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Application in Multiple Sclerosis with Contact Heat Evoked Potentials

Author: LiuShenLong
Tutor: XieBing
School: Tianjin Medical University
Course: Neurology
Keywords: Contact heat evoked potentials Multiple sclerosis Aδ fibers Pain and temperature sensation disorders Nociceptors
CLC: R744.51
Type: Master's thesis
Year: 2009
Downloads: 29
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Abstract

Multiple sclerosis (MS) is a central nervous system demyelinating disease is the most common clinical lesion and its pathogenesis is characterized by multiple times, can affect the central nervous system white matter extensively (including the cerebral hemispheres, brainstem , cerebellum, spinal cord and optic nerve). Great individual variation in multiple sclerosis, in which 1/3 patients with moderate dysfunction, 1/3 remain serious damage, serious impact on patients' quality of life, to social and family brought huge economic burden. Therefore, early diagnosis become critical. Neurophysiological examination in the diagnosis of MS plays a very important role in the central nervous system demyelinating plaques in their temporal and spatial distribution mainly through the MR / and neurophysiological examination to determine. In general, the visual evoked potential (VEP), brainstem auditory evoked potential (BAEP), motor evoked potential (MEP) and somatosensory evoked potential (SEP) through the visual, auditory, corticospinal tract pathways and detection of spinal posterior column function obtain, for the evaluation of spinal thalamic tract function is a lack of corresponding evoked potential testing. Contact heat evoked potentials (CHEP) is a new method of neural electrophysiological examination can selectively excited A6 small diameter myelinated fibers and unmyelinated C fibers, objectively reflect the pain and temperature conduction pathway situation. Objective: To establish your own CEHP criteria for the diagnosis of multiple sclerosis provide CHEP based methods: normal control group of 40 patients, 36 patients with multiple sclerosis selection, application pathway pain \u0026 sensory evaluation system (Medoc) analyzer, 27mm diameter circular stimulators (size 573mm ~ 2), heating rate of 70 ℃ / s, cooling rate of 40 ℃ / s, the baseline temperature to 32 ℃. In 3 parts (upper volar forearm before the 1/3, lower extremity medial malleolus and waist were to be two intensity levels (47 ℃, 51 ℃) thermal stimulation pulse, on Cz recording CHEP waveforms measured at different temperatures visual analogue scale , CHEP latency and amplitude. Results: 1. different parts of the same temperature stimulation VAS scores, waist up (P lt; 0.05). 2. different temperatures stimulate the same part of the VAS scores, 51 ℃ stimulate VAS scores were 47 ℃ high (P lt; 0.05). 3. stimulate upper arm length measured with the N-latency positive linear correlation, legs and lower limb stimulation wave latency measured in N, P wave latencies showed a positive linear correlation (P lt ; 0.05) 4. stimulate different parts of the same temperature, the peak latency and amplitude comparison NP, lower extremity to be 47 ℃ and 51 ℃ stimuli N, P-wave latency compared with the upper and lower back extension (P lt; 0.05), 3 个site irritation NP Volatility twenty-two showed no differences (P gt; 0.05). 5. different parts of the same thermal stimulation, N-wave latency and amplitude NP was no significant difference (P gt; 0.05). 6. Through the lower limbs A6 and waist stimulate fiber conduction velocity is calculated as 18.1 ± 7.3m / s. 7.MS group (there hypoesthesia symptoms) VAS scores were lower than the normal control group (P lt; 0.05). 8.MS group (there hypoesthesia symptoms) N peak latency compared with control groups (P lt; 0.05), NP amplitude reduction (P lt; 0.05), the difference was statistically significant. 9.MS group (there is no sensory loss symptoms) N peak latency compared with the control group extension (P lt; 0.05), a statistically significant difference. 10.MS related factors in patients with CHEP latency analysis showed: N wave latency and limb length and duration of no correlation (P gt; 0.05), and the onset times and sections segments showed a positive correlation (P lt; 0.05). 11.MS CHEP detect abnormalities in patients with lower limb is higher than the upper limb, higher than the overall abnormal somatosensory evoked potentials and laser-evoked potentials. Conclusions: 1. arm length measured with upper limb stimulation N-latency was positively correlated with lower extremity leg stimulation wave latency measured in N, P wave latencies were positively correlated. 2 different parts of the same temperature (47 ℃ and 51 ℃) stimulation, N-wave latency and amplitude did not differ NP 3. We calculated peripheral nerve conduction velocity was 18.1 ± 7.3m / s, that is activated by the CHEP Aδ fiber 4.MS onset latency and the number and the number of segments having a positive correlation, and can objectively reflect MS CHEP pain and temperature conduction pathway circumstances, be able to find subclinical lesions, abnormal higher than somatosensory evoked potentials and laser evoked potentials, can assist the diagnosis of multiple sclerosis.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Spinal cord disease > Demyelinating disease > Multiple sclerosis
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