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Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6022_Библиотеки_им_академика_М_И_Перельмана

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ClinicalApplications
Studies in uninjured individuals have shown that there is a somatotopic localizationand preferentialexcitability ofcertainregions ofthe motorcortex. This is important as providers need to consider that the size, latency, and duration of the MEPs are critically dependent on the type, intensity, and localization of the stimulus as well as on the excitability of the cortical and spinal motoneurons. Depending on the purpose of the test, there are many important parameters that can be measured in cortical stimulation such as stimulation threshold, MEP-latency, MEP-amplitude, response morphology, central motor conduction time, silent period duration, fatigue, intra-cortical inhibitoryandexcitatorypathways,andsoforth.
Thecentralmotorconductiontime(CMCT)(usedtodistinguishcentralvs. peripheraletiology ofthe diseaseordisorder) canbe calculatedbysubtracting thelatencyinresponsetospinalrootstimulationfromthelatencyinresponseto corticalstimulation(48–50).ButitmaybealsocalculatedbyusingtheF-wave latency(51):
CMCTs calculated using F-waves usually exceed those based on root stimulation, which stimulates the peripheral motor axons distal to the ventral roots.
CMCTcanbeaffectedbyanumberoffactorsatseverallevelsincludingthe activation time of the pyramidal tract neurons, the transmission time between motorcortexandspinalmotorneurons,theactivationtimeofmotorneurons,the timebetweenmotoneurondischargeandthesiteofstimulationofthemotorroot, andprobablyothers(52).
The size of electromyographic responses to cortical stimulation or MEP­amplitude can be affected by the type of cortical stimulator (high-voltage electrical or magnetoelectrical) and by the stimulus intensity, as well as the activationofothermuscles.
CMCTcan beincreasedand MEPsize reduced byseveral factorssuchas reducedexcitabilityofthemotorcortex,slowedconductionbetweenthemotor cortex and spinal motor neurons, several factors at the motor neuron level, reducedconductionvelocitiesinmotoraxons,andsoforth.
FIGURE7.3Firstdorsalinterosseusmusclemotorevokedpotentials after transcranial motor cortex stimulation (A) and spinal root stimulation (B) and compound muscle action potential (M) and F­waves(F)afterperipheralulnarnervestimulation(C).CMCT=T1− T2(seetext).
CMCT,centralmotorconductiontime;TMS,transcranialmageneticstimulation.
Clinical applications of transcranial stimulation include SCI, multiple sclerosis, anterior horn cell disorders (e.g., amyotrophic lateral sclerosis), spondyloticmyelopathy,aswellas a host ofotherneurological disorders (53–
71). These can also be utilized in the operating room during surgery, where
monitoringmotorconductionisausefulindicatoroftheintegrityofthecentral motor pathways, especially during neurosurgical operations (31,34,72–79), as wellasintheintensivecareunit(80,81).Finally,MEPsmaybeusefulinfollow upofmotorfunctionduringrehabilitationandasanobjectiveresearchmetric.
In SCI, a good correlation was seen between MEP findings and motor function(68,82–89). Decreased MEPamplitudes or absent MEP responses are
more frequently seen in neoplastic than in inflammatory lesions. Conversely, inflammatorylesionsoftendemonstrateincreasedlatencies(90).Inacutespinal ischemia, normal MEPS are significantly predictive of an excellent prognosis (91).Inpatientswithhighleveltetraplegia,inwhomthediaphragmisaffected, MEPs can be recorded from the diaphragm, as well as from other respiratory muscles, to investigate the central motor conduction properties of this musculature(67–69,71,92,93).
In multiple sclerosis (MS), most authors found clearly delayed CMCTs (62,94–97),inupto79%ofpatientswithdefiniteMS(98).AbsentMEPswere mostlyseeninthoseMSpatientswithmarkedclinicaldisabilities(96).Increased CMCTswereoftenaccompaniedbydispersedandreducedsizeofMEPs,butno correlation was found between CMCT and duration of the disease. In MS patientswithsexualdysfunction,prolongedCMCTsofpelvicfloormuscleswere seen (99). A higher rate of MEP abnormalities was found when altered MRI signal was localized within the parietal cortex, centrum semiovale, and the internalcapsule(100).
In anterior horn cell disorders, prolonged or absent MEPs were found in patients with amyotrophic lateral sclerosis (ALS), either with high-voltage electricalstimulation (48,101,102) or with magnetoelectricalstimulation (103–
105). This was also shown in a subgroup of patients with primary lateral
sclerosis (106). MEPs and cortical excitability may also be helpful in distinguishing anterior horn cell disease from other similar pathologies (107,108). MEPstudies have further suggested that hyperexcitability precedes lowermotorneurondysfunctioninALS(109).
