Intra-epidermal electrically evoked potentials are sensitive to detect degenerative cervical myelopathy suggesting their spinothalamic propagation

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2024-09-19 DOI:10.1016/j.clinph.2024.09.015

Sara U. Júlio , Miriam Schneuwly , Paulina S. Scheuren , Nikolai Pfender , Carl M. Zipser , Michèle Hubli , Martin Schubert

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引用次数: 0

Abstract

Objective

Degenerative cervical myelopathy (DCM) is a centromedullary spinal cord disorder mainly affecting crossing fibers. While contact heat evoked potentials (CHEPs) are sensitive in detecting DCM by testing spinothalamic integrity, somatosensory evoked potentials (dSSEPs) show unaffected dorsal column conduction. Intra-epidermal electrically evoked potentials (IEEPs) have unknown spinal propagation after noxious stimulation. We investigated (1) the spinothalamic tract propagation and (2) the discriminative power in detecting spinal pathology of IEEPs compared to CHEPs and dSSEPs in DCM.

Methods

DCM was diagnosed by neurological examination regarding stenosis (MRI). Stimulation of C6, C8, and T4 dermatomes yielded dSSEPs, CHEPs, and IEEPs. (1) Spinal propagation was assessed through concordant or discordant responses, and (2) discriminative power was determined using receiver operating characteristic curves (ROC).

Results

Twenty-seven patients (8F, 56 ± 12yrs) with DCM were analyzed and compared to age-matched healthy controls. IEEPs were abnormal in 43–54%, CHEPs in 37–69%, and dSSEPs in 4–12%. IEEPs showed high concordance with abnormalities of CHEPs (62–69%). ROC analyses showed good discriminative power of CHEPs and IEEPs contrary to dSSEPs.

Conclusions

The concordance of abnormal responses of CHEPs and IEEPs contrary to dSSEPs suggests spinothalamic propagation of IEEPs.

Significance

Minimal differences between CHEPs and IEEPs suggest complementary potential by the combined testing of spinothalamic tract integrity.

查看原文本刊更多论文

表皮内电诱发电位能敏感地检测出退行性颈椎病，这表明它们是通过脊髓传播的。

目的：退行性颈椎脊髓病（DCM）是一种主要影响交叉纤维的脊髓中央型疾病。接触热诱发电位（CHEPs）可通过检测脊髓的完整性灵敏地检测出 DCM，而体感诱发电位（dSSEPs）则显示背柱传导未受影响。表皮内电诱发电位（IEEPs）在受到有害刺激后的脊髓传播情况不明。我们研究了(1)脊束传播和(2)与CHEPs和dSSEPs相比，IEEPs在检测DCM脊柱病变方面的鉴别力：通过神经系统检查和核磁共振成像（MRI）诊断 DCM。刺激 C6、C8 和 T4 皮节可产生 dSSEPs、CHEPs 和 IEEPs。(1)通过一致或不一致的反应评估脊髓传播，(2)使用接收器操作特征曲线（ROC）确定鉴别力：对 27 名 DCM 患者（8 名女性，56 ± 12 岁）进行了分析，并与年龄匹配的健康对照组进行了比较。43-54%的患者 IEEPs 异常，37-69%的患者 CHEPs 异常，4-12%的患者 dSSEPs 异常。IEEPs与CHEPs异常的一致性很高（62-69%）。ROC分析表明，CHEPs和IEEPs与dSSEPs相比具有良好的鉴别力：结论：与 dSSEPs 相反，CHEPs 和 IEEPs 的异常反应一致，这表明 IEEPs 是由脊髓传播的：意义：CHEPs 和 IEEPs 之间的微小差异表明，通过对脊束完整性的联合检测，两者具有互补潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.