Early deflections of cerebral magnetic responses to median nerve stimulation

We have recorded early components of somatosensory evoked magnetic fields with a sensitive 7-channel first-order gradiometer using a wide recording passband (0.05–2000 Hz) and high sampling frequency (8000 Hz). The left median nerve was stimulated at the wrist and responses were recorded over the right hemisphere. The responses typically consisted of a N20m peaking at 18–20 msec, a small P22m peaking at 21–23 msec and a P27m peaking at 29–31 msec. The topography of N20m could be explained by a tangential current dipole in the posterior wall of the central sulcus (probably in area 3b). The equivalent dipoles of P27m were located on average 10 mm antero-medially to the sources of N20m. This suggests that P27m may get a contribution from the anterior wall of the central sulcus. An increase of stimulus repetition rate from 2 to 5 Hz decreased the amplitude of P27m more than that of N20m, which implies that these two deflactions are generated by different neural netwoks.     

SEPs to finger joint input lack the N20-P20 response that is evoked by tactile inputs: contrast between cortical generators in areas 3b and 2 in humans

A method using a DC servo motor is described to produce brisk angular movements at finger interphalangeal joints in humans. Small passive flexions of 2° elicited sizable somatosensory evoked potentials (SEPs) starting with a contralateral positive P34 parietal response thought to reflect activation of a radial equivalent dipole generator in area 2 which receives joint inputs. By contrast, electric stimulation of tactile (non-joint) inputs from the distal phalanx evoked the usual contralateral negative N20 reflecting a tangential equivalent dipole generator in area 3b. Finger joint inputs also evoked a precentral positivity equivalent to the P22 of motor area 4, and a large frontal negativity equivalent to N30. It is suggested that natural stimulation allows human SEP components to the differentiated in conjunction with distinct cortical somatotopic projections.     

Three-channel Lissajous' trajectory of the binaural interaction components in human auditory brain-stem evoked potentials

The 3-channel Lissajous' trajectory (3-CLT) of the binaural interaction components (BI) in auditory brain-stem evoked potentials (ABEPs) was derived from 17 normally hearing adults by subtracting the response to binaural clicks (B) from the algebraic sum of monaural responses (L + R). ABEPs were recorded in response to 65 dB nHL, alternating polarity clicks, presented at a rate of 11/sec. A normative set of BI 3-CLT measures was calculated and compared with the corresponding measures of simultaneously recorded, single-channel vertex-left mastoid and vertex-neck derivations of BI and of ABEP L+R and B. 3-CLT measures included: apex latency, amplitude and orientation, as well as planar segment duration and orientation.The results showed 3 apices and associated planar segments (“Bd_II,” “Be” and “Bf”) in the 3-CLT of BI which corresponded in latency to the vertex-mastoid and vertex-neck peaks IIIn, V and VI of ABEP L + R and B. These apices corresponded in latency and orientation to apices of the 3-CLT of ABEP L + R and ABEP B. This correspondence suggests generators of the BI components between the trapezoid body and the inferior colliculus output. Durations of BI planar segments were approximately 1.0 msec. Apex amplitudes of BI 3-CLT were larger than the respective peak amplitudes of the vertex-mastoid and vertex-neck recorded BI, while their intersubject variabilities were comparable.     

Glossopharyngeal evoked potentials in normal subjects following mechanical stimulation of the anterior faucial pillar

