Reliability of diaphragmatic motor-evoked potentials induced by transcranial magnetic stimulation.
Reliability of diaphragmatic motor-evoked potentials induced by transcranial magnetic stimulation.
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经颅磁刺激引起的膈肌运动诱发电位的可靠性。
DOI：
10.1152/japplphysiol.00486.2020
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Fox,EmilyJ
中科院分区：
文献类型：
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作者：
Welch,JosephF;Argento,PatrickJ;Mitchell,GordonS;Fox,EmilyJ
经颅磁刺激（TMS）诱发的脑干运动诱发电位（MEP）可用于皮质-脑干通路的电生理评估。尽管TMS在健康和疾病中调查膈肌运动完整性的价值，但该技术的可靠性尚未建立。本研究的目的是确定TMS诱发的膈肌电位的表面肌电图记录的会话内和会话之间的再现性。15名健康的年轻人参与了研究（6名女性，年龄= 29 ± 7岁）。通过将刺激强度从最大刺激器输出（MSO）的60%逐渐增加到100%来确定膈肌激活。每种强度至少进行7次刺激。第二块刺激30分钟后交付的一天内比较，第三块进行了一个单独的一天之间的比较。使用组内相关系数（ICC）和95%一致性限（LOA）在100%MSO下评估隔膜MEP的可靠性。MEP潜伏期（ICC = 0.984，P < 0.001）、持续时间（ICC = 0.958，P < 0.001）、波幅（ICC = 0.950，P < 0.001）和面积（ICC = 0.956，P < 0.001）在一天内重复性较高。MEP各参数的日间重复性良好（潜伏期ICC = 0.953，P < 0.001;时程ICC = 0.879，P = 0.002;波幅ICC = 0.789，P = 0.019;面积ICC = 0.815，P = 0.012）。数据显示，与日内相比，日间的精确度较低，所有MEP特征的LOA较宽。MEP振幅和面积的受试者内和受试者间变异性较大。总之，TMS是一种可靠的方法，诱导膈肌电位在大多数健康individuals.NEW &值得注意的经颅磁刺激（TMS）是一种非侵入性技术，以评估神经冲动传导沿着皮质-丘脑途径。经颅磁刺激诱发的膈肌运动诱发电位（MEP）的可靠性尚不清楚。尽管MEP振幅存在较大的变异性，但我们发现健康成年男性和女性的所有MEP特征（潜伏期，持续时间，振幅和面积）在一天内和一天之间都具有良好的可重复性。我们的研究结果支持使用经颅磁刺激和表面肌电图来评估人类膈肌激活。
The diaphragmatic motor-evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) permits electrophysiological assessment of the cortico-diaphragmatic pathway. Despite the value of TMS for investigating diaphragm motor integrity in health and disease, reliability of the technique has not been established. The study aim was to determine within- and between-session reproducibility of surface electromyogram recordings of TMS-evoked diaphragm potentials. Fifteen healthy young adults participated (6 females, age = 29 ± 7 yr). Diaphragm activation was determined by gradually increasing the stimulus intensity from 60 to 100% of maximal stimulator output (MSO). A minimum of seven stimulations were performed at each intensity. A second block of stimuli was delivered 30 min later for within-day comparisons, and a third block was performed on a separate day for between-day comparisons. Reliability of diaphragm MEPs was assessed at 100% MSO using intraclass correlation coefficients (ICC) and 95% limits of agreement (LOA). MEP latency (ICC = 0.984,P< 0.001), duration (ICC = 0.958,P< 0.001), amplitude (ICC = 0.950,P< 0.001), and area (ICC = 0.956,P< 0.001) were highly reproducible within-day. Between-day reproducibility was good to excellent for all MEP characteristics (latency ICC = 0.953,P< 0.001; duration ICC = 0.879,P= 0.002; amplitude ICC = 0.789,P= 0.019; area ICC = 0.815,P= 0.012). Data revealed less precision between-day versus within-day, as evidenced by wider LOA for all MEP characteristics. Large within- and between-subject variability in MEP amplitude and area was observed. In conclusion, TMS is a reliable means of inducing diaphragm potentials in most healthy individuals.NEW & NOTEWORTHYTranscranial magnetic stimulation (TMS) is a noninvasive technique to assess neural impulse conduction along the cortico-diaphragmatic pathway. The reliability of diaphragm motor-evoked potentials (MEP) induced by TMS is unknown. Notwithstanding large variability in MEP amplitude, we found good-to-excellent reproducibility of all MEP characteristics (latency, duration, amplitude, and area) both within- and between-day in healthy adult men and women. Our findings support the use of TMS and surface EMG to assess diaphragm activation in humans.