Clinical use of the magnetic stimulator in the investigation of peripheral conduction time

Abstract

The application of rapidly changing magnetic fields (magnetic stimulation) over the neck or lower back elicits EMG responses in the muscles of the arm or leg respectively. Such responses have stable onset latencies but their amplitudes vary depending on the position of the coil over the neck or lower back. Supramaximal responses could not be obtained. Comparison of onset latencies with estimates of peripheral conduction time using a conventional F-wave technique suggest that the site of excitation of the motor axons is about 1.3 msec conduction time distal to the cervical motoneurons and 3 msec distal to the lumbosacral motoneurons. Response configuration after paravertebral magnetic stimulation was similar to that of the standard electrically evoked M-wave in the small hand muscles but not in lower limb muscles. Responses in lower limb muscles after paravertebral magnetic stimulation may consist of additional F-wave and H-reflex components. The possible clinical role of paravertebral magnetic stimulation in the investigation of peripheral and central motor pathways is discussed in the light of these findings.