Inspondylotic myelopathy, CMCThas beenreported tocorrelate wellwith clinical and radiological signs of cord compression (14,110–115). CMCT is more often abnormal than amplitude or morphology of the MEPs. In cervical spondylosis, MEP abnormalities exceed those of SEPs, most likely because spondylosisanddischerniationtendtoproducecompressionofthecorticospinal tracts rather than of dorsal columns (14). However, prolonged CMCT is not necessarily due to demyelination but might also be the result from desynchonization of the descending volleys generated by cortical shocks. Conduction block or axonal degeneration ofthe fastest conducting fibers may alsoproduceCMCTlengthening as well as desynchonization of the responses andreductioninamplitude(110).
Finally, MEPs can be useful in the follow up of motor function during treatmentandrehabilitation,whichmayserveofinterestforthetherapeuticstaff
andthepatient’smotivation(84,114–122).
REFERENCES
1. Electrode Position Nomenclature Committee. American electroencephalographic society guidelines
for standard electrode position nomenclature. J Clin Neurophys. 1991;8(2):200–202. doi:10.1097/00004691-199104000-00007
2. Eisen A, Aminoff MJ. Somatosensory evoked potentials. In: Aminoff MJ, ed. Electrodiagnosis in
ClinicalNeurology.2nded.NewYork,NY:ChurchillLivingstone;1986:535–573.
3. Cole JL, Pease W. Central nervous system electrodiagnostics. In: DeLisa J, ed. Rehabilitation
Medicine:PrinciplesandPractice.2nded.Philadelphia,PA:JBLippincott-Raven;1993.
4. Maugière F. Clinicalutility of somatosensory evoked potentials(SEPs): present debates and future
trends.ElectroencephalogrClinNeurophysiolSuppl.1996;46:27–33.
5. Goldberg G. Clinical neurophysiology of the central nervous system. Evoked potentials and other
neurophysiologictechniques.In:GraboisM,GarrisonSJ,HartKA,etal.,eds.PhysicalMedicineand Rehabilitation.TheCompleteApproach.Malden,MA:BlackwellScience,USA;2000.
6. Goldberg G, Cole JL, Lissens MA. Sensory and motor evoked potentials.In: O’Young BJ, Young
MA,StiensSA,eds.PhysicalMedicineandRehabilitationSecrets.3rded.Philadelphia,PA:Mosby, Elsevier:2008;130–141.
7. Chiappa KH,ed. Evoked Potentials in Clinical Medicine. 3rd ed. Philadelphia, PA: JB Lippincott;
1997.
8. SeyalM,GaborAJ.Thehumanposteriortibialsomatosensoryevokedpotential:Synapsedependent
and synapse independent spinal components. Electroencephalogr Clin Neurophysiol. 1985;17:171–
176.doi:10.1016/0168-5597(85)90040-1
9. Spielholz NI, Sell GH, Goodgold J, etal. Electrophysiological studies in patients with spinal cord
lesions.ArchPhysMedRehabil.1972;53(12):558–562.
10. CurtA,DietzV.Electrophysiologicalrecordingsinpatientswith spinalcordinjury:significancefor
predictingoutcome.SpinalCord.1999;37(3):157–165.doi:10.1038/sj.sc.3100809
11. Boakye M, Harkema S, Ellaway PH, et al. Quantitative testing in spinal cord injury: overview of
reliability and predictive validity. J Neurosurg Spine. 2012;17(1 Suppl):141–150. doi:
10.3171/2012.5.AOSPINE1296
12. Hwang P, Sohn MK, Kim CS, Jee S. Tibial somatosensory evoked potential can prognosticate for
ambulatory function in subacute hemiplegic stroke. J Clin Neurosci. 2016;26:122–125. doi:10.1016/j.jocn.2015.05.070
13. PerlikSJ,FisherMA.Somatosensoryevokedresponseevaluationofcervicalspondylyticmyelopathy.
MuscleNerve.1987;10(6):481–489.doi:10.1016/j.jocn.2015.05.070
14. deNoordhoutAM,RemacleJM,PepinJL,etal.Magneticstimulationofthemotorcortexincervical
spondylosis.Neurology.1991:41:75–80.doi:10.1212/WNL.41.1.75
15. NakaiS,SonooM,ShimizuT.Somatosensoryevokedpotentials(SEPs)fortheevaluationofcervical
spondyloticmyelopathy:utilityoftheonset-latency parameters. ClinNeurophysiol.2008;119:2396–
2404.doi:10.1016/j.clinph.2008.07.003
16. Oddo M, Rossetti AO. Predicting neurological outcome after cardiac arrest. Curr Opin Crit Care.
2011;17(3):254–259.doi:10.1097/MCC.0b013e328344f2ae
17. Amantini A, Carrai R, Lori S,etal.Neurophysiologicalmonitoringinadult and pediatric intensive
care.MinervaAnestesiol.2012;78(9):1067–1075.