The anterior faucial pillar, which is innervated by the glossopharyngeal nerve, is thought to be important in eliciting the pharyngeal swallow in awake humans. Glossopharyngeal evoked potentials (GPEP), elicited by mechanically stimulating this structure, were recorded from 30 normal adults using standard averaging techniques and a recording montage of 16 scalp electrodes. Ten of the subjects experienced a desire to swallow in response to stimulation. Repeatable responses were recorded from all 30 subjects. The GPEPs recorded from the posterior scalp were W-shaped and consisted of P1, N1, P2, N2 and P3 peaks. Mean latencies of P1, N1 and P2 were 11, 16 and 22 msec, respectively, for both left and right pillar stimulation. In contrast, latencies of N2 and P3 varied significantly between left and right pillar stimulation. Mean latencies of N2 and P3 were 27 and 34 msec for left, and 29 and 35 msec for right pillar stimulation. Topographical maps acquired at peak latencies for P1, N1 and P2 revealed consistent asymmetrical voltage distributions between the two hemispheres; the largest responses were recorded from the hemisphere ipsilateral to the side of stimulation. The scalp topography of N2 and P3 varied between male and female subjects as well as between left and right pillar stimulation. These findings support the hypothesis that mechanical stimulation to the anterior faucial pillar alone can elicit repeatable responses from the central nervous system. The integration of this subcortical/cortical activity with that of the medullary swallowing center may play an important role in eliciting the pharyngeal swallow.     

Somatotopy of human hand somatosensory cortex revealed by dipole source analysis of early somatosensory evoked potentials and 3D-NMR tomography

Somatosensory evoked potentials (SEPs) to median nerve and finger stimulation were analyzed by means of spatio-temporal dipole modelling combined with 3D-NMR tomography in 8 normal subjects. The early SEPs were modelled by 3 equivalent dipoles located in the region of the brain-stem (B) and in the region of the contralateral somatosensory cortex (T and R). Dipole B explained peaks P14 and N18 at the scalp. Dipole T was tangentially oriented and explained the N20-P20, dipole R was radially oriented and modelled the P22. The tangential dipole sources T were located within a distance of 6 mm on the average and all were less than 9 mm from the posterior bank of the central sulcus. In 6 subjects the tangential sources related to finger stimulation arranged along the central sulcus according to the known somatotopy. The radial sources did not show a consistent somatotopic alignment across subjects. We conclude that the combination of dipole source analysis and 3D-NMR tomography is a useful tool for functional localization within the human hand somatosensory cortex.     

Comparison of short-latency trigeminal evoked potentials elicited by painful dental and gingival stimulation

Painful stimulation of tooth pulp and of the maxillary gingiva was undertaken in 16 volunteers. Short-latency evoked potentials (15–20 msec) were recorded over 800 trials in each case at F3-P3 of F4-P4, and the resultant averaged wave forms were compared. The gingival wave was distinct in all subjects and could be averaged across subjects while the dental waves were either noise or very inconsistent over subjects. Averaging of the dental wave forms across subjects yielded an uninterpretable result. It was clear that dental evoked potentials could not be recorded at these sites. These findings could be explained by either or both of two hypotheses: (1) dental afferents are predominantly small fiber, nociceptive end organs that conduct more slowly than soft tissue afferents whereas gingival stimulation activates both large and small fiber populations; and (2) dental representation in somatosensory cortex is different and phylogenetically more primitive than that of neighboring soft tissue. Therefore, the location of the generator sites in cortex and the orientation of the dipole may be different for dental than for gingival wave forms.     

Tetrahedral recording of 3-D BAEPs: evidence for the centered dipole model

Three-dimensional brain-stem auditory evoked potentials (3-D BAEPs) were recorded from 12 normal subjects using a new tetrahedral montage, as well as two other bipolar montages previously described for 3-channel Lissajous' trajectories (3-CLTs). Mean responses, as well as between-subject and within-subject variability were described. A mathematical transformation was applied to the recorded trajectories to render them in a common canonical form to test the assumption that the BAEP conforms to a centrally generated dipolar field. Apex, segment, and plane orientations were measured for each trajectory, and discrepancies between montages were evaluated to judge the adequacy of the centered dipole model. For the vector means of apices, segments, and planes, median angles of discrepancy between montages ranged from 10 to 23°. These results support the validity of a centered dipole model for the BAEP and affirm the rationale for employing the 3-channel recording technique. Among the montages studied, the tetrahedron provided maximum economy by using fewer electrodes, avoided certain problematic recording sites, and produced less variable data.     

