In craniotomies requiring motor evoked potential (MEP) monitoring, avoiding neuromuscular blockade (NMB) is preferable, but its complete avoidance poses risks of unexpected movement. This retrospective study investigates the application of a post-tetanic MEP augmentation technique to enhance baseline recording of transcranial stimulation MEP (Tc-MEP) under partial NMB during craniotomy.
Methods
Twenty-six patients were included. The level of partial NMB was maintained at a train-of-four ratio of approximately 40 %. Monophasic constant-current stimulation was applied on the craniotomy side with + 20 % of the threshold intensity. Post-tetanic Tc-MEP, involving tetanic stimulation of the median nerve 1 s before transcranial stimulation, was performed on patients who failed to record using conventional baseline recording.
Results
The post-tetanic Tc-MEP technique successfully improved the success rate of baseline recording from 61.5 % to 100 %. Application of post-tetanic Tc-MEP significantly increased amplitudes in both the upper (p = 0.04) and lower limbs (p < 0.01) compared to before post-tetanic Tc-MEP. No patients had unexpected movements.
Conclusions
This study indicates that post-tetanic Tc-MEP enhanced the success rate of baseline recording during craniotomy under partial NMB.
Significance
The combination of partial NMB and post-tetanic Tc-MEP could be a useful regimen for craniotomy with MEP monitoring, addressing both safety concerns and successful baseline recording.
{"title":"Evaluation of post-tetanic motor evoked potential as an augmentation technique under partial neuromuscular blockade during craniotomy","authors":"Ayako Oi , Hironobu Hayashi , Keiko Uemura , Tomoshige Miyabayashi , Tsunenori Takatani , Ryosuke Matsuda , Ryuichi Abe , Ichiro Nakagawa , Masahiko Kawaguchi","doi":"10.1016/j.clinph.2024.11.009","DOIUrl":"10.1016/j.clinph.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>In craniotomies requiring motor evoked potential (MEP) monitoring, avoiding neuromuscular blockade (NMB) is preferable, but its complete avoidance poses risks of unexpected movement. This retrospective study investigates the application of a post-tetanic MEP augmentation technique to enhance baseline recording of transcranial stimulation MEP (Tc-MEP) under partial NMB during craniotomy.</div></div><div><h3>Methods</h3><div>Twenty-six patients were included. The level of partial NMB was maintained at a train-of-four ratio of approximately 40 %. Monophasic constant-current stimulation was applied on the craniotomy side with + 20 % of the threshold intensity. Post-tetanic Tc-MEP, involving tetanic stimulation of the median nerve 1 s before transcranial stimulation, was performed on patients who failed to record using conventional baseline recording.</div></div><div><h3>Results</h3><div>The post-tetanic Tc-MEP technique successfully improved the success rate of baseline recording from 61.5 % to 100 %. Application of post-tetanic Tc-MEP significantly increased amplitudes in both the upper (p = 0.04) and lower limbs (p < 0.01) compared to before post-tetanic Tc-MEP. No patients had unexpected movements.</div></div><div><h3>Conclusions</h3><div>This study indicates that post-tetanic Tc-MEP enhanced the success rate of baseline recording during craniotomy under partial NMB.</div></div><div><h3>Significance</h3><div>The combination of partial NMB and post-tetanic Tc-MEP could be a useful regimen for craniotomy with MEP monitoring, addressing both safety concerns and successful baseline recording.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 22-28"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794465","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 : 2025-02-01DOI: 10.1016/j.clinph.2024.12.001
Steve Vucic , Nathan Pavey , Parvathi Menon , Michael Babayev , Anna Maslyukova , Anatoliy Muraviev , Matthew C. Kiernan
Objective
Assessment of cortical function with threshold tracking transcranial magnetic stimulation (TT-TMS) has developed as a biomarker to inform disease pathophysiology, particularly in neurodegenerative disease and dementia. At present, a fully integrated testing system does not exist. To advance clinical utility, and to streamline software design to integrate with diagnostic approaches in an outpatient setting, the present series of studies assessed the effects of altering diagnostic paradigms to measure interstimulus interval (ISI) including serial ascending [T-SICIs] and parallel [T-SICIp] methodologies as measures of cortical motor function (the MagXite software).
