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J Appl Physiol (October 11, 2002). doi:10.1152/japplphysiol.00581.2002
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Articles in PresS, published online ahead of print October 11, 2002
J Appl Physiol, 10.1152/jap.00581.2002
Submitted on July 1, 2002
Accepted on September 28, 2002

Validation of surface recordings of the diaphragm response to transcranial magnetic stimulation in man

Alexandre Demoule1, Eric Verin2, Chrystele Locher1, Jean-Philippe Derenne1, and Thomas Similowski1*

1 Laboratoire de Physiopathologie Respiratoire, Service de Pneumologie, Groupe Hospitalier Pitie-Salpetriere, Assistance Publique - Hopitaux de Paris, Paris, France; UPRES EA 2397, Universite Pierre et Marie Curie Paris VI, Paris, France
2 UPRES EA 2397, Universite Pierre et Marie Curie Paris VI, Paris, France; Service de Physiologie Respiratoire et Sportive, Hopital Charles Nicolle, Centre Hospitalier Universitaire, Rouen, France

* To whom correspondence should be addressed. E-mail: thomas.similowski{at}psl.ap-hop-paris.fr.

The integrity of the central efferent motor pathways to the diaphragm can be assessed using transcranial magnetic stimulation, by measuring the latency of the corresponding motor evoked potentials using surface electrodes. Because transcranial magnetic stimulation does not activate the diaphragm alone, signal contamination is a potential problem. To evaluate this issue, surface diaphragmatic motor evoked potentials latencies were compared with latencies recorded from diaphragm needle in 9 healthy volunteers. Surface latencies of muscles likely to contaminate the diaphragm signals (serratus anterior, pectoralis major, and tranversus abdominis) were also recorded. The latencies in response to non focal transcranial stimulation from surface electrodes were not significantly different from the needle ones (17±1.3ms vs. 17.2±1.1ms, respectively), but were significantly different from the latencies of the other muscles. In 2 cases, signal contamination appeared likely (serratus anterior in one case, abdominal muscles in 1 case). It is possible to reliably measure the latency of the diaphragm response to transcranial magnetic stimulation with adequately positioned surface electrodes.




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