Clinical Neurophysiology最新文献_第4页

Intra-epidermal electrically evoked potentials are sensitive to detect degenerative cervical myelopathy suggesting their spinothalamic propagation 表皮内电诱发电位能敏感地检测出退行性颈椎病，这表明它们是通过脊髓传播的。

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-19 DOI: 10.1016/j.clinph.2024.09.015

Objective

Degenerative cervical myelopathy (DCM) is a centromedullary spinal cord disorder mainly affecting crossing fibers. While contact heat evoked potentials (CHEPs) are sensitive in detecting DCM by testing spinothalamic integrity, somatosensory evoked potentials (dSSEPs) show unaffected dorsal column conduction. Intra-epidermal electrically evoked potentials (IEEPs) have unknown spinal propagation after noxious stimulation. We investigated (1) the spinothalamic tract propagation and (2) the discriminative power in detecting spinal pathology of IEEPs compared to CHEPs and dSSEPs in DCM.

Methods

DCM was diagnosed by neurological examination regarding stenosis (MRI). Stimulation of C6, C8, and T4 dermatomes yielded dSSEPs, CHEPs, and IEEPs. (1) Spinal propagation was assessed through concordant or discordant responses, and (2) discriminative power was determined using receiver operating characteristic curves (ROC).

Results

Twenty-seven patients (8F, 56 ± 12yrs) with DCM were analyzed and compared to age-matched healthy controls. IEEPs were abnormal in 43–54%, CHEPs in 37–69%, and dSSEPs in 4–12%. IEEPs showed high concordance with abnormalities of CHEPs (62–69%). ROC analyses showed good discriminative power of CHEPs and IEEPs contrary to dSSEPs.

Conclusions

The concordance of abnormal responses of CHEPs and IEEPs contrary to dSSEPs suggests spinothalamic propagation of IEEPs.

Significance

Minimal differences between CHEPs and IEEPs suggest complementary potential by the combined testing of spinothalamic tract integrity.

目的：退行性颈椎脊髓病（DCM）是一种主要影响交叉纤维的脊髓中央型疾病。接触热诱发电位（CHEPs）可通过检测脊髓的完整性灵敏地检测出 DCM，而体感诱发电位（dSSEPs）则显示背柱传导未受影响。表皮内电诱发电位（IEEPs）在受到有害刺激后的脊髓传播情况不明。我们研究了(1)脊束传播和(2)与CHEPs和dSSEPs相比，IEEPs在检测DCM脊柱病变方面的鉴别力：通过神经系统检查和核磁共振成像（MRI）诊断 DCM。刺激 C6、C8 和 T4 皮节可产生 dSSEPs、CHEPs 和 IEEPs。(1)通过一致或不一致的反应评估脊髓传播，(2)使用接收器操作特征曲线（ROC）确定鉴别力：对 27 名 DCM 患者（8 名女性，56 ± 12 岁）进行了分析，并与年龄匹配的健康对照组进行了比较。43-54%的患者 IEEPs 异常，37-69%的患者 CHEPs 异常，4-12%的患者 dSSEPs 异常。IEEPs与CHEPs异常的一致性很高（62-69%）。ROC分析表明，CHEPs和IEEPs与dSSEPs相比具有良好的鉴别力：结论：与 dSSEPs 相反，CHEPs 和 IEEPs 的异常反应一致，这表明 IEEPs 是由脊髓传播的：意义：CHEPs 和 IEEPs 之间的微小差异表明，通过对脊束完整性的联合检测，两者具有互补潜力。

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引用次数: 0

The recovery cycle of excitability assessed by a conventional electrodiagnostic machine: A study in healthy volunteers and in Charcot-Marie-Tooth 1A patients 传统电诊断仪评估的兴奋恢复周期：对健康志愿者和 1A 型夏科-玛丽-牙病患者的研究

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-18 DOI: 10.1016/j.clinph.2024.09.009

Objective

To validate the ‘paired pulses’ technique with a conventional electrodiagnostic machine (CEM) for studying the axonal excitability recovery cycle (ERC).

Methods

Paired pulses, with a variable inter-stimulus interval, were delivered at the wrist along the median nerve. The CEM repeatability was verified in a group of 15 healthy volunteers (test/retest analysis). ERC was then applied in 40 healthy volunteers and 10 patients with Charcot-Marie-Tooth type 1A (CMT1A), using both the threshold tracking (TT) reference method and CEM (basal condition, during and after ischemia).

