19. Central motor conduction time along the phrenic nerve pathway in patients with cervical syringomyelia. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Ciaramitaro, P.; Renosio, D.; Spagone, E.; Giorgi, S.; Faccani, G.; Cocito, D.
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 4(2016:Apr.)
• Page Start: e137
• Publication Date: 2016-04
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2015.09.027
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : The aim of this study was to investigate phrenic central motor conduction time (CMCT) in patients affected by Syringomyelia (Syr) and Chiari Malformation (CM) to point out subclinical phrenic pathway alterations. Forty-two patients (12 M, 30 F, age 18–71 years, mean 49.43 ± 13.56) without clinical signs of respiratory impairment were included and divided into subgroups according to different clinical phenotypes (cervical Syr, cervical-dorsal Syr, Syr with CM). TMS was bilaterally performed, recording by surface electrodes from hemidiaphragm; latency/amplitude of cortical and spinal motor-evoked potentials (Cx-MEP/Sp-MEP) and CMCT were measured in all patients. No adverse local or systemic reactions were reported. Neurophysiological data were analyzed and compared with 16 healthy subjects (T-test). CMCT was significantly prolonged ( p < 0.05) in patients versus controls and in two subgroups: c-Syr with CM, Syr with CM and surgical indication; in all patients Sp-MEP amplitude was reduced ( p < 0.05). This study seems to confirm that CMCT along the phrenic nerve pathway is a sensitive measure to reveal diaphragmatic impairment and may be an effective and safe neurophysiological test in Syr and CM. In conclusion, this technique could reveal phrenic pathway alterations involved in voluntary respiration pattern, that could be used to eventually engrave surgical option in the future.