18. Horn J, Cronberg T, Taccone FS. Prognostication after cardiac arrest. Curr Opin Crit Care.
2014;20(3):280–286.doi:10.1097/MCC.0000000000000085
19. Nociti V, Batocchi AP, Bartalini S, et al. Somatosensory evoked potentials reflect the upper limb
motor performance in multiple sclerosis. J Neurol Sci. 2008;273(1-2):99–102. doi:10.1016/j.jns.2008.06.030
20. LeocaniL,RovarisM,BoneschiFM,et al.Multimodalevokedpotentialstoassessthe evolutionof
multiple sclerosis: a longitudinal study. J Neurol Neurosurg Psychiatry. 2006;77(9):1030–1035. doi:10.1136/jnnp.2005.086280
21. Kallmann BA, Fackelmann S, ToykaKV,etal.Earlyabnormalitiesofevoked potentials and future
disability in patients with multiple sclerosis. Mult Scler J. 2006;12(1):58–65. doi:10.1191/135248506ms1244oa
22. Thirumala PD, Cheng HL,LokeYK,et al. Diagnostic accuracy of somatosensoryevokedpotential
monitoringduringscoliosisfusion.JClinNeurosci.2016;30:8–14.doi:10.1016/j.jocn.2016.01.017
23. ThiagarajanK,ChengHL,HuangJE,etal.Istworeallybetterthanone?Examiningthesuperiorityof
dualmodalityneurophysiologicalmonitoringduringcarotid endarterectomy: ameta-analysis.World Neurosurg.2015;84(6):1941–1949.doi:10.1016/j.wneu.2015.08.040
24. Thirumala PD, Natarajan P, Thiagarajan K, et al. Diagnostic accuracy of somatosensory evoked
potential and electroencephalography during carotid endarterectomy. Neurol Res. 2016;38(8):698–
705.doi:10.1080/01616412.2016.1200707
25. DikmenPY,EmreOgeA.Diagnosticuseofdermatomalsomatosensory-evoked potentialsinspinal
disorders: case series. J Spinal Cord Med. 2013;36(6):672–678. doi:10.1179/2045772313Y.0000000107
26. KramerJK,TaylorP, SteevesJD,etal.Dermatomalsomatosensoryevokedpotentials and electrical
perceptionthresholdsduringrecoveryfromcervicalspinalcordinjury.NeurorehabilNeuralRepair. 2010;24(4):309–317.doi:10.1177/1545968309348312
27. JarratJA,BarkerAT,FreestonIL,etal.Magneticstimulationofthehumannervoussystem:clinical
applications.In:ShokrovertyS,ed.MagneticStimulationinClinicalNeurophysiology.Boston,MA: Butterworths;1990:185–204.
28. MurrayNMF.Magneticstimulationofthebrain:clinicalapplications.In:ShokrovertyS,ed.Magnetic
StimulationinClinicalNeurophysiology.Boston,MA:Butterworths;1990:205–231.
29. Lissens MA, ed. Clinical Applications of Magnetic Transcranial Stimulation. Leuven, Belgium:
PeetersPress;1992.
30. Cros D, Chiappa KH. Clinical applications of motor evoked potentials. In: Devinsky O, Beric A,
DogaliM,eds.Electrical and Magnetic Stimulation of the BrainandSpinal Cord.NewYork, NY: RavenPress;1993:179–185.
