Clinical Neurophysiology最新文献

英文中文

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

Clinical Neurophysiology

Pub Date : 2025-12-17 DOI: 10.1016/j.clinph.2025.2111481

Marten Nuyts , Stefanie Verstraelen , Joana Frieske , Raf Meesen , Sybren Van Hoornweder

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

Clinical Neurophysiology

Pub Date : 2025-12-17 DOI: 10.1016/j.clinph.2025.2111482

Melker Hagsäter , Jonatan Malmros , Jonas Persson , Jonas Jester-Broms , Robert Bodén

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

Clinical Neurophysiology

Pub Date : 2025-12-16 DOI: 10.1016/j.clinph.2025.2111480

Karlo J. Lizarraga , Robert Chen

引用次数: 0

Is EEG useful in predicting neurotoxicity and outcomes related to chimeric antigen receptor (CAR) T-cell therapy? 脑电图在预测嵌合抗原受体（CAR） t细胞治疗相关的神经毒性和预后方面有用吗？

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-16 DOI: 10.1016/j.clinph.2025.2111484

Brin E. Freund , Adrian Safa , Filippo Emanuele Colella , Guido Chiriboga , Toni Betiku , Andy Shar , Cornelia Drees , Jeffrey Britton , Anteneh M. Feyissa , William O. Tatum

Background

Chimeric antigen receptor (CAR) T-cell therapy revolutionized cancer treatment, though has potential for neurotoxicity (immune effector cell-associated neurotoxicity syndrome, ICANS). EEG has been proposed as a predictive and prognostic tool in ICANS.

Objective

Evaluate pre-treatment EEG, neuroimaging, and clinical features in predicting ICANS, and EEG in prognosis in ICANS.

Methods

Retrospective multicenter study involving adult patients who underwent CAR T-cell therapy at Mayo Clinic Florida, Minnesota, and Arizona between October 2019 and July 2024. Univariable, multivariable and survival analyses were performed.

Results

We included 207 patients (111 female). Pre-treatment EEG was performed in 50.2 % of patients. Multivariable analysis of EEG, imaging, and clinical data demonstrated older age (roughly 1 % increased odds per 1 year of increased age, p = 0.006) and generalized slowing on pre-treatment EEG being associated with ICANS (p = 0.021). There were no factors predictive of hospital duration or survival in ICANS using multivariable analysis. Patients with ICANS had longer hospitalization (p < 0.001) and were less likely to survive at 12- and 24-months (p = 0.001, p < 0.001 respectively).

Conclusion

ICANS is associated with longer hospitalization and worse survival. ICANS risk increases with older age. Generalized slowing on pre-treatment EEG may identify patients at risk of ICANS.

Significance

ICANS is associated with worse outcomes and may be predicted by pre-treatment EEG and older age.

背景：嵌合抗原受体（CAR） t细胞疗法彻底改变了癌症治疗，尽管它有潜在的神经毒性（免疫效应细胞相关神经毒性综合征，ICANS）。脑电图已被建议作为ICANS的预测和预后工具。目的：评价治疗前脑电图、神经影像学和临床特征对ICANS的预测价值，以及脑电图对ICANS预后的影响。方法：回顾性多中心研究，涉及2019年10月至2024年7月期间在佛罗里达州、明尼苏达州和亚利桑那州梅奥诊所接受CAR - t细胞治疗的成年患者。进行单变量、多变量和生存分析。结果：纳入207例患者，其中女性111例。50.2%的患者在治疗前进行脑电图检查。脑电图、影像学和临床数据的多变量分析表明，年龄越大（每增加1年的几率增加约1%，p = 0.006）和治疗前脑电图的普遍减慢与ICANS有关（p = 0.021）。使用多变量分析，没有预测ICANS患者住院时间或生存的因素。结论：ICANS患者住院时间较长，生存期较差。ICANS的风险随着年龄的增长而增加。治疗前脑电图的全身性减慢可以识别有ICANS风险的患者。意义：ICANS与较差的预后相关，可通过治疗前脑电图和年龄预测。

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引用次数: 0

Corticospinal excitability as distinctive neurophysiological feature of acquired glycine receptor antibody syndrome 皮质脊髓兴奋性是获得性甘氨酸受体抗体综合征的独特神经生理特征

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-14 DOI: 10.1016/j.clinph.2025.2111479

Pietro Antenucci , Lorenzo Rocchi , Emanuela Maria Raho , Michele Laudisi , Mariachiara Sensi , Maura Pugliatti , Anna Latorre , Jay Guido Capone

引用次数: 0

Brain connectivity predict surgical outcomes of low-grade epilepsy-associated neuroepithelial tumors 脑连通性预测低级别癫痫相关神经上皮肿瘤的手术结果

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-13 DOI: 10.1016/j.clinph.2025.2111478

Wenjie Ming , Yang Zheng , Qi Lian , Chunhong Shen , Yinxi Zhang , Zhongjin Wang , Shuang Wang , Fang Li , Zhe Zheng , Yu Qi , Junming Zhu , Hemmings Wu

Objective

Low-grade epilepsy-associated neuroepithelial tumors (LEATs) often cause drug-resistant epilepsy. Despite complete resection of these lesions, approximately 20% of patients continue to experience suboptimal seizure control. This study aims to investigate the predictive value of quantitative features in determining the surgical outcomes for LEAT patients.

