Pub Date : 2026-01-29DOI: 10.1016/j.clinph.2026.2111517
Ru-Kai Chen , Jie Lin , Chan Zhang , Wu-Xiang Shi , Yu-Rong Li , Zhuo-Peng Hu , Wan-Jin Chen , Nai-Qing Cai
Objectives
Resting-state electroencephalogram (EEG) microstates serve as dynamic markers of intrinsic brain activity, reflecting the transient coordination of large-scale neural networks. However, their role in Wilson’s disease (WD) remains largely unexplored. This study aimed to investigate the spatio-temporal dynamics of EEG microstates in WD and explore their relationship with clinical manifestations.
Methods
Resting-state EEG data were collected from 17 patients with WD and 17 healthy controls (HCs). Microstate parameters were compared between the two groups. Four commonly recognized typical microstate classes (A-D) were calculated.
Results
Microstate analysis results revealed significant differences in the temporal parameters of microstates B, C, and D (p < 0.05) between the HCs and WD patients. Additionally, WD patients exhibited distinct microstate transition patterns (p < 0.05). In the WD cohort, the occurrence and time coverage of microstate B and the transition probability from microstate C to microstate A significantly correlated with the Unified Wilson Disease Rating Scale (UWDRS) scores. The ROC analysis further indicated good discriminative power of these microstate features for differentiating WD patients from HCs.
Conclusions
Abnormal microstate dynamics represent a key aspect of neurological impairments in WD, potentially reflecting underlying functional deficits, thereby enhancing our understanding of WD pathophysiology.
Significance
This study offers a thorough understanding of the spatiotemporal patterns of brain activity interactions in WD patients.
{"title":"Spatiotemporal abnormalities in brain networks as a signature of neurological damage in Wilson’s disease","authors":"Ru-Kai Chen , Jie Lin , Chan Zhang , Wu-Xiang Shi , Yu-Rong Li , Zhuo-Peng Hu , Wan-Jin Chen , Nai-Qing Cai","doi":"10.1016/j.clinph.2026.2111517","DOIUrl":"10.1016/j.clinph.2026.2111517","url":null,"abstract":"<div><h3>Objectives</h3><div>Resting-state electroencephalogram (EEG) microstates serve as dynamic markers of intrinsic brain activity, reflecting the transient coordination of large-scale neural networks. However, their role in Wilson’s disease (WD) remains largely unexplored. This study aimed to investigate the spatio-temporal dynamics of EEG microstates in WD and explore their relationship with clinical manifestations.</div></div><div><h3>Methods</h3><div>Resting-state EEG data were collected from 17 patients with WD and 17 healthy controls (HCs). Microstate parameters were compared between the two groups. Four commonly recognized typical microstate classes (A-D) were calculated.</div></div><div><h3>Results</h3><div>Microstate analysis results revealed significant differences in the temporal parameters of microstates B, C, and D (<em>p</em> < 0.05) between the HCs and WD patients. Additionally, WD patients exhibited distinct microstate transition patterns (<em>p</em> < 0.05). In the WD cohort, the occurrence and time coverage of microstate B and the transition probability from microstate C to microstate A significantly correlated with the Unified Wilson Disease Rating Scale (UWDRS) scores. The ROC analysis further indicated good discriminative power of these microstate features for differentiating WD patients from HCs.</div></div><div><h3>Conclusions</h3><div>Abnormal microstate dynamics represent a key aspect of neurological impairments in WD, potentially reflecting underlying functional deficits, thereby enhancing our understanding of WD pathophysiology.</div></div><div><h3>Significance</h3><div>This study offers a thorough understanding of the spatiotemporal patterns of brain activity interactions in WD patients.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111517"},"PeriodicalIF":3.6,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-25DOI: 10.1016/j.clinph.2026.2111518
Dharmendra Jakhar , Giuseppe Noce , Claudio Del Percio , Susanna Lopez , Filippo Carducci , Roberta Lizio , Mina De Bartolo , Verónica Henao Isaza , Asia Macrì , Andrea Soricelli , Marco Salvatore , Giuseppina Ciccarelli , Simona Galluccio , Angelica Di Cecca , Marco Aiello , Bahar Güntekin , Görsev Yener , Federico Massa , Dario Arnaldi , Francesco Famà , Claudio Babiloni
Objectives
This exploratory study tested the hypothesis that Huntington’s disease (HD) is characterized by distinct abnormalities in resting-state electroencephalographic (rsEEG) rhythms compared to Alzheimer’s disease (AD).
