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Why do stroke patients with negative motor evoked potential show poor limb motor function recovery?

Neural Regeneration Research 2013年第29期8卷 2713-2724页

作者： Zhibin Song Lijuan Dang Yanling Zhou Yanjiang Dong Haimao Liang Zhengfeng Zhu Suyue Pan Department of Neurology Xiaolan Hospital of Southern Medical University Department of Neurology Nanfang Hospital of Southern Medical University

Negative motor evoked potentials after cerebral infarction, indicative of poor recovery of limb motor function, tend to be accompanied by changes in fractional anisotropy values and the cerebral pe-duncle area on the affected side, but the characteristics of these changes have not been reported. This study included 57 cases of cerebral infarction whose motor evoked potentials were tested in the 24 hours after the first inspection for diffusion tensor imaging, in which 29 cases were in the negative group and 28 cases in the positive group. Twenty-nine patients with negative motor evoked potentials were divided into two groups according to fractional anisotropy on the affected side of the cerebral peduncle： a fractional anisotropy 〈 0.36 group and a fractional anisotropy 〉 0.36 group. All patients underwent a regular magnetic resonance imaging and a diffusion tensor imaging examina- tion at 1 week, 1, 3, 6 and 12 months after cerebral infarction. The FugI-Meyer scores of their hemiplegic limbs were tested before the magnetic resonance and diffusion tensor imaging exami-nations. In the negative motor evoked potential group, fractional anisotropy in the affected cerebral peduncle declined progressively, which was most obvious in the first 1-3 months after the onset of cerebral infarction. The areas and area asymmetries of the cerebral peduncle on the affected side were significantly decreased at 6 and 12 months after onset. At 12 months after onset, the area asymmetries of the cerebral peduncle on the affected side were lower than the normal lower limit value of 0.83. FugI-Meyer scores in the fractional anisotropy ≥0.36 group were significantly higher than in the fractional anisotropy 〈 0.36 group at 3-12 months after onset. The fractional anisotropy of the cerebral peduncle in the positive motor evoked potential group decreased in the first 1 month after onset, and stayed unchanged from 3-12 months; there was no change in the area of the cerebral peduncle in the first 1-12 months after cerebral infarction. These fin

关键词： neural regeneration neuroimaging cerebral infarction motor evoked potential fractional anisotropy cerebralpeduncle magnetic resonance diffusion tensor imaging grants-supported paper neuroregeneration

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Cortical evoked potential changes in a rat model of acute ischemic stroke Detection of somatosensory evoked potential and motor evoked potential

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Neural Regeneration Research 2010年第7期5卷 550-554页

作者： Yang Shao Department of Neurology Xiangya Hospital of Central South University Changsha 410008 Hunan Province China

BACKGROUND： Studies have shown that latency changes of some elements in a somatosensory evoked potential （SEP） and motor evoked potential （MEP） can reflect electrical activity of cerebral cortical neurons and conduction of white matter nerve fibers. However, there is a paucity of information regarding the dynamic observation of SEP and MEP following cerebral ischemic injury. OBJECTIVE： To explore SEP and MEP changes following acute ischemic stroke, and investigate the role of evoked potentials in monitoring brain function in stroke. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Chongqing Key Laboratory of Neurology, Affiliated Hospital of Chongqing Medical University from September 2007 to August 2008. MATERIALS＂ Hydrogen blood flow detector was purchased from Soochow University Medical Instrument Co., China, and Power lab system was purchased from AD Instruments, Inc., USA. METHODS A total of 36 healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups （n = 9）, including three ischemia groups （12, 24 and 72 hours of ischemia） and a sham-surgery group. The rat model of acute ischemic stroke was established by middle cerebral artery occlusion （MCAO） in the left hemisphere. MAIN OUTCOME MEASURES＂ SEP and MEP of the left limbs were detected, and cerebral blood flow was measured by the hydrogen cleaning method. RESULTS： The latency of positive wave 1 （P1）, negative wave 1 （N1） and positive wave 2 （P2） waves in SEP, and latency of negative wave 1,2 （N1, N2） waves in MEP were significantly prolonged with increasing ischemic duration following MCAO （P 〈 0.01）, but cerebral blood flow was significantly decreased （P 〈 0.05, or P 〈 0.01）. CONLUSION： Ischemic stroke prolongs the latency of SEP waves （P1, N1, P2） and MEP waves （N1, N2）, and cerebral cortical evoked potential may correlate with cerebral blood flow changes. This indicates that SEP and MEP can be used to evaluate brain function following acute ischemic stroke.

