Electrical Stimulation Of Motor Cortex Research Articles

Sodium nitroprusside enhances stepping test performance and increases medium spiny neurons responsiveness to cortical inputs in a rat model of Levodopa-induced dyskinesias.

Levodopa (L-DOPA) is the classical gold standard treatment for Parkinson's disease. However, its chronic administration can lead to the development of L-DOPA-induced dyskinesias (LIDs). Dysregulation of the nitric oxide-cyclic guanosine monophosphate pathway in striatal networks has been linked to deficits in corticostriatal transmission in LIDs. This study investigated the effects of the nitric oxide (NO) donor sodium nitroprusside (SNP) on behavioural and electrophysiological outcomes in sham-operated and 6-hydroxydopamine-lesioned rats chronically treated with vehicle or L-DOPA, respectively. In sham-operated animals, systemic administration of SNP increased the spike probability of putative striatal medium spiny neurons (MSNs) in response to electrical stimulation of the primary motor cortex. In 6-hydroxydopamine-lesioned animals, SNP improved the stepping test performance without exacerbating abnormal involuntary movements. Additionally, SNP significantly increased the responsiveness of putative striatal MSNs in the dyskinetic striatum. These findings highlight the critical role of the NO signalling pathway in facilitating the responsiveness of striatal MSNs in both the intact and dyskinetic striata. The study suggests that SNP has the potential to enhance L-DOPA's effects in the stepping test without exacerbating abnormal involuntary movements, thereby offering new possibilities for optimizing Parkinson's disease therapy. In conclusion, this study highlights the involvement of the NO signalling pathway in the pathophysiology of LIDs.

ID: 208268 Treatment of Thalamic Stroke Pain With Spinal Cord Stimulation

Post-stroke pain occurs in patients who have sustained cerebrovascular lesions of the central somatosensory nervous system and occurs in up 10% of patients.1 The pain will emerge months or even years after initial injury. Symptoms are characterized as persistent neuropathic pain with allodynia and hyperesthesia. Patient often will develop complex regional pain syndrome due to this syndrome. Treatment options include anti-convulsants, anti-depressants, deep brain stimulation, repetitive transcranial magnetic stimulation, electrical motor cortex stimulation and spinal cord stimulation (SCS).2 SCS has been an effective in treatment of failed back surgery syndrome, complex regional pain syndrome, peripheral neuropathic pain and peripheral vascular disease pain.2 To our knowledge, this is the first case to demonstrate successful pain relief in a patient with hemi-body post- thalamic stroke pain syndrome using SCS at the cervical and thoracic level spine levels.

Spectrum of motor responses elicited by electrical stimulation of primary motor cortex: A polygraphic study in patients with epilepsy

ObjectiveTo study the neurophysiology of motor responses elicited by electrical stimulation of the primary motor cortex. MethodsWe studied motor responses in four patients undergoing invasive epilepsy monitoring and functional cortical mapping via electrical cortical stimulation using surface EMG electrodes. In addition, polygraphic analysis of intracranial EEG and EMG during bilateral tonic-clonic seizures, induced by cortical stimulation, was performed in two patients. Results(a) Electrical cortical stimulation: The motor responses were classified as clonic, jittery, and tonic. The clonic responses were characterized by synchronous EMG bursts of agonist and antagonistic muscles, alternating with silent periods. At stimulation frequencies of <20 Hz, EMG bursts were of ≤50 ms duration (Type I clonic). At stimulation frequencies of 20–50 Hz, EMG bursts were of >50 ms duration and had a complex morphology (Type II clonic). Increasing the current intensity at a constant frequency converted clonic responses into jittery and tonic contractions.(b) Bilateral tonic-clonic seizures: The intracranial EEG showed continuous fast spiking activity during the tonic phase along with interference pattern on surface EMG. The clonic phase was characterized by a polyspike-and-slow wave pattern. The polyspikes were time-locked with the synchronous EMG bursts of agonists and antagonists and the slow waves were time-locked with silent periods. InterpretationThese results suggest that epileptic activity involving the primary motor cortex can produce a continuum of motor responses ranging from type I clonic, type II clonic, and tonic responses to bilateral tonic-clonic seizures. This continuum is related to the frequency and intensity of the epileptiform discharges with tonic seizures representing the highest end of the spectrum.

