Facilitation of motor evoked potentials after repetitive voluntary hand movements depends on the type of motor activity

The modern techniques for assisted reproduction have exposed many women to potent follicular stimulation regimens. Follicular stimulation is associated with an exposure to potent fertility drugs and abnormal estrogen, progesterone and human chorionic gonadotropin (hCG) concentrations. These treatments and hormones might affect the proliferation of epithelial breast cells and thus the risk of breast cancer. The possible effects of ovarian stimulation on the incidence and course of human breast cancer, and the need for long-term cohort studies is discussed.     

Median nerve somatosensory evoked potentials during isoflurane anaesthesia

PURPOSE: The effect of isoflurane on the subcortical P14 component of the median nerve somatosensory evoked potential (SEP) is poorly known. We studied whether the P14 wave from the upper brainstem, recorded with a nasopharyngeal electrode, was attenuated at the isoflurane-induced EEG burst-suppression level. We also compared the effect of isoflurane on the P14, cervical N13 and cortical N20, N35 and N6, components. METHODS: Seventeen elective patients were anaesthetized with isoflurane. Somatosensory evoked potentials were recorded prior to anaesthesia, at 0.5 MAC and 1 MAC end-tidal isoflurane as well as at the level when EEG was in burst-suppression (mean 1.9 vol% end-tidal isoflurane). RESULTS: Isoflurane had varying effects on the subcortical components of median SEP. The amplitude of nasopharyngeal P14 was stable, but the mean latency increased from 14.4 +/- 1.2 msec at 0.5 MAC to 15.2 +/- 1.1 msec at burst-suppression level (P < 0.05). In contrast, the N13 neck response amplitude was attenuated from 3.3 +/- 0.6 microV to 2.6 +/- 0.5 microV (P < 0.005) without latency changes. The latency of the cortical N20 wave was increased from 19.7 +/- 1.1 msec at awake to 24.4 +/- 1.6 msec at burst-suppression level (P < 0.0001) and amplitude was reduced from 3.3 +/- 1.1 microV to 1.3 +/- 0.6 microV (P < 0.0001). The later cortical components were attenuated even during 0.5 MAC isoflurane and were not recordable during EEG burst-suppression. CONCLUSION: We conclude that P14 can reliably be recorded with nasopharyngeal electrodes during isoflurane anaesthesia, even during EEG burst-suppression, when the N20 wave is attenuated. In contrast, the middle-latency SEP components are sensitive to isoflurane anaesthesia.     

Development of cerebellar somatosensory evoked potentials in the rat

The effect of radio and microwave radiation on dietary atherosclerosis of rabbits was tested. 16 New Zealand white rabbits were exposed to microwave (2.45 GHz) radiation at a power density of 20--30 mW/cm2 for 4 h a day, 5 days a week for 8 to 10 weeks. Irradiated animals had serum cholesterol concentrations, aortic wall cholesterol concentrations and percentage of intimal surface involved in atherosclerotic lesions which were not different from age and weight matched controls. Continuous radio frequency irradiation (1 MHz) for 8 to 11 weeks with a field strength of 30 V/cm also failed to change these indices of atherogenesis. We conclude that under the conditions of these experiments radio and microwave irradiation do not affect the course of diet induced atherogenesis.     

Contribution of thalamic somatosensory evoked potentials to stereotaxic thalamometry

INTRODUCTION: In order to use short latency somatosensory thalamic evoked potentials (PES) to locate therapeutic targets in functional surgery, thalamic PES were recorded during stereotactic thalamotomy in 25 patients with Parkinson's disease, using a concentric bipolar semi-micro-electrode, 4 mm in diameter. In the 72 trajectories planned. 628 registers were made, obtaining 314 PES in 55 trajectories. These recordings were divided into 5 groups, according to the electrical variables evaluated in each case (absolute latency, inter-peak latency, absolute amplitude and number of phases). MATERIAL AND METHODS: The electrophysiological characteristics of the PES groups obtained, and the spatial representation of these in a tridimensional system of coordinates, is shown. We analyze the sequence of the groups of potentials in each of the trajectories followed. CONCLUSIONS: We consider that the limit between adjacent nuclear edges, ventral intermediate (Vim)-ventro-caudal (Vc), may be represented by the transition of potentials in group 1 to potentials in group 4 and/or potentials of group 3 to those of group 2. This study shows that thalamic PES are useful for locating targets during stereotactic thalamotomy.     