Methods
Clinical and rsEEG data were collected from 35 patients with HD, 81 patients with AD, and 102 healthy controls (HC). The rsEEG cortical source activations from 30 electrodes were estimated using eLORETA and were harmonized across clinical sites.
Results
Compared to the HC group, both the HD and AD groups showed widespread increases in rsEEG delta source activation and decreases in alpha source activation, with the HD patients exhibiting the most pronounced frontal effects. In patients with HD, those abnormal rsEEG source activations were associated with cognitive, motor, and functional deficits.
Conclusions
Patients with HD were characterized by a particular slowing of frontal rsEEG rhythms associated with clinically relevant variables.
Significance
A topographically widespread slowing of cortical oscillatory activity was observed in both HD and AD groups, with a particularly pronounced frontal effect in HD, which may predict a greater impact on the sleep–wake cycle. These observations should be considered exploratory and need validation in future studies with enhanced vigilance monitoring during longer rsEEG recordings.
{"title":"Abnormal Resting-State EEG delta and alpha rhythms in Huntington’s and Alzheimer’s Diseases: An exploratory study","authors":"Dharmendra Jakhar , Giuseppe Noce , Claudio Del Percio , Susanna Lopez , Filippo Carducci , Roberta Lizio , Mina De Bartolo , Verónica Henao Isaza , Asia Macrì , Andrea Soricelli , Marco Salvatore , Giuseppina Ciccarelli , Simona Galluccio , Angelica Di Cecca , Marco Aiello , Bahar Güntekin , Görsev Yener , Federico Massa , Dario Arnaldi , Francesco Famà , Claudio Babiloni","doi":"10.1016/j.clinph.2026.2111518","DOIUrl":"10.1016/j.clinph.2026.2111518","url":null,"abstract":"<div><h3>Objectives</h3><div>This exploratory study tested the hypothesis that Huntington’s disease (HD) is characterized by distinct abnormalities in resting-state electroencephalographic (rsEEG) rhythms compared to Alzheimer’s disease (AD).</div></div><div><h3>Methods</h3><div>Clinical and rsEEG data were collected from 35 patients with HD, 81 patients with AD, and 102 healthy controls (HC). The rsEEG cortical source activations from 30 electrodes were estimated using eLORETA and were harmonized across clinical sites.</div></div><div><h3>Results</h3><div>Compared to the HC group, both the HD and AD groups showed widespread increases in rsEEG delta source activation and decreases in alpha source activation, with the HD patients exhibiting the most pronounced frontal effects. In patients with HD, those abnormal rsEEG source activations were associated with cognitive, motor, and functional deficits.</div></div><div><h3>Conclusions</h3><div>Patients with HD were characterized by a particular slowing of frontal rsEEG rhythms associated with clinically relevant variables.</div></div><div><h3>Significance</h3><div>A topographically widespread slowing of cortical oscillatory activity was observed in both HD and AD groups, with a particularly pronounced frontal effect in HD, which may predict a greater impact on the sleep–wake cycle. These observations should be considered exploratory and need validation in future studies with enhanced vigilance monitoring during longer rsEEG recordings.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111518"},"PeriodicalIF":3.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-24DOI: 10.1016/j.clinph.2026.2111519
Guillaume Thévoz , Davide Bassi , Andrea O. Rossetti
{"title":"Relevance of EEG recording time for juvenile myoclonic epilepsy diagnosis confirmation: a reappraisal","authors":"Guillaume Thévoz , Davide Bassi , Andrea O. Rossetti","doi":"10.1016/j.clinph.2026.2111519","DOIUrl":"10.1016/j.clinph.2026.2111519","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111519"},"PeriodicalIF":3.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-17DOI: 10.1016/j.clinph.2026.2111506
Marco Sferruzzi , Lorenzo Ricci , Margherita A.G. Matarrese , Mario Tombini , Patrizia Pulitano , Francesca Izzi , Fabio Placidi , Biagio Sancetta , Vincenzo Di Lazzaro , Giovanni Assenza
Objective
This study investigates pharmaco-EEG changes induced by Lacosamide (LCM) in drug-naive people with focal epilepsy (PwE) and explores the association between quantitative EEG (qEEG) and long-term clinical outcome.
