Effects of hypothermia on short latency somatosensory evoked potentials in humans

Short latency somatosensory evoked potentials (SSEPs) elicited by median nerve stimulation were monitored in 14 adult patients undergoing cardiac surgery under cardiopulmonary bypass and induced hypothermia. SSEPs were recorded at 1–2°C steps as the body temperature was lowered from 37°C to 20°C to determine temperature-dependent changes. Hypothermia produced increased latencies of the peaks of N₁₀, P₁₄ and N₁₉ components, the prolongation was more severe for the later components so that N₁₀−P₁₄ and P₁₄−N₁₉ interpeak latencies were also prolonged. The temperature-latency relationship had a linear correlation. The magnitude of latency prolongation (msec) with 1°C decline in temperature was 0.61, 1.15, 1.56 for N₁₀,P₄ and N₁₉ components, respectively, and 0.39 and 0.68 for interpeak latencies N₁₀−P₁₄ and P₁₄−N₁₉, respectively. The rise time and duration of the 3 SSEP components increased progressively with cooling. Cortically generated component, N₁₉ was consistently recordable at a temperature above 26°C, usually disappearing between 20°C and 25°C. On the other hand, more peripherally generated components, N₁₀ and P₁₄, were more resistant to the effect of hypothermia; P₁₄ was always elicitable at 21°C or above, whereas N₁₀ persisted even below 20°C. The amplitude of SSEP components had a poor correlation with temperature; there was a slight tendency for N₁₀ and P₁₄ to increase and for N₁₉ to decrease with declining temperature. Because incidental hypothermia is common in comatose and anesthetized patients, temperature-related changes must be taken into consideration during SSEP monitoring under these circumstances.     

Intracranial recording of short latency somatosensory evoked potentials in man: Identification of origin of each component

In normal subjects the short latency SEPs generally consisted of 3 positive waves (P9, P11, P14) and a succeeding negative wave (N20). To determine the origins of these waves we have made intracranial records from 17 patients, which suggest the following results. P9 originates in stimulated median nerve peripheral to the dorsal roots such as brachial plexus, P11 in the dorsal column of the cervical cord, P14 in the cuneate nucleus and medial lemniscal pathway, and N20 in the cerebral cortex. On the basis of intracranial and intraspinal records, the onset of P11 indicates the arrival of the afferent volley at the cord entry and the peak latency of P11 its arrival time at the C1–2 level dorsal column. The onset latency of P14 indicates the onset of postsynaptic events in cuneate nucleus neurons and the peak latency of P14 arrival at the midbrain.From the ventral surface of the brain-stem 3 positive waves (P′9, P′11, P′14) like the initial positive components of the scalp short latency SEPs (P9, P11, P14) were recorded. The amplitude of P′14 was large compared to that of P14. The peak latencies of P′14 recorded at the medulla and the pons were shorter than that of P14 by 0.7–0.8 msec and 0.2–0.5 msec, respectively. The peak latency of P′14 at the midbrain was almost the same as that of P14. By measuring the distance between the recording electrodes in the brain-stem and the peak latency difference of P′14, the fastest lemniscal conduction velocity was estimated as 56 m/sec.     

Cervical and scalp recorded short latency somatosensory evoked potentials in response to epidural spinal cord stimulation in patients with peripheral vascular disease

Somatosensory evoked potential (SEP) studies were performed in 14 patients with peripheral vascular disease who received epidural spinal cord stimulation (SCS) for chronic pain relief of the lower limbs. Signals were amplified and filtered between 20–2000 Hz and 200–2000 Hz to better identify activities in the high frequency range. In 7 patients bit-colour maps were also computed. In all the patients a homogeneous short-latency scalp evoked potential with a prevalent diphasic shape (P1-N1) was recorded. In all our scalp records, even with the wide bandpass, small short-latency positive deflections were observed on the descending front of the first major positive wave and they were better defined as a series of up to 6 wavelets, preceding the major negative scalp wave in the tracings filtered through the narrow bandpass. They appeared in an interval ranging from 5.5 to 15.6 msec. Bit-colour maps showed consistent positive fields, with a maximum at the vertex, starting mainly at about 5.5 msec; in 3 patients, a prominent positivity between 8.5 and 10.5 msec was recorded followed by smaller components preceding the major positive-negative (Pl-Nl) complex. More synchronous volleys during direct SCS produced clear short-latency SEPs. Although they were of larger amplitude, we regarded them as corresponding to those described by previous authors obtained by stimulation of nerves of the lower limbs, and probably arising from subcortical structures.     

