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PS-7-8 Cerebral conduction time CCT in migraine patients
Poster session 7. Somatosensory evoked potentials: clinical (1) nerve SSEPs were examined in 24 patients with clinically definite MS according to Poser's criteria, confirmed with MRI examination, according to Fazekas criteria. Statistically significant elongation of mean N13 and N20 latency as well as CCT of median-SSEP and N22, P40 latencies and CCT of tibial-SSEP was found in patients group comparing with control group consisted of 30 healthy persons. These latencies underwent further significant elongation during the course of the disease. During 5-years follow-up period there was no decrease in latency of any SSEP component except one case of decrease of previously elongated N13 latency. The latency of N22 and P40 of tibial-SSEP underwent elongation during the course of the disease in all patients. The latencies of peripheral components: N9 of median and N14 of tilial-SSEP remained unchanged during the follow-up period in nearly all patients. Patients disability evaluated with Kurtzke's EDSS increased by 2 points on average during the follow-up period.
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Influence of cooling on somatosensory evoked potentials in subjects with multiple sclerosis
Lawrence Robinson, George Kraft, Sally Fitts, Vicki Schneider.
$99
39 + 12 years, mean EDSS 2.8 -t- 1.2, 6 females) used a cooling suit (Mark VII, Life Support Systems Inc.) one hour daily over two weeks. During cooling the oral temperature decreased by at least 0.5 °C. Their subjective general state, neurological examination, sympathetic skin responses (SSR) and somatosensory evoked potentials (SEP) from all limbs and visual evoked potentials (VEP) from both eyes were evaluated. Before cooling, SSRs were not obtained in 10/20 lower limbs; SEPs were normal in 6/40, not elicited in 21/40, had prolonged latencies in 13/40 limbs. VEPs were prolonged in 14/20 eyes. Following a one-hour cooling no patient felt any subjective change, their neurological status remained stable; SSRs disappeared in 5/8 limbs. Normal SEPs did not change; 8/13 formerly prolonged SEPs disappeared. SEPs not elicited at baseline were not elicitable also following cooling. VEPs did not change in any patient. By the end of two weeks 5 patients reported subjective improvement, although the neurological examination and electrophysiological parameters did not change significantly as compared to the examination after a single cooling. Body cooling is therefore not a valuable treatment in MS. The changes seen following cooling are probably temperaturedependent electrophysiological fluctuations.
Department of Rehabilitation Medicine, University of Washington Objectives: Some subjects with multiple sclerosis (MS) report improved endurance after body cooling. We tested the hypothesis that reducing core body temperature in subjects with MS improves the cortical somatosensory evoked potential (SEP) response. To mimic fatigue, we used changing rates of stimulation. Methods: Twenty subjects with definite MS were compared to 20 subjects without neurological symptoms or disease. SEPs were recorded with stimulation of the tibial and median nerves unilaterally. Stimulation was given at 3.1 and 6.1 Hz. The procedure was repeated after a cooling vest and hat reduced core body temperature by 0.75-1.0 °C. Results: Amplitude of the cortical SEP response was reduced at the 6.1 Hz rate compared to 3.1 Hz. Expressed as a ratio (6.1 Hz/3.1 Hz) amplitudes for the median nerve were: control 0.71 40.13, control after cooling 0.77 4- 0.14, MS 0.67 -t- 0.24, MS after cooling 0.76 + 0.26. For the tibial nerve (only 12 MS subjects had responses) the ratios were: control 0.57 4- 0.18, control after cooling 0.63 4- 0.27, MS 1.07 -4- 0.82, MS after cooling 0.90 + 0.34. Although some trends were noted in the above valuesi no statistically significant differences based on cooling or diagnosis were detected at the p < 0.05 level. While latencies were mildly prolonged after cooling in most subjects, the degree of prolongation was not influenced by diagnosis. Latencies were not significantly influenced by rate of stimulation. Conclusions: Although some reports suggest symptomatic improvement after cooling in subjects with MS, this improvement is not corroborated by changes in the SEE
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Effect of body cooling in patients with multiple sclerosis. A clinical and electrophysiological study