Methods
We retrospectively identified 28 PwE and 25 healthy controls (HC). PwE were classified as seizure-free (SF) or non-seizure-free (NSF) after two years of LCM. EEGs were acquired before and ∼ 6 months after LCM. Power spectral density (PSD), amplitude-envelope correlation (AEC), and graph-theoretical metrics were compared between PwE and HC. Logistic regression was employed to examine the association between long-term outcomes (two-year seizure freedom) and qEEG metrics, in combination with clinical variables (sex, aetiology, seizure type, baseline EEG).
Results
LCM did not significantly modify global-averaged qEEG metrics (p > 0.05). Theta-band PSD was higher in PwE than HC. PwE exhibited higher alpha-band betweenness centrality (BtwC) than HC only before LCM (p = 0.007). Alpha-band BtwC provided the greatest discriminative value for seizure freedom (accuracy = 0.86; area under the curve [AUC] = 0.88).
Conclusions
Although no significant differences were observed between pre- and post-LCM conditions, alpha-band BtwC showed a return toward a more physiological state after treatment, suggesting partial network normalization. Combining qEEG with clinical data improved long-term outcome discrimination, with alpha-band BtwC as the most relevant feature.
Significance
Graph-theoretical qEEG metrics offer additional insight into LCM’s neurophysiological effects in focal epilepsy.
{"title":"Lacosamide modulates alpha-band network hubness: a quantitative EEG study in drug-Naïve focal epilepsy","authors":"Marco Sferruzzi , Lorenzo Ricci , Margherita A.G. Matarrese , Mario Tombini , Patrizia Pulitano , Francesca Izzi , Fabio Placidi , Biagio Sancetta , Vincenzo Di Lazzaro , Giovanni Assenza","doi":"10.1016/j.clinph.2026.2111506","DOIUrl":"10.1016/j.clinph.2026.2111506","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates pharmaco-EEG changes induced by Lacosamide (LCM) in drug-naive people with focal epilepsy (PwE) and explores the association between quantitative EEG (qEEG) and long-term clinical outcome.</div></div><div><h3>Methods</h3><div>We retrospectively identified 28 PwE and 25 healthy controls (HC). PwE were classified as seizure-free (SF) or non-seizure-free (NSF) after two years of LCM. EEGs were acquired before and ∼ 6 months after LCM. Power spectral density (PSD), amplitude-envelope correlation (AEC), and graph-theoretical metrics were compared between PwE and HC. Logistic regression was employed to examine the association between long-term outcomes (two-year seizure freedom) and qEEG metrics, in combination with clinical variables (sex, aetiology, seizure type, baseline EEG).</div></div><div><h3>Results</h3><div>LCM did not significantly modify global-averaged qEEG metrics (p > 0.05). Theta-band PSD was higher in PwE than HC. PwE exhibited higher alpha-band betweenness centrality (BtwC) than HC only before LCM (p = 0.007). Alpha-band BtwC provided the greatest discriminative value for seizure freedom (accuracy = 0.86; area under the curve [AUC] = 0.88).</div></div><div><h3>Conclusions</h3><div>Although no significant differences were observed between pre- and post-LCM conditions, alpha-band BtwC showed a return toward a more physiological state after treatment, suggesting partial network normalization. Combining qEEG with clinical data improved long-term outcome discrimination, with alpha-band BtwC as the most relevant feature.</div></div><div><h3>Significance</h3><div>Graph-theoretical qEEG metrics offer additional insight into LCM’s neurophysiological effects in focal epilepsy.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111506"},"PeriodicalIF":3.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.clinph.2026.2111505
Aleksander Leon Lysomiski , Jan Van Dijk , Davide Giampiccolo
