Pub Date : 2025-11-20DOI: 10.1016/j.clinph.2025.2111449
Marina S. Cherchi , Miguel A. Hernández-Hernández , Javier Hernández-Cabello , Eduardo Torres Díez , Pedro Orizaola , Tetyana Stakhurska-Bilynska , Rubén Martín-Láez , José L. Fernández-Torre
Objective
To assess the ability of routine electroencephalography (rEEG) to predict delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH).
Methods
Single-center prospective study including adult patients with aSAH. Two rEEG recordings with quantitative analysis and transcranial Doppler sonography (TCD) were performed, within the first 72 h (EEG1 and TCD1) and between days 4–7 (EEG2 and TCD2). Multivariate logistic regression was performed to identify DCI predictors.
Results
Seventeen (25.4 %) of 67 patients developed DCI. In qualitative analysis, no patient with a normal EEG1 had DCI, while in EEG2, the absence of bilateral posterior alpha rhythm was more frequently observed in patients with DCI (52.9 % vs 20 %; p = 0.009). Quantitative EEG2 analysis revealed significantly higher total, delta, and theta power in DCI patients, with lower alpha–beta/theta-delta ratio and edge. Delta power ≥ 4.5 μV in EEG2 showed higher sensitivity than vasospasm on TCD2 but lower specificity. Age (OR 1.08; p = 0.04), vasospasm on TCD2 (OR 41.01; p = 0.003) and delta power ≥ 4.5 μV in EEG2 (OR 4.30; p = 0.06) were independent predictors of DCI.
Conclusions
rEEG with quantitative analysis is a useful tool for predicting DCI.
Significance
Integration of rEEG and TCD may improve detection of DCI in aSAH patients.
目的：探讨常规脑电图（rEEG）对动脉瘤性蛛网膜下腔出血（aSAH）迟发性脑缺血（DCI）的预测价值。方法：纳入成年aSAH患者的单中心前瞻性研究。在头72小时（EEG1和TCD1）和第4-7天（EEG2和TCD2）进行2次rEEG定量分析和经颅多普勒超声（TCD）记录。采用多元逻辑回归来确定DCI预测因子。结果：67例患者中17例（25.4%）发生DCI。在定性分析中，EEG1正常的患者没有DCI，而在EEG2中，DCI患者更常观察到双侧后α节律缺失（52.9% vs 20%; p = 0.009）。定量EEG2分析显示，DCI患者的总功率、δ和θ功率显著较高，α - β / δ - δ比值和边缘较低。EEG2 δ功率≥4.5 μV对TCD2的敏感性高于血管痉挛，但特异性较低。年龄（OR 1.08; p = 0.04）、TCD2血管痉挛（OR 41.01; p = 0.003）和EEG2 δ功率≥4.5 μV （OR 4.30; p = 0.06）是DCI的独立预测因子。结论：rEEG结合定量分析是预测DCI的有效工具。意义：结合rEEG和TCD可提高aSAH患者DCI的检出率。
{"title":"Routine EEG with quantitative analysis to detect delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage","authors":"Marina S. Cherchi , Miguel A. Hernández-Hernández , Javier Hernández-Cabello , Eduardo Torres Díez , Pedro Orizaola , Tetyana Stakhurska-Bilynska , Rubén Martín-Láez , José L. Fernández-Torre","doi":"10.1016/j.clinph.2025.2111449","DOIUrl":"10.1016/j.clinph.2025.2111449","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the ability of routine electroencephalography (rEEG) to predict delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH).</div></div><div><h3>Methods</h3><div>Single-center prospective study including adult patients with aSAH. Two rEEG recordings with quantitative analysis and transcranial Doppler sonography (TCD) were performed, within the first 72 h (EEG1 and TCD1) and between days 4–7 (EEG2 and TCD2). Multivariate logistic regression was performed to identify DCI predictors.</div></div><div><h3>Results</h3><div>Seventeen (25.4 %) of 67 patients developed DCI. In qualitative analysis, no patient with a normal EEG1 had DCI, while in EEG2, the absence of bilateral posterior alpha rhythm was more frequently observed in patients with DCI (52.9 % vs 20 %; p = 0.009). Quantitative EEG2 analysis revealed significantly higher total, delta, and theta power in DCI patients, with lower alpha–beta/theta-delta ratio and edge. Delta power ≥ 4.5 μV in EEG2 showed higher sensitivity than vasospasm on TCD2 but lower specificity. Age (OR 1.08; p = 0.04), vasospasm on TCD2 (OR 41.01; p = 0.003) and delta power ≥ 4.5 μV in EEG2 (OR 4.30; p = 0.06) were independent predictors of DCI.</div></div><div><h3>Conclusions</h3><div>rEEG with quantitative analysis is a useful tool for predicting DCI.</div></div><div><h3>Significance</h3><div>Integration of rEEG and TCD may improve detection of DCI in aSAH patients.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111449"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602517","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 : 2025-11-20DOI: 10.1016/j.clinph.2025.2111448
Denise Lima Medeiros de Melo, Dayanne Rodrigues da Cunha Alves Bento Oliveira, Patricia Lago dos Santos Madureira
