Non-invasive characterization of motor unit behaviour in pathological tremor

This paper presents the fully automatic identification of motor unit spike trains from high-density surface electromyograms (EMG) in pathological tremor. First, a mathematical derivation is provided to theoretically prove the possibility of decomposing noise-free high-density surface EMG signals into motor unit spike trains with high correlation, which are typical of tremor contractions. Further, the proposed decomposition method is tested on simulated signals with different levels of noise and on experimental signals from 14 tremor-affected patients. In the case of simulated tremor with central frequency ranging from 5 Hz to 11 Hz and signal-to-noise ratio of 20 dB, the method identified ∼8 motor units per contraction with sensitivity in spike timing identification ≥95% and false alarm and miss rates ≤5%. In experimental signals, the number of identified motor units varied substantially (range 0-21) across patients and contraction types, as expected. The behaviour of the identified motor units was consistent with previous data obtained by intramuscular EMG decomposition. These results demonstrate for the first time the possibility of a fully non-invasive investigation of motor unit behaviour in tremor-affected patients. The method provides a new means for physiological investigations of pathological tremor.