Clinical Neurophysiology最新文献

Investigation of lateralized periodic discharge features associated with epileptogenesis

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-07 DOI: 10.1016/j.clinph.2025.02.254

Eric Zhou , Nicolas R. Thompson , Stephen Hantus , Vineet Punia

Objective

To identify factors, especially the electrographic features, that predispose patients with lateralized periodic discharges (LPDs) to epilepsy development.

Methods

We included adults, without epilepsy history, who had LPDs on continuous EEG (cEEG) monitoring during hospitalization. We characterized LPDs based on American Clinical Neurophysiology Society rhythmic and periodic pattern modifiers. The outcome variable was epilepsy development as defined by clinical seizure after discharge. We used a Cox regression model to calculate adjusted hazard ratios (aHR) for epilepsy development.

Results

Of 174 patients, 52 (30 %) developed epilepsy during a median follow-up time of 15.0 (IQR 62.1) months. We found that an LPD-plus pattern was associated with an increased risk of epilepsy development during the follow-up period [aHR 2.67 (95 %CI 1.26–5.64)]. We also found that LPD frequency ≥ 1.5 Hz was associated with an increased risk of epilepsy development during the first year of follow-up [aHR 2.27 (95 %CI 1.02–5.05)].

Conclusions

Among patients with LPDs, the presence of a plus pattern and discharge frequency ≥ 1.5 Hz are both independently associated with more than two-times increased risk of epilepsy development.

Significance

Identification of EEG-based predictors of epileptogenesis in patients with LPDs can help early identification of patients at higher risk for future seizures and help tailor their management.

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引用次数: 0

Altered cortical excitability in tuberous sclerosis and the effect of mTOR inhibitors: An intracranial electrical stimulation study

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-04 DOI: 10.1016/j.clinph.2025.02.001

Kishore Vedala , Gewalin Aungaroon , David Ritter , Hansel M. Greiner , Jeffrey R. Tenney , Jesse Skoch , Paul S. Horn , James L. Leach , Francesco T. Mangano , Darcy Krueger , Ravindra Arya

Objective

We used electrical stimulation mapping (ESM) of functional responses, after-discharges (ADs), and unwanted electrical stimulation-induced seizures (EIS) to explore differences in cortical excitability in tuberous sclerosis complex (TSC) patients on mTOR inhibitors, TSC patients not on mTOR inhibitors, and drug-resistant epilepsy (DRE) of unknown etiology.

Methods

In 20 patients with TSC and 10 patients with DRE of unknown etiology, incidence and current thresholds of physiologic (language and motor) and pathologic (ADs, EIS) responses were analyzed using mixed effects models against disease phenotype (TSC vs unknown) and use of mTOR inhibitors.

Results

Patients with TSC showed a higher incidence and required a lower threshold current to elicit motor responses and ADs compared to those with DRE of unknown etiology. In TSC patients, mTOR inhibitors increased the threshold for motor responses and ADs, and decreased the incidence of face motor responses, language responses, and ADs.

Conclusions

TSC patients exhibit higher physiologic and pathologic cortical excitability evidenced by a higher incidence and lower current thresholds of ESM responses, which appears to be mitigated by mTOR inhibitors.

Significance

To our knowledge, this is the first study providing direct intracranial evidence for altered cortical excitability in TSC and the corrective effect of mTOR inhibitors.

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引用次数: 0

Neural correlates of semantic and phonemic variants of verbal fluency tasks: A combined MEG and fMRI study.

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-03 DOI: 10.1016/j.clinph.2025.01.015

Alexandru Mihai Dumitrescu, Tim Coolen, Vincent Wens, Antonin Rovai, Nicola Trotta, Charline Urbain, Xavier De Tiège

Objective: The neural correlates of verbal fluency tasks (VFT) have been characterized by functional magnetic resonance imaging (fMRI). Still, the spatio-spectral neural oscillatory dynamics elicited by VFT and the differences between their semantic and phonologic variants are unsettled. We investigate, using fMRI and magnetoencephalography (MEG), the neural correlates of VFT and the differences in neural oscillatory dynamics between phonological (PFT) and semantic (SFT) fluency tasks.

Methods: Thirty right-handed healthy adults underwent MEG and fMRI recordings while performing covert PFT and SFT.