{"title":"Trigemino-cervical reflex can be recorded simultaneously with other trigeminal reflexes after V3 stimulation under general anesthesia","authors":"Denise Lima Medeiros de Melo, Dayanne Rodrigues da Cunha Alves Bento Oliveira, Patricia Lago dos Santos Madureira","doi":"10.1016/j.clinph.2025.2111448","DOIUrl":"10.1016/j.clinph.2025.2111448","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111448"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602548","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 : 2025-11-20DOI: 10.1016/j.clinph.2025.2111451
Tomasz Szymon Szczepanski , Petter Moe Omland , Øystein Dunker , Trond Sand , Martijn Tannemaat , Robert Reijntjes , Anis Yazidi , Kerstin Bach , John Anker Zwart , Joe Jabre , Kristian Bernhard Nilsen
Objective
To compare four novel methods – extrapolated norms (E-norms), extrapolated reference values (E-Ref), multivariable extrapolated reference values (MeRef) and mixture model clustering (MMC) – for obtaining reference limits for nerve conduction studies (NCS) from historical data containing both normal and abnormal studies.
Methods
Reference limits for 29 commonly clinically used NCS measurements were calculated from a historical database containing measurements from 24 618 patients using E-norms, E-ref, MeRef and MMC. The resulting reference limits were compared to reference limits for NCS calculated from 680 healthy subjects using Youden’s J statistics.
Results
Except for distal latencies, E-norms produced reference limits with the highest Youden’s J statistics with higher sensitivity, but lower specificity. E-Ref, MeRef and MMC produced reference limits with high specificity, but lower sensitivity than E-norms.
Conclusions
There are substantial differences in the performance of E-norms, E-Ref, MeRef and MMC. A dynamic approach, where the methods used are changed based on the type of NCS measurement and the amount of historical data available, may yield the highest accuracy.
Significance
When combining the different novel methods, it is possible to create clinically useful reference limits using historical data.
{"title":"Deriving reference limits from historical data – A comparison of four novel methods","authors":"Tomasz Szymon Szczepanski , Petter Moe Omland , Øystein Dunker , Trond Sand , Martijn Tannemaat , Robert Reijntjes , Anis Yazidi , Kerstin Bach , John Anker Zwart , Joe Jabre , Kristian Bernhard Nilsen","doi":"10.1016/j.clinph.2025.2111451","DOIUrl":"10.1016/j.clinph.2025.2111451","url":null,"abstract":"<div><h3>Objective</h3><div>To compare four novel methods – extrapolated norms (E-norms), extrapolated reference values (E-Ref), multivariable extrapolated reference values (MeRef) and mixture model clustering (MMC) – for obtaining reference limits for nerve conduction studies (NCS) from historical data containing both normal and abnormal studies.</div></div><div><h3>Methods</h3><div>Reference limits for 29 commonly clinically used NCS measurements were calculated from a historical database containing measurements from 24<!--> <!-->618 patients using E-norms, E-ref, MeRef and MMC. The resulting reference limits were compared to reference limits for NCS calculated from 680 healthy subjects using Youden’s J statistics.</div></div><div><h3>Results</h3><div>Except for distal latencies, E-norms produced reference limits with the highest Youden’s J statistics with higher sensitivity, but lower specificity. E-Ref, MeRef and MMC produced reference limits with high specificity, but lower sensitivity than E-norms.</div></div><div><h3>Conclusions</h3><div>There are substantial differences in the performance of E-norms, E-Ref, MeRef and MMC. A dynamic approach, where the methods used are changed based on the type of NCS measurement and the amount of historical data available, may yield the highest accuracy.</div></div><div><h3>Significance</h3><div>When combining the different novel methods, it is possible to create clinically useful reference limits using historical data.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111451"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616692","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 : 2025-11-20DOI: 10.1016/j.clinph.2025.2111446
Wilder-Smith E , Tournev I , Chamova T , Asenov O , Bohlhalter S , Antimov P , Mihaylova V
Objective
The aim of our study was to perform high-resolution nerve ultrasound in asymptomatic carriers of transthyretin (TTR) p.Glu89Gln (p.Glu109Gln) mutation and to evaluate its role as a complementary non-invasive diagnostic tool in early detection of amyloid deposits in peripheral nerves.