Results

CEM parameters evaluating absolute refractory and supernormal periods were reproducible (interclass correlation coefficient > 0.75). CEM results were consistent with TT method and literature data. In CMT1A, refractory and superexcitable periods were significantly reduced. According to receiving operator characteristic analysis, the CEM supernormal period area was the most relevant parameter for discriminating CMT1A from healthy volunteers (area under the curve = 0.98).

Conclusions

CEM was a valid procedure for studying ERC. CMT1A patients exhibited ERC alterations due to modifications in passive membrane properties and of nodal ion channel distribution resulting from demyelination.

Significance

Studying ERC with CEM could be performed in routine practice in patients with peripheral neuropathies to provide information on motor axonal excitability.

目的验证 "成对脉冲 "技术与传统电诊断仪（CEM）在研究轴突兴奋性恢复周期（ERC）方面的效果。方法在腕部沿正中神经发出刺激间隔可变的成对脉冲。在 15 名健康志愿者中验证了 CEM 的可重复性（测试/重测分析）。然后在 40 名健康志愿者和 10 名 Charcot-Marie-Tooth 1A 型（CMT1A）患者中使用阈值跟踪（TT）参考方法和 CEM（基础状态、缺血期间和缺血后）进行了 ERC。CEM 结果与 TT 方法和文献数据一致。在 CMT1A 中，不应期和超常期明显缩短。根据接收操作者特征分析，CEM 超常期面积是区分 CMT1A 和健康志愿者的最相关参数（曲线下面积 = 0.98）。CEM是研究ERC的有效方法。CMT1A患者表现出的ERC改变是由于脱髓鞘引起的被动膜特性和结节离子通道分布的改变。

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引用次数: 0

Breakdown of TMS evoked EEG signal propagation within the default mode network in Alzheimer’s disease 阿尔茨海默氏症患者默认模式网络内的 TMS 诱发脑电信号传播断裂

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-17 DOI: 10.1016/j.clinph.2024.09.007

Background

The neural activity of the Default Mode Network (DMN) is disrupted in patients with In Alzheimer’s disease (AD).

Objectives

We used a novel multimodal approach to track neural signal propagation within the DMN in AD patients.

Methods

Twenty mild to moderate AD patients were recruited. We used transcranial magnetic stimulation (TMS) pulses to probe with a millisecond time resolution the propagation of evoked electroencephalography (EEG) signal following the neural activation of the Precuneus (PC), which is a key hub area of the DMN. Moreover, functional and structural magnetic resonance imaging (MRI) data were collected to reconstruct individual features of the DMN.

Results

In AD patients a probe TMS pulse applied over the PC evokes an increased local activity unmasking underlying hyperexcitability. In contrast, the EEG evoked neural signal did not propagate efficiently within the DMN showing a remarkable breakdown of signal propagation. fMRI and structural tractography showed that impaired signal propagation was related to the same connectivity matrices derived from DMN BOLD signal and transferred by specific white matter bundles forming the cingulum. These features were not detectable stimulating other areas (left dorsolateral prefrontal cortex) or for different networks (fronto-parietal network). Finally, connectivity breakdown was associated with cognitive impairment, as measured with the Clinical Dementia Rating Scale sum of boxes (CDR-SB).

Conclusions

TMS-EEG in AD shows both local hyperexcitability and a lack of signal propagation within the DMN. These neurophysiological features also correlate with structural and cognitive attributes of the patients.

Significance

Neuronavigated TMS-EEG may be used as a novel neurophysiological biomarker of DMN connectivity in AD patients.

