Optimum interpulse interval for transcranial electrical train stimulation to elicit motor evoked potentials of maximal amplitude in both upper and lower extremity target muscles

Exploration of the Intraoperative Motor Evoked Potential

“…Therefore, in order to gain the exactly high-sensitive MEP range in the present study, we must take unified stimulation parameters which are applicable to most CCM patients. According the previous literature 3, 12 and our repeated clinical testing experience, we refined appropriate stimulation parameters (details in methods) in the present study and the audience could use our protocol or make their own normative data to identify their ''critical range''. As for the anesthetic regimen, the effects of muscle relaxant and inhalation agents during intraoperative MEP monitoring were quite large and cannot be used.…”

Design and Optimization of a Novel Method for Assessment of the Motor Function of the Spinal Cord by Multipulse Transcranial Electrical Stimulation in Horses

“…Based on experience with TES in anesthetized human patients, a single train stimulation protocol was chosen. The human TES paradigms [15,23] were adapted for the sedated horses, defining default values of n ¼ 3 biphasic pulses per train (ppt), pw 0.1 ms/phase, and ipi ¼ 1.3 ms [20]. Motor-evoked potential amplitudes and delay times were subsequently measured in triple, in an optimization protocol as function of one selected parameter (voltage vs. ipi vs. n) with the other parameters set at their default values, yielding a voltage curve, an ipi curve, and an n curve.…”

“…In very young children, in whom corticospinal axons are immaturely myelinated, even multipulse TES has a low success rate. In these circumstances, additional facilitation by double-train TES [18][19][20] or peripheral stimulation [21] is required.…”

Transcranial Electric Stimulation for Intraoperative Motor Evoked Potential Monitoring: Dependence of Required Stimulation Current on Interstimulus Interval Value

“…There are official guidelines that discuss pulse duration, number of pulses, and interstimulus interval (ISI) in MEP monitoring. 2,3 Train pulse number and ISI in milliseconds (ms) or frequency in Hz (ISI ¼ 1000/frequency) are not standardized. Adding pulses reduces the MEP threshold and increases the amplitude, duration, and polyphasia.…”

“…6,11 Van Hal et al found large intra-and interindividual differences between the mean optimum interstimulus interval (OISI) of the tibialis anterior (TA) and abductor pollicis brevis (APB) muscles (range: 1.78-2.73 ms). 3 The ISI was varied between 0.5 and 4.0 ms, where OISI was defined as the ISI with the highest muscle MEP amplitude for each muscle group.…”