Possible model for generation of P9 far-field potentials

Magnetoneurography to investigate the mechanisms underlying the P9 far-field potential

OBJECTIVE

The mechanism underlying the generation of P9 far-field somatosensory evoked potentials (SEPs) is unresolved. Accordingly, we used magnetoneurography to visualize the current distribution in the body at the P9 peak latency and elucidate the origin of P9 generation.

METHODS

We studied five healthy male volunteers without neurological abnormalities. We recorded far-field SEPs after median nerve stimulation at the wrist to identify the P9 peak latency. Using magnetoneurography, we recorded the evoked magnetic fields in the whole body under the same stimulus conditions as the SEP recording. We analyzed the reconstructed current distribution at the P9 peak latency.

RESULTS

At the P9 peak latency, we observed the reconstructed current distribution dividing the thorax into two parts, upper and lower. Anatomically, the depolarization site at the P9 peak latency was distal to the interclavicular space and at the level of the second intercostal space.

CONCLUSIONS

By visualizing the current distribution, we proved that P9 peak latency originates in the change in volume conductor size between the upper and lower thorax.

SIGNIFICANCE

We clarified that magnetoneurography analysis is affected by the current distribution due to the junction potential.

Detailed magnetoelectric analysis of a nerve impulse propagation along the brachial plexus

OBJECTIVE

To visualize impulse conduction along the brachial plexus through simultaneous electromagnetic measurements.

METHODS

Neuromagnetic fields following median nerve stimulation were recorded above the clavicle with a superconducting quantum interference device biomagnetometer system in 7 healthy volunteers. Compound nerve action potentials (CNAPs) were obtained from 12 locations. Pseudocolor maps of equivalent currents reconstructed from magnetic fields and isopotential contour maps were superimposed onto X-ray images. Surface potentials and current waveforms at virtual electrodes along the brachial plexus were compared.

RESULTS

In magnetic field analysis, the leading axonal current followed by a trailing backward current traveled rostrally along the brachial plexus. The spatial extent of the longitudinal intra-axonal currents corresponded to the extent of the positive-negative-positive potential field reflecting transmembrane volume currents. The peaks and troughs of the intra-axonal biphasic current waveforms coincided with the zero-crossings of triphasic CNAP waveforms. The amplitudes of CNAPs and current moments were linearly correlated.

CONCLUSIONS

Reconstructed neural activity in magnetic field analysis visualizes not only intra-axonal currents, but also transmembrane volume currents, which are in good agreement with the surface potential field.

SIGNIFICANCE

Magnetoneurography is a novel non-invasive functional imaging modality for the brachial plexus whose performance can surpass that of electric potential measurement.

Detailed analysis of the latencies of median nerve somatosensory evoked potential components, 1: selection of the best standard parameters and the establishment of normal values

In order to objectively select the standard parameters best suited for the evaluation of somatosensory conduction in median nerve somatosensory evoked potentials (SEP), we performed a detailed statistical analysis of intersubject variability for the latencies of SEP components based on the recordings of 62 normal subjects. Multiple regression analyses for height, age, (age--20)2 and sex were performed for the latencies of 13 components and 78 intercomponent intervals, and the residual variance was used as an indicator of the stability of each parameter. As a result, N9 onset in EPi-NC lead, N11' onset in C6S-Fz lead, P13/14 onset in scalp-NC leads, for which N13' onset recorded in C6S-Fz lead may substitute, and N20 onset in CPc-Fz lead were the most stable time-points selected as standards. N11 onset in C6S-NC, which other authors have recommended as the standard point representing spinal entry, was not recorded consistently, and P11 onset in scalp-NC leads was also unstable. N20 peak and N13'-N20 interval (equivalent to conventional central conduction time) were extremely unstable. We presented the nomograms to find normal limits of the standard parameters corresponding to the given values of the predictor variables (height, age or sex). As the standard recording montage in routine clinical examinations, we recommended a simple method using Fz reference, for example (1) EPi-Fz, (2) C6S-Fz, (3) CPc-Fz, because this montage is sufficient to measure the stable standard parameters.

P9 in median nerve SEPs is a junctional potential generated by the change of the volume conductor size between trunk and neck

OBJECTIVES

We aimed to investigate the origin of P9 in median SEPs by applying the junctional potential theory.

METHODS

We studied the distribution over the body surface with contralateral shoulder reference in 4 normal subjects.

RESULTS

A stationary potential field P9/tN9 (=truncal N9) was recorded: P9 over head and neck (the smaller part), tN9 over trunk (the larger part), the boundary being located between trunk and neck. This polarity agreed with that expected from simulation studies.

CONCLUSIONS

P9 is a junctional potential generated by the change of the volume conductor size between trunk and neck.

Far-field potential production by quadrupole generators in cylindrical volume conductors

Far-field potentials have been observed clinically and recognized as such for approximately 30 years. Unfortunately a complete understanding of far-field potential generation is not yet at hand. An attractive model is the representation of an action potential by a quadrupole consisting of a leading and trailing dipole with respect to the direction of propagation. This investigation physically models an action potential by using a quadrupole constant current source and substantiates the concept that an action potential as modeled by two dipoles back-to-back is capable of producing far-field potentials in cylindrical volume conductors. The 4 postulated mechanisms of generating far-field potentials are validated, i.e., an action potential encountering (1) different size volume conductors, (2) the termination of excitable tissue, (3) a change in conducting medium conductivity, and (4) a bend in the nerve. A fifth postulated but previously not demonstrated method of far-field production, neural branching, is shown by the quadrupole model to also be capable of yielding far-field potentials. The termination of a volume conductor is also shown to be capable of generating a voltage difference across the quadrupole. Any of the above 6 conditions create an alteration in the symmetry of the leading and trailing dipole moments resulting in a transient potential difference across the quadrupole as recorded with a far-field recording montage. The potential difference produced by the asymmetric electric field between the leading and trailing dipoles recorded distantly in areas of low potential gradient is the so-called far-field potential. This investigation substantiates the utility of the leading/trailing dipole model of far-field production and offers a simple model of passive voltage distributions secondary to dipolar moment imbalances to better understand the generation of far-field potentials in cylindrical volume conductors.

Far-field potentials

Far-field potentials are produced by neural generators located at a distance from the recording electrodes. These potentials were initially characterized incorrectly as being of positive polarity, widespread distribution, and constant latency; however, recent advances have clearly demonstrated that far-field potentials may be either positive or negative depending upon the location of the electrodes with respect to the orientation of the dipole generator. Additionally, peak latencies in the far-field can vary with alterations in body position and the spatial distribution of far-field potentials, while widespread, is not uniform. Recent studies of far-field potentials suggest how such waveforms are produced when the symmetry of an action potential, as recorded by distant electrodes, is broken by such factors as differing conductivities of volume conductor compartments, direction of action potential propagation, size differentials in adjoining body segments, or the termination of action potential propagation in excitable tissue. Human, animal, and computer experiments support the preceding generalizations. These new explanations are directly applicable to such far-field potentials as the short latency somatosensory-evoked potential. Furthermore, since far-field potentials can also occur in muscle tissue, one should expect that these generalizations will hold with respect to electromyographic potentials.