PMID- 18922947
OWN - NLM
STAT- MEDLINE
DCOM- 20090423
LR  - 20081208
IS  - 0022-3077 (Print)
IS  - 0022-3077 (Linking)
VI  - 100
IP  - 6
DP  - 2008 Dec
TI  - Double-pulse magnetic brain stem stimulation: mimicking successive descending 
      volleys.
PG  - 3437-44
LID - 10.1152/jn.90751.2008 [doi]
AB  - Magnetic stimulation with a double-cone-coil over the back of the head activates 
      the motor tracts at the level of pyramidal decussation (brain stem stimulation 
      [BST]). However, single-pulse BST (single BST) sometimes cannot elicit 
      motor-evoked potentials (MEPs) in patients with corticospinal tract involvement. 
      We developed a technique using double-pulse BST (double BST) to elicit MEPs even 
      in patients whose threshold is abnormally elevated. Subjects were 11 healthy 
      volunteers and 12 patients with corticospinal tract involvement in whom single 
      BST evoked no discernible MEP. Double BST was performed at the intensities of 
      resting and active motor threshold for single BST; MEPs were recorded from the 
      first dorsal interosseous muscle. Interstimulus intervals (ISIs) between two 
      pulses were 1.5, 2, 3, 5, and 10 ms in healthy subjects. Double BST enlarged MEPs 
      at ISIs of 1.5-5 ms with a peak at 2 ms in the relaxed condition, but not in the 
      active condition. At an ISI of 2 ms in the relaxed condition, the MEP amplitude 
      was 15 times as large as that to single BST in relaxed muscles. The onset latency 
      of the enlarged MEP from the second pulse in relaxed muscles was the same as that 
      by single BST in active muscles. Double BST at a 2-ms interval elicited MEPs in 
      eight patients. Double BST can enhance MEPs probably by temporal summations of 
      excitatory postsynaptic potentials at the spinal motoneurons. Using this new 
      technique, we can obtain more information about the central motor conduction even 
      when single BST fails to elicit any MEP.
FAU - Matsumoto, Hideyuki
AU  - Matsumoto H
AD  - Department of Neurology, Division of Neuroscience, Graduate School of Medicine, 
      University of Tokyo, Tokyo, Japan. hideyukimatsumoto@mail.goo.ne.jp
FAU - Hanajima, Ritsuko
AU  - Hanajima R
FAU - Hamada, Masashi
AU  - Hamada M
FAU - Terao, Yasuo
AU  - Terao Y
FAU - Yugeta, Akihiro
AU  - Yugeta A
FAU - Inomata-Terada, Satomi
AU  - Inomata-Terada S
FAU - Nakatani-Enomoto, Setsu
AU  - Nakatani-Enomoto S
FAU - Tsuji, Shoji
AU  - Tsuji S
FAU - Ugawa, Yoshikazu
AU  - Ugawa Y
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20081015
PL  - United States
TA  - J Neurophysiol
JT  - Journal of neurophysiology
JID - 0375404
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Brain Stem/*physiology
MH  - Deep Brain Stimulation/*methods
MH  - Electric Stimulation/methods
MH  - Electromyography
MH  - Evoked Potentials, Motor/*physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nervous System Diseases/therapy
MH  - Pulse/*methods
MH  - Pyramidal Tracts/physiology
MH  - Reaction Time/physiology
MH  - Young Adult
EDAT- 2008/10/17 09:00
MHDA- 2009/04/25 09:00
CRDT- 2008/10/17 09:00
PHST- 2008/10/17 09:00 [pubmed]
PHST- 2009/04/25 09:00 [medline]
PHST- 2008/10/17 09:00 [entrez]
AID - 90751.2008 [pii]
AID - 10.1152/jn.90751.2008 [doi]
PST - ppublish
SO  - J Neurophysiol. 2008 Dec;100(6):3437-44. doi: 10.1152/jn.90751.2008. Epub 2008 
      Oct 15.