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Contralateral and ipsilateral corticobulbar motor evoked potentials elicited by magnetic and electrical stimulation of primary motor cortices for laryngeal muscles

Objective: The objective of this study was to investigate the excitability of contralateral and ipsilateral corticobulbar projections recorded as corticobulbar motor evoked potentials (CoMEPs) from laryngeal muscles. Methodology: In 11 healthy subjects, the primary motor cortex (M1) for laryngeal muscles was stimulated by navigated transcranial magnetic stimulation (nTMS) in both hemispheres and the CoMEPs were recorded from the right cricothyroid muscle . In 15 patients undergoing left craniotomy, CoMEPs were obtained from bilateral cricothyroid muscles, using transcranial electrical stimulation (TES) over C3/Cz and C4/Cz montages. Results: In healthy subjects the latency of contralateral CoMEP was 11.75 ± 2.07 ms and amplitude 288.86 ± 209.14 µV, while the latency of ipsilateral CoMEPs was 11.75 ± 1.98 ms and amplitude 144.50 ± 85.30 µV. In patients: for the C3/Cz TES, the contralateral CoMEP amplitude was 334.42 ±101.54 µV with the latency of 13.27 µv 1.87 ms, while the ipsilateral CoMEPs amplitude was 180.83 ± 103.67 µv with the latency of 13.74 µv 2.53 ms ; for the C4/Cz TES, contralateral CoMEPs were recorded with the amplitude of 341.22 ± 81.98 µV and latency of 13.76 ± 2.53 ms, while ipsilateral CoMEPs were recorded with the amplitude of 154.76 ± 54.28 µV and latency of 14.58 ± 3.04 ms. The amplitude of contralateral CoMEP responses were significantly larger compared to ipsilateral CoMEP amplitudes in both groups. Conclusion: We obtained significantly larger amplitude responses of contralateral CoMEPs from laryngeal muscles compared to ipsilateral CoMEP amplitude using nTMS in healthy subjects and TES in patients. This confirms the bilateral nature of corticobulbar pathway projections for laryngeal muscles, with contralateral domination. Contribution/Significance: These findings will influence recording of CoMEPs during preoperative and intraoperative mapping of M1 cortices for laryngeal muscles. Additionally the results might facilitate the pathophysiologic research of motor speech disorders.

laryngeal muscles ; primary motor cortex ; motor evoked potentials ; TMS ; TES ;

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