Tanaka Masato, Shigematsu Hideki, Kawaguchi Masahiko, Takatani Tsunenori, Kawasaki Sachiko, Suga Yuma, Yamamoto Yusuke, Tanaka Yasuhito
Department of Orthopaedic Surgery, Otemae Hospital, Osaka, Japan.
Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan.
Global Spine J. 2025 Mar;15(2):1473-1478. doi: 10.1177/21925682241299713. Epub 2024 Nov 8.
Prospective within-subjects study.
Although motor-evoked potential (MEP) amplitude can reportedly be increased by tetanic stimulation of the peripheral nerves before transcranial electrical stimulation (TES), no reports have described on whether tetanic transcranial stimulation augments the wave amplitudes of spinal cord-evoked potentials (Tc-SCEP). The primary purpose of this study was to investigate whether tetanic stimulation induces waveform amplification of Tc-SCEP. The secondary purpose was to elucidate the mechanism of the amplification effect of tetanic stimulation.
We recruited 20 patients who underwent cervical or thoracic spine surgeries. We compared the compound muscle active potentials (CMAPs) of Tc-MEP and Tc-SCEP before and after tetanic stimulation of the median or tibial nerve.
Although the CMAP wave amplitudes of the abductor pollicis brevis (APB) and abductor hallucis (AH) showed significant enlargement on Tc-MEP following tetanic stimulation of the median and tibial nerves, an augmentation effect regarding Tc-SCEP (203 μV [without tetanic stimulation], 212 μV [tetanic stimulation of the median nerve], and 208 μV [tetanic stimulation of tibial nerve]) could not be demonstrated.
Although MEP amplitudes can be enlarged by tetanic stimulation of the peripheral nerves, the amplification mechanism may not involve the lateral corticospinal tract from the brain stem to the anterior horn.
前瞻性自身对照研究。
尽管据报道在经颅电刺激（TES）前对周围神经进行强直刺激可增加运动诱发电位（MEP）的波幅，但尚无关于强直经颅刺激是否能增强脊髓诱发电位（Tc-SCEP）波幅的报道。本研究的主要目的是探讨强直刺激是否能诱导Tc-SCEP波形放大。次要目的是阐明强直刺激放大效应的机制。
我们招募了20例行颈椎或胸椎手术的患者。比较了正中神经或胫神经强直刺激前后Tc-MEP和Tc-SCEP的复合肌肉动作电位（CMAP）。
尽管在正中神经和胫神经强直刺激后，拇短展肌（APB）和拇展肌（AH）的Tc-MEP的CMAP波幅显著增大，但未证实Tc-SCEP有增强效应（无强直刺激时为203μV，正中神经强直刺激时为212μV，胫神经强直刺激时为208μV）。
尽管对周围神经进行强直刺激可增大MEP波幅，但放大机制可能不涉及从脑干到前角的皮质脊髓侧束。