Pudendal nerve somatosensory evoked potentials in probable multiple sclerosis

One of the most frequent causes of sensorineural hearing loss in childhood is damage to outer hair cells of the cochlea. The presence of otoacoustic emissions, generated by outer hair cells, provides evidence for normal hearing. This finding, however, may give rise to false reassurance, because even severe hearing loss, localized behind the cochlea, can be associated with normal otoacoustic emissions. The coexistence of otoacoustic emissions and hearing loss calls for the prompt exclusion of neurological disease.     

High frequency oscillations in early cortical somatosensory evoked potentials

OBJECTIVE: To evaluate the characteristics of high frequency (HF) components of the early cortical somatosensory evoked potentials (SEPs). METHODS: We recorded 8-channel SEPs from the frontal and left centro-parietal scalp after right median nerve stimulation with a wide band-pass (0.5-2000 Hz) and digitized at 40 kHz sampling rate in 12 healthy subjects. HF components were analyzed after digital band-pass filtering (300-1000 Hz). The power spectrum was obtained by a maximum entropy method. RESULTS: HF oscillations (maximum power at 600-800 Hz) consisting of 5 to 8 peaks were discriminated from the preceding P14 far-field in all cases and their phases were reversed between the frontal and contralateral parietal regions. In addition, in subjects with a high amplitude central P22 potential in original wide-band recordings, a single HF oscillation with a maximum at the central region was present. Furthermore, this component showed no phase reversal over the centro-parietal area. CONCLUSION: We therefore conclude that HF oscillations are superimposed not only on the tangential N20-P20 but on the radial P22 potential, and are generated from both tangential (area 3b) and radial (area 1) current sources.     

Multireference adaptive noise cancellation applied to somatosensory evoked potentials

Somatosensory Evoked Potentials (SEP's) contain information that is useful in diagnosing various physiological disorders. However, surface measurements of these potentials suffer from very poor Signal-to-Noise ratio (SNR) resulting in imperceptible SEP waveforms. This factor motivates the employment of dedicated signal processing techniques to improve the quality of the waveform. The objective of this research work is to improve the SNR of SEP by eliminating the predominant myoelectric interference. The strategy followed to achieve this goal is to process the SEP signal by MultiReference Adaptive Noise Cancellation (MRANC). A theoretical model for the MRANC is presented and its performance under the influence of various factors is investigated and compared with other signal processing techniques. The performance of the MRANC is then evaluated by processing simulated and in vivo SEP data. It is found that the MRANC gives a significant improvement in the SNR of the SEP.     

Median nerve middle-long latency somatosensory evoked potentials in children with tactile evoked spikes

It is known that hand tapping during electroencephalography (EEG) recording evokes centrotemporal spikes in some 4- to 12-year-old children. This phenomenon occurs in both healthy and epileptic children. The same children were reported to show giant middle-long latency evoked potentials (MLSEPs). To study the relationship between tactile evoked spikes (TES) and MLSEPs, we performed a neurophysiologic investigation in 25 children with TES and in 25 children without any EEG abnormality. Such an investigation included a MLSEP study after both electrical and tactile stimulation with simultaneous recording of digital EEG. MLSEPs consistently showed three negative (NI, NII, NIII) and two positive (PI, PII) peaks. Children with TES had MLSEPs of enlarged amplitude. The analysis of MLSEPs and TES characteristics led us to the conclusion that they are the same neurophysiologic event, with NII being the evoked spike and NIII the following slow-wave.     

The cortical representation of somatosensory evoked potentials of the phrenic nerve

Parasitic third-stage larvae of the sheep abomasal nematode Haemonchus contortus develop and molt in vitro to the fourth stage (L4) in 48-72 hr, at which time they begin feeding. Coincident with the third molt, larvae begin to secrete significant amounts of protein into culture fluids, including a zinc metalloproteinase. This culture-derived zinc metalloproteinase differs from a previously described metalloproteinase from infective third-stage larvae (L3[2M]), which mediates the ecdysis process. These differences include time of expression, molecular mass, and substrate specificity. The purified proteinase, from cultures of L4, has a molecular weight of approximately 46 kDa, functions as an endopeptidase, and digests several native proteins of host origin including fibrinogen and fibronectin.     