{"title":"Mapping direct cortical responses to their underlying cytoarchitectonics","authors":"Aleksander Leon Lysomiski , Jan Van Dijk , Davide Giampiccolo","doi":"10.1016/j.clinph.2026.2111505","DOIUrl":"10.1016/j.clinph.2026.2111505","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111505"},"PeriodicalIF":3.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-10DOI: 10.1016/j.clinph.2026.2111504
Stephanie Mellor , George C. O’Neill , Daniel Bush , Arjun Ramaswamy , Ryan C. Timms , David Doig , Tim M. Tierney , Meaghan E. Spedden , Matthew C. Walker , Gareth R. Barnes , Umesh Vivekananda
{"title":"Experiences of ictal OP-MEG","authors":"Stephanie Mellor , George C. O’Neill , Daniel Bush , Arjun Ramaswamy , Ryan C. Timms , David Doig , Tim M. Tierney , Meaghan E. Spedden , Matthew C. Walker , Gareth R. Barnes , Umesh Vivekananda","doi":"10.1016/j.clinph.2026.2111504","DOIUrl":"10.1016/j.clinph.2026.2111504","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111504"},"PeriodicalIF":3.6,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.clinph.2026.2111503
Kai-Jie Liang , Chun-Che Hung , Chia-Wen Ko , Pin-Chi Lin , Pei-Ying S Chan , Chia-Hsiung Cheng
Objective
Alterations in error-related negativity (ERN) and error positivity (Pe)—electrophysiological markers of error processing—have been frequently reported in major depressive disorder (MDD); findings, however, remain inconsistent.
Methods
Literature search was performed using Web of Science, MEDLINE/PubMed, and Scopus electronic databases. The effect sizes (Hedges’ g) in the comparisons of ERN (22 studies) and Pe (10 studies) amplitudes between MDD and healthy controls (HC) were employed by a random-effect, inverse-variance weighted model.
Results
ERN and Pe amplitudes in MDD patients were generally comparable to those of HC. Nevertheless, moderator analyses revealed specific conditions under which Pe amplitudes were reduced in MDD. Specifically, MDD patients with comorbid conditions showed diminished Pe amplitudes relative to HC (p = 0.001). Moreover, task type moderated Pe responses: studies using the Flanker task reported significantly reduced Pe amplitudes in MDD patients (p = 0.012), a pattern not observed with other paradigms. No significant moderators were identified for ERN amplitudes.
Conclusions
Comorbidity and task design, particularly the use of the Flanker task, appear to influence Pe amplitudes in patients with MDD and should be carefully considered in future research.
Significance
Our data highlight the importance of methodological factors in interpreting error processing deficits in MDD.
错误相关负性(ERN)和错误正性(Pe)——错误处理的电生理标记——的改变在重度抑郁症(MDD)中经常被报道;然而,研究结果仍然不一致。方法采用Web of Science、MEDLINE/PubMed、Scopus电子数据库进行文献检索。MDD与健康对照(HC)之间的ERN(22项研究)和Pe(10项研究)振幅比较的效应量(Hedges ' g)采用随机效应、反方差加权模型。结果重度抑郁症患者的sern和Pe波幅与HC大体相当。然而,慢剂分析揭示了MDD中Pe振幅降低的特定条件。具体而言,伴有合并症的重度抑郁症患者的Pe振幅相对于HC降低(p = 0.001)。此外,任务类型调节了Pe反应:使用Flanker任务的研究报告显著降低了重度抑郁症患者的Pe振幅(p = 0.012),这一模式在其他范式中没有观察到。没有发现显著的调节因子对ERN振幅有影响。结论合并症和任务设计,特别是Flanker任务的使用,似乎会影响重度抑郁症患者的Pe振幅,在未来的研究中应仔细考虑。我们的数据强调了方法因素在解释MDD错误处理缺陷中的重要性。
{"title":"Error processing in major depressive disorder: a systematic review and meta-analysis of event-related potential studies","authors":"Kai-Jie Liang , Chun-Che Hung , Chia-Wen Ko , Pin-Chi Lin , Pei-Ying S Chan , Chia-Hsiung Cheng","doi":"10.1016/j.clinph.2026.2111503","DOIUrl":"10.1016/j.clinph.2026.2111503","url":null,"abstract":"<div><h3>Objective</h3><div>Alterations in error-related negativity (ERN) and error positivity (Pe)—electrophysiological markers of error processing—have been frequently reported in major depressive disorder (MDD); findings, however, remain inconsistent.</div></div><div><h3>Methods</h3><div>Literature search was performed using Web of Science, MEDLINE/PubMed, and Scopus electronic databases. The effect sizes (Hedges’ g) in the comparisons of ERN (22 studies) and Pe (10 studies) amplitudes between MDD and healthy controls (HC) were employed by a random-effect, inverse-variance weighted model.