Sonoo M, Kobayashi M, Genba-Shimizu K, Mannen T, Shimizu T
Department of Neurology, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-ku, Tokyo 173, Japan.
Electroencephalogr Clin Neurophysiol. 1996 Jul;100(4):319-31. doi: 10.1016/0168-5597(96)95035-2.
In order to objectively select the standard parameters best suited for the evaluation of somatosensory conduction in median nerve somatosensory evoked potentials (SEP), we performed a detailed statistical analysis of intersubject variability for the latencies of SEP components based on the recordings of 62 normal subjects. Multiple regression analyses for height, age, (age--20)2 and sex were performed for the latencies of 13 components and 78 intercomponent intervals, and the residual variance was used as an indicator of the stability of each parameter. As a result, N9 onset in EPi-NC lead, N11' onset in C6S-Fz lead, P13/14 onset in scalp-NC leads, for which N13' onset recorded in C6S-Fz lead may substitute, and N20 onset in CPc-Fz lead were the most stable time-points selected as standards. N11 onset in C6S-NC, which other authors have recommended as the standard point representing spinal entry, was not recorded consistently, and P11 onset in scalp-NC leads was also unstable. N20 peak and N13'-N20 interval (equivalent to conventional central conduction time) were extremely unstable. We presented the nomograms to find normal limits of the standard parameters corresponding to the given values of the predictor variables (height, age or sex). As the standard recording montage in routine clinical examinations, we recommended a simple method using Fz reference, for example (1) EPi-Fz, (2) C6S-Fz, (3) CPc-Fz, because this montage is sufficient to measure the stable standard parameters.
为了客观地选择最适合评估正中神经体感诱发电位(SEP)中体感传导的标准参数,我们基于62名正常受试者的记录,对SEP各成分潜伏期的个体间变异性进行了详细的统计分析。对13个成分的潜伏期和78个成分间间期,针对身高、年龄、(年龄 - 20)²和性别进行了多元回归分析,并将残差方差用作每个参数稳定性的指标。结果,EPi - NC导联中的N9起始点、C6S - Fz导联中的N11'起始点、头皮 - NC导联中的P13/14起始点(C6S - Fz导联记录的N13'起始点可替代)以及CPc - Fz导联中的N20起始点被选为最稳定的时间点作为标准。其他作者推荐作为代表脊髓入口的标准点的C6S - NC中的N11起始点记录不一致,头皮 - NC导联中的P11起始点也不稳定。N20峰值和N13' - N20间期(相当于传统的中枢传导时间)极其不稳定。我们给出了列线图,以找到与预测变量(身高、年龄或性别)给定值相对应的标准参数的正常范围。作为常规临床检查中的标准记录导联,我们推荐一种使用Fz作为参考的简单方法,例如(1) EPi - Fz,(2) C6S - Fz,(3) CPc - Fz,因为这种导联足以测量稳定的标准参数。