Methods

We retrospectively analyzed 44 temporal LEAT patients who underwent gross-total lesionectomy. EEG features, including power spectral density (PSD) and weighted phase lag index (wPLI), were compared between patients with good (Engel I) and poor (Engel II-IV) outcomes. Significant EEG features were identified through these analyses. Domain Adversarial Neural Network (DANN) was employed to assess the predictive value of these features for surgical outcomes.

Results

No significant PSD differences were found, but patients with good outcomes had higher alpha-band wPLI (p = 0.008). LEATnet, predicted outcomes with an AUC of 0.81and correctly classified 8 of 11 patients in the independent validation cohort.

Conclusions

Alpha-band functional connectivity is a key predictor of surgical outcomes in LEAT patients.

Significance

EEG-based connectivity analysis may improve prognostic accuracy and aid clinical decision-making in LEAT epilepsy.

目的：低级别癫痫相关神经上皮肿瘤（LEATs）常引起耐药癫痫。尽管完全切除了这些病变，大约20%的患者仍然经历不理想的癫痫控制。本研究旨在探讨定量特征在确定LEAT患者手术结果中的预测价值。方法回顾性分析44例颞叶LEAT患者行病灶全切术。比较好（Engel I）和差（Engel II-IV）患者的EEG特征，包括功率谱密度（PSD）和加权相位滞后指数（wPLI）。通过这些分析确定了重要的脑电图特征。应用领域对抗神经网络（DANN）来评估这些特征对手术结果的预测价值。结果两组患者PSD无显著差异，但预后良好的患者α带wPLI较高（p = 0.008）。LEATnet预测结果的AUC为0.81，并在独立验证队列中正确分类了11例患者中的8例。结论alpha -band功能连通性是LEAT患者手术预后的重要预测指标。基于脑电图的连通性分析可提高LEAT癫痫的预后准确性和辅助临床决策。

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引用次数: 0

Spatial activation of motor evoked potentials depends on paired-pulse transcranial magnetic stimulation orientation and intensity 运动诱发电位的空间激活取决于对脉冲经颅磁刺激的方向和强度

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-10 DOI: 10.1016/j.clinph.2025.2111477

Shokoofeh Parvin , Joona Juurakko , Heikki Sinisalo , Giacinto L. Cerone , Alberto Botter , Risto J. Ilmoniemi , Harri Piitulainen , Victor H. Souza

Objective

To investigate how stimulus orientation, intensity, and interstimulus interval (ISI) in paired-pulse transcranial magnetic stimulation (TMS) influence the spatial activation of motor evoked potentials (MEPs) in forearm flexor muscles.

Methods

Paired-pulse paradigms were applied to the motor cortex using multi-coil TMS (mTMS) to control the stimulus parameters electronically without coil repositioning. MEP spatial activation was recorded with a high-density surface electromyography (HDsEMG) grid over the forearm muscles. Conditioning stimuli (CS) were delivered at anterior-to-medial (0°) and posterior-to-medial (90°) orientations and 70–90 % of resting motor threshold (rMT), followed by test stimuli (TS) at 0° and 110 % rMT. ISIs of 0.5 and 8 ms probed neuronal refractoriness and intracortical facilitation, respectively.

Results

MEPs were facilitated at 8-ms and suppressed at 0.5-ms ISI. At 0.5 ms, changing CS orientation from 0° to 90° reduced suppression. Increasing CS intensity shifted activation centroids medially in most cases. Centroids were more medial at 8 ms and more lateral at 0.5 ms.

Conclusions

TMS pulse orientation, intensity, and ISI systematically affect the magnitude and spatial activation of forearm muscles.

Significance

Our findings highlight the utility of mTMS–HDsEMG in probing neurophysiological mechanisms of corticomotor control with important diagnostic and therapeutic clinical implications.

