ICan Transcranial Magnetic Stimulation

ICan Transcranial Magnetic Stimulation (TMS) be used as a novel intra-operative monitor of spinal cord function?

REC REF:  17/LO/1034

Active and recruiting.
 
In this study, the researchers will explore the use of transcranial magnetic stimulation (TMS) of the motor cortex as an alternative to electrical stimulation, which can be very painful.

The aim of the study is to establish the responses of a number of different muscles to magnetic brain stimulation in patients undergoing surgery of lower limb blood vessels and those undergoing surgery of the lower limb bones.

STUDY OBJECTIVES

The study objectives are to find out the characteristics of the electrical signals produced by muscles (called motor evoked potentials, MEP) following stimulation of the area of the brain responsible for voluntary muscle movements (motor cortex) by a magnetic coil (transcranial magnetic stimulation, TMS) in patients with chronic peripheral vascular disease and during acute surgical-mediated intra-operative reduction in lower limb blood flow.
This study enables us to find out the effect of anaesthetic agents and the conduct of anaesthesia on the MEP characteristics. 

OVERVIEW

This study is a prospective observational study, studying patients with vascular disease and comparing two groups of patients.
•    Group A: Chronic peripheral vascular disease group (CPVD).
•    Group B: Acute intra-operative ischaemia group (AII).
A spinal cord injury following surgery to the main blood vessel in the body represents the most feared and significant complication. Even with the advent of minimally invasive techniques, paralysis can affect up to 13% of patients, which is life-changing complication.
In this study, the researchers aim to establish the responses of several different muscles to magnetic brain stimulation in patients undergoing surgery of lower limb blood vessels or the lower aorta in the abdomen, which could pave the way for routine monitoring during surgery. This would ultimately lead to a reduced likelihood of patients having a potentially catastrophic spinal cord injury and being left paralysed following surgery.