关键词： somatosensory evoked potential motor evoked potential latency cerebral blood flow brain function acute ischemic stroke neural regeneration

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motor evoked potential OF MAGNETIC STIMULATION IN THE DETERMINATION OF S_1 RADICULOPATHY

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Journal of Pharmaceutical Analysis 1997年第1期11卷 39-42页

作者：杨哲陈君长赵龙柱王坤正鱼全生王勇

motor evoked potentlal (MEP) elicited by magnetic stimulation was utilised to diagnose S1 radiculopathy non-invasively. Magnetic stimulation estimated motor nerve conduction time (MNCT), which was used in combination with F response recorded from soleus, allowed calculation of motor root conduction time (MRCT). 50 healthy controls and 30 patients with S1 radiculopathy were studied- The results showed that no difference was seen in MNCT in all patients, but MRCT were markedly prolonged in 87% of the patients, which was higher than the prolongation of F wave latency in 71% or the patients. it is concluded that MEP of magnetic stimulation is a useful technique for non-invasive diagnosis of S, radiculopathy.

关键词： magnetic stimulation motor evoked potential F wave latency radiculopathy

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Involuntary muscle spasm expressed as motor evoked potential after olfactory mucosa autograft in patients with chronic spinal cord injury and complete paraplegia

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Journal of Biomedical Science and Engineering 2013年第9期6卷 908-916页

作者： Koichi Iwatsuki Toshiki Yoshimine Yoshiyuki Sankai Fumihiro Tajima Masao Umegaki Yu-Ichiro Ohnishi Masahiro Ishihara Koshi Ninomiya Takashi Moriwaki Department of Neurosurgery Osaka University Medical SchoolOsakaJapan Faculty of Engineering‚Information and Systems University of TsukubaTsukubaJapan Department of Rehabilitation Wakayama Medical UniversityWakayamaJapan

Object: The efficacy of olfactory mucosa autograft (OMA) for chronic spinal cord injury has been reported. New activity in response to voluntary effort has been documented by electromyography (EMG), but the emergence of motor evoked potential (MEP) reflecting electrophysiological conductivity in the central nervous system, including the corticospinal pathway, after OMA, and the best indications for OMA, have not been clarified. Here, we report the emergence of MEPs after OMA and offer recom-mendations for appropriate indications based on the presence of involuntary muscle spasm (IMS). We used analysis of MEP to examine the efficacy of OMA for patients with complete paraplegia due to chronic spinal cord injury. To clarify the indications for OMA, we investigated the association of IMS and efficacy of OMA. Methods: Four patients, 3 men and 1 woman, were enrolled. The mean age of the cases was 30.3 ± 9.5 years (range, 19 to 40 years). All 4 cases were American Spinal Injury Association (ASISA) grade A. The mean duration from injury to OMA was 95.8 ± 68.2 months (range, 17 to 300 months). Samples of olfactory mucosa were removed, cut into smaller pieces, and grafted into the sites of spinal cord lesions after laminectomy. Postoperative subcutaneous fluid collection, postoperative meningitis, postoperative nosebleed, postoperative infection in the nasal cavity, impaired olfaction, neoplastic tissue overgrowth at the autograft site, new sensory disturbance, and involuntary muscle spasm were investigated as safety issues. Improvements in ASIA grade, variations in ASIA scores, EMG, SSEP, and improved urological function were evaluated as efficacy indicators. Results: There were no serious adverse events in this series. In 2 of the 4 cases, an improvement in motor function below the level of injury was recognized. In one, the motor score was 50 until 16 weeks after surgery, and it increased to 52 from 20 weeks after surgery. In the other, the motor score was 50 until 20 weeks after surgery, and it increased to 52 at 24 we

关键词： Olfactory Mucosa Autograft Spinal Cord Injury Transplantation Voluntary Movement motor evoked potential

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Identification of injury type using somatosensory and motor evoked potentials in a rat spinal cord injury model

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Neural Regeneration Research 2023年第2期18卷 422-427页