One-week test-retest reliability of spinal and cortical somatosensory evoked potentials by tibial nerve stimulation

Spinal (Th12) and cortical somatosensory evoked potentials by right and left posterior tibial nerve stimulation at the ankle were performed in 20 healthy volunteers (10 females and 10 males) aged 23-50 years. The procedure was repeated after one week to assess the reliability of the parameters and to establish upper normal variability limits. Reliability was measured by the intraclass correlation coefficient and was excellent for all absolute latencies and at least good for amplitudes and for the spinal-cortical conduction time. Upper variability limits were calculated using a method based on the within-subject mean square, which can be also applied in the case of more than two repetitions.     

Selective modification of somatosensory evoked potential during voluntary finger movement in humans

We examined changes in somatosensory evoked potentials (SEPs) during voluntary movement of fingers innervated by the stimulated nerve and those not innervated by the stimulated nerve and the relationship to the kind of movement modality. Analysis showed that the amplitude of most components at F3, C3', and P3, except for P45 at C3, N35 and P45 at P3, decreased during voluntary finger movement tasks. Further, we found that the components of P40 at F3, P45 at C3', and N35 at P3 were increased during the voluntary pulling movement of the second and the third digits compared to those during the voluntary pushing movement of the fourth and the fifth digits, whereas all other components were decreased at F3, C3', and P3. We also found that not all components of SEPs were decreased while some SEPs in middle latency were increased. In conclusion, we confirmed the selectivity in attenuation of the SEPs. Moreover, we noted an interesting finding that the selectivity of attenuation of the SEPs was most frequently observed in the N20, P30 (P25 at F3), N35 (N30 at F3), and P45 (P40 at F3) components at F3, C3', and P3.     

The effect of thoracic paravertebral blockade on intercostal somatosensory evoked potentials

Streptococcus pneumoniae strains have emerged that are resistant to penicillin (MICs >0.06 microg/mL) and many other beta-lactams. However, some older compounds such as amoxicillin have potency against these pneumococci with altered penicillin-binding proteins, but are labile to beta-lactamases produced by other prevalent respiratory tract pathogens. The interactions of amoxicillin with an enzyme-stable cephalosporin (cefixime) with a long elimination half-life were examined by the checkerboard dilution method versus 39 S. pneumoniae strains (13 resistant, 15 intermediate, and 11 susceptible to penicillin). Among 24 strains with evaluable drug interaction tests, 17 (71%) demonstrated partial or complete synergy. This favorable interaction produces a cefixime susceptibility category change from resistant or intermediate to susceptible for 16 of 28 strains (57%), when combined with < or = 1 microg/mL amoxicillin. Thus, the use of two currently available oral beta-lactams (amoxicillin twice a day + cefixime once a day; three total doses) appears to be a potential alternative treatment with greater spectrum for community-acquired respiratory tract infections pending clinical trial results.     

The value of somatosensory and motor evoked evoked potentials in pre-clinical spondylotic cervical cord compression

This review focuses on the biomaterials used in urology, in particular, the properties of urethral catheters and ureteral stents currently being used in clinical practice. The importance of biomaterial type, biocompatibility, and encrustations are discussed and explained. Current management of bacterial infection and the importance of biofilms are presented, with recommendations based on published information.     

Are frontal and parietal somatosensory evoked potentials functionally dissociated by changing stimulus rate?

The cortical somatosensory evoked potentials are known to be sensitive to relatively small changes in the stimulus repetition rate of the afferent nerve. However, conflicting reports exist as to whether frontally and parietally recorded potentials at a given latency show differential behaviors as a function of stimulus rate. Because such dissociations of frontal and parietal potentials can have significant implications for the SEP generation mechanisms, the present study was undertaken to further describe in detail these effects on frontal, central and parietal waveforms after median nerve stimulation. Increasing stimulus repetition rate from 1 Hz to 5 Hz had the following effects: (i) in 9 of 16 subjects, the frontal P20 diminished while parietal N20 clearly remained unaltered, (ii) the central P22 was reduced in all subjects, (iii) frontal N30 and parietal P27 were attenuated in all subjects, the average magnitude of the reductions being nearly equal for these deflections. The results support the view that changing stimulus rate can functionally dissociate frontal and parietal activity around 20 ms, indicating that several partially independent neural populations can contribute to the frontal P20. The results did not lend support for functional dissociation of frontal N30 from parietal P27.     

