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Publication Detail
Intra-operative recording of motor tract potentials at the cervico-medullary junction following scalp electrical and magnetic stimulation of the motor cortex.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Thompson PD, Day BL, Crockard HA, Calder I, Murray NM, Rothwell JC, Marsden CD
  • Publication date:
  • Pagination:
    618, 623
  • Journal:
    J Neurol Neurosurg Psychiatry
  • Volume:
  • Issue:
  • Status:
  • Country:
  • Print ISSN:
  • Language:
  • Keywords:
    Adult, Aged, Cervical Vertebrae, Efferent Pathways, Electric Stimulation, Electromagnetic Fields, Evoked Potentials, Somatosensory, Female, Hand, Humans, Male, Medulla Oblongata, Middle Aged, Monitoring, Intraoperative, Motor Cortex, Motor Neurons, Muscle Contraction, Muscles, Pons, Spinal Cord, Spinal Cord Compression, Spinal Diseases, Synaptic Transmission
Activity in descending motor pathways after scalp electrical and magnetic brain stimulation of the motor cortex was recorded from the exposed cervico-medullary junction in six patients having trans-oral surgery of the upper cervical spine. Recordings during deep anaesthesia without muscle paralysis revealed an initial negative potential (D wave) at about 2 ms with electrical stimulation in five of the six patients. This was followed by a muscle potential which obscured any later waveforms. Magnetic stimulation produced clear potentials in only one patient. The earliest wave to magnetic stimulation during deep anaesthesia was 1-2 ms later than the earliest potential to electrical stimulation. Following lightening of the anaesthetic and the administration of muscle relaxants a series of later negative potentials (I waves) were more clearly seen to both electrical and magnetic stimulation. More I waves were recorded to magnetic stimulation during light anaesthesia than during deep anaesthesia. Increasing the intensity of electrical stimulation also produced an extra late I wave. At the highest intensity of magnetic stimulation the latency of the earliest potential was comparable to the D wave to electrical stimulation. The intervals between these various D and I waves corresponded to those previously described for the timing of single motor unit discharge after cortical stimulation.
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