Changes in somatosensory evoked potentials elicited by stimulation of upper-limb and lower-limb nerves in amyotrophic lateral sclerosis patients

This study observed the changes in somatosensory evoked potentials between patients with amyotrophic lateral sclerosis （ALS） and healthy controls to evaluate the function of the central deep somatosensory pathway. In patients with ALS, 28 patients （54%） showed an abnormality in somatosensory evoked potentials. All had abnormal lower limb somatosensory evoked potentials. Compared with healthy controls, the abnormality in somatosensory evoked potential was characterized by prolonged N20, P2, N2 latency and central conduction time, with or without a decrease in wave amplitude or disappearance of waveform. Results showed marked alterations in the somatosensory evoked potential in cortical components of the upper and lower limb in 54% of patients with ALS, and confirmed that patients with ALS may also have a defective deep somatosensory pathway, particularly an abnormal central deep somatosensory pathway.

Central somatosensory conduction slowing in adults with isolated elevated plasma level of homocysteine

Aim:Elevated plasma level of homocysteine(eHcy)is a recognized risk factor for dementia.However,whether the central conduction is affected in patients with an isolated eHcy is unknown.In this study,we addressed whether central conduction is altered in adults with eHcy.Methods:Evoked potential studies including somatosensory(SSEP),visual(VEP)and brainstem auditory evoked potentials(BAEP),were performed to evaluate central conduction in patients with isolated eHcy.Results:Nine SSEP,7 VEP,and 6 BAEP were studied in 9 patients with eHcy(age:63.3±7.5 years old,mean±standard deviation,male/female:4/5).SSEP with median nerve stimulation was delayed in peak latency of N9(5/9/55.6%,abnormal/total subjects/percentage),N13(7/9/77.8%),N20(6/9/66.7%),and/or interpeak latency of N9‑N13(5/9/55.6%),N13-N20(5/9/55.6%),and N9-N20(4/9/44.4%).There was one delayed P100 latency(1/7/14.3%)in 7 VEP.BAEP was within normal limits in all the 6 subjects tested.Conclusion:Our pilot study provided neurophysiologic evidence of central conduction slowness in patients with eHcy,which may be due to a large diameter fiber dysfunction within the somatosensory,but not the visual and auditory,white matter pathway.The central conduction slowing in eHcy may be relevant to the pathophysiologic background for slowing the central processing.

Major ozonated autohemotherapy promotes the recovery of upper limb motor function in patients with acute cerebral infarction

Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.

Effects of cortical intermittent theta burst stimulation combined with precise root stimulation on motor function after spinal cord injury: a case series study

Activation and reconstruction of the spinal cord circuitry is important for improving motor function following spinal cord injury.We conducted a case series study to investigate motor function improvement in 14 patients with chronic spinal cord injury treated with 4 weeks of unilateral(right only)cortical intermittent theta burst stimulation combined with bilateral magnetic stimulation of L3-L4 nerve roots,five times a week.Bilateral resting motor evoked potential amplitude was increased,central motor conduction time on the side receiving cortical stimulation was significantly decreased,and lower extremity motor score,Berg balance score,spinal cord independence measure-III score,and 10 m-walking speed were all increased after treatment.Right resting motor evoked potential amplitude was positively correlated with lower extremity motor score after 4 weeks of treatment.These findings suggest that cortical intermittent theta burst stimulation combined with precise root stimulation can improve nerve conduction of the corticospinal tract and lower limb motor function recovery in patients with chronic spinal cord injury.