目的探讨双脉冲经颅磁刺激（TMS）对前臂屈肌运动诱发电位（MEPs）空间激活的影响。方法采用多线圈经颅磁刺激（mTMS）对运动皮层进行脉冲电刺激，无需重新定位线圈即可控制刺激参数。通过前臂肌肉的高密度表面肌电图（HDsEMG）网格记录MEP空间激活。条件反射刺激（CS）在前内侧（0°）和后内侧（90°）方向和70 - 90%的静息运动阈值（rMT）上进行，然后是测试刺激（TS）在0°和110% rMT上进行。0.5和8 ms的ISIs分别探测神经元的难治性和皮质内便利化。结果meps在8 ms时促进，在0.5 ms时抑制。在0.5 ms时，将CS方向从0°改变为90°降低了抑制。在大多数情况下，CS强度的增加使激活质心向内移动。结论stms脉冲方向、强度和ISI系统地影响前臂肌肉的大小和空间激活。我们的研究结果强调了mTMS-HDsEMG在探索皮质运动控制的神经生理机制方面的应用，具有重要的诊断和治疗临床意义。

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引用次数: 0

The price of scientific regulatory misclassification: the case of non-invasive brain stimulation in Europe. 科学监管错误分类的代价：欧洲非侵入性脑刺激的案例。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-09 DOI: 10.1016/j.clinph.2025.2111473

Simone Russo

引用次数: 0

Elevated body mass index in youth is associated with neural disinhibition and internetwork functional dysconnectivity: A magnetoencephalography study 青少年身体质量指数升高与神经去抑制和网络间功能连接障碍有关：一项脑磁图研究

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-08 DOI: 10.1016/j.clinph.2025.2111476

A.C. Reichelt , E. Daskalakis , J. Cohen , K.G. Solar , M. Saberi , M. Ventresca , M. Ali , R. Zamyadi , V. Bhat , S.E. Scratch , J. Hamilton , B.T. Dunkley

Objective

The developing brain has a vulnerability to the negative impact of obesity and excessive consumption of hyperpalatable foods. Animal models suggest changes in the excitation:inhibition balance of the brain in obesogenic diets, including disinhibition and hyperexcitability, and altered connectivity between brain regions.

Methods

We investigated the neurophysiological effects of overweight and obesity in 32youth (8–19 years), using a naturalistic viewing protocol with magnetoencephalography (MEG). Subjects were recruited into two groups based on normalised / z-scored body mass index (zBMI), a < 1 SD group (n = 15) and ≥ 1 SD group (n = 17). We assessed spontaneous oscillatory activity and aperiodic components (spectral exponent and offset) and network functional connectivity.

Results

Elevated zBMI was associated with significant increases in gamma activity, as well as a reduced exponent and offset across multiple regions, which suggest changes in neural excitation and inhibition. Additionally, we observed low frequency hypoconnectivity and high frequency hyperconnectivity between multiple brain networks.

Conclusions

These findings underscore the neural impact of body composition on the developing brain, suggesting deleterious alterations in excitation and inhibition and brain networks linked with cognition and behaviour.

Significance

These alterations may contribute to the persistent behavioural rigidity and difficulties in adopting healthier eating behaviours into adulthood.

目的发育中的大脑容易受到肥胖和过度食用美味食物的负面影响。动物模型表明，在致肥性饮食中，大脑的兴奋：抑制平衡发生了变化，包括去抑制和高兴奋性，以及大脑区域之间连接的改变。方法采用自然观察脑磁图（MEG）方法，对32例8 ~ 19岁青少年超重和肥胖的神经生理影响进行研究。根据标准化/ z评分的体重指数（zBMI）将受试者分为两组，1 SD组（n = 15）和≥1 SD组（n = 17）。我们评估了自发振荡活动和非周期成分（谱指数和偏移）以及网络功能连通性。结果zBMI升高与γ活性显著升高相关，且多个区域的指数和偏移量降低，提示神经兴奋和抑制发生变化。此外，我们观察到多个大脑网络之间的低频低连通性和高频超连通性。这些发现强调了身体组成对发育中的大脑的神经影响，表明与认知和行为相关的兴奋和抑制以及大脑网络的有害改变。这些改变可能导致持续的行为僵化和成年后难以采用更健康的饮食行为。

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引用次数: 0

Cerebellar repetitive transcranial magnetic stimulation attenuates essential tremor by modulating visuomotor network connectivity 小脑重复性经颅磁刺激通过调节视运动网络连接来减弱特发性震颤

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-12-07 DOI: 10.1016/j.clinph.2025.2111472

Xue Shi , Runyang He , Lin Zhu , Nan Yan , Shaoxia Fan , Zian Pei , Xiaolin Su , Fali Li , Yumei Liu , Ge Dang , Shuhan Fan , Peng Xu , Dezhong Yao , Robert Chen , Yi Guo

Objective

To investigate the neurophysiological mechanisms underlying cerebellar repetitive transcranial magnetic stimulation (rTMS) in essential tremor (ET) using source-level electroencephalography (EEG) phase-locking value analysis.

