Differences in motor unit behavior during isometric contractions in patients with diabetic peripheral neuropathy at various disease severities

Mateus André Favretto*, Felipe Rettore Andreis, Sandra Cossul, Francesco Negro, Anderson Souza Oliveira, Jefferson Luiz Brum Marques

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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The aim of this study was to determine whether HD-sEMG is sensitive to detecting changes in motor unit behavior amongst healthy adults and type 2 diabetes mellitus (T2DM) patients presenting diabetic peripheral neuropathy (DPN) at different levels. Healthy control subjects (CON, n = 8) and T2DM patients presenting no DPN symptoms (ABS, n = 8), moderate DPN (MOD, n = 18), and severe DPN (SEV, n = 12) performed isometric ankle dorsiflexion at 30 % maximum voluntary contraction while high-density surface EMG (HD-sEMG) was recorded from the tibialis anterior muscle. HD-sEMG signals were decomposed, providing estimates of discharge rate, motor unit conduction velocity (MUCV), and motor unit territory area (MUTA). As a result, the ABS group presented reduced MUCV compared to CON. The groups with diabetes presented significantly larger MUTA compared to the CON group (p < 0.01), and the SEV group presented a significantly lower discharge rate compared to CON and ABS (p < 0.01). In addition, the SEV group presented significantly higher CoV force compared to CON and MOD. These results support the use of HD-SEMG as a method to detect peripheral and central changes related to DPN.

Original languageEnglish
Article number102725
JournalJournal of Electromyography & Kinesiology
Publication statusPublished - Feb 2023

Bibliographical note

The authors thank the Brazilian Government Funding Agencies CAPES and CNPq for MAF (grant nunber: 170783/2017-0), SC (grant nunber: 142180/2018-1) scholarships and CNPq for JLBM research productivity scholarship. FRA is a part of the Center for Neuroplasticity and Pain (CNAP), supported by the Danish National Research Foundation (DNRF121).

Copyright © 2022 Elsevier Ltd. All rights reserved.


  • Diabetic peripheral neuropathy
  • High-density surface electromyography
  • Conduction velocity
  • Motor Unit
  • Motor unit territory area
  • Discharge rate


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