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Cortical connectivity reorganization Induced by tDCS and Robotic-Assisted gait training in individuals with spinal cord injury 脊髓损伤患者tDCS和机器人辅助步态训练诱导的皮质连通性重组
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-24 DOI: 10.1016/j.clinph.2025.2111498
Daniel Boari Coelho , Artur Cesar Aquino dos Santos , Felipe Fregni , Linamara Rizzo Battistella
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引用次数: 0
Motor evoked potentials as a side effect biomarker for deep brain stimulation 运动诱发电位作为深部脑刺激的副作用生物标志物
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-24 DOI: 10.1016/j.clinph.2025.2111499
Paola Testini , Austin Wang , Eric R. Cole , Svjetlana Miocinovic

Objectives

To determine if motor evoked potentials (MEP) – stimulation-induced muscle activation measured using electromyography – can serve as a biomarker of corticobulbar (CBT) and corticospinal (CST) tract activation induced by deep brain stimulation (DBS).

Methods

In 12 patients with Parkinson’s disease and subthalamic (n = 10) or pallidal (n = 2) DBS, contact mapping determined clinical motor side effect thresholds. For equivalent stimulation parameters (except lower frequency), EMG was recorded from cranial and arm muscles to determine the presence, peak amplitudes and latencies of MEP. Clinical side effect and MEP thresholds were compared and accuracy metrics calculated.

Results

The MEP amplitudes increased with stimulation intensity. Latencies were shorter for cranial muscles, which were also more likely to generate an MEP. Clinical side effect and MEP thresholds were significantly correlated (R2 = 0.31; p = 0.0006), although most MEP thresholds were lower than side effect thresholds. The MEP accuracy in predicting side effects was 0.72, with a sensitivity of 0.68 and a specificity of 0.73.

Conclusions

MEP thresholds correlated with side effect thresholds but were often lower indicating subclinical CBT/CST activations.

Significance

This study characterizes motor potentials evoked by DBS and demonstrates their potential utility as an objective biomarker for motor side effect detection during DBS programming.
目的确定运动诱发电位(MEP) -使用肌电图测量刺激诱导的肌肉激活-是否可以作为脑深部刺激(DBS)诱导的皮质球束(CBT)和皮质脊髓束(CST)激活的生物标志物。方法对12例伴有丘脑下丘脑DBS (n = 10)或pallial DBS (n = 2)的帕金森病患者进行接触映射,确定临床运动副作用阈值。对于等效的刺激参数(低频除外),记录颅骨和手臂肌肉的肌电图,以确定MEP的存在、峰值振幅和潜伏期。比较临床副作用和MEP阈值并计算准确性指标。结果MEP振幅随刺激强度的增大而增大。颅肌的潜伏期较短,也更容易产生MEP。临床副作用与MEP阈值显著相关(R2 = 0.31; p = 0.0006),但大多数MEP阈值低于副作用阈值。MEP预测副作用的准确度为0.72,敏感性为0.68,特异性为0.73。结论smep阈值与不良反应阈值相关,但通常较低表明亚临床CBT/CST激活。本研究表征了DBS诱发的运动电位,并证明了它们作为DBS编程过程中运动副作用检测的客观生物标志物的潜在用途。
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引用次数: 0
Optimization of memory neurofeedback system utilizing intracranial electroencephalogram of the hippocampus 利用颅内海马脑电图优化记忆神经反馈系统
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-22 DOI: 10.1016/j.clinph.2025.2111490
Ako Matsuhashi , Seijiro Shimada , Naoto Kunii , Takeshi Matsuo , Anna Takeda , Toshiya Aono , Shigeta Fujitani , Keisuke Nagata , Makoto Sato , Yohei Ishishita , Kenji Ibayashi , Keisuke Ohtani , Yoshiyuki Onuki , Kensuke Kawai , Nobuhito Saito

Objective

Patients with temporal lobe epilepsy (TLE) suffer from epileptic seizures and memory decline. While focal resection eliminates seizures in 60–70% of patients, surgery carries the risk of further compromising memory. We hypothesized that hippocampal neurofeedback (NF) will induce targeted brain activity associated with memory function.

