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bjective To observe the changes of upper extremity sensory function in patients with radicular cervical spondylosis and evaluate the treatment effect, by using the method of suspension exercise therapy (SET) and soft tissue manipulation. Methods A total of 72 patients with cervical spondylosis were divided into observation group (treated by SET combined with manipulation)and control group (treated by purely cervical traction) by simple random method. Both groups received 4-week continuous treatment for 6 times per week. The somatosensory evoked potential(SEP), current perception threshold (CPT) before and after the treatment in two groups were separatedly tested, and changes in visual analogue scale (VAS) pain scores of the affected limbs were examined, so as to determine the effective rate of treatment. Results After treatment, the latency of SEP was shortened mainly in brachial plexus potential N9 and cervical spinal potential N13 in two groups (P<0.05). The CPT levels and the VAS pain scores of the affected limbs were reduced in two groups (P<0.01), and the treatment effect in observation group was better that in control group (P<0.01)．Conclusion SET combined with soft tissue manipulation can effectively promote the repair of nerve sense function of cervical spondylotic radiculopathy.
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[Objectives] In this study, we examined the effects of acupuncture stimulation on short latency reflexes (SLR) and long latency reflexes (LLR) to determine the site of acupuncture stimulation in modulating motor reflexes. Further, we investigated the relationship between changes in LLR and changes in the N20 somatosensory evoked potential (SEP) component induced by acupuncture stimulation and examined changes in central motor conduction time (CMCT).[Subjects and Methods] Sixteen healthy and right-handed adults (11 males and 5 females; 28.9 ± 6.6 years old; upper limb length 54.9 ± 3.2 cm) participated in this study. The experiments were performed under three conditions: (1) control (no acupuncture stimulation), (2) acupuncture stimulation of right-sided Hegu (LI4), and (3) acupuncture stimulation of left-sided LI4. An acupuncture needle (0.18 mm in diameter) was inserted up to a depth of 10 mm at the right- or left-sided LI4. Electrical stimulation was delivered to the median nerve in the right hand joint at a 120% intensity compared with the threshold to produce an M-wave. SLR and LLR were recorded from the opponens pollicis muscle of the right hand. The frequency and amplitude ratio of SLR (latency, approximately 20-30 ms) and LLR (latency, approximately 40-70 ms) were analyzed. SEP was produced by electrical stimulation delivered to the median nerve. The amplitude from baseline and mean latency of N20 waves were measured. F-wave in the evoked electromyography was evoked by electrical stimulation of the median nerve of the right hand at supramaximal intensity to elicit an M-wave and recorded from the opponens pollicis muscle of the same hand. We analyzed the mean latency and calculated the CMCT using the mean latencies of LLR, N20, F-wave, and M-wave.[Results] The frequency and amplitude ratio of SLR were reduced by acupuncture stimulation of left- and right-sided LI4, respectively. LLR frequency and amplitude ratio were reduced by acupuncture stimulations on either side. A correlation was observed between changes in the LLR amplitude ratio and changes in the N20 SEP amplitude ratio induced by acupuncture stimulation. No effect of acupuncture stimulation was observed on CMCT. [Discussion and Conclusion] SLR is the reflex potential of the spinal cord, and LLR is the motor reflex of the central nervous system via supraspinal pathways. These findings suggest that acupuncture stimulation inhibits motor nerve reflexes via both spinal and supraspinal modulation systems.
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Objective To investigate the effect of intracerebroventricular injection of morphine and orphanin FQ (OFQ) on somatosensory evoked potential (SEP) and Na+-K+ATPase activity in cerebral cortex of rat. MethodsTo study the SEP with the BL-420 biological signal collecting system. The cerebral cortex tissues were extracted, homogenized and centrifuged. Na+-K+ATPase activity was measured with ATPase analytical kit. Results After intracerebroventricular injection with OFQ 0.9 ?g, the amplitude of P1-N1 and N1-P2 increased significantly(P
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[Objective]To evaluate the accuracy and influenceing factors of somatosensory evoked potential in spinal cord monitoring during cervical and thoracic spinal surgery and intraoperative nerve root monitoring in lumbar surgery.[Method]The somatosensory evoked potential(SEP) were used during arvical and thoracic spinal surgery and evaluated the accuracy of SEP according to the record of different stages and spinal cord function after surgery.The EMG were used to monitor the nerve root function in lumber operation to estimate whether nerve root being stimulated or tensioned.In addition,affected fators of SEP and EMG during operation were observed.[Result]Of 128 cases of cervical and thoracic surgery,116 cases did not reach the warning standards(amplitude decreasing 50% or diappearing) and showed no postoperative enhancement of symptom of nerve roots injury.12 cases reached the warning standards intraoperatively and the surgeon were warned to take some steps to finish the operations,only in one case incompletely transient paralysis occurred due to the time of amplitude decreasing of intraoperative SEP more than 10 minutes.Effect of other factors such as anaesthesia and low blood pressure did not reach the warning standards.There were 3 artifical negative cases.Only 1 was artifical positive case.of 40 cases of lumbar surgery,12 cases were found myoelectic responses,which warning the surgeon at any time to avoid nerve roots injury,no nerve roots injury were found after operation.[Conclusion]During cervical and thoracic spinal operation,the somatosensory evoked potential can reflect the physiological and pathological conditions of spinal cord after ruling out the interfering factors.Intraoperative spontaneous electromyography can reflect the nerve roots function promptly and accurately and assure the safety of lumbar surgery.
