Assessment of Motor Evoked Potentials in Multiple Sclerosis
Transcranial magnetic stimulation (TMS) is a noninvasive technique mainly used for the assessment of corticospinal tract integrity and excitability of the primary motor cortices. Motor evoked potentials (MEPs) play a pivotal role in TMS studies. TMS clinical guidelines, concerning the use and interp...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/23/1/497 |
| _version_ | 1827617180223537152 |
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| author | Joško Šoda Sanda Pavelin Igor Vujović Maja Rogić Vidaković |
| author_facet | Joško Šoda Sanda Pavelin Igor Vujović Maja Rogić Vidaković |
| author_sort | Joško Šoda |
| collection | DOAJ |
| description | Transcranial magnetic stimulation (TMS) is a noninvasive technique mainly used for the assessment of corticospinal tract integrity and excitability of the primary motor cortices. Motor evoked potentials (MEPs) play a pivotal role in TMS studies. TMS clinical guidelines, concerning the use and interpretation of MEPs in diagnosing and monitoring corticospinal tract integrity in people with multiple sclerosis (pwMS), were established almost ten years ago and refer mainly to the use of TMS implementation; this comprises the magnetic stimulator connected to a standard EMG unit, with the positioning of the coil performed by using the external landmarks on the head. The aim of the present work was to conduct a narrative literature review on the MEP assessment and outcome measures in clinical and research settings, assessed by TMS Methodological characteristics of different TMS system implementations (TMS without navigation, line-navigated TMS and e-field-navigated TMS); these were discussed in the context of mapping the corticospinal tract integrity in MS. An MEP assessment of two case reports, by using an e-field-navigated TMS, was presented; the results of the correspondence between the e-field-navigated TMS with MRI, and the EDSS classifications were presented. Practical and technical guiding principles for the improvement of TMS studies in MEP assessment for MS are discussed, suggesting the use of e-field TMS assessment in the sense that it can improve the accuracy of corticospinal tract integrity testing by providing a more objective correspondence of the neurophysiological (e-field-navigated TMS) and clinical (Expanded Disability Status Scale—EDSS) classifications. |
| first_indexed | 2024-03-09T09:41:15Z |
| format | Article |
| id | doaj.art-f5a7577677744b9f8414dc3aa12a5b5d |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-09T09:41:15Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-f5a7577677744b9f8414dc3aa12a5b5d2023-12-02T00:57:48ZengMDPI AGSensors1424-82202023-01-0123149710.3390/s23010497Assessment of Motor Evoked Potentials in Multiple SclerosisJoško Šoda0Sanda Pavelin1Igor Vujović2Maja Rogić Vidaković3Signal Processing, Analysis, and Advanced Diagnostics Research and Education Laboratory (SPAADREL), Faculty of Maritime Studies, University of Split, 21000 Split, CroatiaDepartment of Neurology, University Hospital of Split, 21000 Split, CroatiaSignal Processing, Analysis, and Advanced Diagnostics Research and Education Laboratory (SPAADREL), Faculty of Maritime Studies, University of Split, 21000 Split, CroatiaLaboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, 21000 Split, CroatiaTranscranial magnetic stimulation (TMS) is a noninvasive technique mainly used for the assessment of corticospinal tract integrity and excitability of the primary motor cortices. Motor evoked potentials (MEPs) play a pivotal role in TMS studies. TMS clinical guidelines, concerning the use and interpretation of MEPs in diagnosing and monitoring corticospinal tract integrity in people with multiple sclerosis (pwMS), were established almost ten years ago and refer mainly to the use of TMS implementation; this comprises the magnetic stimulator connected to a standard EMG unit, with the positioning of the coil performed by using the external landmarks on the head. The aim of the present work was to conduct a narrative literature review on the MEP assessment and outcome measures in clinical and research settings, assessed by TMS Methodological characteristics of different TMS system implementations (TMS without navigation, line-navigated TMS and e-field-navigated TMS); these were discussed in the context of mapping the corticospinal tract integrity in MS. An MEP assessment of two case reports, by using an e-field-navigated TMS, was presented; the results of the correspondence between the e-field-navigated TMS with MRI, and the EDSS classifications were presented. Practical and technical guiding principles for the improvement of TMS studies in MEP assessment for MS are discussed, suggesting the use of e-field TMS assessment in the sense that it can improve the accuracy of corticospinal tract integrity testing by providing a more objective correspondence of the neurophysiological (e-field-navigated TMS) and clinical (Expanded Disability Status Scale—EDSS) classifications.https://www.mdpi.com/1424-8220/23/1/497multiple sclerosisTMSline navigatione-field navigationnavigated TMSevoked potentials |
| spellingShingle | Joško Šoda Sanda Pavelin Igor Vujović Maja Rogić Vidaković Assessment of Motor Evoked Potentials in Multiple Sclerosis Sensors multiple sclerosis TMS line navigation e-field navigation navigated TMS evoked potentials |
| title | Assessment of Motor Evoked Potentials in Multiple Sclerosis |
| title_full | Assessment of Motor Evoked Potentials in Multiple Sclerosis |
| title_fullStr | Assessment of Motor Evoked Potentials in Multiple Sclerosis |
| title_full_unstemmed | Assessment of Motor Evoked Potentials in Multiple Sclerosis |
| title_short | Assessment of Motor Evoked Potentials in Multiple Sclerosis |
| title_sort | assessment of motor evoked potentials in multiple sclerosis |
| topic | multiple sclerosis TMS line navigation e-field navigation navigated TMS evoked potentials |
| url | https://www.mdpi.com/1424-8220/23/1/497 |
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