31. SalaF,ManganottiP,TramontanoV,etal.Monitoringofmotorpathwaysduringbrainstemsurgery:
what we have achieved and what we still miss? Neurophysiol Clin. 2007;37(6):399–406. doi:10.1016/j.neucli.2007.09.013
32. Edwards MJ, Talelli P, Rothwell JC. Clinical applications of transcranial magnetic stimulation in
patients with movement disorders. Lancet Neurol. 2008;7(9):827–840. doi:10.1016/S1474-
4422(08)70190-X
33. RossiS,HallettM,RossiniPM,etal.Safety,ethicalconsiderations,andapplicationguidelinesforthe
use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009;120(12):2008–2039.doi:10.1016/j.clinph.2009.08.016
34. MorotaN,IharaS,DeletisV.Intraoperativeneurophysiologyforsurgeryinandaroundthebrainstem:
role of brainstem mapping and corticobulbar tract motor-evoked potential monitoring. Childs Nerv Syst.2010;26(4):513–521.doi:10.1007/s00381-009-1080-7
35. NajibU,BashirS,EdwardsD,etal.Transcranialbrainstimulation:clinical applications and future
directions.NeurosurgClinNorthAm.2011:22(2):233–251.doi:10.1016/j.nec.2011.01.002
36. Narayana S, Papanicolaou AC, McGregor A, et al. Clinical applications of transcranial magnetic
stimulation in pediatric neurology. J Child Neurol. 2015;30(9):1111–1124. doi:10.1177/0883073814553274
37. Xie J, Boakye M. Electrophysiological outcomes after spinal cord injury. Neurosurg Focus.
2008;25(5):E11.doi:10.1177/0883073814553274
38. Day BL, Rothwell JC, Thompson PD, et al. Motor cortex stimulation in intact man: 2. Multiple
descendingvolleys.Brain.1987;110:1191–1209.doi:10.1093/brain/110.5.1191
39. Rothwell JC, Thompson PD, Day BL, et al. Motor cortex stimulation in intact man: general
characteristics of EMG responses in different muscles. Brain. 1987;110:1173–1190. doi:10.1093/brain/110.5.1173
40. Rothwell JC, Ferbert A, Caramia MD, et al. Intracortical inbibitory circuits studied in humans.
Neurology.1991;41(Suppl):263P.
41. HessCW,MillsKR,MurrayNMF.Responsesinsmallhandmusclesfrommagneticstimulationofthe
humanbrain.JPhysiol.1987;388:397–419.doi:10.1113/jphysiol.1987.sp016621
42. Henneman E, Somjen G, CarpenterDO.Excitabilityandinhibitibilityof motoneurones of different
sizes.JNeurophysiol.1965;28:599–620.doi:10.1152/jn.1965.28.3.599
43. CantelloR,GianelliM,CivardiC,etal.Magneticbrainstimulation:thesilentperiodafterthemotor
evokedpotential.Neurology.1992;42:1951–1959.doi:10.1212/WNL.42.10.1951
44. InghilleriM,BerardelliA,CruccuG,ManfrediM.Silentperiodevokedbytranscranialstimulationof
thehumanmotorcortexandcervicomedullaryjunction.JPhysiol.1993;161:112–125.
45. Ziemann U, Netz J, Szelényi A, et al. Spinal and supraspinal mechanisms contribute to the silent
periodinthe contracting soleus muscleaftertranscranial magnetic stimulation of thehuman motor cortex.NeurosciLett.1993;156:167–171.doi:10.1016/0304-3940(93)90464-V
46. Säisänen L, Pirinen E, TeittiS,et al.Factors influencingcortical silent period: optimized stimulus
location, intensity and muscle contraction. J Neurosci Methods. 2008;169:231–238. doi:10.1016/j.jneumeth.2007.12.005
47. Schnitzler A, Benecke R. Silent period after transcranial brain stimulation is of exclusive cortical
origin: evidence from isolated cortical ischemic lesions in man. Neurosci Lett. 1994;180(1):33–41. doi:10.1016/0304-3940(94)90909-1
48. HugonJ,LubeauM,TabaraudF,etal.Centralmotorconductioninmotorneurondisease.AnnNeurol.
1987;22:544–546.doi:10.1002/ana.410220417
49. Claus D. Central motor conduction: method and normal results. MuscleNerve.1990;13:1125–1132.
doi:10.1002/mus.880131207
50. Kobayashi M, Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol.
2003;2:145–156.doi:10.1016/S1474-4422(03)00321-1
51. RobinsonLR,JantraP,MacleanIC.Centralmotorconductiontimesusingtranscranialstimulationand
Fwavelatencies.MuscleNerve.1988;11:174–180.doi:10.1002/mus.880110214
52. Komori T, Brown WF. Central electromyography. In: Brown WF and Bolton CF, eds. Clinical
Electromyography.Boston,MA:Butterworth-Heinemann;1993:3–23.
