An atlas of human spinal cord evoked potentials

Abstract

The literature has been steadily growing in size and sophistication regarding the electrical activity generated by the spinal cord and the relation of these events to function within the spinal cord. This growth in understanding of spinal cord physiology is enabling more effective interpretation of human spinal cord evoked potentials (SCEPs) obtained in the healthy and diseased or traumatized condition. The clinical utility of examining SCEPs has been demonstrated in intra-operative monitoring^1–3 and substantial quantities of human SCEP data have been collected in multiple centres^1–6. Since 1981, five International Symposia on Spinal Cord Monitoring and Electrodiagnosis³ have been held and more clinicians and researchers are studying the human spinal cord in this manner. The establishment of a standard reference of human spinal cord evoked potentials would serve these clinicians and researchers. Richard Brown, PhD, has pointed out the wide disparity in the methods employed to acquire SCEPs as well as the terminology used to refer to SCEPs and has challenged those in the field to come to consensus⁷. As it was in the cases of electroencephalography and electromyography, establishment of standards for acquisition, analysis and interpretation of human SCEPs is a crucial step in the creation of a new technique which is intended to gain widespread acceptance as a viable clinical tool. For the researcher, a database of human SCEPs contributed by clinicians collecting SCEPs during intra-operative monitoring and other investigators collecting human SCEPs under well-controlled conditions, offers a unique resource from which a new understanding can be reached. For these reasons and as a means to enhance communication between the scientific and clinical communities, we feel that it is time to develop an atlas of human spinal cord evoked potentials (the Atlas).