Methods
Cortical excitability was assessed in 30 healthy controls with a figure-of-eight coil, using an integrated approach compared to previously established experimental paradigms. Motor evoked responses were recorded over the contralateral abductor pollicis brevis muscle. Short interval intracortical inhibition (SICI) was recorded with each testing paradigm and validated in a healthy control cohort.
Results
The integrated system determined a robust measure of T-SICIs between ISI 1-to-7 ms (16.6 ± 2.2 %) that was comparable to previously established testing paradigms (P = 0.34), but greater than T-SICIp (MagXite 10.7 ± 1.5 %, P = 0.016; Sydney TT-TMS 8.7 ± 1.4 %, P = 0.03). SICI peaks at ISI 1 and 2.5-to-3 ms were evident with both protocols. Significant correlations were evident between mean T-SICIs-MagXite and T-SICIp-MagXite (R = 0.599, P < 0.001).
Conclusion
The present series validates a fully integrated motor cortical functional assessment to provide reproducible measures of SICI, with data obtained for intracortical inhibition that is more prominent when assessed using the method of serial ascending order.
Significance
An integrated system for transcranial magnetic stimulation of the human motor system has been validated for clinical practice, suitable for the assessment of cortical function in neurological disease in an outpatient clinic setting.
{"title":"Neurophysiological assessment of cortical motor function: A direct comparison of methodologies","authors":"Steve Vucic , Nathan Pavey , Parvathi Menon , Michael Babayev , Anna Maslyukova , Anatoliy Muraviev , Matthew C. Kiernan","doi":"10.1016/j.clinph.2024.12.001","DOIUrl":"10.1016/j.clinph.2024.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Assessment of cortical function with threshold tracking transcranial magnetic stimulation (TT-TMS) has developed as a biomarker to inform disease pathophysiology, particularly in neurodegenerative disease and dementia. At present, a fully integrated testing system does not exist. To advance clinical utility, and to streamline software design to integrate with diagnostic approaches in an outpatient setting, the present series of studies assessed the effects of altering diagnostic paradigms to measure interstimulus interval (ISI) including serial ascending [T-SICIs] and parallel [T-SICIp] methodologies as measures of cortical motor function (the MagXite software).</div></div><div><h3>Methods</h3><div>Cortical excitability was assessed in 30 healthy controls with a figure-of-eight coil, using an integrated approach compared to previously established experimental paradigms. Motor evoked responses were recorded over the contralateral abductor pollicis brevis muscle. Short interval intracortical inhibition (SICI) was recorded with each testing paradigm and validated in a healthy control cohort.</div></div><div><h3>Results</h3><div>The integrated system determined a robust measure of T-SICIs between ISI 1-to-7 ms (16.6 ± 2.2 %) that was comparable to previously established testing paradigms (P = 0.34), but greater than T-SICIp (MagXite 10.7 ± 1.5 %, P = 0.016; Sydney TT-TMS 8.7 ± 1.4 %, P = 0.03). SICI peaks at ISI 1 and 2.5-to-3 ms were evident with both protocols. Significant correlations were evident between mean T-SICIs-<sub>MagXite</sub> and T-SICIp-<sub>MagXite</sub> (R = 0.599, P < 0.001).</div></div><div><h3>Conclusion</h3><div>The present series validates a fully integrated motor cortical functional assessment to provide reproducible measures of SICI, with data obtained for intracortical inhibition that is more prominent when assessed using the method of serial ascending order.</div></div><div><h3>Significance</h3><div>An integrated system for transcranial magnetic stimulation of the human motor system has been validated for clinical practice, suitable for the assessment of cortical function in neurological disease in an outpatient clinic setting.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 14-21"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinph.2024.12.002
Nan Hu , Yuxue Nie , Xingbei Dong , Jingwen Niu , Liying Cui , Mingsheng Liu
Objective
To explore the ultrasonographic characteristics of SLE-related peripheral neuropathy (PN) using nerve ultrasound.
Methods
Patients with SLE were recruited consecutively between December 2022 and June 2023. Detailed clinical assessment and nerve ultrasound were conducted on each SLE patient and healthy control (HC) at predetermined sites of peripheral nerves. The upper limit of the CSA for each nerve location was defined as 95th percentile in healthy controls for the identification of nerve enlargement. Nerve conduction studies (NCS) and relevant ancillary examinations were conducted on all SLE patients for comparisons.
