Short latency potentials recorded from the neck and scalp following median nerve stimulation in man

Short latency evoked potentials were recorded from sites overlying the cervical and thoracic vertebrae, the clavicles, mastoid processes and cerebral cortex, following percutaneous stimulation of median nerve fibres at the elbow, wrist and fingers in 23 normal subjects. At least four major early components each with simultaneous positive and negative constituents, plus the first component (N20) of the cortical response, were all found to be mediated by sensory afferent fibres with conduction velocity 65--75 m/sec in the forearm of one subject. Study of the distribution of these potentials, using reference electrodes located at Fz or over the lower part of the spine, has led to the proposal of generator sites in the brachial plexus (N9), spinal roots or dorsal columns (N11), spinal grey matter or brain stem (N13), and brain stem or thalamus (N14). Comparison with intrathecal recordings in man lends support to the view that N11 and N13 are generated in or adjacent to the spinal cord. It is hoped the findings may extend the clinical applications of a non-invasive technique for investigating the afferent sensory pathways in man.