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J Korean Neurosurg Soc. 2017 Jul;60(4):475-480. doi: 10.3340/jkns.2016.0506.006. Epub 2017 Jul 31.

An Electrode Configuration for Recording Muscle Motor Evoked Potentials in the Upper Extremities during Intraoperative Neurophysiological Monitoring.

Choi YD1, Jin SH1,2, Kim CH1,2,3, Kwak GH1, Kim BE1, Chung CK1,2,3,4.

Author information

1
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
2
Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
3
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
4
Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea.

Abstract

OBJECTIVE:

The main aim of the present study is to examine the electrode configurations used to record the muscle motor evoked potential (mMEP) in the upper extremities during surgery with the goal of producing a high and stable mMEP signal, in particular among the abductor pollicis brevis (APB), abductor digiti minimi (ADM), and across the APB-ADM muscles, which have been widely used for the mMEP in the upper extremities.

METHODS:

Thirty right-handed patients were recruited in this prospective study. No patients showed any adverse events in their mMEP signals of the upper extremities during surgery. The mMEPs were recorded independently from the signals for the APB and ADM and for those across the APB-ADM.

RESULTS:

The mMEP amplitude from across the APB-ADM was statistically higher than those recorded from the APB and ADM muscles. Moreover, the coefficient of variation of the mMEP amplitude from across the APB-ADM was smaller than those of mMEP amplitude recorded from the APB and ADM muscles.

CONCLUSION:

The mMEP from across the APB-ADM muscles showed a high yield with high stability compared to those in each case from the APB and ADM muscles. The configuration across the APB-ADM muscles would be best for mMEP recordings from the upper extremities for intraoperative neurophysiological monitoring purposes.

KEYWORDS:

Abductor digiti minimi; Abductor pollicis brevis; Across APB-ADM; Intraoperative neurophysiological monitoring; Motor evoked potential; Upper extremity

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