Piediction of spinal cord function by transcranial magnetic evoked compound muscle action potential and spinal cord potential

经颅磁诱发复合肌肉动作电位和脊髓电位对脊髓功能的预测

• 批准号: 09671477
• 负责人: KAWAGUCHI Yoshiharu
• 金额: $ 1.66万
• 依托单位: Toyama Medical and Pharmaceutical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671477/
• 关键词: neurophysiological; transcranialmagnetic stimulation; evoked papotential; evoked compound muscle action potential; spinal cord compression; spinal cord function; 経頭蓋電気刺激

The validity of the evoked compound muscle action potential (ECMAP) as an index of spinal cord injury has not been established in neurophysiological monitoring of motor function. The critical point of the spinal cord injury determined by ECMAP was investigated to predict the postoperative outcome of the patient's motor function. Ten cats were used. After craniotomy, electric stimuli were applied to the motor area. EGMAP from extensor carpi radialis muscle and evoked spinal cord potential (ESCP) from C6 level were recorded. Five cats were given stimulation of varying numbers and frequencies to characterize the stimulus condition for maximum ECMAP amplitude. The other five cats underwent graded compression of the spinal cord given at C3 level and EGMAPs and ESCPs were recorded. Three cats were awakened thereafter, and their motor function was assessed 3 weeks later. The maximum amplitude amplitude of the EGMAP was recorded in response to 5 consecutive stimuli at 500 Hz. Compression of the spinal cord caused a decrease in the amplitude of the EGMAP and prolongation of the latency under compression. ESCPs also showed a decrease in amplitude and prolongation of the latency under compression. The amplitude (of the ECMAP never fell below 60% of the control value even when ECMAPs disappeared. No motor dysfunction was encountered 3 weeks after the experiment. ECMAP is a very sensitive neurophisiological monitoring method for detection of the jeopardizing of spinal cord motor function. However, it is difficult to predict the prognosis based on ECMAP without the use of ESCP.Therefore, simultaneous use of EGMAP and ESCP is recommended to predict the postoperative outcome of the motor function.

在运动功能的神经生理学监测中，诱发复合肌肉动作电位(ECMAP)作为脊髓损伤指标的有效性尚未得到证实。研究ECMAP确定的脊髓损伤临界点，以预测患者术后运动功能的转归。使用了10只猫。开颅手术后，对运动区进行电刺激。记录桡侧腕伸肌的EGMAP和C6水平的脊髓诱发电位。5只猫被给予不同数量和频率的刺激，以表征获得最大ECMAP幅度的刺激条件。另5只猫在C3节段对脊髓进行分级压迫，记录EGMAP和ESCP。之后唤醒三只猫，并在3周后评估它们的运动功能。在500赫兹连续刺激5次时，记录到EGMAP的最大幅度。脊髓受压导致EGMAP波幅降低，受压潜伏期延长。ESCP还显示受压时波幅降低和潜伏期延长。即使当ECMAP消失时，ECMAP的幅度也从未降到控制值的60%以下。实验3周后未出现运动功能障碍。ECMAP是检测脊髓运动功能损害的一种非常敏感的神经生理监测方法。然而，如果不使用ESCP，则很难根据ECMAP预测预后，因此建议联合使用EGMAP和ESCP来预测术后运动功能的转归。

项目成果

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Nakamura H、Kawaguchi Y 等人：“有意识的人经颅磁刺激后皮质内的促进和抑制。”

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Nakamura H、Kawaguchi Y 等人：“麻醉下人体配对磁刺激后的皮质内促进和抑制。”

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Kitakawa H、Nakamura H、Kawaguchi Y 等人：“脊柱手术中的磁诱发复合肌肉动作电位神经监测”。

Kitagawa H,Nakamura H,Kawaguchi Y,et al.: "Magnetic-evoked compound muscle action potential neuromonitoring in spine surgery." spine. 20. 2233-2239 (1995)

Kitakawa H、Nakamura H、Kawaguchi Y 等人：“脊柱手术中的磁诱发复合肌肉动作电位神经监测”。