53. TassinariCA,MichelucciR,PlasmatiR,etal.Transcranialmagneticstimulationinepilepticpatients:
usefulnessandsafety.Neurology.1990;40:1132–1133.doi:10.1212/WNL.40.7.1132
54. HufnagelA,ElgerCE,DurmenHF,etal.Activationof theepilepticfocusbytranscranialmagnetic
stimulationofthehumanbrain.AnnNeurol.1990;27:49–60.doi:10.1002/ana.410270109
55. Badawy RA,Vogrin SJ, Lai A, et al. Capturingthe epileptic trait: cortical excitabilitymeasures in
patientsandtheirunaffectedsiblings.Brain.2013;136(Pt4):1177–1191.doi:10.1093/brain/awt047
56. BauerPR,KalitzinS,ZijlmansM,etal.Corticalexcitabilityasapotentialclinicalmarkerofepilepsy:
a review of the clinical application of transcranial magnetic stimulation. Int J Neural Syst. 2014;24(2):1430001.doi:10.1142/S0129065714300010
57. ClausD,HardingAE,HessCW,etal.Centralmotorconductionindegenerative ataxicdisorders:a
magnetic stimulation study. J Neurol Neurosurg Psychiatry. 1988;51:790–795. doi:10.1136/jnnp.51.6.790
58. PerettiA,CarusoG,LanzilloB,etal.Centralmotorconductionbydifferentstimulationtechniques:a
study in Friedreich’s ataxia patients. Electroencephalogr Clin Neurophysiol. 1990;75:S117.
doi:10.1016/0013-4694(90)92146-N
59. Murray NMF. The clinical usefulness of magnetic cortical stimulation. Electroencephalogr Clin
Neurophysiol.1991;85:81–85.doi:10.1016/0168-5597(92)90072-J
60. Schwenkreis P, Tegenthoff M, WitscherK, et al. Motor cortex activation by transcranial magnetic
stimulation in ataxia patients depends on the genetic defect. Brain. 2002;125(2):301–309. doi:10.1093/brain/awf023
61. Schelhaas HJ, van de Warrenburg BP, Bos MM, et al. Neurophysiologic studies in early-onset
cerebellarataxia.ClinNeurophysiol.2006;23(4):381–387.doi:10.1097/01.wnp.0000216262.54227.7a
62. Chen R, Cros D, Curra A, et al. The clinicaldiagnosticutilityoftranscranialmagneticstimulation:
report of an IFCN committee. Clin Neurophysiol. 2008;119(3):504–532. doi:10.1016/j.clinph.2007.10.014
63. Maccabee PJ, Amassian VE, Cracco RQ, Cracco JB. Intracranial stimulation of facial nerve in
humans with the magnetic coil. Electroencephalogr Clin Neurophysiol. 1988;70:350–354. doi:10.1016/0013-4694(88)90053-3
64. Schriefer TN, Mils KR, Murray NMF, et al. Evaluation of proximal facial nerve conduction by
transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry. 1988;51:60–66. doi:10.1136/jnnp.51.1.60
65. NowakDA,LinderS,TopkaH.Diagnosticrelevanceoftranscranialmagneticandelectricstimulation
of the facial nerve in the management of facial palsy.Clin Neurophysiol. 2005;116(9):2051–2057. doi:10.1016/j.clinph.2005.05.007
66. Happe S,Bunten S. Electrical and transcranialmagnetic stimulation of the facial nerve: diagnostic
relevance in acute isolated facial nerve palsy. Eur Neurol. 2012;68(5):304–309. doi:10.1159/000341624
67. Lissens MA, Vanderstraeten GG. Motor evoked potentials of the respiratory muscles in tetraplegic
patients.SpinalCord.1996;34:673–678.doi:10.1038/sc.1996.122
68. Kawaguchi Y, KitagawaH, Nakamura H,et al. Neurophysiological testsof respiratory function by
compoundmuscleactionpotentials from the diaphragm. Detection oflesionsinthe higher cervical cord.JBoneJointSurgBr.2000;82(5):695–701.doi:10.1302/0301-620X.82B5.10390
69. RossEZ,NowickyAV,McConnellAK.Influenceofacuteinspiratoryloadingupondiaphragmmotor-
evoked potentials in healthy humans. J Appl Physiol. 2007;102(5):1883–1890. doi:10.1152/japplphysiol.00694.2006
