A pilot study of a novel transmembranous electromyography device for assessment of oral cavity and oropharyngeal muscles

Introduction/Aims

Electromyography (EMG) can provide valuable insights into the pathophysiology of oropharyngeal muscles in various disease states but the invasive nature of the conventional needle EMG (nEMG) has its limitations in this setting. We aimed to examine the inter-rater reliability (IRR) of a novel transmembranous EMG (tmEMG) sensor as a non-invasive technique for assessment of oral cavity and oropharyngeal muscles for neuromuscular pathology.

Methods

The study was a prospective, cohort, pilot study with blinded data analysis in healthy participants (n= 6), patients with moderate to severe obstructive sleep apnea (OSA) (n= 5) and bulbar amyotrophic lateral sclerosis (ALS) (n= 5). Each patient underwent sampling from bilateral palatoglossus (PG) and genioglossus (GG), using both tmEMG and needle EMG (nEMG). IRR was expressed as percentage agreement and prevalence-adjusted bias-adjusted kappa coefficient (PABAK).

Results

Substantial IRR was found for participants with ALS (81.6%, PABAK 0.63) and OSA (78.8%, PABAK 0.61), and in healthy participants (87.1%, PABAK 0.74). A better IRR was seen with tmEMG (95.7%, PABAK 0.92) than with nEMG (73.9%, PABAK 0.48) for healthy participants and also for those with OSA. Studies from genioglossus had higher IRR than palatoglossus. Only one participant had a minor adverse event (sore throat).

Discussion

The current study shows that analysis of PG and GG in both healthy and disease states using tmEMG has high IRR compared with nEMG analysis. Further validation studies can be undertaken to test its utility in analysis of oral cavity and oropharyngeal muscles.

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