P. Nisipeanu, V.E. Drory, G.B. Groozman, A.D. Korczyn. Dept.
of Neurology, Sourasky Med. Center and Sackler Faculty of Medicine, Tel-Aviv, Israel Multiple sclerosis (MS) patients may report temporary neurological deterioration with elevated body or ambient temperatures, probably by conduction block in partially demyelinated axons. Our purpose was to determine whether body cooling could reverse the conduction block clinically and electrophysiologically. Ten stable, temperature-sensitive, clinically definite MS patients (mean age
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Cerebral conduction time CCT in migraine patients
lsao Sakurai 1, Tomiei Iga 1, Masahiro Yamamoto 2, Yasuhisa Kitagawa 2, Yukito Shinohara 2, Hiroshi Murase 3.
l Central Clinical Laboratories, Toukai University School of Medicine, Japan; 2Department of Internal Medicine, Toukai University School of Medicine, Japan; 3 Department of Clinical Pathology, Toukai University School of Medicine, Japan Visual evoked potential (VEP) has proved to be useful in the evaluation of migraine. A comparison of different studies, however, is often difficult because VEPs are so variable depending upon the techniques. Cerebral conduction time (CCT) is known to be much stable and well reflect cerebral vascular hemodynamics. We have recorded CCT as well as VEP and E E G in headache patients. In this paper CCTs are compared among three groups: healthy control (C group) 20 cases, muscle contraction headache (MCH group) 22 cases, and migraine (M group) 50 cases (ictal = xx, postor interictal = yy). Results. 1. CCTs (C7-C3', C7-C4') of each group were as follows: 5.70 4- 0.44 and 5.62 4- 0.42 in N group, 5.83 4- 0.13, 5.65 4- 0.27 in MCH group, and 6.05 4- 0.43, 6.00 4- 0.41 in M group. 2. In MCH group non showed prolonged CCT. 3, in M group, (1) CCT was prolonged in 24 cases out of 50, (2) mean CCTs were significantly prolonged to those of C and MCH, (3) prolonged CCT recovered often over five weeks. The findings lead us to the following conclusion that migraine is caused not merely by cerebro-vascular hemodynamics, but diffuse and probably chemo-dynamic cerebral dysfunction.
~ P - ~ - ~ Enhanced SEPs in patients with hemispheral tumours and epilepsy Lubor Stejskal, Du~an Urgo~fk, Ivana St~tk~i~ov~i. Dept. of Neurosurgery, Charles University, Prague, Czech Republic Somatosensory evoked potentials of the median nerve (SEPs) were registered in 216 patients with hemispheral tumours. Three basic findings were obtained with electrodes placed at C3/C4-Fz: 1. no abnormality (mostly in tumours distant from the central re-
•
Influence of cooling on somatosensory evoked potentials in subjects with multiple sclerosis
Lawrence Robinson, George Kraft, Sally Fitts, Vicki Schneider.
$99
39 + 12 years, mean EDSS 2.8 -t- 1.2, 6 females) used a cooling suit (Mark VII, Life Support Systems Inc.) one hour daily over two weeks. During cooling the oral temperature decreased by at least 0.5 °C. Their subjective general state, neurological examination, sympathetic skin responses (SSR) and somatosensory evoked potentials (SEP) from all limbs and visual evoked potentials (VEP) from both eyes were evaluated. Before cooling, SSRs were not obtained in 10/20 lower limbs; SEPs were normal in 6/40, not elicited in 21/40, had prolonged latencies in 13/40 limbs. VEPs were prolonged in 14/20 eyes. Following a one-hour cooling no patient felt any subjective change, their neurological status remained stable; SSRs disappeared in 5/8 limbs. Normal SEPs did not change; 8/13 formerly prolonged SEPs disappeared. SEPs not elicited at baseline were not elicitable also following cooling. VEPs did not change in any patient. By the end of two weeks 5 patients reported subjective improvement, although the neurological examination and electrophysiological parameters did not change significantly as compared to the examination after a single cooling. Body cooling is therefore not a valuable treatment in MS. The changes seen following cooling are probably temperaturedependent electrophysiological fluctuations.
