An improved method of reducing stimulus artifact in the electrically evoked whole-nerve potential
An improved method of reducing stimulus artifact in the electrically evoked whole-nerve potential
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DOI：
10.1097/00003446-200008000-00003
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发表时间：
2000-08-01
期刊：
影响因子：
3.7
通讯作者：
Brown, CJ
中科院分区：
文献类型：
--
作者：
Miller, CA;Abbas, PJ;Brown, CJ
目的：记录电刺激反应的复合动作电位需要注意减少电刺激伪影造成的污染。在植入Nucleus(R) 24装置的患者中，使用神经反应遥测（NRT）系统记录电诱发全神经电位（EAP）。该系统采用前向掩蔽技术，大大减少了刺激伪影。然而，理论考虑和实验动物数据表明，在某些情况下，该技术可能会扭曲获得的EAP波形。我们提出并评估了对前向掩蔽技术的改进，以解决这一问题，特别是在收集耐火材料恢复数据时。设计：我们首先使用猫制剂检查电刺激听神经的神经反应。通过猫的单纤维记录，我们证明了“标准”前向掩蔽技术可能遇到的潜在生理限制。然后，我们使用标准技术和我们提出的改进技术记录了猫的EAP波形。最后，我们使用两种伪影减少方法收集人工耳蜗患者的EAP数据。这些比较使我们能够评估我们的修改的有效性。结果：cat EAP数据表明，目前在Nucleus(R) NRT系统中使用的标准前向掩膜技术可以在神经部分难阻时扭曲EAP波形。在cat中，这种失真导致了前屏蔽恢复曲线，人为地延长了恢复时间和不准确的延迟趋势。在使用标准技术和改进技术获得的人体恢复曲线的比较中观察到类似的效果。在某些情况下，改进后的技术产生的EAP波形比用标准方法获得的波形具有更清晰的峰。结论：改进后的前掩蔽伪影减少方案可以减少EAP波形的畸变，从而更准确地评估电刺激神经的难愈性。
Objective: Recording a compound action potential in response to electrical stimulation requires attention to minimize contamination due to electrical stimulus artifact. In patients implanted with the Nucleus(R) 24 device, the electrically evoked whole-nerve potential (EAP) is recorded using a neural response telemetry (NRT) system. This system employs a forward-masking technique that greatly reduces stimulus artifact. However, theoretical considerations and experimental animal data suggest that the technique may distort the acquired EAP waveform under some situations. We proposed and evaluated a modification to the forward-masking technique that addresses this concern, particularly during collection of refractory recovery data.Design: We first examined neural responses of the electrically stimulated auditory nerve using cat preparations. Through single-fiber recordings from cats, we demonstrated underlying physiological limitations likely encountered with the "standard" forward masking technique. We then recorded feline EAP waveforms using both the standard technique and our proposed, modified, technique. Finally, we collected EAP data from human cochlear implant patients using both artifact reduction methods. These comparisons allowed us to evaluate the effectiveness of our modification.Results: The cat EAP data demonstrated that the standard forward-masking technique currently in use in the Nucleus(R) NRT system can distort the EAP waveform when the nerve is partially refractory. In the cat, this distortion resulted in forward-masking recovery curves with artifactually prolonged recovery times and inaccurate latency trends. Similar effects were observed in the comparison of human recovery curves obtained using both the standard and modified techniques. In some cases, the modified technique produced EAP waveforms with more clearly defined peaks than were obtainable with the standard method.Conclusions: Consideration should be given to implementing our modified forward-masking artifact reduction scheme, because it introduces less distortion of the EAP waveform and accordingly provides for more accurate assessment of the refractory properties of the electrically stimulated nerve.