Age-dependent changes of short-latency somatosensory evoked potentials in healthy adults

Age-dependent changes of short-latency somatosensory evoked potentials following median nerve stimulation in humans were investigated in two groups of healthy adults aged 20-30 and 50-60 years. Normative values for both age groups are given. Compared to the younger group, in the older one P27 latency and N20-P27 interpeak latency were about 2 ms longer, and P27-N35 and P27-P45 interpeak latencies were significantly decreased. These findings suggest that N20 and P27 are generated by different structures and that the subsequent components do not depend on P27.     

Comparison of scalp distribution of short latency somatosensory evoked potentials (SSEPs) to stimulation of different nerves in the lower extremity

SSEPs to stimulation of the CPN at the knee and PTN, PN and SN at the ankle were recorded from 15 cephalic sites and compared in 8 normal subjects. The configuration, amplitude, peak latency and distribution of P27, N35 (CPN) and P37, N45 (PTN, PN and SN) were analyzed. The configuration and distribution of SSEPs to stimulation of the 3 nerves at the ankle were similar across subjects. Both P37 and N45 were greatest in amplitude at the vertex and at recording sites ipsilateral to the side of stimulation. At contralateral sites either negative (N37) or negative, positive, negative potentials were recorded. The peak latency of N37 was the same or slightly less than that of P37. CPN-SSEPs were lower in amplitude and their configuration and scalp distribution showed much greater intersubject variability. This suggests that complex mechanisms which variably interact with one another are reflected in scalp SSEPs to CPN stimulation at the knee. The larger amplitude plus the minimal intersubject variability in morphology and topography of PTN-SSEPs indicate that this nerve is the most suitable for routine clinical use.     

Inconsistency of auditory middle latency and steady-state responses in infants

Auditory middle latency and steady-state responses (MLR/SSRs) were recorded in normal infants (aged 3 weeks to 28 months) and adults. SSR amplitudes were maximum using stimulus presentation rates near 40 Hz in adults. By contrast, the infant data showed no consistent amplitude maximum across the rates tested (9–59 Hz). With the exception of the brain-stem response wave V to MLR Na deflection, MLR components in infant's responses to 10.85 Hz clicks did not show any consistent pattern. To investigate the hypothesis that the 40 Hz SSR is derived from overlapping of the 10 Hz MLR components, 43.4 Hz SSRs were synthesized from the responses recorded at 10.85 Hz and compared with those recorded at 43.4 Hz. The predictive accuracy of the synthesized 43.4 Hz SSRs was significantly better in adults than in infants. The results of these studies indicate the presence of large age-related differences in the auditory MLR and SSR, and in the relationship between the two responses.     

Short and middle latency vestibular evoked responses to acceleration in man

We have succeeded in recording short and middle latency vestibular evoked responses in human subjects. The head was held rigidly in a special, patented head holder, constructed individually for each subject, which gripped the teeth of the upper jaw. The stimulus consisted of 2/sec steps of angular acceleration impulses produced by a special motor with intensities of about 10,000°/sec² and with a rise time of 1–2 msec. The electrical activity was recorded as the potential difference between special forehead and mastoid electrodes having a large, secure contact area with the skin. The activity was digitally filtered and averaged in 2 separate channels by means of a Microshev 2000 evoked response system. The short latency responses, with peaks at about 3.5 msec (forehead positive), 6.0 msec (forehead negative) and 8.4 msec (forehead positive; bandpass: 200–2000 Hz; average of 1024 trials), had amplitudes of about 0.5 μV. The middle latency responses had peaks at about 8.8 msec (forehead positive), 18.8 msec (forehead negative) and 26.8 msec (forehead positive; 30–300 Hz; N = 128 trials), with larger amplitudes (about 15 μV). These responses were consistently recorded in the same subject at different times and were similar in different normal subjects. Strenuous control experiments were conducted in order to ensure that these responses are not artefacts due to the movement of conducting media (head, electrodes and leads) in the electromagnetic field of the motor and are elicited by activation of normal labyrinths. Among other controls, they were not present in a cadaver, in patients with bilateral absence of nystagmus to caloric stimuli and in conducting volumes the size of the human head. They were also not masked by white noise.     

