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A Comparative Effectiveness Study of Bipolar and Linked Quadripolar Techniques for Eliciting Transcranial Motor
Joseph Haddad1,2, Karl E Minges2, Yanice V Méndez-Fernández2
1Department of Clinical Neurophysiology Neuro Protective Solutions, New York, NY, USA.
Introduction:
Linked Quadripolar Stimulation (LQP) is a recent adaptation of transcranial electric motor evoked potential stimulation, with proposed advantages over traditional Bipolar (BP) stimulation. This study aims to comprehensively compare BP and LQP stimulation to validate the efficacy of LQP.
Methods:
BP and LQP stimulation were performed on 30 patients undergoing anterior cervical discectomy and fusion. A comprehensive assessment involved conducting four trials for each technique on each patient. An Accelerometer placed over the right masseter region recorded movement. A Mann-Whitney U test and Pearson Correlation Coefficient were used to quantitatively compare patient movement, compound muscle action potential (CMAP) response amplitude, and area under the curve (AUC) values.
Results:
TCMEP recordings were successfully obtained from the entire sample. No statistical significance was found between patient movement, amplitude, or area under the curve (AUC) between BP and LQP stimulation. A weak correlation was found between patient movement and stimulation intensity for both techniques. A strong correlation was found between amplitude and AUC values.
Conclusion:
Patient movement and stimulation parameters showed similar outcomes between BP and LQP. LQP did not demonstrate reduced movement compared to BP stimulation. This study contributes valuable insights into the effectiveness of BP and LQP stimulation in anterior cervical discectomy and fusion surgery.