Mapping somatosensory evoked potentials to finger stimulation at intervals of 450 to 4000 msec and the issue of habituation when assessing early cognitive components

Somatosensory evoked potentials (SEPs) to mild electric stimulation of two fingers of the left hand were studied at regular interstimulus intervals (ISIs) of 450, 800, 1400, 2500 and 4000 msec. Habituation was evaluated while the subject was reading a novel so as to virtually ignore the finger stimuli while maintaining steady vigilance levels. Brain SEPs recorded from 25 scalp electrodes were assessed by scatter displays, electronic subtraction, bit-mapped potentials fields, and by calculating theZ estimator and dilation factor. Similar results were obtained with randomly varying ISIs. The P14 farfield and cortical N20 did not change with ISIs. The parietal P27–P45 decreased at ISIs of 800 and 450 msec, but showed no significant habituation at ISIs of 1400, 2500 or 4000 msec. This validated the control conditions used for assessing the early cognitive P30 and P40 to attended target stimuli. The frontal N30 also decremented at the shorter ISIs but still habituated up to ISIs of 2500 msec. The clear dissociation between frontal N30 and parietal P27 at the larger ISIs suggests that they involve at least in part distinct neural generators.     

Determination of conduction times of the peripheral and central parts of the sensory pathway using evoked somatosensory potentials

Determination of conduction times of the peripheral and central parts of the sensory pathway using evoked somatosensory potentials. Acta physiol. pol., 1985, 36 (3): 216-223. Simultaneous recording of the somatosensory evoked potentials (SEP) from Erb's point, neck and scalp allows investigation of the peripheral and central conduction times. The early components of the SEP produced by stimulation of the median nerve at the wrist were recorded using standardized electrode locations in 15 normal subjects. The difference of the latencies between the first peak of the cortical response (N20) and the peak of the neck response (N14) reflects, probably, the conduction time between the dorsal column nuclei and the cortex. Its value was 6 +/- 0.7 msec. The conduction time difference (between peak Erb's point response (N9) and N14) was 5.5 +/- 0.5 msec and it reflected the peripheral conduction time. For diagnostic application the lower limit of the response amplitudes was determined also for every component.     

Midlatency auditory evoked responses: Differential effects of sleep in the human

Middle latency responses (MLRs) in the 10–100 msec latency range, evoked by click stimuli, were studied in 14 adult volunteer subjects during sleep-wakefulness to determine whether such changes in state were reflected by any MLR component. Evoked potentials were collected in 500 trial averages during continuos presentation of 1/sec clicks during initial awake recordings and thereafter during a 2 h afternoon nap or all-night sleep session. Continuously recorded EEG, EOG and EMG were scored for wakefulness, stages 2–4 of slow wave sleep (SWS), and rapid eye movement (REM) sleep during each evoked potential epoch. The major components included in this study and their latency ranges, as determined by peak latency measurements from the awake records, were: ABR V, 5–8 msec, Pa, 30–40 msec, Nb, 45–55 msec, and P1, 55–80 msec. In agreement with previous reports, ABR V and Pa showed no amplitude changes from wakefulness to either SWS or REM. Not previously reported, however, was the dramatic decrease and disappearance of P1 during SWS and its reappearance during REM to an amplitude similar to that during wakefulness. This unique linkage between a particular evoked potential component and sleep-wakefulness indicates that its generator system must be functionally related to states of arousal. Relevant data from the cat model suggest that the generator substrate for P1 may be within the ascending reticular activating system.     

