Non-painful and painful surface and intramuscular electrical stimulation at the thenar and hypothenar sites: Differential cerebral dynamics of early to late latency SEPs

Little is known about somatosensory evoked potentials (SEPs) from muscle stimulation compared to that from skin stimulation. The current study examined this issue in the full SEP spectrum (0-440 ms). The aims of the study were to (1) establish the dynamics of early to late latency SEPs from intramuscular stimulation in contrast to surface stimulation, (2) compare the effect of non-painful and painful stimuli on SEP latencies and amplitudes of the two methods, and (3) investigate to which extent these results can be shared between the median nerve innervated thenar site and ulnar nerve innervated hypothenar site. Stimuli were delivered (2 Hz) at a non-painful and a painful intensity above or within the thenar and hypothenar muscles of the hand. Maximas of the SEPs were extracted by a combination of global field power and visual inspection of the topographies. Amplitudes and latencies of the maximas were analysed by a two-way ANOVA with repeated measures. In the early phase (0-50 ms) the topographic patterns showed different dynamics between surface and intramuscular stimulation and in the late phase (100-440 ms) prolonged latencies were found for intramuscular stimulation. A part from this, similar topographic patterns and time sequences were obtained. Significant higher SEP amplitudes for most of the isolated components (C4′/P25,Fz/N35,C4′/P45,Fc2/N65,P4/P90,T4/N137,F3/P150, Cz/P240-P270) were found with surface stimulation compared to intramuscular stimulation. In contrast to surface stimulation, intramuscular stimulation at a stimulation frequency of 2 Hz did not result in a differentiation in amplitude for any of the isolated components. These results indicate differences in the early and late processing of sensory input from skin and muscle.