New concept for the recovery function of short-latency somatosensory evoked cortical potentials following median nerve stimulation

OBJECTIVES We investigated the recovery function of the cortical components of somatosensory evoked potentials (SEP) at a very short interstimulus interval (ISI, less than 10 ms) using an integrative computer system in 10 healthy subjects (age, 27-38 years). METHODS The SEP and nerve action potentials were recorded at P3 with a reference of Fz in the International 10-20 System and the ipsilateral Erb's point, respectively. Double stimulation of the right median nerve with an ISI from 0.5 to 100 ms was performed to analyze the N20 and P30 components at less than 10 ms. RESULTS The P30 component was recognized following the second stimulation at an ISI of over 1 ms, while N20 was not identified at an ISI of less than 9 ms. There appeared a sub-component of SEP at 1-12 ms ISI, which was not identified following a single stimulation under control conditions. CONCLUSIONS The results indicated that the recovery function of given SEP components was not simply determined by the number of synapses interposed between the stimulus site and the generator source of the response in the central nervous system, but there might be a structural or functional process of low-cut filtering in the primary sensory cortex. We also considered that the final SEP waveform determined by the excitatory and inhibitory balance of the components, which could be changed with ISI, and that the existence of the sub-component might cause the complexity of the recovery curve and large inter-individual difference of the waveform.

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