Normal temporal variability of the P100

Determination of clinically significant temporal changes in P100 latency requires knowledge of the degree of normal intraindividual variability. Checkerboard visual evoked potentials using 3 check sizes (17′, 35′ and 70′) were performed serially on 20 healthy volunteers. Each subject was tested at least twice an average of 6 months apart. The P100 latency was measured at Oz with a forehead reference (Pz, O1 and O2 channels were also recorded). The overall average P100 latency change between studies for all check sizes and both eyes was 2.9 msec. However, the maximum absolute latency change was 11 msec. There was no significant difference between the average latency change for the 3 check sizes. The P100 interocular difference changed a mean of 2.5 msec (maximum 9 msec). Amplitude was more variable, with a mean change of about 1.5 μV or 25% (maximum was a 60% decrease in amplitude). A P100 latency change of up to at least 11 msec needs to be acknowledged as normal when assessing the clinical significance of changes in P100 latencies in patients. Also, P100 latency changes greater than 11 or 12 msec are very suggestive of an abnormality in the visual pathway.     

Cerebral magnetic fields to lingual stimulation

We recorded cerebral magnetic fields to electric stimulation of the tongue in 7 healthy adults. The two main deflections of the response peaked around 55 msec (P55m) and 140 msec (N 140 m). During both oof them the magnetic field pattern, determined with a 7- or 24-channel SQUID magnetometer, suggested a dipolar current source. The topography of P55m can be explained by a tangential dipole at the first somatosensory cortex (SI) in the posterior wall of the central sulcus. The equivalent source of N140m is, on average, about 1 cm lateral to the source of P55m. The reported method allows non-invasive determination of the cortical tongue representation area.     

Topography of somatosensory evoked potentials to median nerve stimulation in patients with cerebral lesions

Scalp distributions and topographies of early cortical somatosensory evoked potentials (SEPs) to median nerve stimulation were studied in 22 patients with 5 different types of cerebral lesion due to cerebrovascular disease or tumor (thalamic, postcentral subcortical, precentral subcortical, diffuse subcortical and parieto-occipital lesions) in order to investigate the origins of frontal (P20, N24) and central-parietal SEPs (N20, P22, P23).In 2 patients with thalamic syndrome, N16 was delayed in latency and N20/P20 were not recorded. No early SEP except for N16 was recorded in 2 patients with pure hemisensory loss due to postcentral subcortical lesion. In all 11 patients with pure hemiparesis or hemiplegia due to precentral subcortical lesion N20/P20 and P22, P23/N24 components were of normal peak latencies. The amplitude of N24 was significantly decreased in all 3 patients with complete hemiplegia. These findings support the hypothesis that N20/P20 are generated as a horizontal dipole in the central sulcus (3b), whereas P23/N24 are a reflection of multiple generators in pre- and post-rolandic fissures. P22 was very localized in the central area contralateral to the stimulation.Topographical studies of early cortical SEPs are useful for detecting each component in abnormal SEPs     

Detailed analysis of the latencies of median nerve somatosensory evoked potential components, 1: selection of the best standard parameters and the establishment of normal values

In order to objectively select the standard parameters best suited for the evaluation of somatosensory conduction in median nerve somatosensory evoked potentials (SEP), we performed a detailed statistical analysis of intersubject variability for the latencies of SEP components based on the recordings of 62 normal subjects. Multiple regression analyses for height, age, (age - 20)² and sex were performed for the latencies of 13 components and 78 intercomponent intervals, and the residual variance was used as an indicator of the stability of each parameter. As a result, N9 onset in EPi-NC lead, N11′ onset in C6S-Fz lead, P13/14 onset in scalp-NC leads, for which N13′ onset recorded in C6S-Fz lead may substitute, and N20 onset in CPc-Fz lead were the most stable time-points selected as standards. N11 onset in C6S-NC, which other authors have recommended as the standard point representing spinal entry, was not recorded consistently, and P11 onset in scalp-NC leads was also unstable. N20 and peak and N13′-N20 interval (equivalent to conventional central conduction time) were extremely unstable. We presented the nomograms to find normal limits of the standard parameters corresponding to the given values of the predictor variables (height, age or sex). As the standard recording montage in routine clinical examinations, we recommended a simple method using Fz reference, for example (1) EPi-Fz, (2) C6S-Fz, (3) CPc-Fz, because this montage is sufficient to measure the stable standard parameters.     

