Stimulus artifact removal to detect trigeminal sensory evoked potentials

Area of Science:

• Neurophysiology
• Evoked Potentials
• Sensory Nerve Conduction Studies

Background:

• Stimulus artifacts and myogenic potentials commonly impede the detection of trigeminal sensory evoked potentials (t-SEPs).
• Accurate recording of t-SEPs is crucial for assessing trigeminal nerve function.

Purpose of the Study:

• To introduce and validate Dual Mode Stimulation (DMS) for artifact removal in t-SEP recordings.
• To enable robust and reproducible dermatomal t-SEP measurements across the trigeminal sensory territory.

Main Methods:

• Dermatomal t-SEPs were recorded from C5/C6 scalp sites in 24 healthy volunteers.
• Selective electrical stimulation was applied to five distinct trigeminal nerve areas.
• Dual Mode Stimulation (DMS) was employed, utilizing alternating anode-cathode configurations to generate opposing stimulus artifacts.

Main Results:

• Reproducible, classical 'W'-shaped t-SEPs were obtained from all stimulated trigeminal areas.
• Consistent cortical responses, characterized by peaks P8, N13, P19, N27, and P38, were identified.
• A later, less stable component (N55-P67) was observed in a subset of participants.

Conclusions:

• Dual Mode Stimulation (DMS) is a simple, robust, and effective method for removing stimulus artifacts in t-SEP recordings.
• This technique facilitates the recording of dermatomal t-SEPs from various clinically relevant trigeminal nerve areas.
• DMS overcomes a major limitation, making t-SEP recording feasible for routine clinical neurophysiological practice.