Methods
The study included 21 asymptomatic carriers of TTR p.Glu89Gln (p.Glu109Gln). History, neurological examination, nerve conduction studies, sympathetic skin response, SudoScan and high-resolution nerve ultrasound were performed.
Results
Ultrasound pattern sum score was abnormal in 70% of the carriers. Despite the younger age of male carriers compared to the female carriers the abnormal ultrasound findings were more frequently encountered in males. The latter also demonstrated more pronounced cross-sectional area enlargement of the peroneal nerve at the fibular head and had more frequently ultrasound evidence of median nerve swelling at the wrist. Sural nerves were not enlarged in contrast to radial and fibular superficial nerves which showed male preponderance.
Conclusions
Our data suggest early ultrasound detection of amyloid deposition in presymptomatic TTR p. Glu89Gln (p.Glu109Gln) carriers and demonstrated sex related differences with earlier amyloid deposition in male carriers.
Significance
As a non-invasive tool nerve ultrasound may be added to the established follow up program for the asymptomatic TTR carriers.
目的对无症状转甲状腺素（TTR） p.Glu89Gln （p.Glu109Gln）突变携带者进行高分辨率神经超声检查，并评价其作为一种辅助的非侵入性诊断工具在早期检测周围神经淀粉样蛋白沉积中的作用。方法选取21例无症状TTR p.Glu89Gln （p.Glu109Gln）携带者。进行病史、神经学检查、神经传导研究、交感皮肤反应、SudoScan和高分辨率神经超声检查。结果70%的携带者超声模式综合评分异常。尽管男性携带者比女性携带者年龄小，但异常超声结果在男性中更常见。后者也表现出腓骨头腓神经更明显的横截面积扩大，并且在手腕处有更频繁的正中神经肿胀的超声证据。腓肠神经没有扩张，而桡骨和腓骨浅神经则以男性为主。结论早期超声可检出TTR p. Glu89Gln （p. glu109gln）症状前携带者的淀粉样蛋白沉积，且与男性携带者的早期淀粉样蛋白沉积存在性别差异。意义：神经超声作为一种无创工具，可加入到已建立的无症状TTR携带者随访计划中。
{"title":"Nerve ultrasound in asymptomatic hereditary transthyretin amyloidosis carriers","authors":"Wilder-Smith E , Tournev I , Chamova T , Asenov O , Bohlhalter S , Antimov P , Mihaylova V","doi":"10.1016/j.clinph.2025.2111446","DOIUrl":"10.1016/j.clinph.2025.2111446","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of our study was to perform high-resolution nerve ultrasound in asymptomatic carriers of transthyretin (<em>TTR</em>) p.Glu89Gln (p.Glu109Gln) mutation and to evaluate its role as a complementary non-invasive diagnostic tool in early detection of amyloid deposits in peripheral nerves.</div></div><div><h3>Methods</h3><div>The study included 21 asymptomatic carriers of <em>TTR</em> p.Glu89Gln (p.Glu109Gln). History, neurological examination, nerve conduction studies, sympathetic skin response, SudoScan and high-resolution nerve ultrasound were performed.</div></div><div><h3>Results</h3><div>Ultrasound pattern sum score was abnormal in 70% of the carriers. Despite the younger age of male carriers compared to the female carriers the abnormal ultrasound findings were more frequently encountered in males. The latter also demonstrated more pronounced cross-sectional area enlargement of the peroneal nerve at the fibular head and had more frequently ultrasound evidence of median nerve swelling at the wrist. Sural nerves were not enlarged in contrast to radial and fibular superficial nerves which showed male preponderance.</div></div><div><h3>Conclusions</h3><div>Our data suggest early ultrasound detection of amyloid deposition in presymptomatic <em>TTR</em> p. Glu89Gln (p.Glu109Gln) carriers and demonstrated sex related differences with earlier amyloid deposition in male carriers.</div></div><div><h3>Significance</h3><div>As a non-invasive tool nerve ultrasound may be added to the established follow up program for the asymptomatic <em>TTR</em> carriers.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111446"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571210","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 : 2025-11-19DOI: 10.1016/j.clinph.2025.2111444
Sabira Alibhai-Najarali , John P. de Grosbois , Aaron E. Philipp-Muller , Jennifer Shao , Matthew J. Hawken , Matea Skenderija , Jed A. Meltzer
Objective
To investigate whether post-movement beta rebound (PMBR), a proposed marker of cortical inhibition, reflects interhemispheric inhibition as measured by the ipsilateral silent period (iSP) following voluntary movement and to assess hemispheric asymmetries.