Motor-evoked potentials after focal electrical stimulation predict drug-induced convulsion potentials in rats

Drug-induced convulsions—often caused by the inhibition of GABA receptors and stimulation of glutamate receptors—are difficult to predict in animals. In this study, we attempted to detect the proconvulsant potential using motor-evoked potentials (MEPs) after focal electrical stimulation or upon using a functional observational battery (FOB). Pentylenetetrazole, kainic acid, and pilocarpine were used as convulsion-inducing drugs, and baclofen was used as a negative control. First, each compound was administered to male rats, and the FOB tests were performed. All drugs induced behavioral changes, but no commonality was found. Single electrical stimulation train MEPs were recorded under anesthesia for 60 min (at 5 min intervals) after administration of each drug. A dose-dependent increase in MEPs was observed for each convulsion-inducing drug. Moreover, paired electrical stimulation (conditioned and test) of the cerebral motor cortex was conducted with a 1–15 ms interstimulus interval (ISI), 10 min after administration of the drug. All convulsion-inducing drugs inhibited the short-interval intracortical inhibition (ISI: 3 ms), which may be associated with GABA. Intracortical facilitation (ISI: 11 ms), related to glutamate, was not enhanced by any drug but was inhibited by pilocarpine. Dose correlation was not found in short-interval intracortical inhibition or intracortical facilitation in any drugs. No changes in MEPs were observed after baclofen administration. These results suggest that it is possible to evaluate the convulsion potential and associated mechanisms using MEP, independent of the behavioral changes. The early identification of convulsion potential using this model will lead to more efficient drug development.

Calcium Activation of Parvalbumin Neurons Induced by Electrical Motor Cortex Stimulation.

Electrical motor cortex stimulation (EMCS) has been used for Parkinson's Disease (PD) treatment. Some studies found that distinct cell types might lead to selective effects. As the largest subgroup of interneurons, Parvalbumin (PV) neurons have been reported to be involved in the mechanisms of therapeutic efficacy for PD treatment. However, little is known about their responses to the EMCS. In this study, we used in-vivo two-photon imaging to record calcium activities of PV neurons (specific type) and all neurons (non-specific type) in layer 2/3 primary motor cortex (MI) during EMCS with various stimulus parameters. We found PV neurons displayed different profiles of activation property compared to all neurons. The cathodal polarity preference of PV neurons decreased at a high-frequency stimulus. The calcium transients of PV neurons generated by EMCS trended to be with large amplitude and short active duration. The optimal activation frequency of PV neurons is higher than that of all neurons. These results improved our understanding of the selective effects of EMCS on specific cell types, which could bring more effective stimulation protocols for PD treatment.

Comparison of the Effect of Direct Transcranial Electrical Stimulation of Motor and Vision Cortex on Working Memory and Motor Performance in Children with Developmental Coordination Disorder

Comparison of the Effect of Direct Transcranial Electrical Stimulation of Motor and Vision Cortex on Working Memory and Motor Performance in Children with Developmental Coordination Disorder

Focal clonic movements elicited by electrical cortical stimulation of primary motor cortex (P1-1.Virtual)

Focal clonic movements elicited by electrical cortical stimulation of primary motor cortex (P1-1.Virtual)

The Effect of Hyperoxia on Central and Peripheral Factors of Arm Flexor Muscles Fatigue Following Maximal Ergometer Rowing in Men.

PurposeThis study evaluates the effect of hyperoxia on cerebral oxygenation and neuromuscular fatigue mechanisms of the elbow flexor muscles following ergometer rowing.MethodsIn 11 competitive male rowers (age, 30 ± 4 years), we measured near-infrared spectroscopy determined frontal lobe oxygenation (ScO2) and transcranial Doppler ultrasound determined middle cerebral artery mean flow velocity (MCA Vmean) combined with maximal voluntary force (MVC), peak resting twitch force (Ptw) and cortical voluntary activation (VATMS) of the elbow flexor muscles using electrical motor point and magnetic motor cortex stimulation, respectively, before, during, and immediately after 2,000 m all-out effort on rowing ergometer with normoxia and hyperoxia (30% O2).ResultsArterial hemoglobin O2 saturation was reduced to 92.5 ± 0.2% during exercise with normoxia but maintained at 98.9 ± 0.2% with hyperoxia. The MCA Vmean increased by 38% (p < 0.05) with hyperoxia, while only marginally increased with normoxia. Similarly, ScO2 was not affected with hyperoxia but decreased by 7.0 ± 4.8% from rest (p = 0.04) with normoxia. The MVC and Ptw were reduced (7 ± 3% and 31 ± 9%, respectively, p = 0.014), while VATMS was not affected by the rowing effort in normoxia. With hyperoxia, the deficit in MVC and Ptw was attenuated, while VATMS was unchanged.ConclusionThese data indicate that even though hyperoxia restores frontal lobe oxygenation the resultant attenuation of arm muscle fatigue following maximal rowing is peripherally rather than centrally mediated.

Understanding Variable Motor Responses to Direct Electrical Stimulation of the Human Motor Cortex During Brain Surgery.

Direct electrical stimulation of the brain is the gold standard technique used to define functional-anatomical relationships during neurosurgical procedures. Areas that respond to stimulation are considered “critical nodes” of circuits that must remain intact for the subject to maintain the ability to perform certain functions, like moving and speaking. Despite its routine use, the neurophysiology underlying downstream motor responses to electrical stimulation of the brain, such as muscle contraction or movement arrest, is poorly understood. Furthermore, varying and sometimes counterintuitive responses can be seen depending on how and where the stimulation is applied, even within the human primary motor cortex. Therefore, here we review relevant neuroanatomy of the human motor system, provide a brief historical perspective on electrical brain stimulation, explore mechanistic variations in stimulation applications, examine neurophysiological properties of different parts of the motor system, and suggest areas of future research that can promote a better understanding of the interaction between electrical stimulation of the brain and its function.

Corticospinal recruitment of spinal motor neurons in human stroke survivors.

Muscle weakness after stroke results from damage to corticospinal fibres that structurally and functionally connect cerebral cortex to the spinal cord. Here, we show an asymmetry in corticospinal recruitment of spinal motor neurons that is linked to maximal voluntary output of hand muscles weakened by stroke. Spike timing-dependent plasticity of synapses between corticospinal and spinal motor neurons transiently reversed recruitment failures in some survivors. These modulatory effects were strongly associated with recruitment asymmetry and hand impairment. Our findings highlight the functional relevance of spinal motor neuron recruitment by corticospinal inputs and the viability of corticospinal motor neuronal synapses for restoring activation of lower motor neurons after stroke. Corticospinal input to spinal motor neurons is structurally and functionally altered by hemiparetic stroke. The pattern and extent to which corticospinal recruitment of spinal motor neurons is reorganized and whether such changes are linked to the severity of motor impairments is not well understood. Here, we performed experiments using the triple stimulation technique to quantify corticospinal recruitment of spinal motor neurons serving paretic and non-paretic intrinsic hand muscles of humans with longstanding motor impairment secondary to stroke (n=13). We also examined whether recruitment failures could be transiently reversed by strengthening corticospinal-motoneuronal synaptic connectivity via targeted, temporally controlled non-invasive stimulation to elicit spike timing-dependent plasticity (STDP). Asymmetries were detected in corticospinal recruitment of spinal motor neurons, central conduction time and motor-evoked potential (MEP) latency. However, only recruitment asymmetry correlated with maximal voluntary motor output from the paretic hand. STDP-like effects were observed as an increase in spinal motor neuron recruitment. Control experiments to isolate the locus of plasticity demonstrated a modulation in MEPs elicited by electrical stimulation of primary motor cortex but not F-wave size or persistence, suggesting that plasticity was mediated through enhanced efficacy of residual corticospinal-motor neuronal synapses. The modulation in recruitment was strongly associated with baseline recruitment asymmetry and impairment severity. Our findings demonstrate that asymmetry in corticospinal recruitment of spinal motor neurons is directly related to impairments experienced by stroke survivors. These recruitment deficits may be partially and transiently reversed by spike timing-dependent plasticity of synapses between upper and lower motor neurons in the spinal cord, downstream of supraspinal circuits damaged by stroke.

Continuous Theta-Burst Stimulation Intensity Dependently Facilitates Motor-Evoked Potentials Following Focal Electrical Stimulation of the Rat Motor Cortex.

Although theta-burst stimulation (TBS) is known to differentially modify motor cortical excitability according to stimulus conditions in humans, whether similar effects can be seen in animals, in particular rats, remains to be defined. Given the importance of experimental rat models for humans, this study explored this stimulation paradigm in rats. Specifically, this study aimed to explore corticospinal excitability after TBS in anesthetized animals to confirm its comparability with human results. Both inhibition-facilitation configurations using paired electrical stimulation protocols and the effects of the TBS paradigm on motor-evoked potentials (MEPs) in rat descending motor pathways were assessed. Paired-stimulation MEPs showed inhibition [interstimulus interval (ISI): 3 ms] and facilitation (11 ms) patterns under medetomidine/midazolam/butorphanol (MMB) anesthesia. Furthermore, while ketamine and xylazine (K/X) anesthesia completely blocked facilitation at 11-ms ISI, inhibition at a 3-ms ISI was preserved. Continuous and intermittent TBS strongly facilitated MEPs depending on stimulus intensity, persisting for up to 25 min under both MMB and K/X anesthesia. These findings are similar to the intracortical inhibition and facilitation observed in the human motor cortex using paired-pulse magnetic stimulation, particularly the glutamate-mediated facilitation phase. However, different TBS facilitatory mechanisms occur in the rat motor cortex. These different TBS facilitatory mechanisms affect the comparability and interpretations of TBS between rat and human models.

Extradural Motor Cortex Stimulation might improve episodic and working memory in patients with Parkinson\u2019s disease

Electric Extradural Motor Cortex Stimulation (EMCS) is a neurosurgical procedure suggested for treatment of patients with advanced Parkinson’s disease (PD). We report two PD patients treated by EMCS, who experienced worsening of motor symptoms and cognition 5 years after surgery, when EMCS batteries became discharged. One month after EMCS restoration, they experienced a subjective improvement of motor symptoms and cognition. Neuropsychological assessments were carried out before replacement of batteries (off-EMCS condition) and 6 months afterward (on-EMCS condition). As compared to off-EMCS condition, in on-EMCS condition both patients showed an improvement on tasks of verbal episodic memory and backward spatial short-term/working memory task, and a decline on tasks of selective visual attention and forward spatial short-term memory. These findings suggest that in PD patients EMCS may induce slight beneficial effects on motor symptoms and cognitive processes involved in verbal episodic memory and in active manipulation of information stored in working memory.

Stimulation of the motor cerebral cortex in chronic neuropathic pain: the role of electrode localization over motor somatotopy.

Previous studies have reported the pain-relieving effect of chronic electrical motor cortex stimulation (eMCS) in various types of neuropathic pain. The study aimed to explore the potential relationship between the clinical efficacy of eMCS for the treatment of chronic neuropathic pain and the precise localization of the contacts over the motor cortex somatotopic representation of the painful area. A total of 22 patients with neuropathic pain were implanted with eMCS electrodes. Implantation of the electrodes was performed using intraoperative 1) anatomical identification by neuronavigation software using 3D-MRI; 2) monitoring of somesthetic evoked potentials to check the potential reverse over the central sulcus; and 3) electrical stimulations through the dura to identify the motor responses and its somatotopy. Image fusion of postoperative 3D-CT and preoperative MRI images allowed postoperative location of the electrodes. Analgesic effects were obtained in 18 (81.81%) out of 22 patients. Postoperative 3D-CT analysis showed a correspondence between localization of the contacts and the motor cerebral cortex somatotopy in the patients with postoperative good analgesic effects. No correspondence was found between localization of the contacts and the motor cerebral cortex somatotopy in the four patients with no analgesic effects. In three out of these four patients, analgesic effects were obtained after new surgery allowed repositioning of the electrode over the motor cortex somatotopy of the painful area. The findings of this study suggest that eMCS provides analgesic effects when the stimulated cortex corresponds to the somatotopy of the painful area.

Phosphodiesterase 9A Inhibition Facilitates Corticostriatal Transmission in Wild-Type and Transgenic Rats That Model Huntington's Disease.

Huntington’s disease (HD) results from abnormal expansion in CAG trinucleotide repeats within the HD gene, a mutation which leads to degeneration of striatal medium-sized spiny neurons (MSNs), deficits in corticostriatal transmission, and loss of motor control. Recent studies also indicate that metabolism of cyclic nucleotides by phosphodiesterases (PDEs) is dysregulated in striatal networks in a manner linked to deficits in corticostriatal transmission. The current study assessed cortically-evoked firing in electrophysiologically-identified MSNs and fast-spiking interneurons (FSIs) in aged (9–11 months old) wild-type (WT) and BACHD transgenic rats (TG5) treated with vehicle or the selective PDE9A inhibitor PF-04447943. WT and TG5 rats were anesthetized with urethane and single-unit activity was isolated during low frequency electrical stimulation of the ipsilateral motor cortex. Compared to WT controls, MSNs recorded in TG5 animals exhibited decreased spike probability during cortical stimulation delivered at low to moderate stimulation intensities. Moreover, large increases in onset latency of cortically-evoked spikes and decreases in spike probability were observed in FSIs recorded in TG5 animals. Acute systemic administration of the PDE9A inhibitor PF-04447943 significantly decreased the onset latency of cortically-evoked spikes in MSNs recorded in WT and TG5 rats. PDE9A inhibition also increased the proportion of MSNs responding to cortical stimulation and reversed deficits in spike probability observed in TG5 rats. As PDE9A is a cGMP specific enzyme, drugs such as PF-04447943 which act to facilitate striatal cGMP signaling and glutamatergic corticostriatal transmission could be useful therapeutic agents for restoring striatal function and alleviating motor and cognitive symptoms associated with HD.

The role of facial nerve motor evoked potentials in predicting facial nerve function in vestibular schwannoma surgery

Objective: To analyze the role of facial nerve motor evoked potentials in predicting facial nerve function in vestibular schwannoma surgery. Methods: In a retrospective clinical study of 226 patients with acoustic neuroma, admitted to our hospital from January 2016 to May 2019, were investigated by facial nerve motor evoked potentials (FNMEP) elicited by multi-pulse transcranial electrical motor cortex stimulation from. For recording the same electrode set-up was used as for continuous EMG monitoring of the orbicularis oculi,oris muscles and mentalis. Pre-surgical (opening dural), intraoperative and post-surgical (closing dural) FNMEP amplitudes and latencies were recorded. End (closing dura) to start (opening dura) amplitude ratios were compared to early-term(3 day after surgery) facial nerve function by House-Brackmann(HB) Grading. Results: 201 patients(88.9%) get a total tumor resection, 15 patients (6.6%) were a subtotal resection, 10 patients(4.4%) were a partial resection. 100 percent of patients had a integrated anatomical preservation of facial nerves, there were four (1.8%) death cases in this group. Reliable FNMEPs were obtained in all patients. The ratio of end-operative to start-operative FNMEP-amplitude showed a negative correlation with early facial nerve function. Correlation was especially close with early function: an amplitude preservation rate of 85.3% led to HB Ⅰ or Ⅱ in 190(84.1%) patients, of 45.6% to HB Ⅲ in 17(7.5%) patients, of 23.1% to HB Ⅳ in 13(5.8%) patients and of 6.7% to HB Ⅴor Ⅵ in 6(2.7%) patients. There was a negative correlation between FNMEP amplitude ratio and post-surgical early HB grading(r=-0.895, P=0.000). Conclusion: FNMEP was highly reliable in predicting early postoperative facial function of the resection of vestibular schwannoma, was a valid protection technique of facial nerve.

Independent replication of motor cortex and cervical spinal cord electrical stimulation to promote forelimb motor function after spinal cord injury in rats

Cervical spinal cord injury (SCI) impairs arm and hand function largely by interrupting descending tracts. Most SCI spare some axons at the lesion, including the corticospinal tract (CST), which is critical for voluntary movement. We targeted descending motor connections with paired electrical stimulation of motor cortex and cervical spinal cord in the rat. We sought to replicate the previously published effects of intermittent theta burst stimulation of forelimb motor cortex combined with trans-spinal direct current stimulation placed on the skin over the neck to target the cervical enlargement. We hypothesized that paired stimulation would improve performance in skilled walking and food manipulation (IBB) tasks. Rats received a moderate C4 spinal cord contusion injury (200 kDynes), which ablates the main CST. They were randomized to receive paired stimulation for 10 consecutive days starting 11 days after injury, or no stimulation. Behavior was assessed weekly from weeks 4–7 after injury, and then CST axons were traced. Rats with paired cortical and spinal stimulation achieved significantly better forelimb motor function recovery, as measured by fewer stepping errors on the horizontal ladder task (34 ± 9% in stimulation group vs. 51 ± 18% in control, p = .013) and higher scores on the food manipulation task (IBB, 0–9 score; 7.2 ± 0.8 in stimulated rats vs. 5.2 ± 2.6 in controls, p = .025). The effect size for both tasks was large (Cohen's d = 1.0 and 0.92, respectively). The CST axon length in the cervical spinal cord did not differ significantly between the groups, but there was denser and broader ipsilateral axons distribution distal to the spinal cord injury. The large behavioral effect and replication in an independent laboratory validate this approach, which will be trialed in cats before being tested in people using non-invasive methods.

Cannabinoids differentially modulate cortical information transmission through the sensorimotor or medial prefrontal basal ganglia circuits.

Background and PurposeIn the sensorimotor (SM) and medial prefrontal (mPF) basal ganglia (BG) circuits, the cortical information is transferred to the substantia nigra pars reticulata (SNr) through the hyperdirect trans‐subthalamic pathway and through the direct and indirect trans‐striatal pathways. The cannabinoid CB1 receptor, which is highly expressed in both BG circuits, may participate in the regulation of motor and motivational behaviours. Here, we investigated the modulation of cortico‐nigral information transmission through the BG circuits by cannabinoids.Experimental ApproachWe used single‐unit recordings of SNr neurons along with simultaneous electrical stimulation of motor or mPF cortex in anaesthetized rats.Key ResultsCortical stimulation elicited a triphasic response in the SNr neurons from both SM and mPF‐BG circuits, which consisted of an early excitation (hyperdirect transmission pathway), an inhibition (direct transmission pathway), and a late excitation (indirect transmission pathway). In the SM circuit, after Δ9‐tetrahydrocannabinol or WIN 55,212‐2 administration, the inhibition and the late excitation were decreased or completely lost, whereas the early excitation response remained unaltered. However, cannabinoid administration dramatically decreased all the responses in the mPF circuit. The CB1 receptor antagonist AM251 (2 mg·kg−1, i.v.) did not modify the triphasic response, but blocked the effects induced by cannabinoid agonists.Conclusions and ImplicationsCB1 receptor activation modulates the SM information transmission through the trans‐striatal pathways and profoundly decreases the cortico‐BG transmission through the mPF circuit. These results may be relevant for elucidating the involvement of the cannabinoid system in motor performance and in decision making or goal‐directed behaviour.