作者： Rong Li Han-Lei Li Hong-Yan Cui Yong-Can Huang Yong Hu Department of Orthopedics and Traumatology The University of Hong Kong-Shenzhen HospitalShenzhenGuangdong ProvinveChina Department of Neurosurgery Neuroscience CenterIntegrated Hospital of Traditional Chinese MedicineSouthern Medical UniversityGuangzhouGuangdong ProvinveChina Institute of Biomedical Engineering Chinese Academy of Medical Sciences and Peking Union Medical CollegeTianjinChina Shenzhen Engineering Laboratory of Orthopedic Regenerative Technologies Department of Spine SurgeryPeking University Shenzhen HospitalShenzhenGuangdong ProvinveChina Department of Orthopedics and Traumatology The University of Hong KongPokfulamHong Kong Special Administrative RegionChina

The spinal cord is at risk of injury during spinal surgery.If intraoperative spinal co rd injury is identified early,irreve rsible impairment or loss of neurological function can be prevented.Different types of spinal cord injury result in damage to diffe rent spinal cord regions,which may cause diffe rent somatosensory and motor evoked potential signal res ponses.In this study,we examined electrophysiological and histopathological changes between contusion,distra ction,and dislocation spinal cord injuries in a rat model.We found that contusion led to the most severe dorsal white matter injury and caused considerable attenuation of both somatosensory and motor evoked potentials.Dislocation resulted in loss of myelinated axons in the lateral region of the injured spinal cord along the rostrocaudal axis.The amplitude of attenuation in motor evoked potential responses caused by dislocation was greater than that caused by contusion.After distraction injury,extracellular spaces were slightly but not significantly enlarged;somatosensory evoked potential res ponses slightly decreased and motor evoked potential responses were lost.Correlation analysis showed that histological and electrophysiological findings we re significantly correlated and related to injury type.Intraope rative monitoring of both somatosensory and motor evoked potentials has the potential to identify iatrogenic spinal cord injury type during surgery.

关键词： contusion injury dislocation injury distraction injury electropnysiology heterogeneity histopathology injury mechanism motor evoked potential somatosensory evoked potential spinal cord injury

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Combined monitoring of evoked potentials during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms

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Chinese Medical Journal 2007年第18期120卷 1567-1573页

作者： KANG De-zhi WU Zan-yi LAN Qing YU Liang-hong LIN Zhang-ya WANG Chen-yang LIN Yuan-xiang Department of Neurosurgery First Affiliated Hospital of FujianMedical University Fuzhou 350005 China Department of Neurosurgery Second Affiliated Hospital of SuzhouUniversity Suzhou 215004 China

Background Neurophysiologic monitoring during surgery is to prevent permanent neurological injury resulting from surgical manipulation. To improve the accuracy and sensitivity of intraoperative neuromonitoring, combined monitoring of transcranial electrical stimulation motor evoked potentials （TES-MEPs）, somatosensory evoked potentials （SSEPs） and brainstem auditory evoked potentials （BAEPs） was attempted in microsurgery for lesions adjacent to the brainstem and intracranial aneurysms. Methods Monitoring of combined TES-MEPs with SSEPs was attempted in 68 consecutive patients with lesions adjacent to the brainstem as well as intracranial aneurysms. Among them, 31 patients （31 operations, 28 of posterior cranial fossa tumors, 3 of posterior circulation aneurysms） were also subjected to monitoring of BAEPs. The correlation of monitoring results and clinical outcome was studied prospectively. Results Combined monitoring of evoked potentials （EPs） was done in 64 （94.1%） of the 68 patients. MEPs monitoring was impossible for 4 patients （5.9%）. No complication was observed during the combined monitoring in all the patients. In 45 （66.2%） of the 68 patients, EPs were stable, and they were neurologically intact. motor dysfunction was detected by MEPs in 8 patients, SSEPs in 5, and BAEPs in 4, respectively. Conclusions A close relationship exists between postoperative motor function and the results of TES-MEPs monitoring TES-MEPs are superior to SSEPs and BAEPs in detecting motor dysfunction, but combined EPs serve as a safe, effective and invasive method for intraoperative monitoring of the function of the motor nervous system. Monitoring of combined EPs during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms may detect potentially hazardous maneuvers and improve the safety of subsequent procedures.

