Objective: Alcohol use disorder (AUD) contributes to 4.7% of deaths worldwide, yet assessment relies on subjective craving reports. Event-related potentials (ERPs) provide objective markers of cue reactivity linked to craving and motivational salience. However, emphasis on later components (P3) may overlook earlier, automatic processes reflecting the transition from controlled to habitual responding. This study examined whether early and late ERP components differentiate alcohol from non-alcohol stimuli in severe AUD and associate with craving.
Methods: Seventy-eight inpatients with severe AUD completed cue-reactivity (CR) and go/no-go (GNG) EEG tasks using personalized alcohol and non-alcohol stimuli. ERPs were analyzed in early (100-200 ms, 200-350 ms) and late (350-650 ms) windows, and their relationship with craving examined.
Results: Alcohol stimuli in the CR task generated significantly more positive ERP amplitudes than non-alcohol stimuli across all windows. Differences correlated positively with craving. The GNG task produced a robust GNG effect but minimal alcohol/non-alcohol differentiation.
Conclusion: Early neural responses to alcohol-related cues emerge before the P3, demonstrating rapid, automatic differentiation. These differences correlate strongly with craving.
Significance: This is the first study showing early neural differentiation of alcohol cues in patients with severe AUD. Associations with craving may serve as objective markers of addiction severity.
{"title":"Early event-related potential differentiation of alcohol cues associates with subjective craving levels in severe alcohol use disorder.","authors":"Helen Tobback, Geert Dom, Marianne Destoop, Tanja Endrass, Raoul Wüllhorst, Salvatore Campanella, Manon Saeys, Natacha Deroost, Kris Baetens","doi":"10.1016/j.clinph.2026.2111738","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111738","url":null,"abstract":"<p><strong>Objective: </strong>Alcohol use disorder (AUD) contributes to 4.7% of deaths worldwide, yet assessment relies on subjective craving reports. Event-related potentials (ERPs) provide objective markers of cue reactivity linked to craving and motivational salience. However, emphasis on later components (P3) may overlook earlier, automatic processes reflecting the transition from controlled to habitual responding. This study examined whether early and late ERP components differentiate alcohol from non-alcohol stimuli in severe AUD and associate with craving.</p><p><strong>Methods: </strong>Seventy-eight inpatients with severe AUD completed cue-reactivity (CR) and go/no-go (GNG) EEG tasks using personalized alcohol and non-alcohol stimuli. ERPs were analyzed in early (100-200 ms, 200-350 ms) and late (350-650 ms) windows, and their relationship with craving examined.</p><p><strong>Results: </strong>Alcohol stimuli in the CR task generated significantly more positive ERP amplitudes than non-alcohol stimuli across all windows. Differences correlated positively with craving. The GNG task produced a robust GNG effect but minimal alcohol/non-alcohol differentiation.</p><p><strong>Conclusion: </strong>Early neural responses to alcohol-related cues emerge before the P3, demonstrating rapid, automatic differentiation. These differences correlate strongly with craving.</p><p><strong>Significance: </strong>This is the first study showing early neural differentiation of alcohol cues in patients with severe AUD. Associations with craving may serve as objective markers of addiction severity.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"186 ","pages":"2111738"},"PeriodicalIF":3.6,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484643","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 : 2026-03-01Epub Date: 2025-10-28DOI: 10.1016/j.clinph.2025.2111407
Markus Kofler , Maria Elisabeth Holzknecht , Elke Pucks-Faes
{"title":"Cutaneous silent periods in Charcot-Marie-Tooth type 1A disease","authors":"Markus Kofler , Maria Elisabeth Holzknecht , Elke Pucks-Faes","doi":"10.1016/j.clinph.2025.2111407","DOIUrl":"10.1016/j.clinph.2025.2111407","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111407"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494960","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}
Movement disorders (MD) are frequent in Wilson’s disease (WD). Surface electromyography (sEMG) with accelerometry is commonly used to analyze hyperkinetic MD, as clinical examination may be insufficiently sensitive. We present here the first neurophysiological description of MD in WD patients to: (1) assess the sensitivity of neurophysiology relative to clinical evaluation; (2) correlate MD diagnosed by neurophysiology with the biological and radiological data of patients.
Methods
WD patients with hyperkinetic MD not fully characterized by clinical examination alone were included from December 2012 to December 2021. Clinical, biological, brain MRI and neurophysiology evaluations were conducted at inclusion and during follow-up.
Results
We included 12 WD patients (3.9 % of the total cohort, and 11 % of the patients with neurological complications). During follow-up, neurophysiological evaluation identified 10 patients as having either isolated or combined tremors (seven postural, six resting, four orthostatic, four functional, two kinetic and one dystonic tremors), and five myoclonus. Four cases of pseudo orthostatic tremors, five of myoclonus and two functional tremors were not detected clinically. Action tremor on sEMG was the only MD significantly associated with a mild-to-moderate midbrain FLAIR hypersignal.