背景阿尔茨海默病（AD）患者的默认模式网络（DMN）的神经活动受到破坏。我们使用经颅磁刺激（TMS）脉冲，以毫秒级的时间分辨率探测楔前肌（PC）神经激活后诱发脑电图（EEG）信号的传播。此外，还收集了功能性和结构性磁共振成像（MRI）数据，以重建 DMN 的各个特征。与此相反，EEG诱发的神经信号在DMN内传播效率不高，显示出信号传播的显著衰减。fMRI和结构束学显示，信号传播受损与从DMN BOLD信号中得出的相同连接矩阵有关，并通过特定的白质束形成的扣带回转移。这些特征在刺激其他区域（左侧背外侧前额叶皮层）或不同网络（前顶叶网络）时无法检测到。结论TMS-EEG在AD中显示出局部过度兴奋和信号在DMN内传播的缺乏。这些神经生理学特征还与患者的结构和认知属性相关。意义神经元导航的 TMS-EEG 可作为一种新型的神经生理学生物标志物，用于检测 AD 患者 DMN 的连接性。

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引用次数: 0

Using deep learning and pretreatment EEG to predict response to sertraline, bupropion, and placebo 利用深度学习和治疗前脑电图预测对舍曲林、安非他明和安慰剂的反应

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-17 DOI: 10.1016/j.clinph.2024.09.002

Objective

Predicting an individual’s response to antidepressant medication remains one of the most challenging tasks in the treatment of major depressive disorder (MDD). Our objective was to use the large EMBARC study database to develop an electroencephalography (EEG)-based method to predict response to antidepressant treatment.

Methods

Pre-treatment EEG data were collected from study participants treated with either sertraline (N = 105), placebo (N = 119), or bupropion (N = 35). After preprocessing, the robust exact low-resolution electromagnetic tomography (ReLORETA) brain source localization method was used to reconstruct the source signals in 54 brain regions. Connectivity between regions was determined using symbolic transfer entropy (STE). A convolutional neural network (CNN) classified participants as responders or non-responders to each treatment.

Results

Classification accuracy was 91.0%, 95.4%, and 86.8% for sertraline, placebo, and bupropion, respectively. The most highly predictive features were connectivity between i) the anterior cingulate cortex and superior parietal lobule (alpha frequency), ii) the anterior cingulate cortex and orbitofrontal area (beta frequency), and iii) the orbitofrontal area and anterior cingulate cortex (gamma frequency).

Conclusion

CNN analysis of EEG connectivity may accurately predict response to sertraline, bupropion, and placebo.

Significance

The suggested method may offer clinicians an accessible and cost-effective tool for speedy treatment and helps pharmaceutical firms to test new antidepressants efficiently.

目标预测个体对抗抑郁药物的反应仍然是重度抑郁症（MDD）治疗中最具挑战性的任务之一。我们的目标是利用大型 EMBARC 研究数据库，开发一种基于脑电图（EEG）的方法来预测对抗抑郁治疗的反应。经过预处理后，使用鲁棒精确低分辨率电磁断层扫描（ReLORETA）脑源定位方法重建了 54 个脑区的脑源信号。利用符号转移熵（STE）确定区域之间的连接性。结果舍曲林、安慰剂和安非他酮的分类准确率分别为 91.0%、95.4% 和 86.8%。最具预测性的特征是 i）前扣带回皮层和上顶叶（α频率）之间的连接性；ii）前扣带回皮层和眶额区（β频率）之间的连接性；iii）眶额区和前扣带回皮层（γ频率）之间的连接性。意义所建议的方法可为临床医生提供一种方便且经济有效的快速治疗工具，并有助于制药公司高效地测试新的抗抑郁药物。

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引用次数: 0

Disconnection of alpha oscillations within default mode network associated with memory dysfunction in amnestic MCI 与失忆性 MCI 患者记忆功能障碍有关的默认模式网络中的α振荡断裂

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-17 DOI: 10.1016/j.clinph.2024.09.010

Objective

Episodic memory dysfunction and alterations of functional connectivity (FC) in default mode network (DMN) were found in patients with amnestic mild cognitive impairment (aMCI). However, previous studies were limited in probing certain oscillations within the DMN. This study employed measures of resting-state FC across various oscillations within the DMN to comprehensively examine the FC and its association with episodic memory performance in aMCI.

Methods

Twenty-six healthy controls (HC) and 30 patients with aMCI were recruited to perform resting-state magnetoencephalographic recordings. We compared the spectral powers and peak frequency values in each frequency band and FC within the DMN between these two groups. The associations of FC values with memory performance were also examined.

Results

No significant between-group differences in spectral powers and peak frequency values were observed in the regional nodes. Patients with aMCI exhibited diminished alpha-band FC as compared to HC. Furthermore, lower alpha-band FC between the medial temporal cortex - and the posterior cingulate cortex/precuneus was correlated with poorer memory performance.

