Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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Laser-evoked potentials have been shown to be clinically useful for the electrophysiological assessment of nociceptive pathways. Contact heat evoked potentials (CHEP) are less established but might be advantageous for clinical purposes. This study aimed at determining the conduction velocity (CV) of central pain (spinothalamic tract, STT) pathways using contact heat stimulation in order to replicate previous findings using laser stimulation. ⋯ This study shows the importance of pain thresholds and their control to attain valid CV of the STT after contact heat stimulation in healthy subjects.
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To investigate the conditioning effects of plantar pressure on flexion reflex excitability in patients with motor complete spinal cord injury (SCI). ⋯ Activation of plantar mechanoreceptors is a feature of normal standing and walking. Rehabilitation for standing and walking in SCI commonly uses body weight support based protocols. The strong inhibitory actions of plantar pressure on reflex pathways in the isolated human spinal cord suggest that sensory feedback from the foot sole may be an important factor in successful rehabilitation of standing and stepping in SCI patients.
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Contact heat evoked potentials (CHEPs) provide an objective approach to investigate cerebral responses to thermal stimuli mediated by Adelta fibers. Skin denervation is often associated with reduced thermal sensibilities. We aimed to investigate the influences of skin denervation on CHEPs in neuropathic patients. ⋯ CHEP offers electrophysiological evidence of thermal responses and provides an objective, non-invasive approach to assess the physiological counterparts of skin denervation in neuropathic patients.
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High Frequency repetitive Transcranial Magnetic Stimulation (HF-rTMS) has yielded divergent results concerning its effect on mood in normal volunteers. In a former study, we were unable to demonstrate negative mood effects after one session of HF-rTMS on the left dorsolateral prefrontal cortex (DLPFC) in a large group of healthy female volunteers: researchers had focused mainly on negative mood changes, overlooking a possible positive mood induction, while no studies had yet examined mood effects of HF-rTMS delivered on the right prefrontal cortex. In this study, we have tried to replicate our previous HF-rTMS findings on the left DLPFC in a new (large) group of healthy female subjects, and we focused especially on positive mood changes. We also extended our former research by stimulating the right DLPFC in a different but comparable (large) group of healthy female volunteers with the same HF-rTMS parameters. ⋯ One HF-rTMS session has no effect on subjective mood in healthy female volunteers.
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Recent advances in technology and the refinement of neurophysiological methodologies are significantly changing intraoperative neurophysiological monitoring (IOM) of the spinal cord. This review will summarize the latest achievements in the monitoring of the spinal cord during spine and spinal cord surgeries. This overview is based on an extensive review of the literature and the authors' personal experience. ⋯ Finally, while MEPs are now considered the gold standard for monitoring the motor pathways, SEPs continue to retain value as they provide specificity for assessing the integrity of the dorsal column. However, we believe SEPs should not be used exclusively--or as an alternative to motor evoked potentials--during spine surgery, but rather as a complementary method in combination with MEPs. For intramedullary spinal tumor resection, SEPs should not be used exclusively without MEPs.