70. Lissens MA. Electrodiagnostic evaluation of the respiratory muscles. Crit Rev Phys Rehabil Med.
2010;22:91–101.doi:10.1615/critrevphysrehabilmed.v22.i1-4.80
71. ShimizuT,KomoriT, KugioY,etal.Electrophysiologicalassessmentofcorticorespiratorypathway
function in amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2010;11(1-2):57–62. doi:10.3109/17482960903207385
72. Zentner J. Noninvasive motor evoked potential monitoring during neurosurgical operations on the
spinalcord.Neurosurgery.1989;24:709–712.doi:10.1227/00006123-198905000-00008
73. JacobsMJ,MessW, Mochtar B,etal.Thevalueofmotorevokedpotentialsinreducingparaplegia
during thoracoabdominal aneurysm repair. J Vasc Surg. 2006;43:239–246. doi:10.1016/j.jvs.2005.09.042
74. Langeloo DD, Journée HL, de Kleuver M, et al. Criteria for transcranial electrical motor evoked
potential monitoring during spinal deformity surgery: a review and discussion of the literature. NeurophysiolClin.2007;37(6):431–439.doi:10.1016/j.neucli.2007.07.007
75. MacdonaldDB,AlZayedZ,AlSaddigiA.Four-limbmusclemotorevokedpotentialandoptimized
somatosensory evoked potential monitoring with decussation assessment: results in 206 thoracolumbarspinesurgeries.EurSpineJ.2007;16:S171–S187.doi:10.1007/s00586-007-0426-7
76. DeletisV,SalaF.Intraoperativeneurophysiologicalmonitoringof thespinalcordduring spinalcord
andspine surgery: a reviewfocus on thecorticospinal tracts. Clin Neurophysiol.2008;119(2):248–
264.doi:10.1016/j.clinph.2007.09.135
77. LallRR,LallRR,HauptmanJS,etal.Intraoperativeneurophysiologicalmonitoringinspinesurgery:
indications, efficacy, and role of the preoperative checklist. Neurosurg Focus. 2012;33(5):E10. doi:10.3171/2012.9.FOCUS12235
78. KohtA,SloanTB.Intraoperativemonitoring:recentadvancesinmotorevokedpotentials.Anesthesiol
Clin.2016;34(3):525–535.doi:10.1016/j.anclin.2016.04.006
79. Kothbauer KF. The interpretation of muscle motor evoked potentials for spinal cord monitoring. J
ClinNeurophysiol.2017;34(1):32–37.doi:10.1097/WNP.0000000000000314
80. FirschingR.ClinicalapplicationsofmagneticTCSincomatosepatients.In:LissensMA,ed.Clinical
ApplicationsofMagneticTranscranialStimulation.Leuven,Belgium:PeetersPress;1992:263–268.
81. ProcaccioF,PoloA,LanteriP,etal.Electrophysiologicmonitoringinneurointensivecare.CurrOpin
CritCare.2001;7(2):74–80.doi:10.1097/00075198-200104000-00004
82. TegenthoffM. Clinicalapplicationsofmagnetictranscranialstimulationin acute spinal cord injury.
In:LissensMA,ed.ClinicalApplications of Magnetic TranscranialStimulation. Leuven, Belgium: PeetersPress;1992:33–41.
83. Dimitrijevic MR, Kofler M, McKay WB, etal. Earlyand late lower limb motorevoked potentials
elicited by transcranial magnetic motor cortex stimulation. Electroenceph Clin Neurophysiol. 1992;85:365–373.doi:10.1016/0168-5597(92)90049-H
84. LissensMA,McKayWB,VanderLindenC,DimitrijevicMR.Transcranialmotorcortexstimulation
inpatientswithestablishedspinalcordinjury.In:LissensMA,ed.ClinicalApplicationsofMagnetic TranscranialStimulation.Leuven,Belgium:PeetersPress;1992:42–55.
