Feasibility and optimal choice of stimulation parameters for supramaximal stimulation of motor evoked potentials.
Interstimulus interval
Intraoperative neurophysiological monitoring
Pulse duration
Scoliosis surgery
Stimulation settings
Transcranial electrical stimulation motor evoked potentials
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
02
11
2022
accepted:
31
12
2022
revised:
08
12
2022
medline:
15
5
2023
pubmed:
13
1
2023
entrez:
12
1
2023
Statut:
ppublish
Résumé
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). 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. 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. 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.
Identifiants
pubmed: 36635569
doi: 10.1007/s10877-022-00972-5
pii: 10.1007/s10877-022-00972-5
pmc: PMC10175431
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
783-793Informations de copyright
© 2023. The Author(s).
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