BACKGROUND Various techniques are described for proximal motor nerve conduction studies (NCSs). We investigated alternative reference electrode (E2) locations for accessory and axillary NCSs. METHODS Multi-channel recordings were made from trapezius or deltoid referred to different sites, and from those sites referred to a remote electrode. Responses were compared using grouped statistics, and correlation analysis. RESULTS For accessory NCSs, all belly:E2 montages showed comparable responses but axillary NCSs were more variable. Low amplitude contamination was seen at the sternum and contralateral acromion but greater distortion using other potential E2 sites. In both accessory and axillary studies, the ipsilateral acromion showed moderate activity, which correlated with the belly:remote response. CONCLUSIONS Variation in E2 electrode sites may significantly distort the measured compound muscle action potential (CMAP). For accessory and axillary NCS, a sternal reference has favorable characteristics. Other sites, such as ipsilateral acromion or deltoid insertion, may not yield a representative CMAP.

中文翻译：

---

辅助和腋神经传导研究的最佳参考电极放置。

背景技术描述了用于近端运动神经传导研究（NCS）的各种技术。我们研究了辅助和腋下NCS的替代参比电极（E2）位置。方法从斜方肌或三角肌指向不同部位，并从那些部位称为远端电极进行多通道记录。使用分组统计数据和相关性分析比较响应。结果对于副NCS，所有的肚皮：E2蒙太奇表现出相似的反应，但腋窝NCS的变化更大。在胸骨和对侧肩峰看到低振幅污染，但使用其他可能的E2位点时畸变更大。在辅助和腋窝研究中，同侧肩峰均显示中等活动度，与腹部：远程反应相关。结论E2电极部位的变化可能会严重扭曲所测复合肌肉动作电位（CMAP）。对于附件和腋窝NCS，胸骨参考具有良好的特性。其他部位，例如同侧肩峰或三角肌插入，可能无法产生代表性的CMAP。