85. MeyerB,ZentnerJ.Domotor evokedpotentialsallowquantitativeassessment ofmotorfunctionin
patients with spinal cord lesions? Eur Arch Psychiatry Clin Neurosci. 1992;241:201–204. doi:10.1007/BF02190253
86. McKayWB,StokicDS,DimitrijevicMR.Assessmentofcorticospinalfunctioninspinalcordinjury
using transcranial motor cortex stimulation: a review. J Neurotrauma. 1997;14:539–548. doi:10.1089/neu.1997.14.539
87. BjerkeforsA,SquairJW,ChuaR,etal.Assessmentofabdominalmusclefunctioninindividualswith
motor-complete spinal cord injury above T6 in response to transcranial magnetic stimulation. J RehabilMed.2015;47(2):138–146.doi:10.2340/16501977-1901
88. NardoneR,HöllerY,BrigoF,etal.Descendingmotorpathwaysandcorticalphysiologyafterspinal
cordinjuryassessedbytranscranialmagneticstimulation:asystematicreview.BrainRes.2015;1619: 139–154.doi:10.1016/j.brainres.2014.09.036
89. Cortes M, Thickbroom GW, Elder J, et al. The corticomotor projection to liminally-contractable
forearmmusclesinchronicspinalcordinjury:atranscranialmagneticstimulationstudy.SpinalCord. 2017;55(4):362–366.doi:10.1038/sc.2016.161
90. Linden D, Berlit P. Magnetic motor evoked potentials (MEP) in diseases of the spinal cord. Acta
NeurolScand.1994;90:348–353.doi:10.1111/j.1600-0404.1994.tb02736.x
91. Artemis D, WolfM, Blahak C, et al. Diagnostic and prognostic relevance of magnetic resonance
imaging and electrophysiological findings in acute spinal ischemia. J Stroke Cerebrovasc Dis. 2017;26(3):459–464.doi:10.1016/j.jstrokecerebrovasdis.2016.12.031
92. LissensMA.Motorevokedpotentialsofthehumandiaphragmelicitedthroughmagnetictranscranial
brainstimulation.JNeurolSci.1994;124:204–207.doi:10.1016/0022-510X(94)90327-1
93. ZifkoU,RemtullaH,PowerK,etal.Transcorticalandcervicalmagneticstimulationwithrecording
of the diaphragm. Muscle Nerve. 1996;19:614–620. doi:10.1002/(SICI)1097-
4598(199605)19:5<614::AID-MUS9>3.0.CO;2-E
94. Cowan JMA, Dick JPR, Day BL, et al. Abnormalities in central motor pathways conduction in
multiplesclerosis.Lancet.1984;2:304–307.doi:10.1016/S0140-6736(84)92683-7
95. HessCW,MillsKR,MurrayNMF.Magneticstimulationofthebrain:facilitationofmotorresponses
byvoluntary contraction of ipsilateraland contralateral muscles withadditional observations on an amputee.NeurosciLett.1986;71:235–240.doi:10.1016/0304-3940(86)90565-3
96. Kale N, Agaoglu J, Onder G, et al. Correlation between disability and transcranial magnetic
stimulationabnormalitiesinpatientswithmultiplesclerosis.JClinNeurosci.2009;16(11):1439–1442. doi:10.1016/j.jocn.2009.03.009
97. SimpsonM,MacdonellR.Theuseoftranscranialmagneticstimulationindiagnosis,prognostication
and treatment evaluation in multiple sclerosis. Mult Scler Relat Disord. 2015;4(5):430–436. doi:10.1016/j.msard.2015.06.014
98. HessCW,MillsKR,MurrayNMF,etal.Magneticbrainstimulation:centralmotorconductionstudies
inmultiplesclerosis.AnnNeurol.1987;22:744–752.doi:10.1016/j.msard.2015.06.014
99. Opsomer RJ, Caramia MD, Zarola F, et al. Neurophysiological evaluation of central-peripheral
sensory and motor pudendal fibers. Electroenceph Clin Neurophysiol. 1989;74:260–270. doi:10.1016/0168-5597(89)90056-7
100. Rossini PM, CaramiaM, Zarola F, etal. Sensory (VEP,BAEP,SEP)and motor evokedpotentials,
liquoral and magnetic resonance findings in multiple sclerosis. Eur Neurol. 1989;29:41. doi:10.1159/000116376
