Characteristics of motor evoked potentials in patients with peripheral vascular disease.

Autor: Sarai P; The Nick Davey Laboratory, Division of Medicine, Department of Surgery and Cancer, Imperial College London, London, United Kingdom., Luff C; The Nick Davey Laboratory, Division of Medicine, Department of Surgery and Cancer, Imperial College London, London, United Kingdom., Rohani-Shukla C; The Nick Davey Laboratory, Division of Medicine, Department of Surgery and Cancer, Imperial College London, London, United Kingdom., Strutton PH; The Nick Davey Laboratory, Division of Medicine, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Apr 25; Vol. 19 (4), pp. e0290491. Date of Electronic Publication: 2024 Apr 25 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0290491
Abstrakt: With an aging population, it is common to encounter people diagnosed with peripheral vascular disease (PVD). Some will undergo surgeries during which the spinal cord may be compromised and intraoperative neuromonitoring with motor evoked potentials (MEPs) is employed to help mitigate paralysis. No data exist on characteristics of MEPs in older, PVD patients, which would be valuable for patients undergoing spinal cord at-risk surgery or participating in neurophysiological research. Transcranial magnetic stimulation, which can be delivered to the awake patient, was used to stimulate the motor cortex of 20 patients (mean (±SD)) age 63.2yrs (±11.5) with confirmed PVD, every 10 minutes for one hour with MEPs recorded from selected upper and lower limb muscles. Data were compared to that from 20 healthy volunteers recruited for a protocol development study (28yrs (±7.6)). MEPs did not differ between patient's symptomatic and asymptomatic legs. MEP amplitudes were not different for a given muscle between patients and healthy participants. Except for vastus lateralis, disease severity did not correlate with MEP amplitude. There were no differences over time in the coefficient of variation of MEP amplitude at each time point for any muscle in patients or in healthy participants. Although latencies of MEPs were not different between patients and healthy participants for a given muscle, they were longer in older participants. The results obtained suggest PVD alone does not impact MEPs; there were no differences between more symptomatic and less symptomatic legs. Further, in general, disease severity did not corelate with MEP characteristics. With an aging population, more patients with PVD and cardiovascular risk factors will be participating in neurophysiological studies or undergoing surgery where spinal cord integrity is monitored. Our data show that MEPs from these patients can be easily evoked and interpreted.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Sarai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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