Volume 67, Issue 6 pp. 439-455
AANEM MONOGRAPH

Volume conduction: Extracellular waveform generation in theory and practice

Daniel Dumitru MD, PhD

Corresponding Author

Daniel Dumitru MD, PhD

Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas

Correspondence

Daniel Dumitru, Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, 7701 Floyd Curl Drive, San Antonio, TX 78229-3900.

Email: [email protected]

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Sanjeev D. Nandedkar PhD

Sanjeev D. Nandedkar PhD

Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin

Natus Medical Inc, Middleton, Wisconsin

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Paul E. Barkhaus MD

Paul E. Barkhaus MD

Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin

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First published: 23 February 2023
Citations: 2
This paper underwent peer review by the AANEM Monograph Review and Development Committee and review by the Muscle & Nerve editor, but did not undergo additional, external peer review. AANEM monographs are designed to be broadly educational to AANEM members and others with interests in neuromuscular, musculoskeletal, and electrodiagnostic medicine, and may at times be outside of the narrower scope of other articles published in Muscle & Nerve.
[Correction added on 02 April 2024, after first online publication: Information regarding CME for this article had previously been included. No CME is offered on this article. This CME information has been removed.]

Abstract

The extracellular waveform manifestations of the intracellular action potential are the quintessential diagnostic foundation of electrodiagnostic medicine, and clinical neurophysiology in general. Volume conduction is the extracellular current flow and associated voltage distributions in an ionic conducting media, such as occurs in the human body. Both surface and intramuscular electrodes, in association with contemporary digital electromyographic systems, permit very sensitive detection and visualization of this extracellular spontaneous, voluntary, and evoked nerve/muscle electrical activity. Waveform configuration, with its associated discharge rate/rhythm, permits the identification of normal and abnormal waveforms, thereby assisting in the diagnosis of nerve and muscle pathology. This monograph utilizes a simple model to explain the various waveforms that may be encountered. There are a limited number of waveforms capable of being generated in excitable tissues which conform to well-known volume conductor concepts. Using these principles, such waveforms can be quickly identified in real time during clinical studies.

CONFLICT OF INTEREST

S.D.N. is an employee of Natus Medical, Inc. No payment was provided to any of the authors pursuant to this publication. None of the authors have a conflict of interest to disclose.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.

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