Evidence map›Paper›PMID 36635569›Full record

ArticleJournal of clinical monitoring and computing2023

Feasibility and optimal choice of stimulation parameters for supramaximal stimulation of motor evoked potentials.

S E Dulfer, F Lange, M M Sahinovic, F H Wapstra, A R Absalom, C Faber, R J M Groen, G Drost

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Article in Journal of clinical monitoring and computing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

S E DulferDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. s.e.dulfer@umcg.nl.
F LangeDepartment of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
M M SahinovicDepartment of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
F H WapstraDepartment of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
A R AbsalomDepartment of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
C FaberDepartment of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
R J M GroenDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
G DrostDepartment of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim was to investigate the feasibility and optimal stimulation parameters for supramaximal stimulation of muscle recorded transcranial electrical stimulation motor evoked potentials (mTc-MEP).

methodsForty-seven consecutive patients that underwent scoliosis surgery were included. First, the feasibility of supramaximal stimulation was assessed for two settings (setting 1: pulse duration 0.075ms, interstimulus interval (ISI) 1.5ms; setting 2: pulse duration 0.300ms, ISI 3ms). Thereafter, three mTc-MEP parameters were considered for both settings; (1) elicitability, (2) amplitude, and (3) if supramaximal stimulation was achieved with ≥ 20 V below maximum output. Finally, ISIs (1ms-4ms) were optimized for setting 1.

resultsNine patients (19.15%) were excluded. Of the remaining patients, supramaximal stimulation was achieved in all patients for setting 1, and in 26 (68.42%) for setting 2. In one patient, mTc-MEPs were elicitable in more muscles for setting (1) Amplitudes were not significantly different. Stimulation voltage could be increased ≥ 20 V in all 38 patients for setting 1 and in 10 (38.46%) for setting (2) Optimal ISI's differed widely.

conclusionWe recommend using setting 1 when monitoring mTc-MEPs with supramaximal stimulation, after which an individualized ISI optimization can be performed. Moreover, when using supramaximal stimulation, short ISI's (i.e. 1ms or 1.5ms) can be the optimal ISI for obtaining the highest mTc-MEP amplitude.

Indexed as

Evoked Potentials, MotorTranscranial Direct Current StimulationElectric StimulationFeasibility StudiesHumansMuscle, SkeletalScoliosisInterstimulus intervalIntraoperative neurophysiological monitoringPulse durationScoliosis surgeryStimulation settingsTranscranial electrical stimulation motor evoked potentials

Identifiers

PMID36635569
PMCPMC10175431

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