Results
A total of 32 SLE female patients and age- and gender-marched 52 HC were finally recruited. At M6 (P = 0.041) point of median nerve, U1 (P < 0.001) and U6-10 (P < 0.001, =0.008, <0.001, <0.001, <0.001, respectively) points of ulnar nerve, the CSA in SLE patients were remarkably higher than that in HC. Mild and moderate nerve enlargement were detected in 12 and 20 SLE patients, respectively. Only 12 tested nerves showed both axonal damage in electrophysiological studies and nerve enlargement under ultrasound.
Conclusion
Nerve enlargement was extremely common in SLE patients, mainly in the forms of mild to moderate and focal thickening in upper limbs. There was significant inconsistency between NCS and ultrasound in detecting peripheral nerve involvement and a combined examination using NCS and nerve ultrasound might be more effective in detecting SLE-related PN.
{"title":"Ultrasonographic characteristics of peripheral neuropathy in systemic lupus erythematosus","authors":"Nan Hu , Yuxue Nie , Xingbei Dong , Jingwen Niu , Liying Cui , Mingsheng Liu","doi":"10.1016/j.clinph.2024.12.002","DOIUrl":"10.1016/j.clinph.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the ultrasonographic characteristics of SLE-related peripheral neuropathy (PN) using nerve ultrasound.</div></div><div><h3>Methods</h3><div>Patients with SLE were recruited consecutively between December 2022 and June 2023. Detailed clinical assessment and nerve ultrasound were conducted on each SLE patient and healthy control (HC) at predetermined sites of peripheral nerves. The upper limit of the CSA for each nerve location was defined as 95th percentile in healthy controls for the identification of nerve enlargement. Nerve conduction studies (NCS) and relevant ancillary examinations were conducted on all SLE patients for comparisons.</div></div><div><h3>Results</h3><div>A total of 32 SLE female patients and age- and gender-marched 52 HC were finally recruited. At M6 (P = 0.041) point of median nerve, U1 (P < 0.001) and U6-10 (P < 0.001, =0.008, <0.001, <0.001, <0.001, respectively) points of ulnar nerve, the CSA in SLE patients were remarkably higher than that in HC. Mild and moderate nerve enlargement were detected in 12 and 20 SLE patients, respectively. Only 12 tested nerves showed both axonal damage in electrophysiological studies and nerve enlargement under ultrasound.</div></div><div><h3>Conclusion</h3><div>Nerve enlargement was extremely common in SLE patients, mainly in the forms of mild to moderate and focal thickening in upper limbs. There was significant inconsistency between NCS and ultrasound in detecting peripheral nerve involvement and a combined examination using NCS and nerve ultrasound might be more effective in detecting SLE-related PN.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 41-48"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812641","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}
Associative memory (AM) declines due to healthy aging as well as in various neurological conditions. Standard transcranial electrical stimulation (tES) protocols show inconclusive facilitatory effects on AM, often lacking function specificity and stimulation focality. We tested the effectiveness of high-density electrode montage delivering anodal theta oscillatory-modulated transcranial direct current stimulation (HD-Theta-otDCS) over the left posterior parietal cortex (PPC), aiming to target AM in a spatially focused and function-specific manner.
Methods
In a sham-controlled cross-over experiment we explored the differential effects of HD-Theta-otDCS applied during either encoding or the retrieval phases of two AM tasks (Face-Word and Object-Location). The stimulation protocol consisted of an anode over the left PPC (P3) and four surrounding return electrodes (CP1, CP5, PO3, POz) with electrical current oscillating in theta rhythm (5 Hz, 1.5 ± 0.5 mA).
Results
HD-Theta-otDCS stimulation applied during both encoding and retrieval increased AM performance compared to sham control in the Face-Word task. We found no differences between the two active stimulation conditions.
Conclusions
HD-Theta-otDCS showed to be a promising tool for enhancing AM, regardless of the stimulation timing. The results provide further support for our previous findings with bipolar otDCS and confirm that PPC stimulation can induce behaviorally relevant modulation in the memory-related cortico-subcortical networks.
Significance
The presented approach is one step forward towards precision brain stimulation for memory neuromodulation. The novelty lies in the combination of increased focality and function-specific current waveform. Positive results set the ground for further research on HD-theta-otDCS effectiveness in clinical populations.
