title: Transcranial motor-evoked potentials monitoring can detect spinal cord ischemia more rapidly than spinal cord-evoked potentials monitoring during aortic occlusion in rats.
abstract: In this study, we evaluated the efficacy of transcranial motor-evoked potentials (tc-MEPs), compared with segmental spinal cord-evoked potentials (SCEPs), for detecting spinal cord ischemia (SCI) and assessed the relationship between neurological outcome and tc-MEPs or SCEPs in the rat aortic occlusion model. In the rats, SCI was induced by aortic occlusion for 10 min with a balloon catheter. At first, tc-MEPs (Group A: n = 6) or segmental SCEPs (Group B: n = 6) was recorded during SCI. Second, in using the quantal bioassay for the relationship between an interval of aortic occlusion and the probability of positive response in tc-MEPs or segmental SCEPs, the P50(MEP) and P50(SCEP) which represent the interval of aortic occlusion associated with 50% probability of assessment of ischemic spinal cord dysfunction by tc-MEP and SCEP were analyzed. The amplitude of tc-MEPs decreased significantly at 30 s and disappeared completely at 2 min after aortic occlusion. In Group B, it took about 6 min after aortic occlusion to diminish SCEP signal amplitude by approximately 50%. P50(MEP) obtained in the quantal analysis was 0.3 +/- 0.1 min. P50(SCEP) was calculated as 6.2 +/- 0.5 min that was significantly (P < 0.01) longer than P50(MEP). Our data indicated that tc-MEP monitoring could detect the onset of SCI so rapidly in comparison with segmental SCEP monitoring, which could provide therapeutic windows in a surgical approach that includes spinal cord protection.
authors.affiliation: Department of Anesthesiology, University of the Ryukyus, Nishihara, Okinawa, Japan. mnb-shk@ryukyu.ne.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Kakinohana
authors.forename: Seiya
authors.initials: S
authors.lastname: Nakamura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fuchigami
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sugahara
mesh_terms: D000818:Animals; D001018:Aortic Diseases / Q000503:physiopathology*; D019054:Evoked Potentials, Motor / Q000502:physiology*; D008297:Male; D008991:Monitoring, Physiologic; D018482:Muscle, Skeletal / Q000503:physiopathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D020760:Spinal Cord Ischemia / Q000175:diagnosis*; D013997:Time Factors