AAEM minimonograph #35: Clinical experience with transcranial magnetic stimulation
- 1 November 1990
- journal article
- research article
- Published by Wiley in Muscle & Nerve
- Vol. 13 (11), 995-1011
- https://doi.org/10.1002/mus.880131102
Abstract
We elicited motor evoked potentials (MEPs) using transcortical magnetic stimulation in 150 control subjects aged 14 to 85 years and 275 patients with a variety of diseases. There were no significant side effects. Cortex-to-target muscle latencies measured 20.2±1.6 ms (thenar),14.2 ± 1.7 ms(extensor digitorum communis), 9.4 ± 1.7 ms(biceps), and 27.2 ± 2.9 ms (tibialis anterior). Central motor delay between the cortex and the C-7 and L-5 measured 6.7 ± 1.2 ms and 13.1 ± 3.8 ms, respectively. Mean spinal cord motor conduction velocity measured 65.4 m/s. MEP amplitude expressed as a percentage of the maximum M wave was never less than 20% of the M wave. A value of less than 10% is considered abnormal. MEP latency increases linearly with age and central motor delay is longer in older subjects. Compound muscle action potentials and absolute MEP amplitudes decrease linearly with age. In multiple sclerosis (MS), MEP latency and central delay were often very prolonged. The MEP was more sensitive than the SEP in MS. In amyotrophic lateral sclerosis, MEP latencies were only modestly prolonged; the characteristic abnormality was reduced amplitude. When pseudobulbar features predominated MEPs were often absent. The MEP was of normal latency in Parkinson's disease, but age-related amplitude was often increased. MEP latency and amplitude were normal in Huntington's disease. Abnormal MEPs persisted several months after stroke despite good functional recovery. The MEP could be used to advantage to demonstrate proximal conduction slowing and block in demyelinating neuropathies. In plexopathy, ability to elicit an MEP several days after onset of paresis was good evidence of neuronal continuity in motor fibers.This publication has 53 references indexed in Scilit:
- The utility of magnetic stimulation for routine peripheral nerve conduction studiesMuscle & Nerve, 1988
- Magnetic brain stimulation: Central motor conduction studies in multiple sclerosisAnnals of Neurology, 1987
- Central motor conduction in motor neuron diseaseAnnals of Neurology, 1987
- Magnetic and electrical transcranial brain stimulationNeurosurgery, 1987
- Mechanisms of nervous propagation along central motor pathwaysNeurosurgery, 1987
- Magnetic stimulation of the human brain: Facilitation of motor responses by voluntary contraction of ipsilateral and contralateral muscles with additional observations on an amputeeNeuroscience Letters, 1986
- Clinical neurophysiology of conduction in central motor pathwaysAnnals of Neurology, 1985
- Corticospinal tract conduction time in multiple sclerosisAnnals of Neurology, 1985
- Principles and pitfalls of nerve conduction studiesAnnals of Neurology, 1984
- Stimulation of the cerebral cortex in the intact human subjectNature, 1980