Abstract
Objective To analyze the features of the latency and interval in somatosensory evoked potentials (SEP) of the upper limbs in subacute combined degeneration (SCD)，and evaluate the SEP of the upper limbs in the diagnosis of SCD. Methods Thirty-four defined SCD patients and 22 healthy controls were included in this study.The patients underwent the SEP test and the magnetic resonance imaging (MRI) of spinal cord.The SEP results of the patients were compared with those of the controls.The results of the SEP，which were divided into the peripheral part and central part to be evaluated，were also compared with the related results of the SEP and MRI. Results Compared with the controls，the N9 ((10.80±1.07) ms vs (10.23±0.64) ms，t=3.223)，P14 ((17.28±2.56) ms vs (14.62±0.84) ms，t=6.643)，N9-P14 ((6.48±2.27) ms vs (4.40±0.58) ms，t=5.951) in the upper limbs and N9 ((12.11±0.83) ms vs (10.93±0.56) ms，t=5.690)，P30 ((36.96±5.56) ms vs (30.37±2.20) ms，t=7.217)，P38 ((46.94±5.83) ms vs (39.80±2.54) ms，t=7.353) in the lower limbs of SCD patients were prolonged (all P<0.01)，however，the P14-N20 was prolonged without statistical significance.The abnormality of SEP was 80.9% (110/136)，in which the abnormality of the upper limbs was 85.3% (58/68) while that of the lower limbs was 76.5% (52/68).N9-P14 had the highest abnormality rate which was 72.1% (49/68).The patients with SCD with normal N9 had prolonged N9-P14 ((5.98±1.90) ms vs (4.40±0.58) ms，t=5.267，P<0.01). Conclusions Subacute combined degeneration can involve not only the peripheral part of the somatosensory pathway but also the central part including the brainstem and brain.In the SEP of upper limbs，N9-P14 has the highest abnormality rate which suggests that the part from cervical spinal cord to the brainstem may be the most vulnerable in SCD.The test of SEP in the upper limbs may provide evidence for the damage in the central part in SCD. Key words: Subacute combined degeneration; Electrophysiology; Evoked potentials，somatosensory; Upper extremity
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