Generators of the early and late median thenar premotor potentials

The generator sources of the median thenar premotor potentials (PMPs) have remained elusive despite debate in the literature. By studying the median nerve in the hand with a variety of bipolar and referential recording montages, we systematically examined the possible near-field and far-field sources that may determine these potentials. The results suggest that the early PMP is a near-field potential recorded by G1 and generated by the median nerve traversing the distal carpal tunnel. The late PMP represents a far-field potential generated by the median digital nerve fibers as they pass from the palm volume into the thumb volume. Characteristics of the late PMP are explained using the leading/trailing dipole (L/TD) model of far-field potential generation. The diagnostic utility of these PMPs is questionable, since they are recorded from "regions" along the nerve rather than from more clearly defined sites.