</div></div><div><h3>Results</h3><div>ERN and Pe amplitudes in MDD patients were generally comparable to those of HC. Nevertheless, moderator analyses revealed specific conditions under which Pe amplitudes were reduced in MDD. Specifically, MDD patients with comorbid conditions showed diminished Pe amplitudes relative to HC (p = 0.001). Moreover, task type moderated Pe responses: studies using the Flanker task reported significantly reduced Pe amplitudes in MDD patients (p = 0.012), a pattern not observed with other paradigms. No significant moderators were identified for ERN amplitudes.</div></div><div><h3>Conclusions</h3><div>Comorbidity and task design, particularly the use of the Flanker task, appear to influence Pe amplitudes in patients with MDD and should be carefully considered in future research.</div></div><div><h3>Significance</h3><div>Our data highlight the importance of methodological factors in interpreting error processing deficits in MDD.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111503"},"PeriodicalIF":3.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.clinph.2025.2111487
Ulf Ziemann, Yang Bai, Fiona M Baumer, Mikkel M Beck, Paolo Belardinelli, Daniele Belvisi, Stephan Bender, Til Ole Bergmann, Marta Bortoletto, Silvia Casarotto, Elias Casula, Arthur R Chaves, Daniel Ciampi de Andrade, Antonella Conte, Zafiris J Daskalakis, Faranak Farzan, Fabio Ferrarelli, Paul B Fitzgerald, Pedro C Gordon, Christian Grefkes, Sylvain Harquel, Julio C Hernandez-Pavon, Aron T Hill, Kate E Hoy, Friedhelm C Hummel, Petro Julkunen, Elisa Kallioniemi, Corey J Keller, Vasilios K Kimiskidis, Melissa Kirkovski, Giacomo Koch, Giorgio Leodori, Pantelis Lioumis, Sara Määttä, Inbal Maidan, Marcello Massimini, Annerose Mengel, Johanna Metsomaa, Carlo Miniussi, Tuomas P Mutanen, Yoshihiro Noda, Recep A Ozdemir, Estelle Raffin, Lorenzo Rocchi, Nigel C Rogasch, Mario Rosanova, Emiliano Santarnecchi, Simone Sarasso, Siobhan M Schabrun, Mouhsin M Shafi, Hartwig R Siebner, Else A Tolner, Leo Tomasevic, Sara Tremblay, Caroline Tscherpel, Domenica Veniero, Viviana Versace, Daphne Voineskos, Steve Vucic, Abraham Zangen, Christoph Zrenner, Risto J Ilmoniemi
Transcranial magnetic stimulation (TMS) is a non-invasive technique to stimulate the brain, while electroencephalography (EEG) is a non-invasive technique to record its electrical activity. Their combined use (TMS-EEG) has been established only relatively recently, after successful development of TMS-compatible EEG amplifiers. TMS-EEG offers the unparalleled opportunity to directly perturb the brain with TMS and simultaneously record its response with EEG. This allows inferences on causal input-output relationships, therefore going critically beyond purely observational techniques, such as resting-state EEG or functional MRI, in the study of brain dynamics. This consensus review updates the work of Tremblay and coworkers [Clin Neurophysiol 2019; 130: 802-844]. Since then, substantial advances have been made in understanding contamination of TMS-EEG signals by physiological and non-physiological artifacts, as well as in developing strategies to avoid or control them. In parallel, new insights have emerged regarding the physiological mechanisms underlying TMS-EEG responses and their diagnostic and prognostic utility in a broad range of psychiatric and neurological disorders. As such, TMS-EEG is rapidly shaping a dynamic new field in clinical neurophysiology and neuroscience. This review provides a critical and comprehensive synthesis of current knowledge, including practical guidance for implementing TMS-EEG in the clinical setting.
