Central and peripheral conduction times in multiple sclerosis

Abstract

Somatosensory evoked potentials (SEPs) were recorded simultaneously from the cervical spine and scalp in 25 normal subjects and 105 patients with established or suspected multiple sclerosis (MS) using median nerve stimulation. The normal latency of the main peak of the cervical SEP (N14) following median nerve stimulation at the wrist was 13.7 +/- 0.8 msec. The peak latency of the first cortical event of the scalp SEP (N20) was 19.1 +/- 0.9 msec. The difference in these latencies (N20 -- N14) reflects a conduction time between the dorsal column nuclei and cortex. It measured 5.45 +/- 0.7 msec. The conduction times between the wrist and Erb's point and Erb's point and N14 measured 8.6 +/- 0.7 msec and 5.1 +/- 0.6 msec respectively. There was a 68.6% overall incidence of abnormalities of N14, N20 or (N20 -- N14) in the patients. This incidence was over 80% in definite and early probable or latent MS, 68.2% in progressive spinal MS and 40.0% in suspects. SEPs were also simultaneously recorded from the lower thoracic spine (T12) and scalp in a different group of 25 normal subjects using tibial nerve stimulation. The latency of the thoracic SEP (N21) was 21.4 +/- 1.5 msec and that of the first cortical event of the scalp SEP (P40) was 38.6 +/- 2.2 msec. The difference in these latencies (P40 -- N21) which reflects conduction between T12 and the cortex measured 17.2 +/- 1.7 msec. Conduction between the ankle and popliteal fossa was 7.0 +/- 0.65 msec and between the popliteal fossa and N21, it was 14.5 +/- 1.1 msec. All of a small group of MS suspects showed abnormality of P40 or (P40 -- N21).