Department of Rehabilitation Medicine, University of Washington Objectives: Some subjects with multiple sclerosis (MS) report improved endurance after body cooling. We tested the hypothesis that reducing core body temperature in subjects with MS improves the cortical somatosensory evoked potential (SEP) response. To mimic fatigue, we used changing rates of stimulation. Methods: Twenty subjects with definite MS were compared to 20 subjects without neurological symptoms or disease. SEPs were recorded with stimulation of the tibial and median nerves unilaterally. Stimulation was given at 3.1 and 6.1 Hz. The procedure was repeated after a cooling vest and hat reduced core body temperature by 0.75-1.0 °C. Results: Amplitude of the cortical SEP response was reduced at the 6.1 Hz rate compared to 3.1 Hz. Expressed as a ratio (6.1 Hz/3.1 Hz) amplitudes for the median nerve were: control 0.71 40.13, control after cooling 0.77 4- 0.14, MS 0.67 -t- 0.24, MS after cooling 0.76 + 0.26. For the tibial nerve (only 12 MS subjects had responses) the ratios were: control 0.57 4- 0.18, control after cooling 0.63 4- 0.27, MS 1.07 -4- 0.82, MS after cooling 0.90 + 0.34. Although some trends were noted in the above valuesi no statistically significant differences based on cooling or diagnosis were detected at the p < 0.05 level. While latencies were mildly prolonged after cooling in most subjects, the degree of prolongation was not influenced by diagnosis. Latencies were not significantly influenced by rate of stimulation. Conclusions: Although some reports suggest symptomatic improvement after cooling in subjects with MS, this improvement is not corroborated by changes in the SEE
•
Effect of body cooling in patients with multiple sclerosis. A clinical and electrophysiological study
P. Nisipeanu, V.E. Drory, G.B. Groozman, A.D. Korczyn. Dept.
of Neurology, Sourasky Med. Center and Sackler Faculty of Medicine, Tel-Aviv, Israel Multiple sclerosis (MS) patients may report temporary neurological deterioration with elevated body or ambient temperatures, probably by conduction block in partially demyelinated axons. Our purpose was to determine whether body cooling could reverse the conduction block clinically and electrophysiologically. Ten stable, temperature-sensitive, clinically definite MS patients (mean age
~-~
Cerebral conduction time CCT in migraine patients
lsao Sakurai 1, Tomiei Iga 1, Masahiro Yamamoto 2, Yasuhisa Kitagawa 2, Yukito Shinohara 2, Hiroshi Murase 3.
l Central Clinical Laboratories, Toukai University School of Medicine, Japan; 2Department of Internal Medicine, Toukai University School of Medicine, Japan; 3 Department of Clinical Pathology, Toukai University School of Medicine, Japan Visual evoked potential (VEP) has proved to be useful in the evaluation of migraine. A comparison of different studies, however, is often difficult because VEPs are so variable depending upon the techniques. Cerebral conduction time (CCT) is known to be much stable and well reflect cerebral vascular hemodynamics. We have recorded CCT as well as VEP and E E G in headache patients. In this paper CCTs are compared among three groups: healthy control (C group) 20 cases, muscle contraction headache (MCH group) 22 cases, and migraine (M group) 50 cases (ictal = xx, postor interictal = yy). Results. 1. CCTs (C7-C3', C7-C4') of each group were as follows: 5.70 4- 0.44 and 5.62 4- 0.42 in N group, 5.83 4- 0.13, 5.65 4- 0.27 in MCH group, and 6.05 4- 0.43, 6.00 4- 0.41 in M group. 2. In MCH group non showed prolonged CCT. 3, in M group, (1) CCT was prolonged in 24 cases out of 50, (2) mean CCTs were significantly prolonged to those of C and MCH, (3) prolonged CCT recovered often over five weeks. The findings lead us to the following conclusion that migraine is caused not merely by cerebro-vascular hemodynamics, but diffuse and probably chemo-dynamic cerebral dysfunction.
~ P - ~ - ~ Enhanced SEPs in patients with hemispheral tumours and epilepsy Lubor Stejskal, Du~an Urgo~fk, Ivana St~tk~i~ov~i. Dept. of Neurosurgery, Charles University, Prague, Czech Republic Somatosensory evoked potentials of the median nerve (SEPs) were registered in 216 patients with hemispheral tumours. Three basic findings were obtained with electrodes placed at C3/C4-Fz: 1. no abnormality (mostly in tumours distant from the central re-