{"title":"Clinical utility and prospective of TMS-EEG: Updated review from an international expert group.","authors":"Ulf Ziemann, Yang Bai, Fiona M Baumer, Mikkel M Beck, Paolo Belardinelli, Daniele Belvisi, Stephan Bender, Til Ole Bergmann, Marta Bortoletto, Silvia Casarotto, Elias Casula, Arthur R Chaves, Daniel Ciampi de Andrade, Antonella Conte, Zafiris J Daskalakis, Faranak Farzan, Fabio Ferrarelli, Paul B Fitzgerald, Pedro C Gordon, Christian Grefkes, Sylvain Harquel, Julio C Hernandez-Pavon, Aron T Hill, Kate E Hoy, Friedhelm C Hummel, Petro Julkunen, Elisa Kallioniemi, Corey J Keller, Vasilios K Kimiskidis, Melissa Kirkovski, Giacomo Koch, Giorgio Leodori, Pantelis Lioumis, Sara Määttä, Inbal Maidan, Marcello Massimini, Annerose Mengel, Johanna Metsomaa, Carlo Miniussi, Tuomas P Mutanen, Yoshihiro Noda, Recep A Ozdemir, Estelle Raffin, Lorenzo Rocchi, Nigel C Rogasch, Mario Rosanova, Emiliano Santarnecchi, Simone Sarasso, Siobhan M Schabrun, Mouhsin M Shafi, Hartwig R Siebner, Else A Tolner, Leo Tomasevic, Sara Tremblay, Caroline Tscherpel, Domenica Veniero, Viviana Versace, Daphne Voineskos, Steve Vucic, Abraham Zangen, Christoph Zrenner, Risto J Ilmoniemi","doi":"10.1016/j.clinph.2025.2111487","DOIUrl":"https://doi.org/10.1016/j.clinph.2025.2111487","url":null,"abstract":"<p><p>Transcranial magnetic stimulation (TMS) is a non-invasive technique to stimulate the brain, while electroencephalography (EEG) is a non-invasive technique to record its electrical activity. Their combined use (TMS-EEG) has been established only relatively recently, after successful development of TMS-compatible EEG amplifiers. TMS-EEG offers the unparalleled opportunity to directly perturb the brain with TMS and simultaneously record its response with EEG. This allows inferences on causal input-output relationships, therefore going critically beyond purely observational techniques, such as resting-state EEG or functional MRI, in the study of brain dynamics. This consensus review updates the work of Tremblay and coworkers [Clin Neurophysiol 2019; 130: 802-844]. Since then, substantial advances have been made in understanding contamination of TMS-EEG signals by physiological and non-physiological artifacts, as well as in developing strategies to avoid or control them. In parallel, new insights have emerged regarding the physiological mechanisms underlying TMS-EEG responses and their diagnostic and prognostic utility in a broad range of psychiatric and neurological disorders. As such, TMS-EEG is rapidly shaping a dynamic new field in clinical neurophysiology and neuroscience. This review provides a critical and comprehensive synthesis of current knowledge, including practical guidance for implementing TMS-EEG in the clinical setting.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111487"},"PeriodicalIF":3.6,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.clinph.2025.2111485
Giovanna Squintani , Marta Di Muzio , Andrea Rasera , Fabio Paio , Giovanni Umberto Borin , Kais Humaidan , Davide Orlando , Nicola Refatti , Silvia Romito , Michele Tinazzi , Bruno Bonetti , Mario Ermani
Objective
Our study evaluates sensory and motor cortical hyperexcitability as diagnostic biomarkers in ALS patients and investigates their relationship, identifying distinct or interconnected pathophysiological mechanisms in different sub-groups.