Results: fMRI showed different neural networks for PFT (left-dominant lexical-semantic control network) and SFT (nodes of the left-dominant semantic network). MEG showed beta-band power suppression in the left operculum in both VFT, with no difference between PFT and SFT.

Conclusions: MEG and fMRI detect distinct task-induced neural activity changes during VFT. MEG findings likely reflect the neural consequences of covert word production initiated at the inferior/middle frontal gyri, as identified by fMRI.

Significance: This study demonstrates the added value of combining MEG and fMRI to fully characterize VFT network dynamics. It paves the way for the use of VFT for non-invasive presurgical language mapping using a method free of neurovascular uncoupling.

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引用次数: 0

Alterations in temporal-spatial brain entropy in treatment-resistant depression treated with nitrous oxide: Evidence from resting-state EEG

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-03 DOI: 10.1016/j.clinph.2025.01.014

Weizhuang Kong , Zhe Sun , Jing Zhu , Lingjiang Li , Guanru Wang , Xuexiao Shao , Xiaowei Li , Bin Hu

Objective

Entropy analysis can quantify the dynamic states of the brain and reflect its information processing capacity. Nitrous oxide has shown rapid antidepressant effects in treatment-resistant depression (TRD) patients, but its biomarkers are not yet established.

Methods

We recruited 44 TRD patients and randomly assigned them to two groups: one received a 1-hour nitrous oxide inhalation treatment, while the other received a placebo. Resting-state EEG (rs-EEG) scans were conducted at baseline and 24 h post-treatment. A novel approach based multivariate multiscale entropy (MMSE) was employed to analyze temporal-spatial brain entropy (ts-BEN) across four hierarchical brain regions.

Results

TRD patients exhibited significant time-dependent increases in BEN in the frontal lobe region (sensor space: time scales 5–10; source space: time scales 1–5), changes not previously observed. Temporal-spatial BEN correlated with the severity of TRD symptoms and treatment efficacy, indicating adaptive adjustments in brain resting states.

Conclusion

MMSE offers a novel supplementary method for rs-EEG BEN analysis, quantifying the sensitivity of ts-BEN in monitoring nitrous oxide treatment effects. Changes in frontal region ts-BEN may serve as potential biomarkers for TRD and its treatment outcomes.

Significance

Our findings enhance the understanding of the physiological mechanisms underlying nitrous oxide treatment for TRD, aiding in clinical diagnosis.

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引用次数: 0

1924–2024: First centennial of EEG 1924-2024：脑电图的第一个百年纪念。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-01 DOI: 10.1016/j.clinph.2024.11.021

Paolo M. Rossini , Jonathan Cole , Walter Paulus , Ulf Ziemann , Robert Chen

On July 6th of 1924 Hans Berger –a German psychiatrist- first recorded electric signals from the human brainvia scalp electrodes. This date marks the beginning of Electroencephalography. In this review a representative panel of past and present Officers of the International Federation of Clinical Neurophysiology (IFCN) and of its Official Journal briefly summarizes the past, present and future of Electroencephalographic and related neurophysiological techniques’ impact and the role of the IFCN in global collaboration, education, standardization, research innovation, and clinical practice.

1924年7月6日，德国精神病学家汉斯·伯杰首次通过头皮电极记录了来自人类大脑的电信号。这个日期标志着脑电图的开始。在这篇综述中，由国际临床神经生理学联合会（IFCN）及其官方期刊的前任和现任官员组成的代表小组简要总结了脑电图和相关神经生理学技术的过去、现在和未来的影响，以及IFCN在全球合作、教育、标准化、研究创新和临床实践中的作用。

引用次数: 0

Machine learning based on event-related oscillations of working memory differentiates between preclinical Alzheimer’s disease and normal aging 基于工作记忆事件相关振荡的机器学习可以区分临床前阿尔茨海默病和正常衰老。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-01 DOI: 10.1016/j.clinph.2024.11.013

Ke Liao , Laura E. Martin , Sodiq Fakorede , William M. Brooks , Jeffrey M. Burns , Hannes Devos

Objective

To apply machine learning approaches on EEG event-related oscillations (ERO) to discriminate preclinical Alzheimer’s disease (AD) from age- and sex-matched controls.