Methods
Twenty right-handed participants underwent transcranial magnetic stimulation (TMS) to elicit iSPs at baseline (no button-press) and eight timepoints following movement of the opposite hand, iSPs and motor-evoked potentials (MEPs) were recorded for both hemispheres. Six participants completed magnetoencephalography (MEG) to characterize beta oscillatory activity during the task. Five participants completed the task without the TMS as a control.
Results
iSP magnitude did not significantly change during PMBR period. Instead, post-movement iSP increased in the right hemisphere and decreased in the left, yielding a significant hemispheric difference (p = 0.014). MEG data confirmed symmetrical PMBR across hemispheres. MEPs showed increased excitability post-movement, particularly at early timepoints. Movement alone, without TMS, did not account for hemispheric asymmetry.
Conclusions
PMBR and iSP appear to reflect distinct inhibitory mechanisms. The dissociation suggests PMBR does not index transcallosal inhibition (TCI). Hemispheric asymmetry in iSP suggests stronger TCI following non-dominant hand movements.
Significance
The dissociation between iSP and PMBR underscores the complexity of motor control, informs understanding lateralized motor function and rehabilitation.
{"title":"Hemispheric asymmetry of the ipsilateral silent period following voluntary movement of the opposite hand","authors":"Sabira Alibhai-Najarali , John P. de Grosbois , Aaron E. Philipp-Muller , Jennifer Shao , Matthew J. Hawken , Matea Skenderija , Jed A. Meltzer","doi":"10.1016/j.clinph.2025.2111444","DOIUrl":"10.1016/j.clinph.2025.2111444","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether post-movement beta rebound (PMBR), a proposed marker of cortical inhibition, reflects interhemispheric inhibition as measured by the ipsilateral silent period (iSP) following voluntary movement and to assess hemispheric asymmetries.</div></div><div><h3>Methods</h3><div>Twenty right-handed participants underwent transcranial magnetic stimulation (TMS) to elicit iSPs at baseline (no button-press) and eight timepoints following movement of the opposite hand, iSPs and motor-evoked potentials (MEPs) were recorded for both hemispheres. Six participants completed magnetoencephalography (MEG) to characterize beta oscillatory activity during the task. Five participants completed the task without the TMS as a control.</div></div><div><h3>Results</h3><div>iSP magnitude did not significantly change during PMBR period. Instead, post-movement iSP increased in the right hemisphere and decreased in the left, yielding a significant hemispheric difference (p = 0.014). MEG data confirmed symmetrical PMBR across hemispheres. MEPs showed increased excitability post-movement, particularly at early timepoints. Movement alone, without TMS, did not account for hemispheric asymmetry.</div></div><div><h3>Conclusions</h3><div>PMBR and iSP appear to reflect distinct inhibitory mechanisms. The dissociation suggests PMBR does not index transcallosal inhibition (TCI). Hemispheric asymmetry in iSP suggests stronger TCI following non-dominant hand movements.</div></div><div><h3>Significance</h3><div>The dissociation between iSP and PMBR underscores the complexity of motor control, informs understanding lateralized motor function and rehabilitation.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111444"},"PeriodicalIF":3.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647444","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 : 2025-11-19DOI: 10.1016/j.clinph.2025.2111445
Nicholas Cothros , Catherine Lowrey , Stephen H. Scott , Alex Medina Escobar , Sean Dukelow , Davide Martino , Tamara Pringsheim
Objective
Essential tremor (ET) likely includes deficits outside tremor, though this is under-examined in youth. We tested the hypothesis that reaching movements in youth with ET are characterized by greater incoordination.