Somatosensory evoked potentials from the thalamic sensory relay nucleus (VPL) in humans: correlations with short latency somatosensory evoked potentials recorded at the scalp

Somatosensory evoked potentials (SEPs) were recorded in humans from an electrode array which was implanted so that at least two electrodes were placed within the nucleus ventralis posterolateralis (VPL) of the thalamus and/or the medial lemniscus (ML) of the midbrain for therapeutic purposes. Several brief positive deflections (e.g., P11, P13, P14, P15, P16) followed by a slow negative component were recorded from the VPL. The sources of these components were differentiated on the basis of their latency, spatial gradient, and correlation with the sensory experience induced by the stimulation of each recording site. The results indicated that SEPs recorded from the VPL included activity volume-conducted from below the ML (P11), activity in ML fibers running through and terminating within the VPL (P13 and P14), activity in thalamocortical radiations originating in and running througn the VPL (P15, P16 and following positive components) and postsynaptic local activity (the negative component). The sources of the scalp-recorded SEPs were also analyzed on the basis of the timing and spatial gradients of these components. The results suggested that the scalp P11 was a potential volume-conducted from below the ML, the scalp P13 and P14 were potentials reflecting the activity of ML fibers, the small notches on the ascending slope on N16 may potentially reflect the activity of thalamocortical radiations, and N16 may reflect the sum of local postsynaptic activity occurring in broad areas of the brain-stem and thalamus.     

Effect of selective attention on somatosensory evoked potentials in healthy people

The effect of selective attention on various waves of the somatosensory evoked potentials was studied in healthy people in the area of specific projection (sensorimotor) and the area of non-specific projection (occipital). Significant changes of the amplitude of waves with latency exceeding 55 msec were observed when attention was concentrated on the received stimulus (I and II group of subjects). In group I the process of attention concentration was associated with a phenomenon connected with the new yet unknown experimental situation (prevalence of amplitude increase), while in group II habituation was observed (prevailing amplitude fall). Waves M125 and N200 in the sensorimotor area and N200 and N235-255 in the occipital area seemed to be associated in a peculiar way with the process of attention concentration.     

Dependence between the latency of sensorimotor reactions and parameters of the somatosensory evoked potentials related to this reaction: A study in humans

In 18 27- to 56-year-old tested subjects, we measured the latency of sensorimotor reactions (SMRL) and parameters of the somatosensory evoked potentials (SSEP), related to these reactions, observed in two experimental paradigms. In test 1, every third stimulus in a train of identical stimuli was considered the “necessary” signal, while in test 2, the subject had to select such a signal from three different versions of the stimuli presented in a randomized manner. For each subject, we selectively averaged the SSEP related to different (short and long) SMRL. We demonstrated the existence of different types of the dependences between the SSEP parameters and the values of SMRL; the pattern of these dependences could be different in tests 1 and 2. For test 1, a negative dependence between the variations of SMRL and amplitude of the P100 SSEP component was observed, while test 2 results were characterized by a clearly expressed negative correlation between the SMRL, and N150 amplitude (P<0.05). Negative correlation between the SMRL and integral amplitude of the P100-N150-P250 complex (P<0.05) was a common manifestation of the dependence between the SMR and SSEP parameters observed under conditions of both tests. We suppose that the dependences between the variations of SSEP parameters and SMRL values reflect changes in the level of mobilization of attention and in the structure of the latter in the course of performance of a sensorimotor task.     

Three-channel Lissajous' trajectory of the human short latency visual evoked potentials

Three orthogonally derived voltage-time records, when plotted simultaneously on three-dimensional voltage-voltage-voltage coordinates, produce a 3-Channel Lissajous' Trajectory (3CLT). 3CLTs of short latency visual evoked potentials (SVEP) were obtained for 8 adult humans (16 eyes) in response to monocular flash stimulation.Intersubject variability of 3CLT of SVEP was small enough to enable identification along the trajectory of comparable planar-segments of approx. 3–5 ms duration across subjects. In each planar-segment, the point at which the trajectory exhibited marked bonding was noted. These points were called apices and they corresponded to maxima in the trajectory's distance from the origin (Trajectory Amplitude). Intersubject variability in apex latencies was comparable to, or smaller than, peak latency variability of single-channel records. 3CLT of SVEP consisted of 8 planar-segments in each of the latency ranges of 0–40, 40–70 and 70–100 ms.Analysis of 3CLT, combining the criteria of segment planarity, apices and trajectory amplitude peaks, enabled differentiation between components that had been considered the same in surface distribution studies. 3CLT of SVEP seemed to be influenced by the direction of propagaion along the visual pathway.     