Methods

Patients with intracranial electrodes implanted in bilateral hippocampi performed a memory NF task, developed specifically for this project. The NF task involved real-time analysis of hippocampal activity using the electrode in the less-affected hippocampus while conducting a memory task. Changes in theta activity and task performance were assessed.

Results

The NF task was conducted in seven TLE patients. In five patients, theta activity increased significantly in the targeted hippocampus (Mann-Kendall test; p < 0.05). Mixed linear model analysis across all sessions revealed a significant increase in theta activity in the targeted hippocampus (p = 0.0032), with no significant change contralaterally (p = 0.19). Three additional TLE patients underwent random NF to assess if theta activity was induced merely by the encoding process, but none of them showed significant changes in theta activity.

Conclusion

Memory NF task effectively induced targeted hippocampal activity in TLE patients.

Significance

Hippocampal NF may enhance memory function in TLE patients prior to focal resection.
目的颞叶癫痫(TLE)患者以癫痫发作和记忆减退为主。虽然局灶性切除可消除60-70%患者的癫痫发作,但手术有进一步损害记忆的风险。我们假设海马神经反馈(NF)将诱导与记忆功能相关的目标脑活动。方法在双侧海马体植入脑内电极的患者执行专门为该项目开发的记忆NF任务。NF任务包括在执行记忆任务时,利用电极在受影响较小的海马体上实时分析海马体活动。评估θ波活动和任务表现的变化。结果7例TLE患者均完成了NF任务。在5例患者中,靶海马区θ活动显著增加(Mann-Kendall检验;p < 0.05)。所有疗程的混合线性模型分析显示,靶海马的θ活动显著增加(p = 0.0032),而对侧无显著变化(p = 0.19)。另外三名TLE患者接受了随机NF试验,以评估θ活动是否仅仅由编码过程引起,但没有人显示出θ活动的显著变化。结论记忆NF任务可有效诱导TLE患者海马靶向活动。意义海马NF可增强TLE患者局灶性切除前的记忆功能。
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引用次数: 0
Artifactual signal detection using intraoperative electrocorticographic devices during functional brain mapping of brain tumors 术中脑皮质电成像设备在脑肿瘤功能成像中的人工信号检测。
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-22 DOI: 10.1016/j.clinph.2025.2111489
William O. Tatum , Adrian Safa , Filippo Colella , Erik H. Middlebrooks , Anteneh M. Feyissa , Aafreen Khan , David Sabsevitz , Alicia Kissinger-Knox , Phillip Gauthier , Dawn Radford , Anahita Jafari , Marco Failla Mulone , Sanjeet Grewal , Rich Byrne , Kaisorn Chaichana , Alfredo Quinones-Hinojosa , Brin Freund

Objective

To compare the signal detection performance of a circular grid versus a strip electrode during intraoperative electrocorticography (iECoG) for Functional Brain Mapping (FBM).

Methods

We performed a single center retrospective evaluation of signal detection by recording intraoperative ECoG comparing two intraoperative recording devices and techniques during awake craniotomy for FBM. A circular grid and linear strip evaluated stimulation artifact, afterdischarges (ADs), and epileptiform activity.

Results

142 patients underwent awake craniotomy, and 26 (18.3 %) had reoperations with repeat iECoG performed during their subsequent procedure. A total of 71 patients underwent iECoG using circular grids and 71 with linear strip electrodes. Max and min Signal amplitudes were higher with the circular grid (p < 0.01). The minimum (2.3 vs. 2.8 mA) and maximum (4.9 vs. 6.3 mA) currents required to evoke visible stimulation artifact were lower with the circular grid (p < 0.01), suggesting increased sensitivity to stimulation-related signals. Physiological signals represented by ADs were detected in 59.2 % of circular-grid patients vs 40.8 % of strip-electrode patients (Fisher’s exact p = 0.044). When adjusting for stimulation trials in a Negative Binomial model with an offset, AD rates per stimulation were 2.5 × higher with circular grids (rate ratio 2.51; 95 % CI 1.61–3.91; p < 0.0001). Total stimulation counts were 2,786 (circular) and 2,209 (strip). Notably, the circular grid also involved more electrodes (5.06 vs. 0.95, p < 0.001).

Conclusions

High-density circular grids enhance intraoperative detection of artifacts and ADs with lower stimulus currents.

