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Melo DLMD, Comerlato EA, Pinheiro DS, Manzano GM. Letter to Editor regarding: "Long latency responses in tongue muscle elicited by various stimulation sites in anesthetized humans - New insights into tongue-related brainstem reflexes". Brain Stimul 2023; 16:1553-1554. [PMID: 37909112 DOI: 10.1016/j.brs.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/14/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
| | - Enio Alberto Comerlato
- Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil
| | - Denise Spinola Pinheiro
- Department of Clinical Neurophysiology, Federal University of São Paulo, São Paulo, SP, Brazil
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Throckmorton GA, Thayer W, Duco Jansen E, Mahadevan-Jansen A. Infrared neural stimulation markedly enhances nerve functionality assessment during nerve monitoring. Sci Rep 2023; 13:4362. [PMID: 36928795 PMCID: PMC10020565 DOI: 10.1038/s41598-023-31384-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
In surgical procedures where the risk of accidental nerve damage is prevalent, surgeons commonly use electrical stimulation (ES) during intraoperative nerve monitoring (IONM) to assess a nerve's functional integrity. ES, however, is subject to off-target stimulation and stimulation artifacts disguising the true functionality of the specific target and complicating interpretation. Lacking a stimulation artifact and having a higher degree of spatial specificity, infrared neural stimulation (INS) has the potential to improve upon clinical ES for IONM. Here, we present a direct comparison between clinical ES and INS for IONM performance in an in vivo rat model. The sensitivity of INS surpasses that of ES in detecting partial forms of damage while maintaining a comparable specificity and sensitivity to more complete forms. Without loss in performance, INS is readily compatible with existing clinical nerve monitoring systems. These findings underscore the clinical potential of INS to improve IONM and surgical outcomes.
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Affiliation(s)
- Graham A Throckmorton
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Station B, Box 351631, Nashville, TN, 37235-1631, USA
- Vanderbilt Biophotonics Center, 410 24th Ave. South, Nashville, TN, 37232, USA
| | - Wesley Thayer
- Department of Plastic Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - E Duco Jansen
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Station B, Box 351631, Nashville, TN, 37235-1631, USA
- Vanderbilt Biophotonics Center, 410 24th Ave. South, Nashville, TN, 37232, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, 1161 21St Avenue, Nashville, TN, 37232-2380, USA
| | - Anita Mahadevan-Jansen
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Station B, Box 351631, Nashville, TN, 37235-1631, USA.
- Vanderbilt Biophotonics Center, 410 24th Ave. South, Nashville, TN, 37232, USA.
- Department of Neurological Surgery, Vanderbilt University Medical Center, 1161 21St Avenue, Nashville, TN, 37232-2380, USA.
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
- Department of Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
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Abstract
There are many recent advances in intraoperative evoked potential techniques for mapping and monitoring neural function during surgery. In particular, somatosensory evoked potential optimization speeds surgical feedback, motor evoked potentials provide selective motor system information, and new visual evoked potential methods promise reliable visual system monitoring. This chapter reviews these advances and provides a comprehensive background for understanding their context and importance.
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Affiliation(s)
| | - Charles C Dong
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Alberto Uribe
- Department of Anesthesiology, Ohio State University, Columbus, OH, United States
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