CORTICOSPINAL VOLLEYS EVOKED BY ELECTRICAL-STIMULATION OF HUMAN MOTOR CORTEX AFTER WITHDRAWAL OF VOLATILE ANESTHETICS

被引:74
作者
HICKS, R
BURKE, D
STEPHEN, J
WOODFORTH, I
CRAWFORD, M
机构
[1] UNIV NEW S WALES,PRINCE HENRY HOSP,DEPT ORTHOPED SURG,SYDNEY 2036,AUSTRALIA
[2] UNIV NEW S WALES,PRINCE HENRY HOSP,DEPT ANAESTHESIA,SYDNEY 2036,AUSTRALIA
[3] UNIV NEW S WALES,PRINCE WALES HOSP,SYDNEY 2036,AUSTRALIA
[4] UNIV NEW S WALES,PRINCE WALES RES INST,SYDNEY 2036,AUSTRALIA
来源
JOURNAL OF PHYSIOLOGY-LONDON | 1992年 / 456卷
关键词
D O I
10.1113/jphysiol.1992.sp019342
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
1. In twenty-two neurologically normal patients undergoing surgery for scoliosis, corticospinal volleys to transcranial electrical stimulation of the motor cortex were recorded from the spinal cord using epidural electrodes. While anaesthesia was maintained by nitrous oxide and narcotics, volatile anaesthetics were withdrawn to determine whether such agents had a depressant effect on the evoked corticospinal volley. 2. Profound changes were documented in liminal D waves, there being an increase in amplitude averaging 392% following withdrawal of the volatile anaesthetic. There was a proportionately smaller increase (averaging 26%) in supraliminal D waves; these had a complex bifid or trifid shape indicating that some corticofugal axons were being activated deep to cortex. In general the effect on the D wave of withdrawing the anaesthetic agent was similar to that of increasing stimulus intensity. 3. Withdrawal of isoflurane dramatically increased the number of I waves and their mean amplitude. In the absence of isoflurane, I3, (mean latency 3.5 ms after the D wave) became the dominant I wave. The amplitude of I2 (mean latency 2.2 ms) became slightly smaller. The change in I waves could not be likened to an increase in stimulus intensity, because I waves invariably increase in, or remain of the same, amplitude as stimulus intensity is increased. 4. These findings indicate that changes in motor cortex excitability can result in major changes in the corticospinal volley produced by transcranial electrical stimulation, affecting both the D wave and I waves. They caution against identifying a cortical action solely on the basis of a change in the responses to magnetic stimulation of motor cortex but no such change to electrical stimulation.
引用
收藏
页码:393 / 404
页数:12
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