The use of high-density surface electromyography in amyotrophic lateral sclerosis: a scoping review.
Patricia A Bayer, Steven J O'Bryan, Hannah J Thomas and 4 others
PMID 42157222WHAT IT FOUND
High-density surface EMG can non-invasively detect muscle twitches and motor unit changes in ALS, but no single measure reliably distinguishes ALS from other conditions.
Inconsistent recording methods across studies prevent current clinical use as a diagnostic or progression tool.
Key findings
01No individual high-density surface EMG parameter currently has sufficient specificity and sensitivity to reliably distinguish ALS from other conditions.
02Fasciculations are sensitive but not specific to ALS, while multiple discharges are highly specific but less sensitive and require uncomfortable repeated stimulation.
03High heterogeneity in recording hardware, analysis methods, and participant reporting across the 26 included studies limits the ability to compare results or implement the technique clinically.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
High heterogeneity in study designs, recording protocols, and analysis methods makes comparison between studies difficult. Many studies did not report key clinical participant characteristics like disease onset location or functional status (ALSFRS-R), limiting interpretation. Nine of the 26 included studies were classified as low quality. The review included only studies measuring upper and lower limb muscles, excluding respiratory, trunk, and neck muscles which are critical in ALS. Most studies used healthy controls rather than disease-specific controls, making it hard to determine if HDsEMG findings are unique to ALS.
Declared interests
Funded by the National Health and Medical Research Council. The provided text does not list specific author disclosures or conflicts of interest.
The easy way to misread this
Do not interpret high-density surface EMG findings as a diagnostic test for ALS. The review found that no single measure is specific enough to distinguish ALS from other conditions, and fasciculations can occur in benign cases. The technique remains experimental for clinical use due to a lack of standardized protocols.
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