Methods

Twenty-two cognitively normal preclinical AD participants with elevated amyloid and 21 cognitively normal controls without elevated amyloid completed n-back working memory tasks (n = 0, 1, 2). The absolute and relative power of ERO was extracted using the discrete wavelet transform in the delta, theta, alpha, and beta bands. Four machine learning methods were employed, and classification performance was assessed using three metrics.

Results

The low-frequency bands produced higher discriminative performances compared to high-frequency bands. The 2-back task yielded the best classification capability among the three tasks. The highest area under the curve value (0.86) was achieved in the 2-back delta band nontarget condition data. The highest accuracy (80.47%) was obtained in the 2-back delta and theta bands nontarget data. The highest F1 score (0.82) was in the 2-back theta band nontarget data. The support vector machine achieved the highest performance among tested classifiers.

Conclusion

This study demonstrates the promise of using machine learning on EEG ERO from working memory tasks to detect preclinical AD.

Significance

EEG ERO may reveal pathophysiological differences in the earliest stage of AD when no cognitive impairments are apparent.

目的：应用脑电图事件相关振荡（ERO）的机器学习方法来区分临床前阿尔茨海默病（AD）与年龄和性别匹配的对照组。方法：22名认知正常且淀粉样蛋白升高的临床前AD参与者和21名认知正常且无淀粉样蛋白升高的对照者完成n-back工作记忆任务（n = 0,1, 2）。使用离散小波变换在delta， theta， alpha和beta波段提取ERO的绝对和相对功率。采用了四种机器学习方法，并使用三个指标评估分类性能。结果：低频波段比高频波段具有更高的识别性能。2-back任务的分类能力最好。曲线下面积最大的是2-back δ波段非目标条件数据（0.86）。在2-back delta和theta波段非目标数据中，准确率最高（80.47%）。2-back θ波段非目标数据F1得分最高（0.82）。在测试的分类器中，支持向量机取得了最高的性能。结论：本研究证明了利用机器学习对工作记忆任务的EEG ERO检测临床前AD的前景。意义：脑电图ERO可揭示AD早期无明显认知障碍时的病理生理差异。

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引用次数: 0

Local and network changes after multichannel transcranial direct current stimulation using magnetoencephalography in patients with refractory epilepsy 顽固性癫痫患者多通道经颅直流电刺激后脑磁图的局部和网络变化。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-01 DOI: 10.1016/j.clinph.2024.12.006

Maeva Daoud , Samuel Medina Villalon , Ricardo Salvador , Maria Fratello , Khoubeib Kanzari , Francesca Pizzo , Giada Damiani , Elodie Garnier , Jean-Michel Badier , Fabrice Wendling , Giulio Ruffini , Christian Bénar , Fabrice Bartolomei

Objective

Non-invasive neuromodulation techniques, particularly transcranial direct current stimulation (tDCS), are promising for drug-resistant epilepsy (DRE), though the mechanisms of their efficacy remain unclear. This study aims to (i) investigate tDCS neurophysiological mechanisms using a personalized multichannel protocol with magnetoencephalography (MEG) and (ii) assess post-tDCS changes in brain connectivity, correlating them with clinical outcomes.

Methods

Seventeen patients with focal DRE underwent three cycles of tDCS over five days, each consisting of 40-minute stimulations targeting the epileptogenic zone (EZ) identified via stereo-EEG. MEG was performed before and after sessions to assess functional connectivity (FC) and power spectral density (PSD),estimated at source level (beamforming).

Results

Five of fourteen patients experienced a seizure frequency reduction > 50 %. Distinct PSD changes were seen across frequency bands, with reduced FC in responders and increased connectivity in non-responders (p < 0.05). No significant differences were observed between EZ network and non-involved networks. Responders also had higher baseline FC, suggesting it could predict clinical response to tDCS in DRE.

Conclusions

Personalized multichannel tDCS induces neurophysiological changes associated with seizure reduction in DRE.

Significance

These results provide valuable insights into tDCS effects on epileptic brain networks, informing future clinical applications in epilepsy treatment.