Significance

The high-density circular grid offered more interpretable contacts and higher sensitivity.
目的:比较术中皮质电图(iECoG)功能脑图(FBM)中圆形网格电极和带状电极的信号检测性能。方法:我们通过记录术中ECoG对FBM清醒开颅术中两种记录设备和技术的信号检测进行了单中心回顾性评估。圆形网格和线性条带评估刺激伪影、后放电(ADs)和癫痫样活动。结果:142例患者行清醒开颅手术,26例(18.3%)患者在后续手术中再次行iECoG检查。共有71例患者使用圆形栅极进行iECoG, 71例使用线性条形电极。结论:高密度圆形网格能增强术中低电流刺激下伪影和ad的检测。意义:高密度圆形网格提供了更多的可解释触点和更高的灵敏度。
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引用次数: 0
Influence of myelo-architectures on direct cortical response evoked by electrical stimulation. 髓细胞结构对电刺激引起的直接皮层反应的影响。
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-20 DOI: 10.1016/j.clinph.2025.2111488
Clotilde Turpin, Olivier Rossel, Félix Schlosser-Perrin, Riki Matsumoto, Emmanuel Mandonnet, Sam Ng, Hugues Duffau, François Bonnetblanc

Objectives: Cyto-myelo architecture vary across brain regions, particularly between primary areas (motor M1, sensory S1), the premotor cortex and the more associative areas such as the Broca, Wernicke, and other association areas. Due to the specific characteristics of electrical stimulation, these architectural variations should be reflected in cortical responses evoked by direct electrical stimulation (DES). We sought to test this hypothesis.

Methods: DES was administered directly to different regions of the cortex while recording DCRs (direct cortical responses) in 10 patients. The shapes of the first components P0 and N1 of the signals were analyzed.

Results: The downward slope of the first component (P0) of the signal is statistically greater for responses recorded in precentral motor cortex and S1 than that of EPs recorded in more associative areas.

Conclusions: Precentral motor cortex and S1 are distinguished by the presence of larger diameter, heavily myelinated fibers. These anatomical features explain the response and the increased slope of the P0 component in these regions, compared to associative areas.

Significance: The first component of DES-evoked responses reflects myelo architecture in particular. This could form the basis of an electrodiagnostic method using the evoked response.

目的:细胞-髓细胞结构在不同的大脑区域不同,特别是在主要区域(运动M1,感觉S1),运动前皮层和更多的关联区域(如Broca, Wernicke和其他关联区域)之间。由于电刺激的特殊性,这些结构变化应该反映在直接电刺激(DES)引起的皮层反应中。我们试图验证这一假设。方法:对10例患者的不同皮质区直接给予DES,同时记录DCRs(皮质直接反应)。分析了信号的第一分量P0和N1的形状。结果:在中央前运动皮层和S1记录的反应中,信号第一分量(P0)的下降斜率在统计学上大于在更多相关区域记录的EPs。结论:中央前运动皮层和S1以直径较大、有髓鞘纤维较多为特征。这些解剖特征解释了与相关区域相比,这些区域P0分量的反应和斜率增加。意义:des诱发反应的第一个组成部分特别反映了骨髓结构。这可以形成使用诱发反应的电诊断方法的基础。
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引用次数: 0
Repetitive wide-band cortical power in benign adult familial myoclonus epilepsy 良性成人家族性肌阵挛性癫痫的重复宽带皮质功率
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-19 DOI: 10.1016/j.clinph.2025.2111486
Haruo Yamanaka , Katsuya Kobayashi , Takefumi Hitomi , Maya Tojima , Masao Matsuhashi , Kiyohide Usami , Ryosuke Takahashi , Akio Ikeda

Background

Cortical tremor (CT), a rhythmic variant of cortical myoclonus (CM), is the hallmark of benign adult familial myoclonus epilepsy (BAFME), though the underlying mechanism of rhythmicity remains unproven. This study aimed to reveal the cortical rhythmic activity of CT using induced activity analysis for somatosensory evoked potentials (SEP).

Methods

We investigated 46 SEP datasets from 23 patients (11 with BAFME, 12 with other CM) and 35 SEPs from 18 healthy controls. SEPs were recorded by 1.1-Hz stimuli at a sampling rate of 10,000 Hz. A short-time Fourier transform was applied to each SEP epoch, and the power spectrums were averaged. We set an analysis window of 0–150 ms and a frequency range of 0–1,000 Hz for time–frequency representation and compared the induced power changes between groups.