关键词： motor evoked potential transcranial electrical stimulation, somatosensory evoked potential brainstem auditory evoked potential brainstem intracranial aneurysm

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Collagen/heparan sulfate porous scaffolds loaded with neural stem cells improve neurological function in a rat model of traumatic brain injury

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Neural Regeneration Research 2021年第6期16卷 1068-1077页

作者： Jian Zhang Ren-Jie Wang Miao Chen Xiao-Yin Liu Ke Ma Hui-You Xu Wu-Sheng Deng Yi-Chao Ye Wei-Xin Li Xu-Yi Chen Hong-Tao Sun Tianjin Key Laboratory of Neurotrauma Repair Institute of Traumatic Brain Injury and NeuroscienceCharacteristic Medical Center of Chinese People’s Armed Police ForceTianjinChina Graduate School Logistics University of People’s Armed Police ForceTianjinChina Graduate School Affiliated Hospital of Traditional Chinese MedicineXinjiang Medical UniversityUrumqiXinjiang Uygur Autonomous RegionChina Graduate School Tianjin Medical UniversityTianjinChina

One reason for the poor therapeutic effects of stem cell transplantation in traumatic brain injury is that exogenous neural stem cells cannot effectively migrate to the local injury site,resulting in poor adhesion and proliferation of neural stem cells at the injured area.To enhance the targeted delivery of exogenous stem cells to the injury site,cell therapy combined with neural tissue engineering technology is expected to become a new strategy for treating traumatic brain injury.Collagen/heparan sulfate porous scaffolds,prepared using a freeze-drying method,have stable physical and chemical properties.These scaffolds also have good cell biocompatibility because of their high porosity,which is suitable for the proliferation and migration of neural stem cells.In the present study,collagen/heparan sulfate porous scaffolds loaded with neural stem cells were used to treat a rat model of traumatic brain injury,which was established using the controlled cortical impact method.At 2 months after the implantation of collagen/heparan sulfate porous scaffolds loaded with neural stem cells,there was significantly improved regeneration of neurons,nerve fibers,synapses,and myelin sheaths in the injured brain tissue.Furthermore,brain edema and cell apoptosis were significantly reduced,and rat motor and cognitive functions were markedly recovered.These findings suggest that the novel collagen/heparan sulfate porous scaffold loaded with neural stem cells can improve neurological function in a rat model of traumatic brain injury.This study was approved by the Institutional Ethics Committee of Characteristic Medical Center of Chinese People’s Armed Police Force,China(approval No.2017-0007.2)on February 10,2019.

关键词： collagen heparan sulfate injury neural stem cells regeneration repair scaffold traumatic brain injury morris water maze motor evoked potential synapses myelin sheaths

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Corticospinal excitability during motor imagery is diminished by continuous repetition-induced fatigue

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Neural Regeneration Research 2021年第6期16卷 1031-1036页

作者： Akira Nakashima Takefumi Moriuchi Daiki Matsuda Takashi Hasegawa Jirou Nakamura Kimika Anan Katsuya Satoh Tomotaka Suzuki Toshio Higashi Kenichi Sugawara Department of Rehabilitation Juzenkai HospitalNagasakiJapan Graduate School of Biomedical Sciences Nagasaki UniversityNagasakiJapan School of Rehabilitation Kanagawa University of Human ServicesYokosukaJapan

Application of continuous repetition of motor imagery can improve the performance of exercise tasks.However,there is a lack of more detailed neurophysiological evidence to support the formulation of clear standards for interventions using motor imagery.Moreover,identification of motor imagery intervention time is necessary because it exhibits possible central fatigue.Therefore,the purpose of this study was to elucidate the development of fatigue during continuous repetition of motor imagery through objective and subjective evaluation.The study involved two experiments.In experiment 1,14 healthy young volunteers were required to imagine grasping and lifting a 1.5-L plastic bottle using the whole hand.Each participant performed the motor imagery task 100 times under each condition with 48 hours interval between two conditions:500 mL or 1500 mL of water in the bottle during the demonstration phase.Mental fatigue and a decrease in pinch power appeared under the 1500-mL condition.There were changes in concentration ability or corticospinal excitability,as assessed by motor evoked potentials,between each set with continuous repetition of motor imagery also under the 1500-mL condition.Therefore,in experiment 2,12 healthy volunteers were required to perform the motor imagery task 200 times under the 1500-mL condition.Both concentration ability and corticospinal excitability decreased.This is the first study to show that continuous repetition of motor imagery can decrease corticospinal excitability in addition to producing mental fatigue.This study was approved by the Institutional Ethics Committee at the Nagasaki University Graduate School of Biomedical and Health Sciences(approval No.18121302)on January 30,2019.

