Giant early components of somatosensory evoked potentials to tibial nerve stimulation in cortical myoclonus.
Giant early components of somatosensory evoked potentials to tibial nerve stimulation in cortical myoclonus.
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DOI：
10.1016/j.nicl.2016.07.001
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Franciotti R
中科院分区：
文献类型：
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作者：
Anzellotti F;Onofrj M;Bonanni L;Saracino A;Franciotti R
在大多数皮层肌阵挛（CM）患者中观察到脑电图（EEG）记录的体感诱发电位（巨SEP）的皮层成分增大和脑磁图（MEG）记录的异常体感诱发磁场（SEFs）。同步记录SEP和SEF的研究表明，巨大SEP的发生机制涉及初级感觉和运动皮层。然而，巨大SEP的发生器来源尚未完全了解，因为只有一份报告清楚地描述了下肢刺激后的巨大SEP。在我们的研究中，我们进行了联合EEG-MEG记录的反应引起的正中神经和胫神经电刺激的患者谁因此发展到甲基溴中毒CM与巨大的SEP正中神经和胫神经刺激。根据早期研究和指南定义的极性-潜伏期分量（例如P15-N20-P25）确定SEP波形。在EEG记录时，SEP巨大成分没有出现在正中神经SEP（N20）的第一皮层成分的潜伏期范围内，而是出现在P37胫神经SEP的范围内，P37胫神经SEP目前被确定为由胫神经刺激引起的第一皮层成分。我们的MEG和EEG SEP记录也表明，在P37的潜伏期范围内的组件之前的其他皮质成分。这些结果表明，下肢P37不对应于上肢N20。MEG结果证实，巨大SEF是胫骨（N43 m-P43 m）和正中（N27 m-P27 m）神经刺激的第二个成分。这些巨大成分的MEG偶极源位于初级感觉和运动区。下肢P37可能不是对应于上肢N20的分量。下肢P37之前的其他皮质成分。巨大SEP和SEF是胫神经和正中神经的第二个组成部分。
Enlarged cortical components of somatosensory evoked potentials (giant SEPs) recorded by electroencephalography (EEG) and abnormal somatosensory evoked magnetic fields (SEFs) recorded by magnetoencephalography (MEG) are observed in the majority of patients with cortical myoclonus (CM). Studies on simultaneous recordings of SEPs and SEFs showed that generator mechanism of giant SEPs involves both primary sensory and motor cortices. However the generator sources of giant SEPs have not been fully understood as only one report describes clearly giant SEPs following lower limb stimulation. In our study we performed a combined EEG-MEG recording on responses elicited by electric median and tibial nerve stimulation in a patient who developed consequently to methyl bromide intoxication CM with giant SEPs to median and tibial nerve stimuli. SEPs wave shapes were identified on the basis of polarity-latency components (e.g. P15-N20-P25) as defined by earlier studies and guidelines. At EEG recording, the SEP giant component did not appear in the latency range of the first cortical component for median nerve SEP (N20), but appeared instead in the range of the P37 tibial nerve SEP, which is currently identified as the first cortical component elicited by tibial nerve stimuli. Our MEG and EEG SEPs recordings also showed that components in the latency range of P37 were preceded by other cortical components. These findings suggest that lower limb P37 does not correspond to upper limb N20. MEG results confirmed that giant SEFs are the second component from both tibial (N43m-P43m) and median (N27m-P27m) nerve stimulation. MEG dipolar sources of these giant components were located in the primary sensory and motor area. Lower limb P37 is probably not the component corresponding to upper limb N20. Lower limb P37 was preceded by other cortical components. Giant SEPs and SEFs are the second component for both tibial and median nerve.