Motor evoked potentials from the pelvic floor in patients with multiple sclerosis

Motor evoked potentials (MEP) and evoked pressure curves (EPC) from the urethral compressive musculature (UCM) by functional magnetic stimulation in healthy volunteers and patients with neurogenic incontinence

“…Eardley et al [1991] described decreased EUS^MEP latency in patients with MS and other spinal diseases. Our MS patients showed normal peripheral latencies while their spinal latencies were clearly delayed and di⁄cult to record [Brostrom et al, 2003c], as already described in extremity muscles [Cowan et al, 1984;Snooks and Swash, 1985;Hess et al, 1987;Ingram et al, 1988]. This phenomenon is explained by the demyelinization and formation of plaques in pyramidal (corticospinal) nervous pathways resulting in impared conduction [Mc Donald, 1974;Snooks and Swash, 1985].…”

“…Whereas MEP recording with surface electrodes from pelvic £oor muscles can become contaminated by EMG activity of adjacent larger periurethral muscles such as pelvic £oor, glutaei, levator ani, EPC measurement is technically less trouble-prone and yields more accurate data of the mechanical activity of the muscle of our interest, i.e., the EUS. In some patients (e.g., MS) and healthy subjects the tc MEP response of the EUS cannot be evoked and recorded despite voluntary contraction ability [Brostrom et al, 2003c]; tc EPCs however can be evoked even in subjects/patients with low pelvic £oor muscle awareness, indicating at least partially present corticofugal pelvic £oor control. This may be important information for treatment options using external magnetic stimulation for stress urinary incontinence [Galloway et al, 1999;Gunnarsson et al, 1999].…”

Peripheral repetitive magnetic stimulation for the treatment of neurogenic urinary disorders: literature review and investigational study

“…S. Brostrоm и соавт. в 2003 г. провели исследование, включившее 30 здоровых женщин и 16 пациенток с рассеянным склерозом и расстройством мочеиспускания, которое имело своими целями срав-нение различных типов регистрирующих электродов, создание базы нормативных значений латентности коркового и сегментарного моторных ответов, оценку воспроизводимости диагностического теста, опреде-ление клинической значимости методики у пациентов с нейрогенным нарушением мочеиспускания вследст-вие рассеянного склероза в сопоставлении с моторным отведением с мышц нижних конечностей и имеющи-мися уродинамическими данными [12]. Авторы пред-…”

“…Следует отметить, что как в ука-занной работе, так и в других похожих исследованиях ученые столкнулись с трудностями, ограничившими клиническое использование метода [10][11][12][13]:…”

Neurophysiology of the pelvic floor in clinical practice: a systematic literature review

“…Despite methodological differences, all studies investigating pMEPs in patients with spinal cord lesions and pelvic floor dysfunctions showed a high rate of abnormalities. However, there is general consensus on the marked variability of responses and methodological issues, also in normal subjects (Brostrom, 2003). These factors limit the clinical value of this method (Grade D).…”