Feasibility and optimal choice of stimulation parameters for supramaximal stimulation of motor evoked potentials.

Autor: Dulfer SE; Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. s.e.dulfer@umcg.nl.; Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. s.e.dulfer@umcg.nl., Lange F; Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Sahinovic MM; Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Wapstra FH; Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Absalom AR; Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Faber C; Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Groen RJM; Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Drost G; Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.; Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of clinical monitoring and computing [J Clin Monit Comput] 2023 Jun; Vol. 37 (3), pp. 783-793. Date of Electronic Publication: 2023 Jan 13.
DOI: 10.1007/s10877-022-00972-5
Abstrakt: Purpose: The aim was to investigate the feasibility and optimal stimulation parameters for supramaximal stimulation of muscle recorded transcranial electrical stimulation motor evoked potentials (mTc-MEP).
Methods: Forty-seven consecutive patients that underwent scoliosis surgery were included. First, the feasibility of supramaximal stimulation was assessed for two settings (setting 1: pulse duration 0.075ms, interstimulus interval (ISI) 1.5ms; setting 2: pulse duration 0.300ms, ISI 3ms). Thereafter, three mTc-MEP parameters were considered for both settings; (1) elicitability, (2) amplitude, and (3) if supramaximal stimulation was achieved with ≥ 20 V below maximum output. Finally, ISIs (1ms-4ms) were optimized for setting 1.
Results: Nine patients (19.15%) were excluded. Of the remaining patients, supramaximal stimulation was achieved in all patients for setting 1, and in 26 (68.42%) for setting 2. In one patient, mTc-MEPs were elicitable in more muscles for setting (1) Amplitudes were not significantly different. Stimulation voltage could be increased ≥ 20 V in all 38 patients for setting 1 and in 10 (38.46%) for setting (2) Optimal ISI's differed widely.
Conclusion: We recommend using setting 1 when monitoring mTc-MEPs with supramaximal stimulation, after which an individualized ISI optimization can be performed. Moreover, when using supramaximal stimulation, short ISI's (i.e. 1ms or 1.5ms) can be the optimal ISI for obtaining the highest mTc-MEP amplitude.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: