Document Detail


Reversible prolongation of motor conduction time after transcranial magnetic brain stimulation after neurogenic claudication in spinal stenosis.
MedLine Citation:
PMID:  12394909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A consecutive and controlled cohort study. OBJECTIVES: To assess the value of motor conduction time (MCT) between cortex and symptomatic leg muscles after transcranial magnetic brain stimulation as an indicator of reversible root ischemia in patients with neurogenic claudication in spinal stenosis. SUMMARY OF BACKGROUND DATA: Neurogenic claudication in spinal stenosis is thought to result from transient ischemia of active nerve root fibers. Subgroups of these patients have slowing of sensory or motor nerve root conduction during spinal claudication. MATERIAL AND METHODS: Forty-two patients with spinal claudication and radiologically confirmed signs of spinal stenosis were consecutively recruited. Motor conduction time was measured before and repetitively after challenge of walking on a treadmill (four stimuli per minute) until disappearance of the symptoms. Data of 30 patients (65 +/- 10 years) with a defined onset of motor-evoked potentials were compared with those of 12 control subjects (62 +/- 12 years). RESULTS: One minute after treadmill challenge, MCT increased in all 13 patients with signs of an exercise-dependent neurologic deficit by at least 1 msec (mean increase, 1.6 +/- 0.6 msec; < 0.001). Test-retest comparisons in six of these patients revealed good reproducibility of the MCT increase (coefficient of repeatability, 1.24 msec). In contrast, MCTs were unchanged or decreased in all 17 patients without exercise-dependent neurologic deficit ( < 0.01) and in the control subjects ( < 0.05). CONCLUSIONS: Measurements of MCT before and after treadmill challenge can demonstrate reversible root ischemia in patients with spinal claudication and exercise-dependent deficit of thickly myelinated nerve root fibers.
Authors:
Eberhard Lang; Max Josef Hilz; Harald Erxleben; Mirko Ernst; Bernhard Neundörfer; Klaus Liebig
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Spine     Volume:  27     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-23     Completed Date:  2002-11-25     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2284-90     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany. eberhard.lang@rzmail.uni-erlangen.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / physiopathology*
Efferent Pathways / physiology,  physiopathology*
Electric Stimulation / instrumentation*
Electromagnetic Fields
Evoked Potentials, Motor
Exercise Test
Female
Humans
Male
Middle Aged
Motor Activity
Muscle Weakness / diagnosis,  etiology
Nerve Fibers, Myelinated / physiology
Neural Conduction* / physiology
Neurologic Examination
Pain / etiology,  physiopathology*
Pain Measurement
Reaction Time
Reference Values
Reproducibility of Results
Somatosensory Disorders / diagnosis,  etiology
Spinal Stenosis / complications,  physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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