101. BerardelliA,InghilleriM,FormisanoR,etal.Stimulationofmotortractsinmotorneuronedisease.J
NeurolNeurosurgPsychiatry.1987;50:732–737.doi:10.1136/jnnp.50.6.732
102. Ingram DA, Swash M. Central motor conduction is abnormal in motor neuron disease. J Neurol
NeurosurgPsychiatry.1987;50:159–166.doi:10.1136/jnnp.50.2.159
103. EisenA,ShtybelW,MurphyK,etal.Corticalmagneticstimulationinamyotrophiclateralsclerosis.
MuscleNerve.1990;13:146–151.doi:10.1002/mus.880130211
104. KoharaN,KajiR,KojimaY,etal.Abnormalexcitabilityofthecorticospinalpathwayinpatientswith
amyotrophic lateral sclerosis: a single motor unit study using transcranial magnetic stimulation. ElectroencephalogrClinNeurophysiol.1996;101:32–41.doi:10.1016/0013-4694(95)00166-2
105. Vucic S, Ziemann U, Eisen A, et al. Transcranial magnetic stimulation and amyotrophic lateral
sclerosis: pathophysiological insights. J Neurol Neurosurg Psychiatry. 2013;84(10):1161–1170. doi:10.1136/jnnp-2012-304019
106. BrownWF,EbersGC,HudsonAJ,etal.Motorevokedresponsesinprimarylateralsclerosis.Muscle
Nerve.1992;15:626–629.doi:10.1002/mus.880150515
107. VucicS,KiernanMC.CorticalexcitabilitytestingdistinguishesKennedy’sdiseasefromamyotrophic
lateralsclerosis.ClinNeurophysiol.2008;119:1088–1096.doi:10.1016/j.clinph.2008.01.011
108. AttarianS,VedelJP,PougetJ,SchmiedA.Progressionofcorticalandspinaldysfunctionsovertime
inamyotrophiclateralsclerosis.MuscleNerve.2008;37:364–375.doi:10.1016/j.clinph.2014.04.023
109. MenonP,KiernanMC,VucicS.Corticalhyperexcitabilityprecedeslowermotorneurondysfunction
inALS.ClinNeurophysiol.2015;126(4):803–809.doi:10.1016/j.clinph.2014.04.023
110. ThompsonPD,DickJPR,Asselman P, et al.Examinationofmotorfunctioninlesionsof thespinal
cordbystimulationofthemotorcortex.AnnNeurol.1987;21:389–396.doi:10.1002/ana.410210412
111. AbbruzzeseG,Dall’AgataD,MorenaM,etal.Electricalstimulationofthemotorcortexincervical
spondylosis.JNeurolNeurosurgPsychiatry.1988;51:796–802.doi:10.1136/jnnp.51.6.796
112. MasurH, Elger CE, Render K, et al. Functionaldeficits of centralsensory and motor pathways in
patients with cervical spondylosis: a study of SEPs and EMG responses to non invasive brain stimulation. Electroencephalogr Clin Neurophysiol. 1989;74:450–457. doi:10.1016/0168-
5597(89)90035-X
113. LoYL,ChanLL,LimW,etal.Transcranialmagneticstimulationscreeningforcordcompressionin
cervicalspondylosis.JNeurolSci.2006;244:1721.doi:10.1016/j.jns.2005.12.002
114. Kalupahana NS, Weerasinghe VS, Dangahadeniya U, et al. Abnormal parameters of magnetically
evoked motor-evoked potentials in patients with cervical spondylotic myelopathy. Spine J. 2008;8(4):645–649.doi:10.1016/j.spinee.2006.11.010
115. RikitaT,TanakaN,NakanishiK,etal.Therelationshipbetweencentralmotorconductiontimeand
spinal cord compression in patients with cervical spondylotic myelopathy. Spinal Cord. 2017;55(4):419–426.doi:10.1038/sc.2016.130
116. LissensMA,McKayWB.Valueofmotorevokedpotentialselicitedbymagnetictranscranial motor
cortex stimulation in the prognosis and follow-up during rehabilitation of stroke rehabilitation. In: Lissens MA, ed. Clinical Applications of Magnetic Transcranial Stimulation. Leuven, Belgium: PeetersPress;1992:283–290.
117. HummelsheimH,HauptmannB, Neumann S. Influence ofphysiotherapeuticfacilitationtechniques
on motor evoked potentials in centrally paretic hand extensor muscles. Electroencephalogr Clin Neurophysiol.1995;97:18–28.doi:10.1016/0924-980X(94)00279-G
118. Hendricks HT,Zwarts MJ, Plat EF, et al. Systematic review for the early prediction of motor and
functional outcome after stroke by using motor-evoked potentials. Arch Phys Med Rehabil. 2002;83(9):1303–1308.doi:10.1053/apmr.2002.34284
119. Liepert J. Transcranial magnetic stimulation in neurorehabilitation. Acta Neurochir Suppl.
2005;93:71–74.doi:10.1007/3-211-27577-0_10
120. LeeSY,KimBR,HanEY.Associationbetweenevokedpotentialsandbalancerecoveryinsubacute
hemipareticstrokepatients.AnnRehabilMed.2015;39(3):451–461.doi:10.5535/arm.2015.39.3.451
121. CakarE,AkyuzG,DurmusO,etal.Therelationshipsofmotor-evokedpotentialstohanddexterity,
motorfunction, and spasticity in chronic stroke patients:a transcranial magnetic stimulation study. ActaNeurolBelg.2016;116(4):481–487.doi:10.1007/s13760-016-0633-2
122. YoJY,LeeA,KimMS,et al. Prediction of motor recovery using quantitativeparametersofmotor
evoked potentials in patients with stroke. Ann Rehabil Med. 2016;40(5):806–815. doi:10.5535/arm.2016.40.5.806