Spinal and cortical somatosensory evoked responses in man

Soar, Jagjit Singh (1980) Spinal and cortical somatosensory evoked responses in man. University of Southampton, Doctoral Thesis.

Abstract

Generators of the cervical somatosensory evoked potential (C.S.E.P.) following peripheral nerve stimulation of the upper limbs are suggested as follows: the early N9 wave originates as an action potential from the brachial plexus; the N13 wave originates from the region of the terminals of the primary afferent fibres located in the dorsal horns. Each wave spreads by volume conduction to both active and reference recording sites. Interaction of such spread is likely to produce resultant activity seen as the N11 and N14 waves. Cervical cord activity is thought to be composed of a fast negativity (N13 wave) proceeded by a slow positivity (P wave). The latter is thought to inhibit and lead to the decay of the excitatory N13 potential, functionally giving rise to reflex inhibition of flexor, extensor and cutaneous afferent input and is responsible for enhancement and attenuation of the N13 response observed following spatial and temporal test stimulation. Such testing is considered to demonstrate unique information concerning synaptic organisation. In studies concerning neurological disease Staten, the C.S.E.P. was found not to be a satisfactory monitoring aid for therapeutic S.C.S. in M.S. patients. It is suggested that diagnostic interpretations should be limited to amplitude and latency changes of the N9, N13 and N20 components only. The C.S.E.P. may provide a unique contribution to the clinical diagnosis. Finally, scalp recorded potentials following anal stimulation have been recorded. Such potentials show maturation features in neonates and young children and may be useful in the clinical assessment of ano-rectal disorders.

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