Application of transcranial electrical stimulation-facial nerve motor evoked potentials in resection of large acoustic neuromas

Objective To discuss the role of transcranial electrical stimulation facial nerve motor evoked potentials (TCE-FNMEP) in resection of large acoustic neuromas. Methods In a retrospective clinical study, 58 patients with large acoustic neuroma were investigated at Department of Neurosurgery, Tianjin HuanHu Hospital form July 2016 to March 2017.All patients were investigated by facial nerve motor evoked potentials elicited by multi-pulse transcranial electrical motor cortex stimulation. For recording, the same electrode set-up was used as for continuous EMG (electromyogram) monitoring of the orbicularis oculi, oris muscles and mentalis. Pre-surgical (dura opening), intraoperative and post-surgical (dura closing) TCE-FNMEP amplitudes and latencies were documented. End (dura closing) to start (dura opening) amplitude ratios were compared to early-term (1 day post surgery) facial nerve function by House-Brackmann (H-B) grading. Results Fifty-one (87.9%, 51/58) patients obtained total tumor resection and 7 (12.1%, 7/58) achieved subtotal resection. All patients had anatomical preservation of facial nerves. There was no death in this series. Reliable TCE-FNMEPs were obtained in all patients. At 1 day post operation, 48 out of 58 case were graded as H-B Ⅰ-Ⅱ, the range of TCE-FNMEP amplitude ratio was 47.6%-100.0%, and the median was 85.4%. Five cases were graded as H-B Ⅲ, the range of TCE-FNMEP amplitude ratio was 43.2%-55.8%, and the median was 45.4%. Three cases were graded as H-B Ⅳ, the range of TCE-FNMEP amplitude ratio was 31.4%-53.2%, and the median was 33.6%. Two cases were graded as H-B Ⅴ-Ⅵ, the range of TCE-FNMEP amplitude ratio was 6.1% and 11.3%, respectively. There was a negative correlation between TCE-FNMEP amplitude ratio and early post-surgical HB grading (r=-0.611, P<0.01). Conclusion TCE-FNMEP seems to be highly reliable in predicting early postoperative facial function in resection of large acoustic neuromas and could be a valid protection technique of facial nerve. Key words: Neuroma, acoustic; Facial nerve; Evoked potentials, motor; Transcranial electrical stimulation

Motor Cortex Stimulation Regenerative Effects in Peripheral Nerve Injury: An Experimental Rat Model.

Immediate microsurgical nerve suture remains the gold standard after peripheral nerve injuries. However, functional recovery is delayed, and it is satisfactory in only 2/3 of cases. Peripheral electrical nerve stimulation proximal to the lesion enhances nerve regeneration and muscle reinnervation. This study aims to evaluate the effects of the motor cortex electrical stimulation on peripheral nerve regeneration after injury. Eighty rats underwent right sciatic nerve section, followed by immediate microsurgical epineural sutures. Rats were divided into 4 groups: Group 1 (control, n= 20): no electrical stimulation; group 2 (n= 20): immediate stimulation of the sciatic nerve just proximal to the lesion; Group 3 (n= 20): motor cortex stimulation (MCS) for 15 minutes after nerve section and suture (MCSa); group 4 (n= 20): MCS performed over the course of two weeks after nerve suture (MCSc). Assessment included electrophysiology and motor functional score at day 0 (baseline value before nerve section), and at weeks 4, 8, and 12. Rats were euthanized for histological study at week12. Our results showed that MCS enhances functional recovery, nerve regeneration, and muscle reinnervation starting week 4 compared with the control group (P < 0.05). The MCS induces higher reinnervation rates even compared with peripheral stimulation, with better results in the MCSa group (P < 0.05), especially in terms of functional recovery. MCS seems to have a beneficial effect after peripheral nerve injury and repair in terms of nerve regeneration and muscle reinnervation, especially when acute mode is used.

Advanced Functional Materials Solutions to Engineering the Neural Interface

Advanced Functional Materials Solutions to Engineering the Neural Interface