SEP testing in deeply comatose and brain dead patients: the role of nasopharyngeal,scalp and earlobe derivations in recording the P14 potential

Median nerve somatosensory evoked potentials (SEPs) were tested in 50 patients (20 brain dead, 18 comatose and in 12 progessing from coma to brain death, i.e., 32 cases with brain death and 30 cases with coma were recorded).Derivations were taken from nasopharynx, earlobes, scalp, and neck using cephalic and non-cephalic references. Cortical and subcortical SEP components were evaluated, focussing on the P14 potential. There is evidence that rostral and caudal parts of the P14 generator (lemniscus medialis) are differently affected in brain death, resulting in an abolition of the rostral part, while occassionally leaving intact for some time the caudal part. Non-cephalic referenced scalp records pick up the whole P14 dipole, whereas nasopharyngeal and earlobe derivations pick up different parts of P14, depending on the reference used. Scalp-to-nasopharynx records derive the most rostral part of P14; this “rostral P14” was bilaterally lost in all brain dead patients, but preserved in all deeply comatose patients with diffuse brain-sttem injuries. Scalp-to-earlobe records in contrast, picked up a P14 dipole segment reaching more caudally, resulting in a P14 potential also in brain dead patients. It is concluded that midfrontal scalp-to-nasopharynx derivations give the moset valuable contribution to the electrophysiological assessment of brain death versus deep coma.     

Event-related potentials recorded from the scalp and nasopharynx. I. N1 and P2

Event-related potentials were recorded from the scalp and nasopharynx during a signal-detection task. These responses were evaluated with respect to the effects of interstimulus interval, intensity, frequency, attention and modality. Our results indicate the existence of at least 4 distinct processes occurring in the 75–150 msec latency range following auditory stimuli. The first process is indexed in the vertex-N1b/temporal-N1a component. This component does not reverse in polarity below the sylvian fissure and is not seen in nasopharyngeal recordings. The location of its generator is not known. Probably there are two or more sources active at this latency. The second process finds reflection in the N1c/PgP120 component. This component is recorded with maximum amplitude on the side contralateral to the ear of delivery. A source in the lateral surface of the temporal lobe is a likely generator. The third process corresponds to Wolpaw and Penry's (1975) Ta positivity. How much of this represents the underside of a vertically oriented dipole and how much a surface positivity is unknown. Finally, during attention, a lateralized processing negativity seems to overlap these components at the scalp, but not at the nasopharynx. The auditory vertex N1 peak is quite distinct from the visual N1 which is more posteriorly recorded on the scalp and which is associated with a definite nasopharyngeal positive wave. The P2 peak is quite similar across auditory and visual modalities. In both modalities it is maximally recorded from the vertex and has no nasopharyngeal concomitant.     

SEP topographies elicited by innocuous and noxious sural nerve stimulation. I. Identification of stable periods and individual differences

Scalp potential topographies evoked by innocuous and noxious sural nerve stimulation were obtained from 15 human subjects. The SEP scalp topography could be separated into 6 different stable periods (SP), that is, consecutive time points where there were no major changes in the topographic pattern, SP1 (occurring 58–90 msec post stimulus) was characterized by a contralateral frontal positivity and a central negativity oriented ipsilateral to the evoking stimulus; SP2 (92–120 msec by a bilateral frontal positivity and a symmetrical central negativity; SP3 (135–158 msec) by a widespread negativity with a minimum at the contralateral temporo-frontal region; and SP4 (178–222 msec), SP5 (223–277 msec) and SP6 (282–339 msec) by a widespread positivity with a maximum located along the centro-parietal midline. SP4, SP5, amd SP6 could be distinguished by changes in the orientation of the isovoltage contour lines and/or by changes in the location of the maximum. The stable periods had similar onset and offset latencies and the same major features across subjects. However, the topographic patterns were not identical across subjects. These individual differences are likely due to the expected variability in the orientation of the equivalent regional dipole sources generating these potentials.     