Methods

EEG recordings and clinical assessments of ET patients (n = 20) before and after 4-week bilateral cerebellar rTMS were studied and evaluated for correlations. Brain source activities were reconstructed using standardized low-resolution brain electromagnetic tomography (LORETA). Functional connectivity and local network metrics in the alpha band (8–13 Hz) were compared with those of healthy controls (n = 20).

Results

ET patients had lower nodal efficiency in visual areas and reduced inter-regional occipital connectivity than controls. Local network metrics in the left superior occipital gyrus, left cuneus, and right fusiform gyrus negatively correlated with tremor severity and significantly improved with rTMS. Connectivity changes between the left inferior occipital gyrus (IOG) and superior parietal gyrus (SPG) and the right SPG and midcingulate cortex (MCC), strongly correlated with improvements in activities of daily living. Performance-related connectivity changes involved the left IOG-SPG, right SPG-MCC, and left middle occipital gyrus to the supplementary motor area.

Conclusions

Cerebellar rTMS may alleviate ET by reorganizing functional connectivity within the visuomotor network.

Significance

Our findings provide preliminary mechanistic insights and potential biomarkers for ET treatment, pending validation in future sham-controlled studies.

目的通过源级脑电图（EEG）锁相值分析，探讨小脑重复经颅磁刺激（rTMS）治疗特发性震颤（ET）的神经生理机制。方法对20例ET患者（n = 20）双侧小脑rTMS前后4周的seeg记录和临床评价进行研究，并评价相关性。采用标准化低分辨率脑电磁断层扫描（LORETA）重建脑源活动。将α波段（8-13 Hz）的功能连通性和局部网络指标与健康对照（n = 20）进行比较。结果与对照组相比，set组患者视觉区节效率较低，枕叶区域间连通性较差。左侧枕上回、左侧楔叶和右侧梭状回的局部网络指标与震颤严重程度呈负相关，rTMS显著改善了震颤严重程度。左侧枕下回（IOG）和顶叶上回（SPG）以及右侧SPG和中扣带皮层（MCC）之间的连通性变化与日常生活活动的改善密切相关。与表现相关的连通性变化包括左眼动脑区、右眼动脑区和左枕中回至辅助运动区。结论小脑rTMS可能通过重组视觉运动网络内的功能连接来缓解ET。我们的发现为ET治疗提供了初步的机制见解和潜在的生物标志物，有待于未来的假对照研究的验证。

{"title":"Cerebellar repetitive transcranial magnetic stimulation attenuates essential tremor by modulating visuomotor network connectivity","authors":"Xue Shi , Runyang He , Lin Zhu , Nan Yan , Shaoxia Fan , Zian Pei , Xiaolin Su , Fali Li , Yumei Liu , Ge Dang , Shuhan Fan , Peng Xu , Dezhong Yao , Robert Chen , Yi Guo","doi":"10.1016/j.clinph.2025.2111472","DOIUrl":"10.1016/j.clinph.2025.2111472","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the neurophysiological mechanisms underlying cerebellar repetitive transcranial magnetic stimulation (rTMS) in essential tremor (ET) using source-level electroencephalography (EEG) phase-locking value analysis.</div></div><div><h3>Methods</h3><div>EEG recordings and clinical assessments of ET patients (n = 20) before and after 4-week bilateral cerebellar rTMS were studied and evaluated for correlations. Brain source activities were reconstructed using standardized low-resolution brain electromagnetic tomography (LORETA). Functional connectivity and local network metrics in the alpha band (8–13 Hz) were compared with those of healthy controls (n = 20).</div></div><div><h3>Results</h3><div>ET patients had lower nodal efficiency in visual areas and reduced inter-regional occipital connectivity than controls. Local network metrics in the left superior occipital gyrus, left cuneus, and right fusiform gyrus negatively correlated with tremor severity and significantly improved with rTMS. Connectivity changes between the left inferior occipital gyrus (IOG) and superior parietal gyrus (SPG) and the right SPG and midcingulate cortex (MCC), strongly correlated with improvements in activities of daily living. Performance-related connectivity changes involved the left IOG-SPG, right SPG-MCC, and left middle occipital gyrus to the supplementary motor area.</div></div><div><h3>Conclusions</h3><div>Cerebellar rTMS may alleviate ET by reorganizing functional connectivity within the visuomotor network.</div></div><div><h3>Significance</h3><div>Our findings provide preliminary mechanistic insights and potential biomarkers for ET treatment, pending validation in future sham-controlled studies.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111472"},"PeriodicalIF":3.6,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788253","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}

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