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由二氧化碳或钕:钇铝石榴石激光传递的伤害性刺激诱发的电位。

Evoked potentials to nociceptive stimuli delivered by CO2 or Nd:YAP lasers.

作者信息

Perchet Caroline, Godinho Fabio, Mazza Stéphanie, Frot Maud, Legrain Valéry, Magnin Michel, Garcia-Larrea Luis

机构信息

INSERM U879- Central integration of pain unit, Lyon F-69677, France.

出版信息

Clin Neurophysiol. 2008 Nov;119(11):2615-22. doi: 10.1016/j.clinph.2008.06.021. Epub 2008 Oct 11.

Abstract

OBJECTIVE

This study compares the amplitude, latency, morphology, scalp topography and intracranial generators of laser-evoked potentials (LEPs) to CO(2) and Nd:YAP laser stimuli.

METHODS

LEPs were assessed in 11 healthy subjects (6 men, mean age 39+/-10 years) using a 32-channel acquisition system. Laser stimuli were delivered on the dorsum of both hands (intensity slightly above pain threshold), and permitted to obtain lateralised (N1) and vertex components (N2-P2) with similar scalp distribution for both types of lasers.

RESULTS

The N1-YAP had similar latencies but significantly higher amplitudes relative to N1-CO(2). The N2-P2 complex showed earlier latencies, higher amplitudes (N2) and more synchronised responses when using Nd:YAP stimulation. The distribution of intracranial generators assessed with source localization analyses (sLORETA) was similar for Nd:YAP and CO(2) lasers. The insular, opercular, and primary sensorimotor cortices were active during the N1 time-window, whereas the anterior midcingulate, supplementary motor areas and mid-anterior insulae were active concomitant to the N2-P2 complex.

CONCLUSIONS

Earlier latencies and larger amplitudes recorded when using Nd:YAP pulses suggest a more synchronized nociceptive afferent volley with this type of laser.

SIGNIFICANCE

This, together with its handy utilization due to optic fibre transmission, may favour the use of Nd:YAP lasers in clinical settings.

摘要

目的

本研究比较了二氧化碳(CO₂)激光和钕钇铝石榴石(Nd:YAP)激光刺激诱发的激光诱发电位(LEP)的波幅、潜伏期、形态、头皮地形图及颅内发生器。

方法

使用32通道采集系统对11名健康受试者(6名男性,平均年龄39±10岁)进行LEP评估。在双手背部施加激光刺激(强度略高于疼痛阈值),以获取两种激光在头皮分布相似的偏侧化成分(N1)和头顶成分(N2-P2)。

结果

相对于N1-CO₂,N1-Nd:YAP潜伏期相似,但波幅显著更高。使用Nd:YAP刺激时,N2-P2复合波潜伏期更早、波幅更高(N2)且反应更同步。通过源定位分析(sLORETA)评估的颅内发生器分布,Nd:YAP激光和CO₂激光相似。在N1时间窗期间,岛叶皮质、岛盖皮质和初级感觉运动皮质活跃,而在N2-P2复合波期间,前扣带回中部、辅助运动区和前岛叶中部活跃。

结论

使用Nd:YAP脉冲时记录到更早的潜伏期和更大的波幅,表明这种类型的激光能使伤害性传入冲动更同步。

意义

这一点,连同其因光纤传输而便于使用的特点,可能有利于Nd:YAP激光在临床环境中的应用。

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