Methods
Fifteen youth with ET (ages 11 to 17) recruited from the Calgary Tourette and Pediatric Movement Disorders Clinic completed a visually-guided reaching task using the Kinarm Exoskeleton Lab. Performance in several kinematic parameters was compared with age-matched controls.
Results
Youth with ET differed from controls in multiple parameters. In the dominant arm, the initial portion of reaching movements was slower and smaller-amplitude, with longer reaction time and greater posture speed at movement end when the hand should be at rest. In the non-dominant arm, those with ET differed from controls in a larger number of parameters. All but three with ET were impaired in at least one task parameter, scoring outside age-predicted norms.
Conclusion
Our study supports the notion of ET as a disorder with abnormalities beyond tremor, and that motoric abnormalities are demonstrable in youth with ET.
Significance
This is the first study showing youth with ET differ from age-matched controls in multiple aspects of reaching movements, including initial trajectory control, movement smoothness, overall trajectory, and endpoint control.
{"title":"Youth with essential tremor differ from age-matched controls in multiple aspects of visually-guided reaching movements","authors":"Nicholas Cothros , Catherine Lowrey , Stephen H. Scott , Alex Medina Escobar , Sean Dukelow , Davide Martino , Tamara Pringsheim","doi":"10.1016/j.clinph.2025.2111445","DOIUrl":"10.1016/j.clinph.2025.2111445","url":null,"abstract":"<div><h3>Objective</h3><div>Essential tremor (ET) likely includes deficits outside tremor, though this is under-examined in youth. We tested the hypothesis that reaching movements in youth with ET are characterized by greater incoordination.</div></div><div><h3>Methods</h3><div>Fifteen youth with ET (ages 11 to 17) recruited from the Calgary Tourette and Pediatric Movement Disorders Clinic completed a visually-guided reaching task using the Kinarm Exoskeleton Lab. Performance in several kinematic parameters was compared with age-matched controls.</div></div><div><h3>Results</h3><div>Youth with ET differed from controls in multiple parameters. In the dominant arm, the initial portion of reaching movements was slower and smaller-amplitude, with longer reaction time and greater posture speed at movement end when the hand should be at rest. In the non-dominant arm, those with ET differed from controls in a larger number of parameters. All but three with ET were impaired in at least one task parameter, scoring outside age-predicted norms.</div></div><div><h3>Conclusion</h3><div>Our study supports the notion of ET as a disorder with abnormalities beyond tremor, and that motoric abnormalities are demonstrable in youth with ET.</div></div><div><h3>Significance</h3><div>This is the first study showing youth with ET differ from age-matched controls in multiple aspects of reaching movements, including initial trajectory control, movement smoothness, overall trajectory, and endpoint control.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111445"},"PeriodicalIF":3.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571209","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 : 2025-11-17DOI: 10.1016/j.clinph.2025.2111443
Giuseppe Didato , Nicolò Castelli , Chiara Pastori , Paola Lanteri , Ambra Dominese , Michele Introna , Rita Garbelli , Fabio Martino Doniselli , Gianluca Marucci , Elena Freri , Angelo Del Sole , Valeria Cuccarini , Francesco Deleo , Andrea Stabile , Roberta Di Giacomo , Francesca Ragona , Laura Rossini , Carla Carozzi , Massimiliano Del Bene , Vittoria Nazzi , Michele Rizzi
Objective
Type II focal cortical dysplasias (FCDII) present a clear-cut anatomo-electro-clinical profile and are associated with optimal surgical outcome when completely resected. Alongside presurgical planning and neuroimaging, intraoperative electrocorticography (ECoG) can aid in delineating FCDII boundaries. We report outcomes from patients undergoing FCDII resection using 3D-ECoG with an intracerebral electrode guided by intraoperative ultrasound (ioUS).