{"title":"High-density theta oscillatory-modulated tDCS over the parietal cortex for targeted memory enhancement","authors":"Milica Manojlović , Jovana Bjekić , Danka Purić , Saša R. Filipović","doi":"10.1016/j.clinph.2024.12.004","DOIUrl":"10.1016/j.clinph.2024.12.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Associative memory (AM) declines due to healthy aging as well as in various neurological conditions. Standard transcranial electrical stimulation (tES) protocols show inconclusive facilitatory effects on AM, often lacking function specificity and stimulation focality. We tested the effectiveness of high-density electrode montage delivering anodal theta oscillatory-modulated transcranial direct current stimulation (HD-Theta-otDCS) over the left posterior parietal cortex (PPC), aiming to target AM in a spatially focused and function-specific manner.</div></div><div><h3>Methods</h3><div>In a sham-controlled cross-over experiment we explored the differential effects of HD-Theta-otDCS applied during either encoding or the retrieval phases of two AM tasks (Face-Word and Object-Location). The stimulation protocol consisted of an anode over the left PPC (P3) and four surrounding return electrodes (CP1, CP5, PO3, POz) with electrical current oscillating in theta rhythm (5 Hz, 1.5 ± 0.5 mA).</div></div><div><h3>Results</h3><div>HD-Theta-otDCS stimulation applied during both encoding and retrieval increased AM performance compared to sham control in the Face-Word task. We found no differences between the two active stimulation conditions.</div></div><div><h3>Conclusions</h3><div>HD-Theta-otDCS showed to be a promising tool for enhancing AM, regardless of the stimulation timing. The results provide further support for our previous findings with bipolar otDCS and confirm that PPC stimulation can induce behaviorally relevant modulation in the memory-related cortico-subcortical networks.</div></div><div><h3>Significance</h3><div>The presented approach is one step forward towards precision brain stimulation for memory neuromodulation. The novelty lies in the combination of increased focality and function-specific current waveform. Positive results set the ground for further research on HD-theta-otDCS effectiveness in clinical populations.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 80-90"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863368","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 : 2025-02-01DOI: 10.1016/j.clinph.2024.12.008
Huang Zheng , Han Xiao , Yinan Zhang, Haozhe Jia, Xing Ma, Yiqun Gan
Objective
Alzheimer’s disease (AD) and frontotemporal dementia (FTD) are prevalent neurodegenerative diseases characterized by altered brain functional connectivity (FC), affecting over 100 million people worldwide. This study aims to identify distinct FC patterns as potential biomarkers for differential diagnosis.
Methods
Resting-state EEG data from 36 AD patients, 23 FTD patients, and 29 healthy controls were analyzed using time-frequency and bandpass filtering FC metrics. These metrics were estimated through Pearson’s correlations, mutual information, and phase lag index, and served as input features in a support vector machine (SVM) with Leave-One-Out Cross-Validation for group classification.
Results
Both AD and FTD exhibited significantly decreased FC in the theta band within the frontal lobe and increased FC in the beta band in the posterior regions. Additionally, a decreased FC in central regions at theta band was observed uniquely in AD, but not in FTD. SVM classification accuracies reached 95% for AD and 86% for FTD.
Conclusions
High classification accuracies underscore the potential of these FC alterations as reliable biomarkers for AD and FTD.
Significance
This is the first study to integrate time-frequency and bandpass filtering FC metrics to reveal brain network alterations in AD and FTD, providing new insights for diagnostics and neurodegenerative pathologies.