目的：非侵入性神经调节技术，特别是经颅直流电刺激（tDCS），有望治疗耐药癫痫（DRE），尽管其疗效机制尚不清楚。本研究旨在(i)利用个性化的多通道协议和脑磁图（MEG）研究tDCS的神经生理机制，（ii）评估tDCS后大脑连接的变化，并将其与临床结果联系起来。方法：17例局灶性DRE患者在5天内接受了3个tDCS周期，每个周期由40分钟的刺激组成，目标是通过立体脑电图识别的癫痫发生区（EZ）。在会话前后进行MEG，以评估功能连通性（FC）和功率谱密度（PSD），在源水平（波束形成）估计。结果：14例患者中有5例癫痫发作频率降低50%。不同频带的PSD变化明显，反应者的FC减少，无反应者的连通性增加(结论：个性化多通道tDCS诱导与DRE癫痫发作减少相关的神经生理变化。意义：这些结果为tDCS对癫痫脑网络的影响提供了有价值的见解，为未来癫痫治疗的临床应用提供了信息。

{"title":"Local and network changes after multichannel transcranial direct current stimulation using magnetoencephalography in patients with refractory epilepsy","authors":"Maeva Daoud , Samuel Medina Villalon , Ricardo Salvador , Maria Fratello , Khoubeib Kanzari , Francesca Pizzo , Giada Damiani , Elodie Garnier , Jean-Michel Badier , Fabrice Wendling , Giulio Ruffini , Christian Bénar , Fabrice Bartolomei","doi":"10.1016/j.clinph.2024.12.006","DOIUrl":"10.1016/j.clinph.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>Non-invasive neuromodulation techniques, particularly transcranial direct current stimulation (tDCS), are promising for drug-resistant epilepsy (DRE), though the mechanisms of their efficacy remain unclear. This study aims to (i) investigate tDCS neurophysiological mechanisms using a personalized multichannel protocol with magnetoencephalography (MEG) and (ii) assess post-tDCS changes in brain connectivity, correlating them with clinical outcomes.</div></div><div><h3>Methods</h3><div>Seventeen patients with focal DRE underwent three cycles of tDCS over five days, each consisting of 40-minute stimulations targeting the epileptogenic zone (EZ) identified via stereo-EEG. MEG was performed before and after sessions to assess functional connectivity (FC) and power spectral density (PSD),estimated at source level (beamforming).</div></div><div><h3>Results</h3><div>Five of fourteen patients experienced a seizure frequency reduction > 50 %. Distinct PSD changes were seen across frequency bands, with reduced FC in responders and increased connectivity in non-responders (p < 0.05). No significant differences were observed between EZ network and non-involved networks. Responders also had higher baseline FC, suggesting it could predict clinical response to tDCS in DRE.</div></div><div><h3>Conclusions</h3><div>Personalized multichannel tDCS induces neurophysiological changes associated with seizure reduction in DRE.</div></div><div><h3>Significance</h3><div>These results provide valuable insights into tDCS effects on epileptic brain networks, informing future clinical applications in epilepsy treatment.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 145-155"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of post-tetanic motor evoked potential as an augmentation technique under partial neuromuscular blockade during craniotomy 开颅术中部分神经肌肉阻断下破伤风后运动诱发电位增强技术的评价。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-01 DOI: 10.1016/j.clinph.2024.11.009

Ayako Oi , Hironobu Hayashi , Keiko Uemura , Tomoshige Miyabayashi , Tsunenori Takatani , Ryosuke Matsuda , Ryuichi Abe , Ichiro Nakagawa , Masahiko Kawaguchi

Objective

In craniotomies requiring motor evoked potential (MEP) monitoring, avoiding neuromuscular blockade (NMB) is preferable, but its complete avoidance poses risks of unexpected movement. This retrospective study investigates the application of a post-tetanic MEP augmentation technique to enhance baseline recording of transcranial stimulation MEP (Tc-MEP) under partial NMB during craniotomy.

Methods

Twenty-six patients were included. The level of partial NMB was maintained at a train-of-four ratio of approximately 40 %. Monophasic constant-current stimulation was applied on the craniotomy side with + 20 % of the threshold intensity. Post-tetanic Tc-MEP, involving tetanic stimulation of the median nerve 1 s before transcranial stimulation, was performed on patients who failed to record using conventional baseline recording.

