Intraoperative direct cortical stimulation motor evoked potentials: Stimulus parameter recommendations based on rheobase and chronaxie

One elicits intraoperative direct cortical stimulation (DCS) muscle motor evoked potentials (MEPs) with a short train of monophasic rectangular electrical pulses having a user-selected interstimulus interval (ISI) and pulse duration (D). While practitioners commonly choose 4ms ISI and 0.5msD, reported parameters vary and none have been proven optimal, leaving no consistent scientific rationale for the selection (Taniguchi et al., 1993; Cedzich et al., 1996; Kombos et al., 2000; Neuloh et al., 2004; Kombos et al., 2009; Kamada et al., 2009; Szelényi et al., 2010; Nossek et al., 2011).

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