Conclusions

Aberrant DMN connectivity, particularly in the alpha frequency range, might be a neural correlate of episodic memory impairment.

Significance

Our results inform the potential development of brain stimulation in managing memory impairments in aMCI.

目的在失忆性轻度认知障碍（aMCI）患者中发现了外显记忆功能障碍和默认模式网络（DMN）功能连接（FC）的改变。然而，以往的研究在探究默认模式网络内的某些振荡时受到了限制。本研究采用静息态FC对DMN内的各种振荡进行测量，以全面研究AMCI患者的FC及其与外显记忆表现的关系：我们招募了26名健康对照组（HC）和30名aMCI患者进行静息态脑磁图记录。我们比较了这两组患者的频谱功率、各频段的峰值频率值以及 DMN 内的 FC 值。我们还研究了FC值与记忆表现的关联：结果：在区域节点中，没有观察到组间频谱功率和峰值频率值的明显差异。与 HC 相比，aMCI 患者的 alpha 波段 FC 值降低。此外，颞叶内侧皮层与扣带后皮层/楔回之间较低的α波段FC与较差的记忆表现相关：结论：DMN连接性异常，尤其是α频率范围内的连接性异常，可能是外显记忆障碍的神经相关因素：重要意义：我们的研究结果为开发脑刺激疗法治疗 aMCI 患者记忆障碍提供了参考。

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引用次数: 0

Early maturation of neural auditory novelty detection − Typical development with no major effects of dyslexia risk or music intervention 神经听觉新奇感检测的早期成熟--典型的发展，没有阅读障碍风险或音乐干预的重大影响

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-14 DOI: 10.1016/j.clinph.2024.09.005

Objective

To determine the early development of novelty detection and the effect of familial dyslexia risk and infant music intervention on this development.

Methods

In the longitudinal DyslexiaBaby study, we investigated the maturation of novelty-P3 and late-discriminative negativity (LDN) event-related potentials to novel sounds at birth (N = 177) and at the ages of 6 (N = 83) and 28 months (N = 131).

Results

Novelty-P3 was elicited at all ages, whereas LDN was elicited at 6 and 28 months. Novelty-P3 amplitude was largest at 6 months, and its latency decreased with age. LDN amplitude decreased and latency increased between 6 to 28 months. Dyslexia risk or intervention had no effects, apart from a longer LDN latency in the high-risk than no-risk group.

Conclusions

Already neonates respond to novel environmental sounds, indicating prerequisites for detecting potentially relevant events at birth. Maturation influences neural novelty detection.

Significance

Novelty detection is crucial for perceiving important events, but its early development has been scarcely studied. We found, with a large sample, that neonates detect novel events, and showed the developmental pattern of its neural signature. The results serve as a reference for studies on typical and atypical novelty-detection development in infancy when behavioral testing is challenging.

方法在 "阅读障碍婴儿 "纵向研究中，我们调查了婴儿出生时（177 人）、6 个月时（83 人）和 28 个月时（131 人）对新奇声音的新奇-P3 和晚期鉴别性否定（LDN）事件相关电位的成熟情况。新奇-P3 振幅在 6 个月时最大，其潜伏期随年龄增长而缩短。在 6 到 28 个月期间，LDN 振幅减小，潜伏期增加。除了高风险组的LDN潜伏期长于无风险组之外，阅读障碍风险或干预没有影响。意义新颖性检测对感知重要事件至关重要，但对其早期发展的研究却很少。我们在一个大样本中发现，新生儿能检测到新奇事件，并显示了其神经特征的发育模式。在行为测试具有挑战性的情况下，这些结果可作为婴儿期典型和非典型新奇事物检测发展研究的参考。

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引用次数: 0

Normative atlases of high-frequency oscillation and spike rates under Sevoflurane anesthesia 七氟醚麻醉下的高频振荡和尖峰率标准图谱

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-13 DOI: 10.1016/j.clinph.2024.09.004

Objective

We analyzed the dose-dependent effects of Sevoflurane anesthesia on high-frequency oscillations (HFOs) and spike discharges at non-epileptic sites and evaluated their effectiveness in identifying the epileptogenic zone.