Results

Stimulus-induced power changes over a wide-band (0–1000 Hz) were conspicuously prominent in BAFME patients compared to both CM and controls. These activities presented repetitive and alternating increases and decreases in power and its total number of induced activities were the highest in age 40s and declined with aging.

Conclusions

We demonstrated rhythmic cortical activity in BAFME patients, which may reflect the underlying pathophysiology of CT.

Significance

Detecting the induced activity of a single somatosensory stimulus may offer novel insights into the pathophysiology of BAFME.
背景皮质震颤(CT)是皮质肌阵挛(CM)的一种节律变体,是良性成人家族性肌阵挛性癫痫(BAFME)的标志,尽管节律性的潜在机制尚未得到证实。本研究旨在利用体感诱发电位(SEP)的诱发活动分析来揭示CT皮层的节律性活动。方法对23例BAFME患者(11例BAFME, 12例其他CM)的46个SEP数据集和18例健康对照的35个SEP数据集进行分析。在1.1 Hz的刺激下,以10,000 Hz的采样率记录sep。对每个SEP历元进行短时傅里叶变换,对功率谱进行平均。我们设置了0-150 ms的分析窗口和0-1,000 Hz的频率范围来表示时间-频率,并比较了组间诱导功率的变化。结果与CM和对照组相比,BAFME患者在宽频带(0-1000 Hz)上刺激引起的功率变化明显突出。这些活动的强度呈反复、交替的增减趋势,诱导活动总数在40岁时最高,随年龄增长而下降。结论BAFME患者有节律性皮层活动,这可能反映了CT的潜在病理生理。意义检测单个体感刺激的诱导活性可能为BAFME的病理生理学提供新的见解。
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引用次数: 0
Revisiting the accuracy of motor evoked potential determination: The overlooked role of surface electrode montage 重新审视运动诱发电位测定的准确性:表面电极蒙太奇被忽视的作用
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-17 DOI: 10.1016/j.clinph.2025.2111483
Marco Antonio Cavalcanti Garcia , Anaelli Aparecida Nogueira-Campos
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引用次数: 0
Reply to “Revisiting the accuracy of motor evoked potential determination: The overlooked role of surface electrode montage” 回复“重新审视运动诱发电位测定的准确性:表面电极蒙太奇被忽视的作用”。
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-17 DOI: 10.1016/j.clinph.2025.2111481
Marten Nuyts , Stefanie Verstraelen , Joana Frieske , Raf Meesen , Sybren Van Hoornweder
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引用次数: 0
The integrity of double-blinding of continuous theta-burst stimulation targeting the supplementary motor area in a within-subjects design 以辅助运动区域为目标的连续脉冲刺激双盲实验的完整性。
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-17 DOI: 10.1016/j.clinph.2025.2111482
Melker Hagsäter , Jonatan Malmros , Jonas Persson , Jonas Jester-Broms , Robert Bodén
{"title":"The integrity of double-blinding of continuous theta-burst stimulation targeting the supplementary motor area in a within-subjects design","authors":"Melker Hagsäter ,&nbsp;Jonatan Malmros ,&nbsp;Jonas Persson ,&nbsp;Jonas Jester-Broms ,&nbsp;Robert Bodén","doi":"10.1016/j.clinph.2025.2111482","DOIUrl":"10.1016/j.clinph.2025.2111482","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111482"},"PeriodicalIF":3.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827109","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}
引用次数: 0
Clinical neurophysiology in movement disorders: toward integration into systems-based practice 运动障碍的临床神经生理学:迈向系统实践的整合。
IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-16 DOI: 10.1016/j.clinph.2025.2111480
Karlo J. Lizarraga , Robert Chen
{"title":"Clinical neurophysiology in movement disorders: toward integration into systems-based practice","authors":"Karlo J. Lizarraga ,&nbsp;Robert Chen","doi":"10.1016/j.clinph.2025.2111480","DOIUrl":"10.1016/j.clinph.2025.2111480","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111480"},"PeriodicalIF":3.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780522","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}
引用次数: 0
期刊
Clinical Neurophysiology
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