Methods
We examined 26 ALS patients and 18 healthy controls. Motor cortex excitability was assessed using transcranial magnetic stimulation to measure the motor evoked potential (MEP) suppression ratio. Somatosensory cortex excitability was evaluated through upper-limb somatosensory evoked potentials (SEPs) with conventional and paired-pulse techniques. Statistical analyses included parametric/non-parametric tests, correlation analyses, and χ2 tests. ROC analysis was used to assess diagnostic performance. Significance threshold was p < 0.05.
Results
ALS patients showed a significantly reduced MEP suppression ratio (p < 0.001) with excellent discriminative power (100 % accuracy). SEP suppression ratio was significantly lower in ALS (p < 0.001), with sensitivity 76.3 %, specificity 91.7 %, and accuracy 84 %. In patients with giant SEPs, a strong inverse correlation was observed between MEP and SEP suppression ratios (r = − 0.70, p < 0.001).
Conclusions
MEP and SEP suppression ratio are robust biomarkers of motor cortical dysfunction in ALS patients with a highlighting cortical heterogeneity between sub-groups, suggesting cortical interconnection.
Significance
Alongside confirming motor and sensory cortical hyperexcitability as ALS hallmarks, this study reveals subgroup-specific patterns suggesting a compensatory interplay between sensory and motor cortex.
{"title":"Sensory and motor cortical hyperexcitability in patients with amyotrophic lateral sclerosis: are they related? a prospective pilot study","authors":"Giovanna Squintani , Marta Di Muzio , Andrea Rasera , Fabio Paio , Giovanni Umberto Borin , Kais Humaidan , Davide Orlando , Nicola Refatti , Silvia Romito , Michele Tinazzi , Bruno Bonetti , Mario Ermani","doi":"10.1016/j.clinph.2025.2111485","DOIUrl":"10.1016/j.clinph.2025.2111485","url":null,"abstract":"<div><h3>Objective</h3><div>Our study evaluates sensory and motor cortical hyperexcitability as diagnostic biomarkers in ALS patients and investigates their relationship, identifying distinct or interconnected pathophysiological mechanisms in different sub-groups.</div></div><div><h3>Methods</h3><div>We examined 26 ALS patients and 18 healthy controls. Motor cortex excitability was assessed using transcranial magnetic stimulation to measure the motor evoked potential (MEP) suppression ratio. Somatosensory cortex excitability was evaluated through upper-limb somatosensory evoked potentials (SEPs) with conventional and paired-pulse techniques. Statistical analyses included parametric/non-parametric tests, correlation analyses, and χ<sup>2</sup> tests. ROC analysis was used to assess diagnostic performance. Significance threshold was p < 0.05.</div></div><div><h3>Results</h3><div>ALS patients showed a significantly reduced MEP suppression ratio (p < 0.001) with excellent discriminative power (100 % accuracy). SEP suppression ratio was significantly lower in ALS (p < 0.001), with sensitivity 76.3 %, specificity 91.7 %, and accuracy 84 %. In patients with giant SEPs, a strong inverse correlation was observed between MEP and SEP suppression ratios (r = − 0.70, p < 0.001).</div></div><div><h3>Conclusions</h3><div>MEP and SEP suppression ratio are robust biomarkers of motor cortical dysfunction in ALS patients with a highlighting cortical heterogeneity between sub-groups, suggesting cortical interconnection.</div></div><div><h3>Significance</h3><div>Alongside confirming motor and sensory cortical hyperexcitability as ALS hallmarks, this study reveals subgroup-specific patterns suggesting a compensatory interplay between sensory and motor cortex.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111485"},"PeriodicalIF":3.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.clinph.2026.2111502
Katsuaki Kojima , Chunyan Liu , Shelley Ehrlich , Harvey Dillon , Chelsea Blankenship , Lina Motlagh Zadeh , Jennifer Vannest , Lisa Hunter , Srikantan Nagarajan , David R. Moore
Objective
To investigate neural mechanisms underlying speech-in-speech listening in adolescents with listening difficulties (LiD).