Methods

We studied 21 children with drug-resistant focal epilepsy who achieved seizure control after focal resective surgery. Open-source detectors quantified HFO and spike rates during extraoperative and intraoperative intracranial EEG recordings performed before resection. We determined under which anesthetic conditions HFO and spike rates differentiated the seizure onset zone (SOZ) within the resected area from non-epileptic sites.

Results

We analyzed 925 artifact-free electrodes, including 867 at non-epileptic sites and 58 at SOZ sites. Higher Sevoflurane doses significantly increased HFO and spike rates at non-epileptic sites, exhibiting spatial variability among different detectors. These biomarkers were elevated in the SOZ more than in non-epileptic sites under 2–4 vol% Sevoflurane anesthesia, with Cohen’s d effect sizes above 3.0 and Mann-Whitney U-Test r effect sizes above 0.5.

Conclusions

We provided normative atlases of HFO and spike rates under different Sevoflurane anesthesia conditions. Sevoflurane elevates HFO and spike rates preferentially in the epileptogenic zone.

Significance

Assessing the relative severity of biomarker levels across sites may be relevant for localizing the epileptogenic zone under Sevoflurane anesthesia.

目的我们分析了七氟醚麻醉对非癫痫部位高频振荡（HFOs）和尖峰放电的剂量依赖性影响，并评估了它们在确定致痫区方面的有效性。方法我们研究了21名患有耐药性局灶性癫痫的患儿，他们在接受局灶性切除手术后癫痫得到了控制。在切除手术前进行的术外和术中颅内脑电图记录中，开放源码检测器量化了HFO和尖峰率。我们确定了在何种麻醉条件下，HFO和尖峰率可将切除区域内的癫痫发作起始区（SOZ）与非癫痫部位区分开来。结果我们分析了925个无伪影电极，其中867个位于非癫痫部位，58个位于SOZ部位。较高的七氟烷剂量可显著增加非癫痫部位的 HFO 和尖峰率，不同检测器之间存在空间差异。结论我们提供了不同七氟醚麻醉条件下 HFO 和尖峰率的标准图谱。意义评估不同部位生物标志物水平的相对严重程度可能与定位七氟醚麻醉下的致痫区有关。

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引用次数: 0

Interactive effect between transcranial focused ultrasound and transcranial magnetic stimulation on human motor cortex 经颅聚焦超声和经颅磁刺激对人体运动皮层的交互效应

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-11 DOI: 10.1016/j.clinph.2024.09.001

Objective

Transcranial focused ultrasound (TUS) can suppress human motor cortical excitability. However, it is unclear whether the TUS may interact with transcranial magnetic stimulation (TMS) when they co-delivered in multiple trials.

Methods

Nineteen subjects received three different TUS-TMS co-stimulation protocols to the motor cortex including concurrent stimulation (TUS-TMS-C), separated stimulation (TUS-TMS-S), and TMS only. In each condition, two runs of 30 stimulation trials were conducted with a five-minute rest between runs. Motor-evoked potentials (MEP) were recorded during stimulation and at 0, 10, 20, and 30 min after stimulation. The MEP amplitudes after intervention were normalized to the mean pre-intervention MEP amplitude and expressed as MEP ratios. An additional test with TUS alone was applied to all participants to assess whether TUS itself can elicit after-effects.

Results

There were no significant after-effects of all three interventions on MEP ratios. However, 11 subjects who showed online inhibition (OI + ) during the TUS-TMS-C protocol, defined as having MEP ratio less than 1 during TUS-TMS-C, showed significant MEP suppression at 10, 20 and 30 min after TUS-TMS-C. In 8 subjects did not show online inhibition (OI-), defined as having MEP ratios greater than 1 during TUS-TMS-C, showed no significant inhibitory after-effects. OI + and OI- status did not change in a follow-up repeat TUS-TMS-C test. TUS alone did not generate inhibitory after-effects in either OI + or OI- participants.

Conclusions

Our results showed that co-delivery of TUS and TMS can elicit inhibitory after-effect in subjects who showed online inhibition, suggesting that TUS and TMS may interact with each other to produce plasticity effects.

Significance

TUS and TMS may interact with each other to modulate cortical excitability.

