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急性脊髓损伤猫的运动诱发电位

Motor evoked potential in cats with acute spinal cord injury.

作者信息

Levy W, McCaffrey M, York D

出版信息

Neurosurgery. 1986 Jul;19(1):9-19. doi: 10.1227/00006123-198607000-00002.

Abstract

We have previously reported that a motor evoked potential (MEP) can be produced by transcranial stimulation of the motor cortex in cats and humans. This signal travels in both dorsolateral and ventral spinal cord. We report here the evaluation of this evoked potential in comparison to the somatosensory evoked potential (SEP) in an acute spinal cord weight drop model. In all animals, the peripheral nerve signal was the component of the MEP most sensitive to injury. Often, it was significantly reduced in amplitude by incidental manipulation of the spinal cord during a careful laminectomy and then returned. It was lost first in animals with weight drop spinal cord injury and was abolished with as little as 50 to 75 g/cm of force. The spinal cord signal of the MEP was consistently more sensitive to injury than the SEP and was abolished at about 100 to 150 g/cm of impact. The cortical SEP was abolished at about 200 to 250 g/cm, and the spinal cord SEP was abolished at similar levels. The SEP returned earlier after injury than the MEP. Anesthetic agents had an effect on the MEP in the spinal cord and substantially changed the peripheral nerve signal, in both wave form shape and optimal stimulation frequency. Marginal cord injury and abnormal metabolic conditions caused the peripheral nerve signal to decrement in amplitude with increasing trial numbers during a run and become unstable. These latter effects need further characterization and are critical guides to investigative and clinical use of this test. This study indicates that the MEP is more sensitive than the SEP in detecting spinal cord injury.

摘要

我们之前曾报道,经颅刺激猫和人类的运动皮层可产生运动诱发电位(MEP)。该信号在脊髓背外侧和腹侧均有传导。在此,我们报告在急性脊髓重物坠落模型中,将这种诱发电位与体感诱发电位(SEP)进行比较的评估结果。在所有动物中,外周神经信号是MEP中对损伤最敏感的成分。在仔细的椎板切除术期间,脊髓的偶然操作常常会使其幅度显著降低,随后又恢复。在重物坠落导致脊髓损伤的动物中,它首先消失,施加低至50至75 g/cm的力即可将其消除。MEP的脊髓信号对损伤始终比对SEP更敏感,在约100至150 g/cm的撞击时被消除。皮层SEP在约200至250 g/cm时被消除,脊髓SEP在相似水平时被消除。SEP在损伤后比MEP更早恢复。麻醉剂对脊髓中的MEP有影响,并在波形形状和最佳刺激频率方面显著改变外周神经信号。边缘性脊髓损伤和异常代谢状况导致外周神经信号在一次测试过程中随着测试次数增加而幅度递减并变得不稳定。后一种效应需要进一步表征,并且是该测试在研究和临床应用中的关键指导。这项研究表明,在检测脊髓损伤方面,MEP比SEP更敏感。

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