{"title":"Time-Frequency functional connectivity alterations in Alzheimer’s disease and frontotemporal dementia: An EEG analysis using machine learning","authors":"Huang Zheng , Han Xiao , Yinan Zhang, Haozhe Jia, Xing Ma, Yiqun Gan","doi":"10.1016/j.clinph.2024.12.008","DOIUrl":"10.1016/j.clinph.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>Alzheimer’s disease (AD) and frontotemporal dementia (FTD) are prevalent neurodegenerative diseases characterized by altered brain functional connectivity (FC), affecting over 100 million people worldwide. This study aims to identify distinct FC patterns as potential biomarkers for differential diagnosis.</div></div><div><h3>Methods</h3><div>Resting-state EEG data from 36 AD patients, 23 FTD patients, and 29 healthy controls were analyzed using time-frequency and bandpass filtering FC metrics. These metrics were estimated through Pearson’s correlations, mutual information, and phase lag index, and served as input features in a support vector machine (SVM) with Leave-One-Out Cross-Validation for group classification.</div></div><div><h3>Results</h3><div>Both AD and FTD exhibited significantly decreased FC in the theta band within the frontal lobe and increased FC in the beta band in the posterior regions. Additionally, a decreased FC in central regions at theta band was observed uniquely in AD, but not in FTD. SVM classification accuracies reached 95% for AD and 86% for FTD.</div></div><div><h3>Conclusions</h3><div>High classification accuracies underscore the potential of these FC alterations as reliable biomarkers for AD and FTD.</div></div><div><h3>Significance</h3><div>This is the first study to integrate time-frequency and bandpass filtering FC metrics to reveal brain network alterations in AD and FTD, providing new insights for diagnostics and neurodegenerative pathologies.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 110-119"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871607","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 : 2025-02-01DOI: 10.1016/j.clinph.2024.12.013
Yusuke Osaki , Hiroyuki Nodera , Ryota Sato , Shotaro Haji , Koji Fujita , Ryosuke Miyamoto , Kohei Muto , Hiroki Yamazaki , Hiroyuki Morino , Takashi Kanda , Shigeo Murayama , Ryuji Kaji , Yuishin Izumi
Objective
Neuronal Intranuclear Inclusion Disease (NIID) is a neurodegenerative disease affecting the central and peripheral nerves. We aimed to assess the pathophysiological features of peripheral nerve dysfunction in NIID.
Methods
We observed six unrelated NIID patients through clinical records, nerve conduction studies, and multiple measures of motor nerve excitability. Additionally, we reviewed one NIID patientt who underwent a nerve biopsy. Control measures were obtained from 22 age-matched normal subjects.
Results
The NIID patients exhibited mild conduction slowing and distinct nerve excitability abnormalities, including a significant decrease in excitability through hyperpolarizing threshold electrotonus (TE) and increased overshoots in both depolarizing and hyperpolarizing conditions. Histopathology revealed thinly myelinated fibers and axonal degeneration. Mathematical modeling suggested that reduced leak conductance was the key factor contributing to the observed excitability changes.
Conclusions
The findings indicate that NIID involves a complex interplay of axonal degeneration and myelin dysfunction, leading to unique peripheral nerve excitability changes. These results provide new insights into the pathophysiology of NIID.
Significance
Nerve excitability testing offers insight into particular axonal excitability abnormalities especially combined with histopathologic studies.
{"title":"Peripheral nerve excitability abnormalities in Neuronal Intranuclear Inclusion Disease: Assessment with histopathological analysis","authors":"Yusuke Osaki , Hiroyuki Nodera , Ryota Sato , Shotaro Haji , Koji Fujita , Ryosuke Miyamoto , Kohei Muto , Hiroki Yamazaki , Hiroyuki Morino , Takashi Kanda , Shigeo Murayama , Ryuji Kaji , Yuishin Izumi","doi":"10.1016/j.clinph.2024.12.013","DOIUrl":"10.1016/j.clinph.2024.12.013","url":null,"abstract":"<div><h3>Objective</h3><div>Neuronal Intranuclear Inclusion Disease (NIID) is a neurodegenerative disease affecting the central and peripheral nerves. We aimed to assess the pathophysiological features of peripheral nerve dysfunction in NIID.</div></div><div><h3>Methods</h3><div>We observed six unrelated NIID patients through clinical records, nerve conduction studies, and multiple measures of motor nerve excitability. Additionally, we reviewed one NIID patientt who underwent a nerve biopsy. Control measures were obtained from 22 age-matched normal subjects.</div></div><div><h3>Results</h3><div>The NIID patients exhibited mild conduction slowing and distinct nerve excitability abnormalities, including a significant decrease in excitability through hyperpolarizing threshold electrotonus (TE) and increased overshoots in both depolarizing and hyperpolarizing conditions. Histopathology revealed thinly myelinated fibers and axonal degeneration. Mathematical modeling suggested that reduced leak conductance was the key factor contributing to the observed excitability changes.</div></div><div><h3>Conclusions</h3><div>The findings indicate that NIID involves a complex interplay of axonal degeneration and myelin dysfunction, leading to unique peripheral nerve excitability changes. These results provide new insights into the pathophysiology of NIID.</div></div><div><h3>Significance</h3><div>Nerve excitability testing offers insight into particular axonal excitability abnormalities especially combined with histopathologic studies.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 156-167"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892589","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 : 2025-02-01DOI: 10.1016/j.clinph.2024.12.016
