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The triple stimulation technique to study central motor conduction to the lower limbs
- Source :
- Clinical Neurophysiology. 112:938-949
- Publication Year :
- 2001
- Publisher :
- Elsevier BV, 2001.
-
Abstract
- Objective : To quantify the percentage of motor units of a foot muscle that can be activated by transcranial magnetic stimulation (TMS) in normal subjects and patients. Methods : We adapted the recently described triple stimulation technique (TST) for recordings from abductor hallucis (AH). Conventional motor evoked potentials (MEPs) of this muscle are usually small and variable in shape, because of an important temporal desynchronization of the TMS induced spinal motor neuron discharges. The TST allows ‘resynchronization’ of these discharges and thereby a quantification of the proportion of motor units activated by TMS. The lower limb (LL-) TST was applied to 33 sides of 18 normal subjects and 51 sides of 46 patients with multiple sclerosis, amyotrophic lateral sclerosis, or spinal cord disorders. Results : In healthy subjects, the LL-TST demonstrated that TMS achieves activation of virtually all motor neurons supplying the AH. In 33 of 51 patient sides, abnormal LL-TST responses suggested corticospinal conduction failures of various degrees. The LL-TST was 2.54 times more sensitive to detect central conduction failures than the conventional LL-MEPs. Combining the LL-TST with TST of the upper limbs further increased the sensitivity to detect a conduction failure by 1.50 times. Conclusion : The LL-TST markedly improves the examination of corticospinal pathways.
- Subjects :
- Adult
Male
medicine.medical_specialty
Multiple Sclerosis
medicine.medical_treatment
Neural Conduction
Pyramidal Tracts
Central nervous system disease
Muscular Diseases
Physiology (medical)
Internal medicine
medicine
Humans
Motor Neuron Disease
Amyotrophic lateral sclerosis
Muscle, Skeletal
Motor Neurons
Leg
business.industry
Motor control
Middle Aged
Motor neuron
Evoked Potentials, Motor
bacterial infections and mycoses
medicine.disease
Electric Stimulation
Sensory Systems
Motor unit
Transcranial magnetic stimulation
medicine.anatomical_structure
Spinal Cord
Neurology
Corticospinal tract
Cardiology
Female
Neurology (clinical)
business
Neuroscience
Motor cortex
Subjects
Details
- ISSN :
- 13882457
- Volume :
- 112
- Database :
- OpenAIRE
- Journal :
- Clinical Neurophysiology
- Accession number :
- edsair.doi.dedup.....4666007325e47df749f13c2326979949