目的经颅聚焦超声（TUS）可以抑制人体运动皮层的兴奋性。方法 19 名受试者接受了三种不同的 TUS-TMS 联合刺激运动皮层方案，包括同时刺激（TUS-TMS-C）、分离刺激（TUS-TMS-S）和仅 TMS。在每种情况下，进行两次共 30 次刺激试验，两次试验之间休息五分钟。在刺激过程中以及刺激后 0、10、20 和 30 分钟记录运动诱发电位（MEP）。干预后的 MEP 振幅与干预前的平均 MEP 振幅进行归一化处理，并以 MEP 比值表示。所有受试者都接受了单独的 TUS 测试，以评估 TUS 本身是否会引起后效应。然而，11 名受试者在 TUS-TMS-C 方案期间表现出在线抑制（OI + ），即在 TUS-TMS-C 期间 MEP 比率小于 1，在 TUS-TMS-C 后 10、20 和 30 分钟表现出明显的 MEP 抑制。8 名受试者未出现在线抑制（OI-），即 TUS-TMS-C 期间 MEP 比率大于 1，未显示出明显的抑制后效应。在后续的重复 TUS-TMS-C 测试中，OI + 和 OI- 状态没有变化。结论我们的研究结果表明，TUS 和 TMS 的联合传递可以在表现出在线抑制的受试者中引起抑制性后效应，这表明 TUS 和 TMS 可能会相互作用，产生可塑性效应。

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引用次数: 0

Short-latency afferent inhibition and its relationship to covert sensory and motor hand impairment in multiple sclerosis 短时传入抑制及其与多发性硬化症患者隐性手部感觉和运动障碍的关系

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-11 DOI: 10.1016/j.clinph.2024.09.003

Objective

To investigate sensorimotor integration by quantifying short-latency afferent inhibition (SAI) in people with MS who experience manual dexterity problems compared to controls.

Methods

22 people with MS with self-reported manual dexterity problems and 10 sex and age-matched controls were assessed using various upper extremity clinical tests. SAI was assessed by a transcranial magnetic stimulation pulse over the primary motor cortex preceded by peripheral nerve stimulation to the median nerve at 6 interstimulus intervals 2 – 8 ms longer than individualized N20 latencies.

Results

Although within normal limits, persons with MS exhibited significantly slower Nine Hole Peg Test performance and pinch strength in the dominant hand. They also exhibited greater sensory impairment (monofilament test) in the dominant hand. Persons with MS showed significantly greater disinhibition of SAI in the dominant hand compared to controls, which was significantly correlated with weaker pinch strength.

Conclusion

Reduced SAI in people with MS, particularly in the dominant hand, signifies disruptions in cortical cholinergic inhibitory activity and is associated with lower pinch strength.

Significance

Evaluating changes in SAI may offer insight into the disrupted cortical cholinergic inhibitory activity that contributes to sensorimotor disintegration, potentially advancing disease management in persons with MS.

方法使用各种上肢临床测试对 22 名自述有手部灵活性问题的多发性硬化症患者和 10 名性别和年龄匹配的对照组患者进行评估。在对正中神经进行外周神经刺激之前，先对初级运动皮层进行经颅磁刺激脉冲，刺激间隔为 6 次，每次比个体化的 N20 潜伏期长 2 - 8 毫秒，以此来评估 SAI。他们的惯用手还表现出更大的感觉障碍（单纤测试）。与对照组相比，多发性硬化症患者显性手的SAI抑制明显更强，这与捏合强度的减弱明显相关。

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引用次数: 0

Infant sleep spindle measures from EEG improve prediction of cerebral palsy 通过脑电图测量婴儿睡眠纺锤体可提高对脑瘫的预测能力

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2024-09-05 DOI: 10.1016/j.clinph.2024.08.017

Objective

Early identification of infants at risk of cerebral palsy (CP) enables interventions to optimize outcomes. Central sleep spindles reflect thalamocortical sensorimotor circuit function. We hypothesized that abnormal infant central spindle activity would predict later contralateral CP.

Methods

We trained and validated an automated detector to measure spindle rate, duration, and percentage from central electroencephalogram (EEG) channels in high-risk infants (n = 35) and age-matched controls (n = 42). Neonatal magnetic resonance imaging (MRI) findings, infant motor exam, and CP outcomes were obtained from chart review. Using univariable and multivariable logistic regression models, we examined whether spindle activity, MRI abnormalities, and/or motor exam predicted future contralateral CP.