Results

The post-tetanic Tc-MEP technique successfully improved the success rate of baseline recording from 61.5 % to 100 %. Application of post-tetanic Tc-MEP significantly increased amplitudes in both the upper (p = 0.04) and lower limbs (p < 0.01) compared to before post-tetanic Tc-MEP. No patients had unexpected movements.

Conclusions

This study indicates that post-tetanic Tc-MEP enhanced the success rate of baseline recording during craniotomy under partial NMB.

Significance

The combination of partial NMB and post-tetanic Tc-MEP could be a useful regimen for craniotomy with MEP monitoring, addressing both safety concerns and successful baseline recording.

目的：在需要运动诱发电位（MEP）监测的开颅手术中，避免神经肌肉阻滞（NMB）是可取的，但它的完全避免会带来意外运动的风险。本回顾性研究探讨了破伤风后MEP增强技术的应用，以增强部分NMB开颅术中经颅刺激MEP （Tc-MEP）的基线记录。方法：纳入26例患者。部分NMB水平维持在约40%的四列比率。在开颅侧施加+ 20%阈值强度的单相恒流刺激。破伤风后Tc-MEP，包括在经颅刺激前1 s对正中神经进行破伤风刺激，对未使用常规基线记录的患者进行记录。结果：破伤风后Tc-MEP技术成功地将基线记录成功率从61.5%提高到100%。应用破伤风后Tc-MEP可显著提高上肢和下肢振幅（p = 0.04）。结论：本研究提示破伤风后Tc-MEP可提高部分NMB下开颅时基线记录的成功率。意义：部分NMB联合破伤风后Tc-MEP可能是一种有用的治疗方案，用于MEP监测的开颅手术，既解决了安全问题，又成功记录了基线。

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引用次数: 0

Muscle ultrasound aids diagnosis in amyotrophic lateral sclerosis 肌肉超声有助于肌萎缩性脊髓侧索硬化症的诊断。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-01 DOI: 10.1016/j.clinph.2024.11.008

Andrew Hannaford , Nathan Pavey , Parvathi Menon , Mehdi A.J. van den Bos , Matthew C Kiernan , Neil Simon , Steve Vucic

Objective

There is a need for improved diagnostic tools in Amyotrophic Lateral Sclerosis (ALS). Our objective was to assess muscle ultrasound as a diagnostic tool in patients with ALS and determine a simplified screening protocol to aid implementation in clinical practice.

Methods

Ultrasound of bulbar and limb muscles was prospectively performed on all patients referred to a single centre with suspected ALS. Clinical measures of disease severity and upper motor neuron impairment were also recorded. Receiver operating characteristic (ROC) curves were calculated to assess the diagnostic utility of muscle ultrasound.

Results

94 patients initially suspected of ALS were recruited to this observational cohort study. Forty-four were subsequently diagnosed as ALS and 50 as disease mimics. ALS patients demonstrated a higher frequency and more generalised distribution of fasciculations compared to mimics. A simplified 5 muscle screening protocol exhibited an AUC of 0.94 (95 %CI 0.89–0.99) in discriminating ALS from mimics. The presence of ≥ 3 fasciculating muscles detected using this screening protocol was 89 % sensitive and 88 % specific for the diagnosis of ALS.

Conclusions

Muscle ultrasound, screening as few as 5 muscles, has diagnostic utility in ALS.

Significance

Muscle ultrasound enhances clinical diagnosis in ALS.

目的：肌萎缩侧索硬化症（ALS）需要更好的诊断工具。我们的目的是评估肌肉超声作为 ALS 患者诊断工具的作用，并确定一个简化的筛查方案，以帮助临床实践的实施：方法：对所有转诊至一家中心的疑似 ALS 患者进行球部和四肢肌肉超声检查。同时还记录了疾病严重程度和上运动神经元损伤的临床指标。通过计算接收者操作特征曲线（ROC）来评估肌肉超声的诊断效用：这项观察性队列研究共招募了 94 名初步怀疑为 ALS 的患者。结果：这项观察性队列研究共招募了 94 名初步怀疑为 ALS 的患者，其中 44 人随后被诊断为 ALS，50 人被诊断为疾病模拟者。与模拟患者相比，肌萎缩性脊髓侧索硬化症患者出现筋束的频率更高，分布更广。简化的5块肌肉筛查方案在区分肌萎缩性脊髓侧索硬化症和模拟患者方面的AUC为0.94（95 %CI 0.89-0.99）。使用该筛查方案检测到≥3块筋膜样肌肉时，诊断ALS的敏感性为89%，特异性为88%：结论：肌肉超声可筛查少至 5 块肌肉，对 ALS 具有诊断作用：意义：肌肉超声检查可提高 ALS 的临床诊断率。

