Dissociation of somatosensory and motor evoked potentials in non- comatose patients after head injury

Andrei V. Chistyakov, Hava Hafner, Jean F. Soustiel, Meital Trubnik, Galit Levy, Moshe Feinsod

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Objectives: This study was performed to evaluate the clinical value of combined use of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) in patients with different brain lesions after head trauma. Methods: A total of 64 patients with minor and moderate head injury were investigated by means of SEPs recorded over the parietal and frontal areas and MEPs following single-pulse transcranial magnetic stimulation (sTMS) and slow-rate repetitive transcranial magnetic stimulation (rTMS). Results: In almost 50% of the patients, a dissociated impairment of somatosensory and motor evoked potentials was found. This dissociation was related to different distribution of SEP and MEP abnormalities in head injury subgroups. The higher threshold to sTMS and increased variability of the MEP amplitude during slow-rate rTMS were the most prominent features in patients with focal brain contusions, suggesting impairment of the cortical excitability. SEP abnormalities, as well as central conduction impairments, were more noticeable in patients with diffuse brain injury. Conclusions: A combined analysis of SEPs and MEPs may improve the assessment of cortical dysfunctions and central conduction abnormalities in non-comatose patients with head injury. A slow-rate rTMS may be considered as a complementary technique to the evaluation of the threshold in assessment of the excitability of the motor cortex in minor and moderate head injury.

Original languageEnglish
Pages (from-to)1080-1089
Number of pages10
JournalClinical Neurophysiology
Volume110
Issue number6
DOIs
StatePublished - 1 Jun 1999
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by the generosity of the Joseph Szydlowsky Foundation. The authors are greatly indebted to the commitment of Mrs. S. Stern.

Keywords

  • Head injury
  • Motor evoked potentials
  • Somatosensory evoked potentials
  • Transcranial magnetic stimulation

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