論文

2018年6月1日

A multi-train electrical stimulation protocol facilitates transcranial electrical motor evoked potentials and increases induction rate and reproducibility even in patients with preoperative neurological deficits

Journal of Clinical Monitoring and Computing
  • Shuta Ushio
  • ,
  • Shigenori Kawabata
  • ,
  • Satoshi Sumiya
  • ,
  • Tsuyoshi Kato
  • ,
  • Toshitaka Yoshii
  • ,
  • Tsuyoshi Yamada
  • ,
  • Mitsuhiro Enomoto
  • ,
  • Atsushi Okawa

32
3
開始ページ
549
終了ページ
558
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10877-017-0045-8
出版者・発行元
Springer Netherlands

This study sought to evaluate the facilitation effect of repetitive multi-train transcranial electrical stimulation (mt-TES) at 2 repetition rates on transcranial electrical motor evoked potential (Tc-MEP) monitoring during spinal surgery, and to assess the induction rate in patients with impaired motor function from a compromised spinal cord or spinal nerve. We studied 32 consecutive patients with impaired motor function undergoing cervical or thoracic spinal surgery (470 muscles). A series of 10 TESs with 5 pulse trains were preoperatively delivered at 2 repetition rates (1 and 5 Hz). All peak-topeak amplitudes of the MEPs of the upper and lower extremity muscles elicited by the 10 TESs were measured. The induction rates of the lower extremity muscles were also assessed with muscle and preoperative lower extremity motor function scores. In each of the muscles, MEP amplitudes were augmented by about 2–3 times at 1 Hz and 5–6 times at 5 Hz. Under the 5-Hz condition, all limb muscles showed significant amplification. Also, in all preoperative motor function score groups, the amplitudes and induction rates of the lower extremity muscles were significantly increased. Moreover, the facilitation effects tended to peak in the last half of the series of 10 TESs. In all score groups of patients with preoperative neurological deficits, repetitive mt-TES delivered at a frequency of 5 Hz markedly facilitated the MEPs of all limb muscles and increased the induction rate. We recommend this method to improve the reliability of intraoperative monitoring during spinal surgery.

リンク情報
DOI
https://doi.org/10.1007/s10877-017-0045-8
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28710663
ID情報
  • DOI : 10.1007/s10877-017-0045-8
  • ISSN : 1573-2614
  • ISSN : 1387-1307
  • PubMed ID : 28710663
  • SCOPUS ID : 85023761360

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