Three-dimensional human pattern visual evoked potentials. II. Multiple sclerosis patients

Pattern visual evoked potentials were obtained from 46 patients with definite relapsing/remitting multiple sclerosis, using both a conventional 5-channel occipital array and a 3-D recording technique consisting of three bipolar derivations approximating the three dimensions of space. These three orthogonal wave forms were displayed as a 3-D Lissajous trajectory for each subject. Two of the 15 patients with completely normal conventional pattern VEPs had abnormalities of the orientation of the B-C curvilinear segment of the 3-D pattern VEPs. Delays in the first major occipital positive component (P100) were evident using both techniques; the correlation between P100 latency and the latency of the corresponding trajectory apex was r = 0.99 (P < 0.01). Post-chiasmal MRI abnormalities were associated with 3-D VEP orientation abnormalities. Three-dimensional pattern VEPs are moderately more sensitive than conventional pattern VEPs at detecting dysfunction posterior to the optic chiasm in demyelinating disease and do not require the use of eccentric fixation to do so.     

Scalp potentials following sudden coherence and discoherence of binaural noise and change in the inter-aural time difference: a specific binaural evoked potential or a “mismatch” response?

When uncorrelated random noise signals presented to the two ears suddenly become identical (coherent), a centrally located sound image is abruptly perceived and long latency scalp potentials are evoked. When the same signals are presented monaurally there is no perceived change and no potentials are evoked: hence the response must be purely a function of the binaural interaction.P70, N130 and P220 components were consistently recorded to both coherence and discoherence. N130 was usually largest at Fz and P220 at Cz. No potentials of shorter latency were identified, even after averaging 5000 or more sweeps. When the noise became coherent with an inter-aural time difference (δT) of ±0.5 msec (giving rise to an off-centre sound image), the responses were of slightly longer latency and showed no significant asymmetries between C3 and C4. In binaurally coherent noise, δT changes of ±0.5 or ±1.0 msec evoked similar responses which showed no significant asymmetries on the scalp. N130 was of longer latency when δT was changed from ±0.5 msec to zero, as compared with the converse change.In view of the similarity of all these responses it is considered unlikely that they were due to specific populations of binaurally responsive cortical neurones. The N130 and P220 components are thought to be non-specific potentials which are elicited by amy perceptible change in steady auditory stimulus conditions, due to a “mismatch” between the stimulus and the contents of a short-term auditory memory.     

Origin of frontal N15 component of somatosensory evoked potential in man

Origin of the frontal somatosensory evoked potential (SEP) by median nerve stimulation was investigated in normal volunteers and in patients with localized cerebrovascular diseases, and the following results were obtained.

• 1.(1) In normal subjects, SEPs recorded at F3 (or F4) contralateral to the stimulating median nerve were composed of P12, N15, P18.5 and N26. Similar components were recognized in SEP recorded at Fz.
• 2.(2) In patients in whom putaminal or thalamic hemorrhages had destroyed the posterior limbs of the internal capsules, frontal N15 and parietal N18 (N20) disappeared. These components were also absent in patients with cortical (parietal) infarctions. Among these patients, the thalamus was not affected in cases with putaminal hemorrhages and cortical infarctions.

These facts indicate that the generator of the frontal N15 does not exist in the thalamus but that it originates from the neural structure central to the internal capsule, which suggests a similarity to the generator of the parietal N18.Because N15 was recorded in the midline of the frontal region with shorter latency than parietal N18, the frontal N15 might represent a response to the sensory input of the frontal lobe via the non-specific sensory system.