John W. Chow, Stuart A. Yablon, Dobrivoje S. Stokic
{"title":"Comment on “Tonic stretch reflex threshold as a measure of disordered motor control and spasticity – A critical review” by Levin et al. (2024)","authors":"John W. Chow, Stuart A. Yablon, Dobrivoje S. Stokic","doi":"10.1016/j.clinph.2024.12.016","DOIUrl":"10.1016/j.clinph.2024.12.016","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 180-181"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892529","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 : 2025-02-01DOI: 10.1016/j.clinph.2024.12.017
Mindy F. Levin, Daniele Piscitelli, Joy Khayat
{"title":"Reply to: Commentary: Tonic stretch reflex threshold as a measure of disordered motor control and spasticity – A critical review","authors":"Mindy F. Levin, Daniele Piscitelli, Joy Khayat","doi":"10.1016/j.clinph.2024.12.017","DOIUrl":"10.1016/j.clinph.2024.12.017","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 192-193"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892594","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}
Seizure suppression using the neurofeedback (NFB) method by self-regulation of scalp-recorded slow cortical potential (SCP) is effective for patients with refractory focal epilepsy. However, the prolonged training period required prevents it from wider implementation as the standard treatment in clinical practice. Therefore, we examined whether it would be appropriate to shorten the training period, in spite of the small number of patients.
Methods
12 patients participated the NFB training. 1 course of NFB training consisted of 35 sessions divided into 2 phases. After each phase we evaluated whether each patient acquired NFB control, and seizure reduction was assessed compared to that before training.
Results
Of 11 patients who completed the first training phase, 4 showed reduced post-training seizure frequency, of whom 3 could regulate the SCP polarity (NFB control). Of the remaining 7, 2 acquired NFB control during the second training phase but seizure frequency did not decrease. Furthermore, the other 5 did not acquire NFB control, and seizure frequency did not decrease.
Conclusions
Patients who acquired NFB control within a short period, i.e., 3 weeks, were more likely to exhibit a lower post-training seizure frequency.
Significance
SCP self-regulation can be acquired within a short period and is associated with seizure reduction.
{"title":"Self-regulation of slow cortical potential and seizure suppression by scalp electroencephalography: Early prediction of therapeutic efficacy","authors":"Tomoyuki Fumuro , Masao Matsuhashi , Masako Kinoshita , Riki Matsumoto , Ryosuke Takahashi , Akio Ikeda","doi":"10.1016/j.clinph.2024.11.018","DOIUrl":"10.1016/j.clinph.2024.11.018","url":null,"abstract":"<div><h3>Objective</h3><div>Seizure suppression using the neurofeedback (NFB) method by self-regulation of scalp-recorded slow cortical potential (SCP) is effective for patients with refractory focal epilepsy. However, the prolonged training period required prevents it from wider implementation as the standard treatment in clinical practice. Therefore, we examined whether it would be appropriate to shorten the training period, in spite of the small number of patients.</div></div><div><h3>Methods</h3><div>12 patients participated the NFB training. 1 course of NFB training consisted of 35 sessions divided into 2 phases. After each phase we evaluated whether each patient acquired NFB control, and seizure reduction was assessed compared to that before training.</div></div><div><h3>Results</h3><div>Of 11 patients who completed the first training phase, 4 showed reduced post-training seizure frequency, of whom 3 could regulate the SCP polarity (NFB control). Of the remaining 7, 2 acquired NFB control during the second training phase but seizure frequency did not decrease. Furthermore, the other 5 did not acquire NFB control, and seizure frequency did not decrease.</div></div><div><h3>Conclusions</h3><div>Patients who acquired NFB control within a short period, i.e., 3 weeks, were more likely to exhibit a lower post-training seizure frequency.</div></div><div><h3>Significance</h3><div>SCP self-regulation can be acquired within a short period and is associated with seizure reduction.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 182-191"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892613","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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