Facilitation of motor evoked potentials after tetanic peripheral nerve stimulation
Year: 2024
Type: article
Abstract: Objective Tetanic stimulation of a peripheral nerve prior to transcranial electrical stimulation (TES) may enhance motor evoked potential (MEP) amplitudes. The purpose of this study was to investigate the post-tetanic MEP (p-MEP) technique in improving MEP amplitudes. Methods Conventional TES MEPs (c-MEP) and p-MEPs with left upper limb stimulation (p-MEP UL ) or left lower limb stimulation (p-MEP LL ) were performed in 26 patients. Bilateral hand and foot MEP amplitudes obtained with each protocol were compared. Subgroup comparisons were performed for myelopathy and peripheral neuropathy patients. Within-subject amplitude differences between c-MEP and each p-MEP technique were compared using a Wilcoxon test. Results The mean age of the patients was 52.7 years (range, 12–79 years). Overall, p-MEP UL resulted in MEP improvement in 25 of 26 (96%) patients, and p-MEP LL improved MEPs in 19 of 26 (73%) patients. The increase in MEP amplitudes were statistically significant in all muscle groups except left foot. Similar improvements were seen in the myelopathy group; in the neuropathy group, p-MEP UL produced similar results, but p-MEP LL did not. Conclusions The p-MEP technique can improve MEP amplitudes, including in patients with myelopathy . In patients with peripheral neuropathy, the results were mixed. Significance Tetanic stimulation can enhance intraoperative MEP amplitudes.
Source: Clinical Neurophysiology
Authors: Zaman Wehab, Michael W. Lutz, Emily P. Bell, Holly E. Johnson, Mohanad AlGaeed, Aatif M. Husain
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,590
OpenAlex ID: W4392907266