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@#ObjectiveTo explore the role of ssomatosensory evoked potential (SEP) in evaluating and predicting the lower limb motor function of patients with acute cerebral infarction.Methods19 patients (13 male, 6 female) with acute cerebral infarction diagnosed according to the standard of Chinese Classifications of the Cerebral Vascular Disease were chosen as the case group and 18 patients (11 male, 7 female) with non-nerve system injury were taken as the control group. All patients of two groups were received SEP test within 7 days after onset and latency and amplitude values of SEP of two groups were compared. To the case group, SEP was tested again at 30th day after admission, the Fugl-Meyer assessment (FMA) was also carried out at same times of two SEP tests, and the correlation of SEP and FMA scores was analyzed.ResultsThe difference of latency and amplitude value of SEP test between the case group and control group was significantly (P<0.01). The latency value of SEP in lower limb was correlated with FMA scores (P<0.01). But the amplitude value was no difference between the onset and 30th day after admission in the case group.ConclusionSEP is sensitive in the acute stage of stroke. SEP has significant value for predicting the prognosis of patients with acute cerebral infarction and correlates with the clinical FMA scores. The value of amplitude is not sensitive.
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We studied whether exercise fatigue affects somatosensorv input using somatosensory evoked potential (SEP) . Sixteen subjects performed intermittent grip strength exercises with muscle fatigue while ignoring electrical stimulation given to an elbow. We induced SEP in the exercise task (during contraction) in every stage (first stage, middle stage and final stage) . In addition, we induced SEP in the exercise task during relaxation in the first stage and final stage. As a result, the early component amplitude of SEP decreased with the progress of exercise (manifestation of muscle fatigue) during contraction and relaxation. Our findings suggested that somatosensory input decreased with the manifestation of muscle fatigue. Somatosensory input is necessary for control of voluntary movement. Therefore, we speculate that these factors play a role in decreased performance of athletes competing in long-duration events.
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OBJECTIVE: Intraoperative somatosensory evoked potentials (SEPs) are widely used for the early detections of cerebral ischemia during temporary occlusive procedures of the parent vessels in aneurysm surgery. This study intended to evaluate the usefulness of median nerve SEPs during intracranial aneurysm surgery. METHOD: Between September 1995 and June 1997, we monitored 42 aneurysm patients in Uijongbu St. Mary's hospital. Median nerve SEPs were detected on scalp and cervical spine during surgery. We measured latencies, amplitudes of N20 and N13 waveforms and central conduction time (CCT, N20-N13). We analyzed pre- and post-surgical radiologic findings and changes of neurologic signs. RESULTS: The delayed latencies, CCT, and reduced amplitudes of median nerve SEPs during intraoperative monitoring were closely related to neurological deficits after surgery. CONCLUSION: Intraoperative SEPs are useful in preventing clinical neurological injury during surgery of intracranial aneurysm and in predicting which patients will have unfavourable outcomes.
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Humans , Aneurysm , Brain Ischemia , Evoked Potentials, Somatosensory , Intracranial Aneurysm , Median Nerve , Monitoring, Intraoperative , Neurologic Manifestations , Parents , Scalp , SpineABSTRACT
The effect of electrical nerve stimulation are controversial because of the inconsistent variables of stimulating current and electrophysiologic study. The purposes of this study are to reconfirm the electrophysiolgic changes by electrical stimulation of the peripheral nerve that had been reported in 1993, and to monitor how long they will be maintained. In this study, the following conditioning stimulations were applied to 20 healthy volunteers; interferential current (frequency: 80 - 100 Hz, intensity: 27 - 34 mA) on the sacral paraspinal area. The H reflex, the Fresponse, and the somatosensory evoked potential (SEP) of the tibial nerve were evaluated as the electrophysiologic study before, immediately after, 30 minutes, 60 minutes, and 120 minutes after the above conditioning stimulation. The following results were obtained; 1) Latencies of the H reflex, the F response and the SEP (P1), and the F wave conduction time, the F wave conduction velocity and the F ratio in the tibial nerve conduction study were increased by conditioning stimulation of the proximal peripheral nerves (P>0.01). 2) Changes of the amplitude of the H reflex, the H/M ratio, and the amplitude (P1N1) of the tibial SEP were not significant in the same conditioning stimulation (P>0.05). 3) Prolongations of the latencies of H reflex, F response and P1 SEP of the tibial nerve were the most significant immediately after conditioning stimulation and sustained for 45 minutes after conditioning on average (P<0.01). The above results suggest that certain conditional electrical stimulation of the peripheral nerves causes reversible changes in the conduction of the H reflex, the F response and the SEP and they may be inhibitory effect of the proximal conduction via the spinal cord.
Subject(s)
Electric Stimulation , Evoked Potentials, Somatosensory , H-Reflex , Healthy Volunteers , Peripheral Nerves , Spinal Cord , Tibial NerveABSTRACT
Objective: To study the effect of notoginsenoside in various doses on local ischemic neurotic dysfunction and the ultrastructure. Methods: 35 Wistar rats were divided at random. The reversible middle cerebral artery occlusion (MCAO) model was made according to the assessment of the literature. The changes of SEP contents of cerebral cortex NO and SOD, and the changes of the ultrastrcture were recorded by evoked potential electrograph before and after MCAO. Results: notoginsenoside 200mg?kg -1 and 400mg?kg -1 could remarkably alter MCAO, shorten the latent period, improve the dysfuntion induced by MCAO, lower the concentration of NO and enhance the activity of SOD. The differential value in MCAO group was statistically remarkable ( P