Results

The detector had excellent performance (F1 = 0.50). Spindle rate (p = 0.005, p = 0.0004), duration (p < 0.001, p < 0.001), and percentage (p < 0.001, p < 0.001) were decreased in hemispheres corresponding to future CP compared to those without. In this cohort, PLIC abnormality (p = 0.004) and any MRI abnormality (p = 0.004) also predicted subsequent CP. After controlling for MRI findings, spindle features remained significant predictors and improved model fit (p < 0.001, all tests). Using both spindle duration and MRI findings had highest accuracy to classify hemispheres corresponding to future CP (F1 = 0.98, AUC 0.999).

Conclusion

Decreased central spindle activity improves the prediction of future CP in high-risk infants beyond early MRI or clinical exam alone.

Significance

Decreased central spindle activity provides an early biomarker for CP.

目的及早识别有脑瘫（CP）风险的婴儿，以便采取干预措施，优化治疗效果。中枢睡眠纺锤体反映丘脑皮层感觉运动回路的功能。我们假设，婴儿中枢纺锤体活动异常可预测日后的对侧脑瘫。方法我们训练并验证了一种自动探测器，该探测器可测量高危婴儿（35 人）和年龄匹配对照组（42 人）中枢脑电图（EEG）通道的纺锤体速率、持续时间和百分比。新生儿磁共振成像（MRI）结果、婴儿运动检查和CP结果均来自病历审查。通过单变量和多变量逻辑回归模型，我们研究了纺锤体活动、MRI 异常和/或运动检查是否可预测未来对侧的 CP。与无 CP 的半球相比，有 CP 的半球的纺锤率（p = 0.005，p = 0.0004）、持续时间（p < 0.001，p < 0.001）和百分比（p < 0.001，p < 0.001）均有所下降。在该队列中，PLIC 异常（p = 0.004）和任何 MRI 异常（p = 0.004）也可预测未来的 CP。在控制磁共振成像结果后，纺锤体特征仍是重要的预测因素，并提高了模型的拟合度（p < 0.001，所有测试）。同时使用纺锤体持续时间和核磁共振成像结果对与未来 CP 相对应的半球进行分类的准确性最高（F1 = 0.98，AUC 0.999）。

{"title":"Infant sleep spindle measures from EEG improve prediction of cerebral palsy","authors":"","doi":"10.1016/j.clinph.2024.08.017","DOIUrl":"10.1016/j.clinph.2024.08.017","url":null,"abstract":"<div><h3>Objective</h3><p>Early identification of infants at risk of cerebral palsy (CP) enables interventions to optimize outcomes. Central sleep spindles reflect thalamocortical sensorimotor circuit function. We hypothesized that abnormal infant central spindle activity would predict later contralateral CP.</p></div><div><h3>Methods</h3><p>We trained and validated an automated detector to measure spindle rate, duration, and percentage from central electroencephalogram (EEG) channels in high-risk infants (n = 35) and age-matched controls (n = 42). Neonatal magnetic resonance imaging (MRI) findings, infant motor exam, and CP outcomes were obtained from chart review. Using univariable and multivariable logistic regression models, we examined whether spindle activity, MRI abnormalities, and/or motor exam predicted future contralateral CP.</p></div><div><h3>Results</h3><p>The detector had excellent performance (F1 = 0.50). Spindle rate (p = 0.005, p = 0.0004), duration (p < 0.001, p < 0.001), and percentage (p < 0.001, p < 0.001) were decreased in hemispheres corresponding to future CP compared to those without. In this cohort, PLIC abnormality (p = 0.004) and any MRI abnormality (p = 0.004) also predicted subsequent CP. After controlling for MRI findings, spindle features remained significant predictors and improved model fit (p < 0.001, all tests). Using both spindle duration and MRI findings had highest accuracy to classify hemispheres corresponding to future CP (F1 = 0.98, AUC 0.999).</p></div><div><h3>Conclusion</h3><p>Decreased central spindle activity improves the prediction of future CP in high-risk infants beyond early MRI or clinical exam alone.</p></div><div><h3>Significance</h3><p>Decreased central spindle activity provides an early biomarker for CP.</p></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232636","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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