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引用次数: 0

Neurophysiological assessment of cortical motor function: A direct comparison of methodologies 皮质运动功能的神经生理学评估：方法的直接比较。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-02-01 DOI: 10.1016/j.clinph.2024.12.001

Steve Vucic , Nathan Pavey , Parvathi Menon , Michael Babayev , Anna Maslyukova , Anatoliy Muraviev , Matthew C. Kiernan

Objective

Assessment of cortical function with threshold tracking transcranial magnetic stimulation (TT-TMS) has developed as a biomarker to inform disease pathophysiology, particularly in neurodegenerative disease and dementia. At present, a fully integrated testing system does not exist. To advance clinical utility, and to streamline software design to integrate with diagnostic approaches in an outpatient setting, the present series of studies assessed the effects of altering diagnostic paradigms to measure interstimulus interval (ISI) including serial ascending [T-SICIs] and parallel [T-SICIp] methodologies as measures of cortical motor function (the MagXite software).

Methods

Cortical excitability was assessed in 30 healthy controls with a figure-of-eight coil, using an integrated approach compared to previously established experimental paradigms. Motor evoked responses were recorded over the contralateral abductor pollicis brevis muscle. Short interval intracortical inhibition (SICI) was recorded with each testing paradigm and validated in a healthy control cohort.

Results

The integrated system determined a robust measure of T-SICIs between ISI 1-to-7 ms (16.6 ± 2.2 %) that was comparable to previously established testing paradigms (P = 0.34), but greater than T-SICIp (MagXite 10.7 ± 1.5 %, P = 0.016; Sydney TT-TMS 8.7 ± 1.4 %, P = 0.03). SICI peaks at ISI 1 and 2.5-to-3 ms were evident with both protocols. Significant correlations were evident between mean T-SICIs-_MagXite and T-SICIp-_MagXite (R = 0.599, P < 0.001).

Conclusion

The present series validates a fully integrated motor cortical functional assessment to provide reproducible measures of SICI, with data obtained for intracortical inhibition that is more prominent when assessed using the method of serial ascending order.

Significance

An integrated system for transcranial magnetic stimulation of the human motor system has been validated for clinical practice, suitable for the assessment of cortical function in neurological disease in an outpatient clinic setting.

目的：阈值跟踪经颅磁刺激（TT-TMS）评估皮质功能已经发展成为一种生物标志物，为疾病病理生理学提供信息，特别是在神经退行性疾病和痴呆中。目前还不存在完全集成的测试系统。为了促进临床应用，并简化软件设计以整合门诊诊断方法，本系列研究评估了改变诊断范式以测量间刺激间隔（ISI）的效果，包括连续上升[T-SICIs]和平行[T-SICIp]方法作为皮质运动功能的测量（MagXite软件）。方法：采用与先前建立的实验范式相比较的综合方法，用8字形线圈评估30名健康对照者的皮质兴奋性。运动诱发反应记录在对侧拇短外展肌。每个测试模式记录短间隔皮质内抑制（SICI），并在健康对照队列中进行验证。结果：该集成系统在ISI 1 ~ 7 ms（16.6±2.2%）之间确定了t - sici的稳健测量值，与先前建立的测试范式相当（P = 0.34），但高于T-SICIp (MagXite 10.7±1.5%,P = 0.016；悉尼TT-TMS 8.7±1.4%,P = 0.03)。两种方案在ISI 1和2.5 ~ 3 ms时都有明显的SICI峰。T-SICIs-MagXite平均值和t - sicp - magxite平均值之间存在显著相关性（R = 0.599， P）。结论：本系列研究验证了一种完全整合的运动皮质功能评估方法，提供了SICI的可重复性测量，使用序列升序方法评估时获得的皮质内抑制数据更为突出。意义：经颅磁刺激人体运动系统的集成系统已在临床实践中得到验证，适用于门诊神经系统疾病皮质功能的评估。

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引用次数: 0