>1097-4598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10btuFDEYhmELgcgSKLgBZIkGikl8Wo9dohwAKYgCItGNvJ7fG0cz9uJ_Jmg6Ci6Aa-RK8GoDBRKVm8evbH2EPOfshDMmTscZT0QrpH5AVpzZtlFrax6SFePKNFraL0fkCeItY4wb3T4mR1K2ylhjV-THecQdFIw50RzoCC5RnxOCn6d4B7SPIUCB5AFpTBRj2g7w6_vPEDdQKAzgp5LHJW-L290slfgCDivuo9umjFP0FCFhrLU4LTTkQsfF4XQDKTpar91FfEoeBTcgPLs_j8n15cXns3fN1ce378_eXDVecaub4EDZjZaBaSdDC8ZKsMwaGaBljitlvQmmFcJp8PXvtpe6D2vJldsIB2t5TF4duruSv86AUzdG9DAMLkGesRNrJrVW2ohKX_5Db_NcUn1dVcIwrq3dq9cH5UtGLBC6XYmjK0vHWbefphv32f001b64L86bEfq_8s8WFZwewLc4wPL_Uvfh-tMh-RsJxZzB</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Kojima, Yuta</creator><creator>Shibuya, Kazumoto</creator><creator>Uzawa, Akiyuki</creator><creator>Kano, Hiroki</creator><creator>Nakamura, Keigo</creator><creator>Yasuda, Manato</creator><creator>Suzuki, Yo‐ichi</creator><creator>Tsuneyama, Atsuko</creator><creator>Suichi, Tomoki</creator><creator>Ozawa, Yukiko</creator><creator>Misawa, Sonoko</creator><creator>Noto, Yu‐ichi</creator><creator>Mizuno, Toshiki</creator><creator>Kuwabara, Satoshi</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1169-8574</orcidid></search><sort><creationdate>202106</creationdate><title>Dispersion of mean consecutive differences in single‐fiber electromyography increases diagnostic sensitivity for myasthenia gravis</title><author>Kojima, Yuta ; Shibuya, Kazumoto ; Uzawa, Akiyuki ; Kano, Hiroki ; Nakamura, Keigo ; Yasuda, Manato ; Suzuki, Yo‐ichi ; Tsuneyama, Atsuko ; Suichi, Tomoki ; Ozawa, Yukiko ; Misawa, Sonoko ; Noto, Yu‐ichi ; Mizuno, Toshiki ; Kuwabara, Satoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4196-fae49b63f06a3f7e893e90983fe70a1449c8f8722a6ec0149d36df5314ab2ae53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Coefficient of variation</topic><topic>concentric needle electrode</topic><topic>Criteria</topic><topic>Diagnosis</topic><topic>diagnostic criteria</topic><topic>Diagnostic systems</topic><topic>Dispersion</topic><topic>Electromyography</topic><topic>Mathematical analysis</topic><topic>Mean</topic><topic>mean consecutive difference</topic><topic>Medical diagnosis</topic><topic>Muscles</topic><topic>Myasthenia</topic><topic>Myasthenia gravis</topic><topic>Neuromuscular junctions</topic><topic>Outliers (statistics)</topic><topic>Signs and symptoms</topic><topic>Vibration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kojima, Yuta</creatorcontrib><creatorcontrib>Shibuya, Kazumoto</creatorcontrib><creatorcontrib>Uzawa, Akiyuki</creatorcontrib><creatorcontrib>Kano, Hiroki</creatorcontrib><creatorcontrib>Nakamura, Keigo</creatorcontrib><creatorcontrib>Yasuda, Manato</creatorcontrib><creatorcontrib>Suzuki, Yo‐ichi</creatorcontrib><creatorcontrib>Tsuneyama, Atsuko</creatorcontrib><creatorcontrib>Suichi, Tomoki</creatorcontrib><creatorcontrib>Ozawa, Yukiko</creatorcontrib><creatorcontrib>Misawa, Sonoko</creatorcontrib><creatorcontrib>Noto, Yu‐ichi</creatorcontrib><creatorcontrib>Mizuno, Toshiki</creatorcontrib><creatorcontrib>Kuwabara, Satoshi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Muscle & nerve</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kojima, Yuta</au><au>Shibuya, Kazumoto</au><au>Uzawa, Akiyuki</au><au>Kano, Hiroki</au><au>Nakamura, Keigo</au><au>Yasuda, Manato</au><au>Suzuki, Yo‐ichi</au><au>Tsuneyama, Atsuko</au><au>Suichi, Tomoki</au><au>Ozawa, Yukiko</au><au>Misawa, Sonoko</au><au>Noto, Yu‐ichi</au><au>Mizuno, Toshiki</au><au>Kuwabara, Satoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dispersion of mean consecutive differences in single‐fiber electromyography increases diagnostic sensitivity for myasthenia gravis</atitle><jtitle>Muscle & nerve</jtitle><addtitle>Muscle Nerve</addtitle><date>2021-06</date><risdate>2021</risdate><volume>63</volume><issue>6</issue><spage>885</spage><epage>889</epage><pages>885-889</pages><issn>0148-639X</issn><eissn>1097-4598</eissn><abstract>Introduction
In this study we aimed to investigate the dispersion of mean consecutive difference (MCD) of concentric needle jitter studies of patients with myasthenia gravis (MG) and its effect on diagnostic sensitivity for MG.
Methods
One hundred fifty‐three patients, including 76 patients with MG and 77 controls with possible MG who later received another diagnosis, underwent stimulated concentric needle jitter studies of the frontalis muscle. MCD mean, standard deviation (SD), and coefficient of variation (CV) were calculated. Diagnostic sensitivity and specificity were determined using receiver operating characteristic (ROC) analyses.
Results
MG patients showed a significantly greater MCD mean (MG: control, 26.3 μs; 13.5 μs [median]; P < .0001), MCD SD (MG: control, 12.8 μs; 5.1 μs [median]; P < .0001), and MCD CV (MG: control, 46.1; 37.5 [median]; P < .001) than those without MG. An ROC curve of SD showed a large area under the curve (0.88), and a cut‐off value of 7.2 μs, which was calculated by maximum Youden index, exhibited high diagnostic sensitivity (86%) for MG. Combined MCD mean, outliers, and SD criteria showed higher sensitivity (88%) than conventional criteria alone (82%), at the expense of lower specificity. Five MG patients with normal MCD mean and abnormal MCD SD had only ocular symptoms.
Discussion
The dispersion of MCD as measured by MCD SD greater than 7.2 μs is significantly increased in patients with MG and may be a useful measure of abnormal jitter in the diagnosis of MG, especially for identifying patients with mild disease.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>33748989</pmid><doi>10.1002/mus.27236</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-1169-8574</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Coefficient of variation concentric needle electrode Criteria Diagnosis diagnostic criteria Diagnostic systems Dispersion Electromyography Mathematical analysis Mean mean consecutive difference Medical diagnosis Muscles Myasthenia Myasthenia gravis Neuromuscular junctions Outliers (statistics) Signs and symptoms Vibration |
| title | Dispersion of mean consecutive differences in single‐fiber electromyography increases diagnostic sensitivity for myasthenia gravis |
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