Conclusion
Postural and resting tremors were the most frequent MD, whereas myoclonus was the most frequent MD that had remained clinically uncharacterized and diagnosed at neurophysiological evaluation.
Significance
This study emphasizes the undeniable added value of neurophysiological evaluation in these patients.
{"title":"Diagnostic utility of clinical neurophysiology in Wilson’s disease with hyperkinetic movements","authors":"Alban Gravier , Mickael Alexandre Obadia , Jean-Luc Thibault , Christine Delmaire , Aurélia Poujois , Nathalie Kubis","doi":"10.1016/j.clinph.2025.2111471","DOIUrl":"10.1016/j.clinph.2025.2111471","url":null,"abstract":"<div><h3>Objective</h3><div>Movement disorders (MD) are frequent in Wilson’s disease (WD). Surface electromyography (sEMG) with accelerometry is commonly used to analyze hyperkinetic MD, as clinical examination may be insufficiently sensitive. We present here the first neurophysiological description of MD in WD patients to: (1) assess the sensitivity of neurophysiology relative to clinical evaluation; (2) correlate MD diagnosed by neurophysiology with the biological and radiological data of patients.</div></div><div><h3>Methods</h3><div>WD patients with hyperkinetic MD not fully characterized by clinical examination alone were included from December 2012 to December 2021. Clinical, biological, brain MRI and neurophysiology evaluations were conducted at inclusion and during follow-up.</div></div><div><h3>Results</h3><div>We included 12 WD patients (3.9 % of the total cohort, and 11 % of the patients with neurological complications). During follow-up, neurophysiological evaluation identified 10 patients as having either isolated or combined tremors (seven postural, six resting, four orthostatic, four functional, two kinetic and one dystonic tremors), and five myoclonus. Four cases of pseudo orthostatic tremors, five of myoclonus and two functional tremors were not detected clinically. Action tremor on sEMG was the only MD significantly associated with a mild-to-moderate midbrain FLAIR hypersignal.</div></div><div><h3>Conclusion</h3><div>Postural and resting tremors were the most frequent MD, whereas myoclonus was the most frequent MD that had remained clinically uncharacterized and diagnosed at neurophysiological evaluation.</div></div><div><h3>Significance</h3><div>This study emphasizes the undeniable added value of neurophysiological evaluation in these patients.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111471"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084681","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 : 2026-02-28DOI: 10.1016/j.clinph.2026.2111722
Tommaso Bocci
{"title":"Pain as a multi‑level story: Spinal biomarkers at the crossroads of bottom‑up and top‑down modulation.","authors":"Tommaso Bocci","doi":"10.1016/j.clinph.2026.2111722","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111722","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111722"},"PeriodicalIF":3.6,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430247","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}
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.
{"title":"Repetitive wide-band cortical power in benign adult familial myoclonus epilepsy","authors":"Haruo Yamanaka , Katsuya Kobayashi , Takefumi Hitomi , Maya Tojima , Masao Matsuhashi , Kiyohide Usami , Ryosuke Takahashi , Akio Ikeda","doi":"10.1016/j.clinph.2025.2111486","DOIUrl":"10.1016/j.clinph.2025.2111486","url":null,"abstract":"<div><h3>Background</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>We demonstrated rhythmic cortical activity in BAFME patients, which may reflect the underlying pathophysiology of CT.</div></div><div><h3>Significance</h3><div>Detecting the induced activity of a single somatosensory stimulus may offer novel insights into the pathophysiology of BAFME.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111486"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837697","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}
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.
{"title":"Optimization of memory neurofeedback system utilizing intracranial electroencephalogram of the hippocampus","authors":"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","doi":"10.1016/j.clinph.2025.2111490","DOIUrl":"10.1016/j.clinph.2025.2111490","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Memory NF task effectively induced targeted hippocampal activity in TLE patients.</div></div><div><h3>Significance</h3><div>Hippocampal NF may enhance memory function in TLE patients prior to focal resection.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111490"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837698","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 : 2026-02-01DOI: 10.1016/j.clinph.2026.2111591
Caterina M Leone, Giuseppe di Pietro, Giulia di Stefano, Charles Quesada, Charbel Salameh, Caroline Perchet, Luis Garcia-Larrea, André Mouraux, Louisien Lebrun, Solenn Gousset, Niko Möller-Grell, Anna V Kostenko, Nanna B Finnerup, Ombretta Caspani, Bo Jiang, Thomas Li, Clarence Rong, Bernd Genser, Rolf-Detlef Treede, Andrea Truini
Introduction: Chronic pain is a major public health issue due to limited treatment efficacy. Within the IMI-PainCare project, we aimed to identify spinal biomarkers reflecting nociceptive processing and responsive to analgesics. Standardization and pharmacological validation are key for advancing analgesic development and improving care.