Brainstem auditory evoked potentials (BAEPs) and somatosensory evoked potentials (SEPs) in enteric encephalopathy (EE)

BAEPs and SEPs were studied in 25 patients of enteric encephalopathy in acute phase and the results were compared with 25 healthy control persons. In the study the important observations of BAEPs were delayed peak latency of wave III, wave V and delayed ILP I-V, and of SEPs was prolonged peak latency of N20. The electrophysiological evidence suggests metabolic cause for the coma and the SEP changes were similar to those observed in cerebral malaria reported earlier in this laboratory.     

The origins of the subcortical component of the median nerve somatosensory evoked potentials

Short latency median nerve somatosensory evoked potentials (SEPs) were studied in two patients presenting with well localized unilateral pontine lesions producing hemisensory deficits. Both the early subcortical (N11-N13) and the later cortical component (N19-P22) of the SEP were abnormal in the patient whose lesion involved the medial lemniscus, while they remained unaffected in a second case of lateral inferior pontine infarction in which the medial lemniscus was spread. These results suggest that the N11-N13 component of the scalp recorded SEP emanates from the brain stem medial lemniscal pathway.     

Modulation of cerebral somatosensory evoked potentials arising from tibial and sural nerve stimulation during rhythmic active and passive movements of the human lower limb

The magnitudes of cerebral somatosensory evoked potentials (SEPs), following stimulation of cutaneous or muscle afferents in the upper limb, are reduced during active and passive movements of the fingers. The generalizability of such a movement effect was tested for lower limb events. We measured SEP magnitudes following activation of cutaneous (sural) and mixed (tibial) nerves during the flexion phase of active and passive rhythmic movements of the human lower limb. In eight volunteers, 150 SEPs per condition were recorded from Cz' referenced to Fpz'. Compared to stationary controls, both active and passive movements significantly depressed the early SEP components (P1-N1) [mean values, to 12.8%, 9.9% respectively for tibial nerve and to 29.6%, 25.6% for sural nerve stimulation, p < 0.05]. The attenuation was still observed when only one leg was moved and with stimulation at an earlier point in the flexion phase of movement. Visual fixation did not significantly affect P1-N1 amplitudes, compared to eyes closed. As previously shown, soleus H reflexes with stable M waves were significantly depressed during the movements (p < 0.05). The general construct may be that centripetal flow initiated from somatosensory receptors during limb movement leads to modulation of both spinal and cortical responses following large diameter cutaneous or muscle afferent activation.     

Intraoperative control by somatosensory evoked potentials in the treatment of cervical myeloradiculopathy. Results in 210 cases

Somatosensory evoked potentials (SEPs) were used for continuous monitoring of 210 patients during anterior surgery for cervical myeloradiculopathy, to test how effectively they help avoid irreversible neurological damage during surgery. The pathologies differed in severity and were treated by diskectomy or by extended corporectomy using the Senegas technique. Intraoperative SEP changes were recorded in 84 patients (40%); in 13 (6.2%) of these, changes in SEP amplitude and latency were caused by mechanical stress. SEPs revealed transient episodes of regional ischaemia or neurophysiological anomalies during anaesthesia (mainly hypotension) in 27 patients (12.8%). The traces detected incipient and potentially dangerous mechanical pressure on, or metabolic anomalies of, the spinal cord during manipulation and placement procedures of spinal fixation devices. They were particularly sensitive indicators of ischaemia; one of the most common causes of irreversible injury. The traces of 44 patients (21.0%) improved markedly during surgery. There were no false-negatives in this series and, thanks to the fact that SEPs gave immediate warnings of incipient ischaemia to the surgical team, we had no case of irreversible medullary or nerve-root deficit.