Can TMS be used as a novel intra-operative monitor

  • Research type

    Research Study

  • Full title

    Transcranial Magnetic Stimulation (TMS) in Vascular Disease- Can TMS be used as a novel intra-operative monitor of spinal cord function?? A Preliminary Study

  • IRAS ID

    214530

  • Contact name

    Paul Strutton

  • Contact email

    p.strutton@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    1 years, 11 months, 30 days

  • Research summary

    Spinal cord injury (SCI) following major aortic (main blood vessel in the body) surgery represents the most feared and significant post-operative complication. Despite the advent of minimally-invasive techniques, paralysis can affect up to 13% of patients. This is a life-changing complication with high mortality and a huge health-economic impact.
    Monitoring of spinal cord function, where the brain is stimulated with large electric currents and muscle contractions (motor evoked potentials - MEPs) are measured, has been widely used during open aortic aneurysm repairs. It is used to detect spinal cord damage secondary to reduced blood flow and to guide remedial interventions.
    Transcranial magnetic stimulation (TMS) is a painless and non-invasive method of brain stimulation which has been used as both a diagnostic and therapeutic tool for a number of decades. There is no evidence of its use during surgery of major blood vessels and this project proposes to investigate the use of TMS as an alternative to conventional electrical stimulation.
    The expected outcome is to ascertain the profile of MEPs in patients with long standing (chronic) disease of the blood vessels, where there is a reduction in blood flow in their lower limbs (peripheral vascular disease) and new onset (acute) reduction in lower limb blood flow which is seen during vascular surgery. This data is will compared to data from a previous study with healthy volunteers.
    Results from both studies will provide essential reference data for the development of an intra-operative monitor of spinal cord function during major surgery of the aorta.

  • REC name

    London - Central Research Ethics Committee

  • REC reference

    17/LO/1034

  • Date of REC Opinion

    5 Jul 2017

  • REC opinion

    Favourable Opinion