Scalp-recorded short and middle latency peroneal somatosensory evoked potentials in normals: comparison with peroneal and median nerve SEPs in patients with unilateral hemispheric lesions

Peroneal somatosensory evoked potentials (SEPs) were performed on 23 normal subjects and 9 selected patients with unilateral hemispheric lesions involving somatosensory pathways.Recording obtained from right and left peroneal nerve (PN) stimulations were compared in all subjects, using open and restricted frequency bandpass filters. Restricted filter (100–3000 Hz) and linked ear reference (A1–A2) enhanced the detection of short latency potentials (P1, P2, N1 with mean peak latency of 17.72, 21.07, 24.09) recorded from scalp electrodes over primary sensory cortex regions. Patients with lesions in the parietal cortex and adjacent subcortical areas demonstrated low amplitude and poorly formed short latency peroneal potentials, and absence of components beyond P3 peak with mean latency of 28.06 msec. In these patients, recordings to right and left median nerve (MN) stimulation showed absence or distorted components subsequent to N1 (N18) potential.These observations suggest that components subsequent to P3 potential in response to PN stimulation, and subsequent to N18 potential in response to MN stimulation, are generated in the parietal cortical regions.     

High-rate sequential sampling of auditory brain-stem and somatosensory evoked responses in hypoxia

We developed a high-rate sequential recording technique that allowed simultaneous measurements of both auditory brain-stem response (ABR) and somatosensory evoked potential (SEP) every 10 sec. Using this method, a transient increase in amplitude of all the ABR and SEP components in response to hypoxia in dogs could be detected. The increase in amplitude preceded the prolongation of latency. Our study showed that there were succesive changes of evoked potentials in response to hypoxia. A transient increase in amplitude is the first to occur, followed by a latency prolongation and an amplitude decrease for both ABRs and SEPs.     

Age-related dynamics of the parameters of somatosensory evoked potentials in healthy children

The purpose of this study was to evaluate the parameters of somatosensory evoked potentials (SSEPs) in healthy children of different age groups (n = 94). The amplitudes of the main cortical peaks and the central sensory conduction time (CSCT) from n. medianus and n. tibialis in children aged under 12 months, 1–12 years, and 12–17 years were estimated and compared. No significant cortical peaks were recorded from the tibial nerve in five children younger than 1 year (5 out of 23, 22%). Significant differences in CSCT were observed between the children younger than 1 year and two other groups. The amplitudes did not significantly differ between the groups. Thus, SSEPs may be used for the evaluation of somatosensory pathways in children aged one month to 17 years. CSCT differs significantly between children younger than 1 year and other age groups. Age-related reduction in CSCT and elevation of the cortical peak amplitudes may reflect the myelination of somatosensory pathways and the improvement in nervous system integration.     

痛觉诱发电位的研究进展

痛觉诱发电位的研究在过去的几十年内取得了重要进展 ,出现了许多用于被试的诱发明确疼痛感的刺激技术 ,并与诱发电位方法学联合应用 ,已经成为脑映像学研究中重要的组成部分。本文从刺激技术、痛觉诱发电位成分分析和偶极子源分析等方面出发 ,讨论了痛觉诱发电位的研究进展     

Acoustic and somatosensory evoked responses in the brain hemispheres of chick embryos.

