Comparison of Transcranial Motor Evoked Potential Amplitude Responses Between Intramuscular and Subcutaneous Needles in Proximal Thigh Muscle

Gonzalez, Andres A.; Cheongsiatmoy, Justin; Shilian, Parastou; Parikh, Pooja

doi:10.1097/wnp.0000000000000490

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…The amplitudes were significantly higher when recording mTc-MEPs with subcutaneous needle electrodes compared to amplitudes recorded with surface electrodes. This corresponds with the intra-operative findings of other studies [ 13 , 19 ]. Gonzalez et al showed that recordings from intramuscular electrodes have significantly higher amplitudes than subcutaneous electrodes [ 13 ].…”

Section: Discussionsupporting

confidence: 92%

“…This corresponds with the intra-operative findings of other studies [ 13 , 19 ]. Gonzalez et al showed that recordings from intramuscular electrodes have significantly higher amplitudes than subcutaneous electrodes [ 13 ]. Journee et al found higher amplitudes with subcutaneous electrodes compared to surface electrodes in horses [ 19 ].…”

Section: Discussionsupporting

confidence: 92%

“…These include mTc-MEP elicitability, motor threshold, amplitude, area under the curve (AUC), signal-to-noise ratio (SNR), and the variability of mTc-MEP amplitudes over time [ 5 ]. Two studies have compared mTc-MEP amplitudes of signals recorded using intramuscular versus extramuscular electrodes [ 12 , 13 ]. Both found that higher amplitudes were recorded with intramuscular electrodes.…”

Section: Introductionmentioning

confidence: 99%

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Comparing Motor-Evoked Potential Characteristics of NEedle versus suRFACE Recording Electrodes during Spinal Cord Monitoring—The NERFACE Study Part I

Gadella

Dulfer

Absalom

et al. 2023

JCM

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Muscle-recorded transcranial electrical stimulation motor-evoked potentials (mTc-MEPs) are used to assess the spinal cord integrity. They are commonly recorded with subcutaneous needle or surface electrodes, but the different characteristics of mTc-MEP signals recorded with the two types of electrodes have not been formally compared yet. In this study, mTc-MEPs were simultaneously recorded from the tibialis anterior (TA) muscles using surface and subcutaneous needle electrodes in 242 consecutive patients. Elicitability, motor thresholds, amplitude, area under the curve (AUC), signal-to-noise ratio (SNR), and the variability between mTc-MEP amplitudes were compared. Whereas amplitude and AUC were significantly higher in subcutaneous needle recordings (p < 0.01), motor thresholds and elicitability were similar for surface and subcutaneous needle recordings. Moreover, the SNRs were >2 in more than 99.5% of the surface and subcutaneous needle recordings, and the variability between consecutive amplitudes was not significantly different between the two recording electrode types (p = 0.34). Surface electrodes appear to be a good alternative to needle electrodes for spinal cord monitoring. They are non-invasive, can record signals at similar threshold intensities, have adequately high SNRs, and record signals with equivalent variability. Whether surface electrodes are non-inferior to subcutaneous needle electrodes in detecting motor warnings is investigated in part II of the NERFACE study.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Comparing Motor-Evoked Potential Characteristics of NEedle versus suRFACE Recording Electrodes during Spinal Cord Monitoring—The NERFACE Study Part I

Gadella

Dulfer

Absalom

et al. 2023

JCM

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“…The aforementioned similarity of wave morphology is not present when comparing between im and em needle electrode recordings. Intramuscular EMGs differ markedly from extramuscular recordings due to the presence of polyphasic waves (Giroux and Lamontagne, 1990;Skinner et al, 2008;Gonzalez et al, 2018). Similarity of waveforms is essential for specific comparison of electrode qualities and to judge whether they are interchangeable and free from bias from differences between intramuscular and extramuscular characteristics.…”

Section: Similarity Of Myographic Recordings Between Sc Needle and Sumentioning

confidence: 99%

“…Extramuscular MEPs typically reflect electrical activity of many motor units representing a large population of motor neurons whereas characteristics of single motor neurons are filtered out. Therefore, em MEP recordings are appropriate for assessing the upper motor neuron function since these sense the integral activity of many axons of spinal motor tracts and interconnected neurons and are insensitive for the activity of individual lower motor neurons ( Skinner et al, 2008 ; Gonzalez et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Extramuscular Recording of Spontaneous EMG Activity and Transcranial Electrical Elicited Motor Potentials in Horses: Characteristics of Different Subcutaneous and Surface Electrode Types and Practical Guidelines

Journée

Reed

et al. 2020

Front. Neurosci.

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Introduction: Adhesive surface electrodes are worthwhile to explore in detail as alternative to subcutaneous needle electrodes to assess myogenic evoked potentials (MEP) in human and horses. Extramuscular characteristics of both electrode types and different brands are compared in simultaneous recordings by also considering electrode impedances and background noise under not mechanically secured (not taped) and taped conditions. Methods: In five ataxic and one non-ataxic horses, transcranial electrical MEPs, myographic activity, and noise were simultaneously recorded from subcutaneous needle (three brands) together with pre-gelled surface electrodes (five brands) on four extremities. In three horses, the impedances of four adjacent-placed surfaceelectrode pairs of different brands were measured and compared. The similarity between needle and surface EMGs was assessed by cross-correlation functions, pairwise comparison of motor latency times (MLT), and amplitudes. The influence of electrode noise and impedance on the signal quality was assessed by a failure rate (FR) function. Geometric means and impedance ranges under not taped and taped conditions were derived for each brand. Results: High coherencies between EMGs of needle-surface pairs degraded to 0.7 at moderate and disappeared at strong noise. MLTs showed sub-millisecond simultaneous differences while sequential variations were several milliseconds. Subcutaneous MEP

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IONM During Lumbosacral Spinal Fusion Procedures

Wilent¹,

Trott²,

Epplin-Zapf³

et al. 2022

Koht, Sloan, Toleikis's Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals

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Comparison of Transcranial Motor Evoked Potential Amplitude Responses Between Intramuscular and Subcutaneous Needles in Proximal Thigh Muscle

Cited by 4 publications

References 5 publications

Comparing Motor-Evoked Potential Characteristics of NEedle versus suRFACE Recording Electrodes during Spinal Cord Monitoring—The NERFACE Study Part I

Comparing Motor-Evoked Potential Characteristics of NEedle versus suRFACE Recording Electrodes during Spinal Cord Monitoring—The NERFACE Study Part I

Extramuscular Recording of Spontaneous EMG Activity and Transcranial Electrical Elicited Motor Potentials in Horses: Characteristics of Different Subcutaneous and Surface Electrode Types and Practical Guidelines

IONM During Lumbosacral Spinal Fusion Procedures

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