scholarly journals Motor evoked potentials from the external anal sphincter in patients with autosomal dominant pure spastic paraplegia linked to chromosome 2p

2001 ◽  
Vol 71 (4) ◽  
pp. 561-562 ◽  
Author(s):  
P JENNUM
Keyword(s):  
Evoked Potentials ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Autosomal Dominant ◽  
Motor Evoked Potentials ◽  
Spastic Paraplegia

Quantification of motor pathways to the pelvic floor in humans

1991 ◽  
Vol 260 (5) ◽  
pp. G720-G723 ◽  
Author(s):  
J. Herdmann ◽  
K. Bielefeldt ◽  
P. Enck
Keyword(s):  
Pelvic Floor ◽  
Evoked Potentials ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Motor Evoked Potentials ◽  
Motor Innervation ◽  
Anterior Tibial Muscle ◽  
Motor Pathways ◽  
Anterior Tibial ◽  
Stimulation Of

The motor innervation of the pelvic floor plays a major role in defecation disorders such as fecal incontinence. It consists of central motor pathways and peripheral nerve fibers. Transcranial magnetoelectric stimulation of the brain and magnetoelectric stimulation of the lumbosacral motor roots were performed in 10 healthy volunteers. Motor evoked potentials were recorded from the external anal sphincter. This procedure allowed differentiation between a predominantly central and a solely peripheral component of the motor innervation of the external and sphincter. To compare these recordings with well-established data, motor evoked potentials were also recorded from the anterior tibial muscle. The central motor conduction time was 20.9 +/- 2.4 ms to the external anal sphincter and 14.8 +/- 2.3 ms to the anterior tibial muscles. Central motor conduction velocities were 40.7 +/- 5.2 and 55.5 +/- 7.6 m/s, respectively. This showed that conduction in the central fibers to the external anal sphincter was significantly slower than in those to the anterior tibial muscle. We conclude 1) that magnetoelectric stimulation allows differentiation between central and peripheral portions of the motor innervation of the pelvic floor, and 2) that central motor pathways innervating the pelvic floor differ significantly in their physiological properties from those innervating limb muscles.

scholarly journals Motor Evoked Potentials in Hereditary Spastic Paraplegia—A Systematic Review

2019 ◽  
Vol 10 ◽  
Author(s):  
Sue-Faye Siow ◽  
Ruaridh Cameron Smail ◽  
Karl Ng ◽  
Kishore R. Kumar ◽  
Carolyn M. Sue
Keyword(s):  
Systematic Review ◽  
Evoked Potentials ◽  
Hereditary Spastic Paraplegia ◽  
Motor Evoked Potentials ◽  
Spastic Paraplegia

031 Investigating motor evoked potentials as a biomarker for disease severity in hereditary spastic paraplegia

2018 ◽  
Vol 89 (6) ◽  
pp. A13.2-A13
Author(s):  
Sue-Faye Siow ◽  
Carolyn Sue ◽  
Kishore Kumar ◽  
Sharon Coward ◽  
Amy Lofts ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Disease Severity ◽  
Lower Limb ◽  
Hereditary Spastic Paraplegia ◽  
Disease Duration ◽  
Rating Scale ◽  
Motor Evoked Potentials ◽  
Conduction Time ◽  
Spastic Paraplegia ◽  
Resting Motor Threshold

IntroductionHereditary spastic paraplegia (HSP) encompasses a diverse group of neurodegenerative disorders that results in significant disability with no curative or disease-modifying treatment. The lack of standardised biomarkers of disease severity has limited the evaluation of potential therapeutic agents. Our aim is to investigate motor evoked potentials (MEPs) as a marker of HSP disease severity.MethodsWe studied 21 subjects (10 male, 11 female; mean age 54.3±13.8 years) with a clinical diagnosis of HSP (10 SPG4, 4 SPG7, 1 SPG3A, 1 SPG 30, 5 genetically undetermined). All patients underwent transcranial magnetic stimulation to measure central motor conduction time (CMCT), resting motor threshold (rMT) and MEP amplitude from the tibialis anterior (TA), abductor hallucis (AH) and abductor digiti minimi (ADM). Clinical disease severity was assessed with the Spastic Paraplegia Rating Scale (SPRS). Pearson correlation coefficient was used to assess correlation between variables, significance was defined as P value<0.05.ResultsTA CMCT was prolonged in 16/21 subjects (76%). AH CMCT was absent in 3/18 subjects (16.7%) and prolonged in 9/18 subjects (50%). ADM CMCT was measured in 19 subjects; all were normal. There was no significant correlation between SPRS scores and MEP amplitude, rMT or CMCT for TA or AH. There was also no significant correlation between these MEP measures and disease duration or patient age. Subgroup analysis of SPG4 HSP (10 subjects) revealed significant correlation between TA and AH CMCT with disease duration (r=0.841, p=0.001; r=0.930, p=0.001) but not SPRS scores.ConclusionLower limb CMCT was absent or prolonged in the majority of subjects. Despite being potentially useful as a diagnostic biomarker for HSP, this study only showed a correlation between lower limb CMCT and disease duration in the SPG4 subgroup. Further genotype-specific studies utilising larger numbers may clarify the relationship between MEP markers and clinical features.

Speed and pressure characteristics of external anal sphincter contractions

1995 ◽  
Vol 269 (2) ◽  
pp. G225-G231 ◽  
Author(s):  
J. Herdmann ◽  
P. Enck ◽  
P. Zacchi-Deutschbein ◽  
U. Ostermann
Keyword(s):  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Motor Evoked Potentials ◽  
Sphincter Muscle ◽  
Anal Sphincter Muscle ◽  
Wide Range ◽  
Fast Twitch Muscle ◽  
Contraction Times ◽  
Fast Twitch ◽  
Voluntary Contractions

The principle of isochronism reflects constant contraction time for varying strengths of muscle contraction. This principle was studied for the innervation of the pelvic floor in humans using motor-evoked potentials (MEPs) and evoked pressure curves (EPCs) from the external anal sphincter muscle (EAS). MEPs and EPCs were simultaneously recorded after transcranial magnetic stimulation of the motor cortex. Voluntary contractions were also studied. Contraction times of the EAS were significantly longer in voluntary contractions (mean, 237 ms) than in EPCs (mean, 90 ms). Depending on either mode of contraction, contraction times varied only slightly despite a wide range of contraction strengths. It is shown that the contractile behavior of the EAS is a function of slow- and fast-twitch muscle fiber distribution and that the principle of isochronism governs motor performance not only of limb muscles but also of the EAS. There exists a unique optimal working range of each muscle to meet its individual function. Disturbance of this principle results in a less efficient contraction with either inappropriate basic tone or disturbed reflex activation in the EAS. Both are possible causes of incontinence.

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