The author explored the auditory projection in the brain hemispheres of 16- to 21-day-old chick embryos, using biaural stimulation, and the somatosensory projection, using electrical stimulation of the contralateral sciatic nerve. The first auditory evoked responses appeared on the surface of the hemisphere at the beginning of the 18th day of incubation and were localized in its mediolateral part. Up to hatching, the latent period of the surface response shortened from 76.3 msec to 28.9 msec and its amplitude augmented from 10.6 muV to 36.2 muV. If the electrode was plunged into the tissue, the evoked responses with the optimum latent period and amplitude parameters were recorded at a depth of 2-2.5 mm (latent period 20.2 msec, amplitude 40-45 muV). The maximum surface somatosensory responses were found in the medial occipital quadrant of the contralateral hemisphere. They developed from the second half of the 17th day of incubation. Up to the end of incubation the mean latent period shortened from 58.3 msec to 21.6 msec and the mean amplitude increased from 11.8 muV to 28.7 muV. What was at first a simple negative wave developed into a positive-negative complex by the end of incubation. Evoked responses at a depth of about 3.5 mm from the surface of the hemisphere had the optimum parameters (latent period 18.4 msec, amplitude 30.2 muV).     

Interactions of acoustic and somatosensory evoked responses in a polysensory cortex of the cat

Interactions of acoustic and somatosensory evoked potentials were studied in the anterior suprasylvian gyrus of the cat. The interactions showed dynamic changes and were susceptible to different kinds of influences. The interactions could be influenced by synchronous activation of the acoustic and somatosensory inputs with 2 Hz frequency, or by elevating the stimulus frequency. Interactions could be influenced by amphetamine and gamma-glutamyl-taurine, drugs known as capable of influencing the arousal level of the brain. The antagonists of amphetamine prevented this effect. Drugs acting on the cortical GABA-ergic system proved also to be decisive in the interactions of evoked potentials of different origins. In some experiments unit activity was recorded parallel with evoked potentials.     

Electromyographic latency of postural evoked responses from the leg muscles during EquiTest Computerised Dynamic Posturography: Reference data on healthy subjects

No normative data are available for the latencies of the EMG signals from the ankle muscles in response to sudden sagittal tilt (toes-UP or toes-DOWN) or shift (shift-FOR or shift-BACK) of the support surface during standing. In this study the postural evoked response (PER) paradigm on the EquiTest™ force platform was applied to 31 healthy adults (18 women and 13 men; mean age 29 years). The EMG latencies (PEREMG) were computed both through the standard manual procedure and through a specially designed automated algorithm. The manually computed PEREMG onset yielded a 95% tolerance interval between 82 ms and 148 ms after toes-UP perturbation, between 93 ms and 182 ms after toes-DOWN perturbation, between 67 ms and 107 ms after shift-BACK perturbation, and between 73 ms and 113 ms after shift-FOR perturbation. When comparing the two methods, paired t-tests showed no significant mean difference (Bonferroni-adjusted p-values ranged from 0.440 to 1.000) and all Bland–Altman plots included zero difference within the limits of agreement. Therefore, the manual and the automated methods appear to be sufficiently consistent. These results foster the clinical application of PEREMG testing on the EquiTest platform.     

Comparison in man of short latency averaged evoked potentials recorded in thalamic and scalp hand zones of representation

Recordings were performed in the thalamus of 13 patients suffering from either abnormal movements or intractable pain, with the aim of delimiting the region to be destroyed or stimulated in order to diminish the syndrome. In 11 of these patients averaged evoked potentials were recorded simultaneously from the scalp and specific thalamus (VP) hand area levels following median nerve stimulation. These recordings were done during the operation or afterwards when an electrode was left in place for a program of stimulation.The latencies of onsets and peaks on the scalp ‘P15’ were compared with those of the VP wave; a clear correspondence was found. Moreover, when increased stimulation was used, both waves began to develop in parallel. Thus in the contralateral ‘P15’ a component exists due to the field produced by the thalamic response. To explain the presence of an ipsilateral scalp ‘P15’ wave, we propose that a second wave having the same latency and a slightly shorter peak exists on the scalp due to a field produced by a brain-stem response. This double origin of ‘P15’ is also shown by the different changes which the ipsilateral and contralateral waves present during changes in alertness.The scalp ‘N18–N20’ is also composed of at least 2 components. The first peak appears on the scalp with a latency shorter than that of the negativity which develops in the thalamus. The N wave, moreover, increases in latency with rapid stimulus repetition. We propose with others that ‘N18’ is a cortical event reflecting the arrival of the thalamo-cortical volley. The second component, ‘N20,’ has a peak latency closely correlated to that of the thalamic negativity. This component was present alone in ‘N’ when rapid stimulation (> 4/sec) was used, which did not change the thalamic response. It must be a field produced by the thalamic negativity.