Movement Along the Spine Induced by Transcranial Electrical Stimulation Related Electrode Positioning.

STUDY DESIGN: A prospective, nonrandomized cohort study. OBJECTIVE: To describe a technique quantifying movement induced by transcranial electrical stimulation (TES) induced movement in relation to the positioning of electrodes during spinal deformity surgery. SUMMARY OF BACKGROUND DATA: TES induced movement may cause injuries and delay surgical procedures. When TES movements are evoked, muscles other than those being monitored any adjustments in stimulation protocols and electrode positioning may be expected to minimize movement whereas preserving quality of monitoring. In this study, seismic evoked responses (SER) induced through TES were studied at different electrode positions. METHODS: Intraoperative TES-motor evoked potentials were carried out in 12 patients undergoing corrective spine surgery. Accelerometer transducers recorded SER in two directions at four different locations of the spine for TES-electrode montage groups Cz-Fz and C3-C4. A paired t test was used to compare the means of SER and the relationship between movement and TES electrode positioning. RESULTS: SERs were strongest in the upper body. All mean SERs values for the Cz-Fz group were up to five times larger when compared with the C3-C4 group. However, there were no differences between the C3-C4 and Cz-Fz groups in the lower body locations. Both electrode montage groups showed a gradual stepwise reduction in all mean SER values along the spine from the cranial to caudal region. For the upper body locations, there were no significant associations between SER and both montages; in contrast, a significant association SER was demonstrated in the lumbar region. CONCLUSION: At supramaximum levels, movements resulting from multipulse TES are likely caused by relatively strong contractions from muscles in the neck resulting from direct extracranial stimulation. When interchanging electrode montages in individual cases, the movement in the neck may become reduced. At lumbar levels transcranial evoked muscle contractions dominate movement in the surgically exposed areas. LEVEL OF EVIDENCE: 4.

Multimodality intraoperative neuromonitoring in extreme lateral interbody fusion. Transcranial electrical stimulation as indispensable rearview.

PURPOSE: To optimize intraoperative neuromonitoring during extreme lateral interbody fusion (XLIF) by adding transcranial electrical stimulation with motor evoked potential (TESMEP) to previously described monitoring using spontaneous EMG (sEMG) and peripheral stimulation (triggered EMG: tEMG). METHODS: Twenty-three patients with degenerative lumbar scoliosis had XLIF procedures and were monitored using sEMG, tEMG and TESMEP. Spontaneous and triggered muscle activity, and the MEP of 5 ipsilateral leg muscles, 2 contralateral leg muscles and 1 arm muscle were monitored. RESULTS: During XLIF surgery decreased MEP amplitudes were measured in 9 patients and in 6 patients sEMG was documented. In 4 patients, both events were described. In 30 % of the cases (n = 7), the MEP amplitude decreased immediately after breaking of the table and even before skin incision. After reduction of the table break, the MEP amplitudes recovered to baseline. In two patients, the MEP amplitude deteriorated during distraction of the psoas with the retractor, while no events were reported using sEMG and tEMG. Repositioning of the retractor led to recovery of the MEP. CONCLUSIONS: Monitoring the complete nervous system during an XLIF procedure is found to be helpful since nerve roots, lumbar plexus as well as the intradural neural structures may be at risk. TESMEP has additional value to sEMG and tEMG during XLIF procedure: (1) it informed about otherwise unnoticed events, and (2) it confirmed and added information to events measured using sEMG.

S-methylmethionine reduces cell membrane damage in higher plants exposed to low-temperature stress.

S-methylmethionine (SMM), an important intermediate compound in the sulphur metabolism, can be found in various quantities in majority of plants. The experiments were designed to determine the extent to which SMM is able to preserve cell membrane integrity or reduce the degree of membrane damage in the course of low-temperature stress. By measuring electrolyte leakage (EL), it was proved that SMM treatment reduced cell membrane damage, and thus EL, during low-temperature stress in both the leaves and roots of peas, maize, soy beans and eight winter wheat varieties with different levels of frost resistance. Investigations on the interaction between SMM and polyamine biosynthesis revealed that SMM increased the quantities of agmatine (Agm) and putrescine (Put) as well as that of spermidine (Spd), while it had no effect on the quantity of spermine (Spn). Using a specific inhibitor, methylglyoxal-bis-guanyl hydrazone (MGBG), it was proved that the polyamine metabolic pathway starting from methionine played no role in the synthesis of Spd or Spn, so there must be an alternative pathway for the synthesis of SMM-induced polyamines.

Ferritin2 gene in paraquat-susceptible and resistant biotypes of horseweed Conyza canadensis (L.) Cronq.

Ferritins, the multimeric iron storage proteins, are the main regulators of the cellular level of uncomplexed iron. Ferritins are encoded by small gene families and expressed differentially under various developmental conditions depending on iron availability, effect of hormones or oxygen radical generating agents. In the present work the primary structure of the ferritin2 gene from resistant and susceptible biotypes of horseweed Conyza canadensis was determined. This gene was found to exhibit great similarity and possess all the structural characteristics of known plant ferritin2 genes. The C. canadensis ferritin2 genes had identical primary structure in the two biotypes and were upregulated by paraquat (Pq) in both susceptible and resistant plants. The enhanced expression level was probably connected with defence reactions in the plants after Pq treatment.