Percutaneous magnetic coil stimulation of the phrenic nerve roots and trunk |
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| Institution: | 1. Department of Rheumatology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium;2. Department of Internal Medicine, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium;3. Department of Laboratory Medicine, Ghent University Hospital, Department of Diagnostic Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium;4. Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Dermatology, SKIN research group, Laarbeeklaan 101, 1090, Brussels, Belgium;5. Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy;6. Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Technologiepark-Zwijnaarde 71, 9052, Ghent, Belgium;1. Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina;2. Department of Medicine, Griffith University, Brisbane, Queensland, Australia;3. Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria;4. Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle, WA, United States;5. Rheumatology Unit, Hospital Italiano de Buenos Aires and Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina;6. Pfizer Inc, Buenos Aires, Argentina;7. Pfizer Inc, Collegeville, PA, United States;8. Pfizer Inc, New York, NY, United States;9. Pfizer Inc, Lima, Peru;1. Department of Dermato-Venereology, Bispebjerg and Frederiksberg Hospital, University Hospitals of Copenhagen, Denmark;2. Department of Rheumatology, Bispebjerg and Frederiksberg Hospital, University Hospitals of Copenhagen, The Parker Institute, Denmark;3. Department of Photonics, Technical University of Denmark, DTU, Kgs. Lyngby, Denmark;4. Dept. of Clinical Medicine. Faculty of Health Sciences, University of Copenhagen, Denmark |
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| Abstract: | We describe a technique of percutaneous magnetic coil NO stimulation of the phrenic nerve trunk on one side of the neck and phrenic roots over the upper cervical vertebral column in 10 normal subjects and 2 patients. We were able to obtain compound muscle action potentials (CMAPs) from the diaphragm at two sites (xiphoid process and 7th intercostal space) after stimulation of the phrenic nerve trunk and roots. We noted that the onset latencies after phrenic root stimulation remained fixed despite increasing the stimulus intensity from 50% to 100% and on moving the MC vertically or laterally, suggesting that stimulation of the fastest conducting fibers was occurring at a fixed site, most likely at the intervertebral foramina. Absent responses unilaterally in one and prolonged latencies to diaphragmatic CMAPs in another patient confirmed phrenic neuropathy in these patients. |
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