DocumentCode :
933616
Title :
Urethral Sphincter EMG as Event Detector for Neurogenic Detrusor Overactivity
Author :
Hansen, John ; Borau, Albert ; Rodríguez, Alfred ; Vidal, Joan ; Sinkjaer, Thomas ; Rijkhoff, Nico J M
Author_Institution :
Aalborg Univ., Aalborg
Volume :
54
Issue :
7
fYear :
2007
fDate :
7/1/2007 12:00:00 AM
Firstpage :
1212
Lastpage :
1219
Abstract :
The aim of this study was to investigate the feasibility of using external urethral sphincter electromyogram (EMG) (EUSEMG) to detect the onset of detrusor contractions in patients with both neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD). Detrusor pressure (Pdet) and EUSEMG was recorded in 23 neurogenic patients during slow artificial bladder filling. The time delay between the onset of EUSEMG detrusor contraction and the onset of activity was calculated together with the detrusor pressure increase related to this delay. Of 23 patients enrolled, 12 patients showed both NDO and DSD. Of these 12 patients, 10 had a strong correlation between detrusor pressure and EUSEMG . One patient in this group was excluded due to a storage pressure above 30 cmH2O . Two detection methods were applied on the remaining 9 patients. Method 1 was a root mean square (RMS)-integrator with simple thresholding. This approach had a good sensitivity but also a poor specificity (many false-positive detections). Detection method 2 included a kurtosis-based scaling function, which was multiplied to a similar RMS-integrator as used in method 1. Onset detection occurred before Pdet exceeded 18 cmH2O with both methods. However, method 1 resulted in 14.1plusmn12.8 false-positive detections during one bladder filling.Pdet at onset detection was on average 1.0plusmn1.1 cmH2O higher with detection method 2 but the number of false-positives was reduced by 95.8%. This paper demonstrates the feasibility of using EUSEMG to estimate the onset of a detrusor contraction in selected patients.
Keywords :
biological organs; biomechanics; electromyography; medical signal processing; neurophysiology; artificial bladder filling; detrusor contraction; detrusor sphincter dyssynergia; electromyogram; event detector; external urethral sphincter EMG; false-positive detections; kurtosis-based scaling function; neurogenic detrusor overactivity; onset detection; root-mean square integrator; signal thresholding; Bladder; Delay effects; Detectors; Electromyography; Event detection; Filling; Helium; Prosthetics; Root mean square; Spinal cord injury; Electromyography; neural prostheses; neurogenic bladder; spinal cord injury; urinary incontinence; Adult; Diagnosis, Computer-Assisted; Electromyography; Feasibility Studies; Female; Humans; Male; Manometry; Muscle Contraction; Muscle, Skeletal; Pressure; Urethra; Urinary Bladder, Neurogenic; Urinary Bladder, Overactive;
fLanguage :
English
Journal_Title :
Biomedical Engineering, IEEE Transactions on
Publisher :
ieee
ISSN :
0018-9294
Type :
jour
DOI :
10.1109/TBME.2007.890739
Filename :
4237339
Link To Document :
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