关键词： central nervous system concentration continuous repetition of motor imagery corticospinal excitability mental fatigue motor evoked potential motor imagery muscle fatigue neurophysiology transcranial magnetic stimulation

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Combining motor Imagery and Action Observation with Vibratory Stimulation Increases Corticomotor Excitability in Healthy Young Adults

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Journal of Behavioral and Brain Science 2022年第5期12卷 177-195页

作者： Nodoka Kimura Tomoya Furuta Gen Miura Eiichi Naito Center for Information and Neural Networks (CiNet) Advanced ICT Research Institute National Institute of Information and Communications Technology (NICT) Osaka Japan Graduate School of Frontier Biosciences Osaka University Osaka Japan

Vibratory stimulation but also motor imagery and action observation can induce corticomotor modulation, as a bottom-up stimulus and top-down stimuli, respectively. However, it remains unknown whether the combination of motor imagery, action observation, and vibratory stimulation can effectively increase corticomotor excitability. This study aimed to investigate the effect of motor imagery and/or action observation, in the presence or absence of vibratory stimulation, on the corticomotor excitability of healthy young adults. Vibratory stimulation was provided to the palm of the right hand. Action observation consisted in viewing a movie of someone else’s finger flexion and extension movements. The imagery condition required the participants to imagine they were moving their fingers while viewing the movie and attempting to move their fingers in accordance with the movie. Eleven right-handed healthy young adults were asked to perform six conditions randomly: 1) vibratory stimulation, imagery, and action observation, 2) vibratory stimulation and action observation, 3) vibratory stimulation and viewing of a blank screen, 4) imagery and action observation, 5) action observation, and 6) viewing of a blank screen. Single-pulse transcranial magnetic stimulation was conducted to assess corticomotor excitability and the peak-to-peak amplitude of the motor evoked potentials. The results showed that vibratory stimulation increases corticospinal excitability. The findings further revealed that performing motor imagery while viewing finger movement is more effective at inducing an augmentation of corticomotor excitability compared to action observation alone. Thus, the combination of motor imagery, action observation, and vibratory stimulation can effectively augment corticomotor excitability.

关键词： motor evoked potential Transcranial Magnetic Stimulation Vibratory Stimulation motor Imagery Action Observation

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Combined application of three evoked potentials to improve the diagnosis of multiple sclerosis

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Neural Regeneration Research 2006年第6期1卷 569-572页

作者： Xiaoyi Li Neuroelect rophysiological Center Guizhou Provincial People＇s Hospital Guiyang 520002 Guizhou Province China

BACKGROUND ： It is very important to find out the focal sites for the early diagnosis of multiple sclerosis, especially the discovery of tiny or potential focal site, so that multiple sclerosis can be diagnosed at the early period （the first attack） or when the focus has not displayed completely, and the evoked potential can discover the abnormality of the pathway between spinal cord to cerebral cortex. OBJECTIVE： To observe the values of motor evoked potential （MEP）, somatosensory evoked potential （SEP） and evoked-related potential （P300） in the diagnosis of multiple sclerosis. DESIGN： A case-controlledstudy SETTING： Neuroelectrophysiological Center of Guizhou Provincial People＇s Hospita PARTICIPANTS ： Twenty-five outpatients or inpatients with multiple sclerosis were selected from the Department of Neurology, Guizhou Provincial People＇s Hospital from October 2001 to March 2005. The patients were diagnosed according to the diagnostic standards of multiple sclerosis suggested by Poser et al in 1983 and MRI examination. There were 17 males and 8 females, aged 18-65 years old with an average of 39 years, and their disease courses ranged from 6 months to 5 years. Meanwhile, 30 healthy physical examinees were selected in our hospital as the control group, and they all had no abnormality by detailed inquisition, physical examination and examination of nervous system, including 15 males and 5 females, aged 20-66 years old. All the enrolled subjects were informed and agreed with the detections. METHODS ：（1） The MEP, SEP and P300 were detected with synergy evoked potential equipment （Oxford Instruments, UK） in all the 25 patients with multiple sclerosis and 20 healthy subjects. （2） Standards for judging the abnormalities of evoked potentials： The abnormalities referred to deletion of wave form or the latency was prolonged by more than the reference value of normal subject±3SD. （3） The differences of measurement data were compared with the ttest.MAIN OUTCOME MEASURES ： The results of MEP, SEP and P300 in the

关键词： multiple sclerosis diagnosis of motor evoked potential cognitive function evoked potentials measurement data reference value cerebral cortex nervous system examination of spinal cord

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