Mechanism of prolonged central motor conduction time in compressive cervical myelopathy

Objective: To investigate the mechanism of prolonged central motor conduction time (CMCT) in compressive cervical myelopathy, we compared the calculated CMCT following transcranial magnetic stimulation (TCM) and evoked spinal cord potentials (ESCPs) following transcranial electric stimulation (TCE)....

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Bibliographic Details
Published in:Clinical neurophysiology 2001-06, Vol.112 (6), p.1035-1040
Main Authors: Kaneko, Kazuo, Taguchi, Toshihiko, Morita, Hideki, Yonemura, Hiroshi, Fujimoto, Hideaki, Kawai, Shinya
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cervical myelopathy
Cervical Vertebrae
Electric Stimulation
Electrodiagnosis. Electric activity recording
Electromagnetic Phenomena
Evoked Potentials, Motor - physiology
Evoked spinal cord potentials
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Motor evoked potentials
Nervous system
Spinal Cord - physiology
Spinal Cord Compression - physiopathology
Spinal Cord Compression - surgery
Statistics, Nonparametric
Transcranial magnetic stimulation
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Summary:Objective: To investigate the mechanism of prolonged central motor conduction time (CMCT) in compressive cervical myelopathy, we compared the calculated CMCT following transcranial magnetic stimulation (TCM) and evoked spinal cord potentials (ESCPs) following transcranial electric stimulation (TCE). Method: Motor evoked potentials following TCM were recorded from abductor digiti minimi and abductor hallucis brevis muscles in 16 patients with compressive cervical myelopathy. CMCT was calculated by subtracting peripheral conduction time using peripheral nerve stimulation from MEP latency. ESCPs following TCE were recorded intraoperatively from posterior epidural space. Results: CMCT was prolonged and significant attenuation of the ESCP amplitude following TCE was observed in all patients with cervical myelopathy. In 8 of 16 patients CMCT was significantly prolonged but ESCPs were recorded at the C6-7 level with normal negative peak latency. Conclusions: Prolonged CMCT may occur with only a minor amount of conduction slowing in the corticospinal tract in compressive cervical myelopathy. Impaired temporal summation of multiple descending potentials following TCM produced delays of motor neuron firing that contribute to the mechanism of prolonged CMCT.
ISSN:1388-2457
1872-8952
DOI:10.1016/S1388-2457(01)00533-8