Artifact reduction by using alternating polarity stimulus pairs in intraoperative peripheral nerve action potential recording.
Artifact reduction by using alternating polarity stimulus pairs in intraoperative peripheral nerve action potential recording.
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DOI：
10.1007/s10877-020-00613-9
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发表时间：
2021-12
影响因子：
2.2
通讯作者：
Ringkamp M
中科院分区：
文献类型：
--
作者：
Wu G;Belzberg A;Nance J;Gutierrez-Hernandez S;Ritzl EK;Ringkamp M
术中神经动作电位 (NAP) 记录可以直接研究受伤的神经，以连续性地评估病变的功能。刺激伪影污染通常会妨碍 NAP 记录并干扰其解释。在本研究中，我们评估了在周围神经记录中使用交替极性的伪影减少方法。我们的研究是在受控条件下对实验动物进行的。 NAP 是通过手术暴露的正中神经或尺神经记录的。对于具有交替极性的伪影减少方法，采集了两个连续记录，一个具有正常刺激极性，一个具有反向刺激极性，并对来自该记录对的信号进行平均。还进行了仿真以进一步评估交替极性对波形的影响。结果如下：首先，我们发现该方法适用于具有不饱和电刺激伪影的记录。其次，NAP 对中出现了轻微不等的延迟，这种不等使得在对两个记录进行平均时 NAP 幅度的损失最小。第三，模拟还证明了完美的伪影消除和最小的信号损失。最后，我们在神经微动过程中应用了该方法，并证明了其在术中 NAP 记录中的有用性，因为该方法使记录对短传导距离更具弹性。因此，我们的研究结果表明，这种伪影减少方法可以与我们之前描述的桥接地技术或非提升神经记录配置一起用作补充工具，以进一步改善术中周围神经记录。该方法可应用于临床。
Intraoperative nerve action potential (NAP) recording permits direct study of an injured nerve for functional assessment of lesions in continuity. Stimulus artifact contamination often hampers NAP recording and interferes with its interpretation. In the present study, we evaluated the artifact reduction method using alternating polarity in peripheral nerve recording. Our study was conducted under controlled conditions in laboratory animals. NAPs were recorded from surgically exposed median or ulnar nerves. For the artifact reduction method with alternating polarity, two sequential recordings, one with normal and one with reversed stimulus polarity, were acquired and the signals from this recording pair were averaged. Simulation was also performed to further evaluate the effects of alternating polarity on the waveforms. The results are as follows: First, we found that this method worked for recordings with unsaturated electrical stimulus artifacts. Second, slightly unequal latencies occurred in an NAP pair, and this inequality contributed to a minimal loss of NAP amplitudes when averaging the two recordings. Third, perfect artifact cancelation and minimal signal loss were also demonstrated by simulation. Finally, we applied the method during nerve inching and demonstrated its usefulness in intraoperative NAP recordings as the method made the recording more resilient to short conduction distances. Thus, our findings demonstrate that this artifact reduction method can be used as a supplemental tool together with our previously described bridge grounding technique or the nonlifting nerve recording configuration to further improve intraoperative peripheral nerve recording. The method can be applied in clinical settings.
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4.8
作者：
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通讯作者：
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