Methods: In a multi-center, randomized, double-blind, placebo-controlled crossover trial in healthy subjects, we assessed single doses of tapentadol (primary endpoint), lacosamide, and pregabalin (secondary endpoints) on two spinal biomarkers: RIII flexion reflex area and N13 somatosensory evoked potentials (N13-SEP), after hyperalgesia induction via high-frequency stimulation (HFS). Exploratory analyses included RIII reflex threshold and pain ratings.
Results: Twenty-four participants were enrolled. Tapentadol and pregabalin reduced the RIII flexion reflex area on the HFS sensitized side, 60 min after drug, compared to placebo, but the predetermined level of significance (p = 0.025) was not reached. No drug affected N13-SEP amplitude. All drugs significantly increased RIII threshold vs. placebo. Tapentadol and pregabalin also reduced RIII pain ratings.
Conclusions: Although primary and secondary endpoints were not met, tapentadol and pregabalin reduced the RIII flexion reflex area with medium, non-significant effect sizes. Exploratory analysis showed all drugs significantly increased the RIII threshold in HFS-induced hyperalgesic condition. N13-SEP amplitudes remained unchanged, questioning its reliability as a spinal biomarker.
Significance: Our findings support the RIII threshold as an objective spinal biomarker to assess antihyperalgesic drug effect. This study informs future choices of biomarkers, optimal timing, and analysis strategies in analgesic research.
{"title":"A multicentre randomized double-blind placebo-controlled study of lacosamide, pregabalin, and tapentadol on spinal pain biomarkers.","authors":"Caterina M Leone, Giuseppe di Pietro, Giulia di Stefano, Charles Quesada, Charbel Salameh, Caroline Perchet, Luis Garcia-Larrea, André Mouraux, Louisien Lebrun, Solenn Gousset, Niko Möller-Grell, Anna V Kostenko, Nanna B Finnerup, Ombretta Caspani, Bo Jiang, Thomas Li, Clarence Rong, Bernd Genser, Rolf-Detlef Treede, Andrea Truini","doi":"10.1016/j.clinph.2026.2111591","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111591","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is a major public health issue due to limited treatment efficacy. Within the IMI-PainCare project, we aimed to identify spinal biomarkers reflecting nociceptive processing and responsive to analgesics. Standardization and pharmacological validation are key for advancing analgesic development and improving care.</p><p><strong>Methods: </strong>In a multi-center, randomized, double-blind, placebo-controlled crossover trial in healthy subjects, we assessed single doses of tapentadol (primary endpoint), lacosamide, and pregabalin (secondary endpoints) on two spinal biomarkers: RIII flexion reflex area and N13 somatosensory evoked potentials (N13-SEP), after hyperalgesia induction via high-frequency stimulation (HFS). Exploratory analyses included RIII reflex threshold and pain ratings.</p><p><strong>Results: </strong>Twenty-four participants were enrolled. Tapentadol and pregabalin reduced the RIII flexion reflex area on the HFS sensitized side, 60 min after drug, compared to placebo, but the predetermined level of significance (p = 0.025) was not reached. No drug affected N13-SEP amplitude. All drugs significantly increased RIII threshold vs. placebo. Tapentadol and pregabalin also reduced RIII pain ratings.</p><p><strong>Conclusions: </strong>Although primary and secondary endpoints were not met, tapentadol and pregabalin reduced the RIII flexion reflex area with medium, non-significant effect sizes. Exploratory analysis showed all drugs significantly increased the RIII threshold in HFS-induced hyperalgesic condition. N13-SEP amplitudes remained unchanged, questioning its reliability as a spinal biomarker.</p><p><strong>Significance: </strong>Our findings support the RIII threshold as an objective spinal biomarker to assess antihyperalgesic drug effect. This study informs future choices of biomarkers, optimal timing, and analysis strategies in analgesic research.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111591"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137297","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 : 2026-02-01Epub Date: 2025-12-17DOI: 10.1016/j.clinph.2025.2111483
Marco Antonio Cavalcanti Garcia , Anaelli Aparecida Nogueira-Campos
{"title":"Revisiting the accuracy of motor evoked potential determination: The overlooked role of surface electrode montage","authors":"Marco Antonio Cavalcanti Garcia , Anaelli Aparecida Nogueira-Campos","doi":"10.1016/j.clinph.2025.2111483","DOIUrl":"10.1016/j.clinph.2025.2111483","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111483"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788252","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 : 2026-02-01Epub Date: 2025-12-22DOI: 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.
{"title":"Artifactual signal detection using intraoperative electrocorticographic devices during functional brain mapping of brain tumors","authors":"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","doi":"10.1016/j.clinph.2025.2111489","DOIUrl":"10.1016/j.clinph.2025.2111489","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the signal detection performance of a circular grid versus a strip electrode during intraoperative electrocorticography (iECoG) for Functional Brain Mapping (FBM).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>High-density circular grids enhance intraoperative detection of artifacts and ADs with lower stimulus currents.</div></div><div><h3>Significance</h3><div>The high-density circular grid offered more interpretable contacts and higher sensitivity.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"183 ","pages":"Article 2111489"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145832922","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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