Augmentation of motor evoked potentials using multi-train transcranial electrical stimulation in intraoperative neurophysiologic monitoring during spinal surgery

Verfasser / Beitragende:
[Shunji Tsutsui, Hiroshi Iwasaki, Hiroshi Yamada, Hiroshi Hashizume, Akihito Minamide, Yukihiro Nakagawa, Hideto Nishi, Munehito Yoshida]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/1(2015-02-01), 35-39
Format:
Artikel (online)
ID: 605509581
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024 7 0 |a 10.1007/s10877-014-9565-7  |2 doi 
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245 0 0 |a Augmentation of motor evoked potentials using multi-train transcranial electrical stimulation in intraoperative neurophysiologic monitoring during spinal surgery  |h [Elektronische Daten]  |c [Shunji Tsutsui, Hiroshi Iwasaki, Hiroshi Yamada, Hiroshi Hashizume, Akihito Minamide, Yukihiro Nakagawa, Hideto Nishi, Munehito Yoshida] 
520 3 |a Transcranial motor evoked potentials (TcMEPs) are widely used to monitor motor function during spinal surgery. Improvements in transcranial stimulation techniques and general anesthesia have made it possible to record reliable and reproducible potentials. However, TcMEPs are much smaller in amplitude compared with compound muscle action potentials (CMAPs) evoked by maximal peripheral nerve stimulation. In this study, multi-train transcranial electrical stimulation (mt-TES) was introduced to enhance TcMEPs, and the optimal setting of mt-TES was investigated. In 30 patients undergoing surgical correction of spinal deformities (4 males and 26 females with normal motor status; age range 11-75years), TcMEPs from the abductor hallucis (AH) and quadriceps femoris (QF) were analyzed. A multipulse (train) stimulus with an individual pulse width of 0.5ms and an inter-pulse interval of 2ms was delivered repeatedly (2-7 times) at different rates (2, 5, and 10Hz). TcMEP amplitudes increased with the number of train stimuli for AH, with the strongest facilitation observed at 5Hz. The response amplitude increased 6.1 times on average compared with single-train transcranial electrical stimulation (st-TES). This trend was also observed in the QF. No adverse events (e.g., seizures, cardiac arrhythmias, scalp burns, accidental injury resulting from patient movement) were observed in any patients. Although several facilitative techniques using central or peripheral stimuli, preceding transcranial electrical stimulation, have been recently employed to augment TcMEPs during surgery, responses are still much smaller than CMAPs. Changing from conventional st-TES to mt-TES has potential to greatly enhance TcMEP responses. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Intraoperative neurophysiologic monitoring  |2 nationallicence 
690 7 |a Motor evoked potential  |2 nationallicence 
690 7 |a Multi-train transcranial electrical stimulation  |2 nationallicence 
690 7 |a Spinal surgery  |2 nationallicence 
700 1 |a Tsutsui  |D Shunji  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Iwasaki  |D Hiroshi  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Yamada  |D Hiroshi  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Hashizume  |D Hiroshi  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Minamide  |D Akihito  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Nakagawa  |D Yukihiro  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Nishi  |D Hideto  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
700 1 |a Yoshida  |D Munehito  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/1(2015-02-01), 35-39  |x 1387-1307  |q 29:1<35  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-014-9565-7  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tsutsui  |D Shunji  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Iwasaki  |D Hiroshi  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yamada  |D Hiroshi  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hashizume  |D Hiroshi  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Minamide  |D Akihito  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nakagawa  |D Yukihiro  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nishi  |D Hideto  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yoshida  |D Munehito  |u Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, 641-8510, Wakayama, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/1(2015-02-01), 35-39  |x 1387-1307  |q 29:1<35  |1 2015  |2 29  |o 10877