Evidence map›Paper›PMID 41399399›Full record

ArticleClinical neurophysiology practice2025

Evaluating diaphragm motor response variability in electric and magnetic phrenic nerve stimulations during passive expiration.

Ivan Chakalov, Swen Hülsmann, Perianen Ramasawmy, Lukas Diedrich, Mathias Bähr, Leif Saager, Konrad Meissner, Onnen Moerer, Caspar Stephani, Andrea Antal

Abstract read
In one paragraph

Article in Clinical neurophysiology practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ivan ChakalovDepartment of Anesthesiology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Swen HülsmannDepartment of Anesthesiology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Perianen RamasawmyDepartment of Neurology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Lukas DiedrichDepartment of Neurology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Mathias BährDepartment of Neurology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Leif SaagerDepartment of Anesthesiology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Konrad MeissnerDepartment of Anesthesiology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Onnen MoererDepartment of Anesthesiology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Caspar StephaniDepartment of Anesthesiology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.
Andrea AntalDepartment of Neurology, University Medical Center Goettingen, Robert Koch-Strasse 40, 37075 Goettingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This study assessed variability in cervical electrical (CEPNS) and magnetic (CMPNS) phrenic nerve stimulation alongside transcranial magnetic stimulation (diTMS) of the diaphragm, focusing on motor response latency and amplitude at individually calculated suprathreshold intensities. Methods: Diaphragm motor responses were elicited via CEPNS and CMPNS (measuring compound muscle action potentials, CMAPs) and diTMS (measuring diaphragm motor evoked potentials, diMEPs). Latency and amplitude were recorded. Statistical analyses compared methods, evaluated variability using coefficients of variation (CV), and explored associations with height and central motor conduction time. Results: Among 25 participants (mean age 25 ± 4 years), CMPNS evoked CMAPs in 21 subjects, CEPNS in 16, with 12 responding to both. No significant latency or amplitude differences emerged between CEPNS and CMPNS responders. TMS evoked diMEPs in 24 participants. Latency was more consistent than amplitude across all methods; CMPNS exhibited the lowest amplitude variability. Height moderately correlated positively with CMAP latency and negatively with central motor conduction time. Conclusions: Individually adapted suprathreshold CEPNS and CMPNS assessed phrenic nerve conduction with varying success rates. Latency was a more reliable measure than amplitude. CMPNS and diTMS surpassed CEPNS in response reliability, positioning magnetic stimulations as preferable for assessing phrenic nerve conduction. CEPNS might not be suitable for examining motor response amplitudes when not applied at supramaximal intensity. Height-related anatomical factors influencing conduction merit further study. Significance: Latency of diaphragm motor responses elicited at individually estimated stimulation intensities offers a more consistent biomarker over amplitude for assessing phrenic nerve function.

Indexed as

CEPNSCMAP-LatencyCMPNSdiMEP-LatencyPhrenic nerveTMS

Identifiers

PMID41399399
PMCPMC12702034

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.