Methods
Neural speech tracking (NST) was assessed using magnetoencephalography (MEG; 275 sensors) in 21 adolescents with LiD (11 females), identified by caregiver report, and 25 typically developing (TD) peers (10 females), all with normal audiograms and frequency-matched on age, sex, race, and ethnicity. Participants completed a cocktail-party task with target speech alone and with competing streams that varied in talker and spatial cues. NST was quantified using theta-band (4–8 Hz) inter-event phase coherence (IEPC) to acoustic edges.
Results
Adolescents with LiD showed reduced target-speech NST relative to TD peers, with comparable competitor tracking. Theta-band IEPC correlated with listening ability (partial R2 = 0.10; p = 0.037). Concurrent talker and spatial cues synergistically enhanced target-speech NST, especially in TD adolescents, but not competitor streams.
Conclusions
LiD is characterized by impaired processing of attended speech rather than enhanced competitor processing or generalized auditory disengagement. Reduced integration of talker and spatial cues in LiD may contribute to real-world listening challenges.
Significance
Theta‑band NST provides a clinically relevant neural index of everyday listening and may guide interventions targeting selective attention and cue integration.
目的探讨听力障碍青少年语中听的神经机制。方法采用脑磁图(MEG; 275个传感器)对21名青少年(11名女性)和25名正常发育(TD)同龄人(10名女性)的神经语音跟踪(NST)进行评估,这些青少年的听力图正常,年龄、性别、种族和民族的频率匹配。参与者完成了一项鸡尾酒会任务,其中有单独的目标演讲,也有在说话者和空间线索上不同的竞争流。利用theta波段(4-8 Hz)到声学边缘的事件间相位相干性(IEPC)对NST进行量化。结果在竞争对手跟踪方面,低语言障碍青少年的目标言语NST水平低于低语言障碍同龄人。θ波段IEPC与听力能力相关(偏R2 = 0.10; p = 0.037)。同时说话者和空间线索协同增强了目标言语NST,特别是在TD青少年中,但没有竞争者线索。结论滑脱的特点是参与言语加工受损,而非竞争对手加工增强或广义听觉脱离。在LiD中,说话者和空间线索的整合减少可能会导致现实听力挑战。theta - band NST提供了临床相关的日常听力神经指标,可以指导针对选择性注意和线索整合的干预措施。
{"title":"Reduced neural speech tracking in adolescents with listening difficulty","authors":"Katsuaki Kojima , Chunyan Liu , Shelley Ehrlich , Harvey Dillon , Chelsea Blankenship , Lina Motlagh Zadeh , Jennifer Vannest , Lisa Hunter , Srikantan Nagarajan , David R. Moore","doi":"10.1016/j.clinph.2026.2111502","DOIUrl":"10.1016/j.clinph.2026.2111502","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate neural mechanisms underlying speech-in-speech listening in adolescents with listening difficulties (LiD).</div></div><div><h3>Methods</h3><div>Neural speech tracking (NST) was assessed using magnetoencephalography (MEG; 275 sensors) in 21 adolescents with LiD (11 females), identified by caregiver report, and 25 typically developing (TD) peers (10 females), all with normal audiograms and frequency-matched on age, sex, race, and ethnicity. Participants completed a cocktail-party task with target speech alone and with competing streams that varied in talker and spatial cues. NST was quantified using theta-band (4–8 Hz) inter-event phase coherence (IEPC) to acoustic edges.</div></div><div><h3>Results</h3><div>Adolescents with LiD showed reduced target-speech NST relative to TD peers, with comparable competitor tracking. Theta-band IEPC correlated with listening ability (partial R<sup>2</sup> = 0.10; p = 0.037). Concurrent talker and spatial cues synergistically enhanced target-speech NST, especially in TD adolescents, but not competitor streams.</div></div><div><h3>Conclusions</h3><div>LiD is characterized by impaired processing of attended speech rather than enhanced competitor processing or generalized auditory disengagement. Reduced integration of talker and spatial cues in LiD may contribute to real-world listening challenges.</div></div><div><h3>Significance</h3><div>Theta‑band NST provides a clinically relevant neural index of everyday listening and may guide interventions targeting selective attention and cue integration.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111502"},"PeriodicalIF":3.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}