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Sci Rep. 2019 Mar 7;9(1):3773. doi: 10.1038/s41598-019-39883-y.

Monophasic transcranial constant-current versus constant-voltage stimulation of motor-evoked potentials during spinal surgery.

Author information

1
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.
2
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan. shideki714@gmail.com.
3
Department of Anesthesiology, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.
4
Division of Central Clinical Laboratory, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.

Abstract

Constant-voltage and constant-current stimulators may be used for transcranial electrical stimulation of motor evoked potentials (TES-MEP). However, no previous report has determined whether the two monophasic stimulation methods lead to similar responses during intra-operative monitoring. We studied differences in the lateralities of compound muscle action potentials (CMAPs) during intra-operative spinal cord monitoring via TES-MEP using monophasic constant-current and constant-voltage stimulations. CMAPs were bilaterally recorded from the upper and lower limb muscles in 95 patients who underwent elective spine and spinal cord surgery. We used two monophasic stimulation patterns: pattern 1, right anode and left cathode; pattern 2, right cathode and left anode. There were no statistically significant differences between the right and left sides with respect to success rates, wave amplitudes, and efficiencies, with constant-voltage stimulation, however, there were statistically significant differences between the right and left sides with constant-current stimulation. In case of our stimulation condition, there were no statistically significant differences between the right and left sides with respect to CMAPs with constant-voltage stimulation; constant-current stimulation was influenced by the type of monophasic stimulation, which necessitates the switch the polarity of the stimulation to bilaterally record CMAPs.

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