Methods
Patients with suspected FCDII underwent 3D-ECoG during surgery to record intracerebral interictal epileptiform discharges (IEDs) classified as: 1) rhythmic spikes (RS), and 2) periodic bursts of polyspikes (PBOP).
Results
Ten patients (5 male, 5 female; median age 19.5 years, median epilepsy duration 16 years) were included. Bottom-of-sulcus dysplasia (BOSD) was found in 60 %. 3D-ECoG identified RS in 30 % and PBOP in 70 %. Total IED removal was achieved in 60 %. Histopathology revealed FCDII in 80 %, while 20 % had a diagnosis of “no definite FCD on histopathology”. After a median 24-month follow-up, 90 % achieved ILAE class 1 outcome (seizure free), 10 % had class 2 (only auras). No major complications occurred.
Conclusions
IoUS-assisted 3D-ECoG is a safe procedure for intraoperative delineation of FCDII, supporting complete resection.
Significance
Integrating IoUS with 3D-ECoG can offer substantial benefits for surgical management of FCDII-related epilepsy.
{"title":"Intraoperative Ultrasound-Assisted 3D-Electrocorticography for resection of type II focal cortical dysplasias","authors":"Giuseppe Didato , Nicolò Castelli , Chiara Pastori , Paola Lanteri , Ambra Dominese , Michele Introna , Rita Garbelli , Fabio Martino Doniselli , Gianluca Marucci , Elena Freri , Angelo Del Sole , Valeria Cuccarini , Francesco Deleo , Andrea Stabile , Roberta Di Giacomo , Francesca Ragona , Laura Rossini , Carla Carozzi , Massimiliano Del Bene , Vittoria Nazzi , Michele Rizzi","doi":"10.1016/j.clinph.2025.2111443","DOIUrl":"10.1016/j.clinph.2025.2111443","url":null,"abstract":"<div><h3>Objective</h3><div>Type II focal cortical dysplasias (FCDII) present a clear-cut anatomo-electro-clinical profile and are associated with optimal surgical outcome when completely resected. Alongside presurgical planning and neuroimaging, intraoperative electrocorticography (ECoG) can aid in delineating FCDII boundaries. We report outcomes from patients undergoing FCDII resection using 3D-ECoG with an intracerebral electrode guided by intraoperative ultrasound (ioUS).</div></div><div><h3>Methods</h3><div>Patients with suspected FCDII underwent 3D-ECoG during surgery to record intracerebral interictal epileptiform discharges (IEDs) classified as: 1) rhythmic spikes (RS), and 2) periodic bursts of polyspikes (PBOP).</div></div><div><h3>Results</h3><div>Ten patients (5 male, 5 female; median age 19.5 years, median epilepsy duration 16 years) were included. Bottom-of-sulcus dysplasia (BOSD) was found in 60 %. 3D-ECoG identified RS in 30 % and PBOP in 70 %. Total IED removal was achieved in 60 %. Histopathology revealed FCDII in 80 %, while 20 % had a diagnosis of “no definite FCD on histopathology”. After a median 24-month follow-up, 90 % achieved ILAE class 1 outcome (seizure free), 10 % had class 2 (only auras). No major complications occurred.</div></div><div><h3>Conclusions</h3><div>IoUS-assisted 3D-ECoG is a safe procedure for intraoperative delineation of FCDII, supporting complete resection.</div></div><div><h3>Significance</h3><div>Integrating IoUS with 3D-ECoG can offer substantial benefits for surgical management of FCDII-related epilepsy.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111443"},"PeriodicalIF":3.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616625","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 : 2025-11-16DOI: 10.1016/j.clinph.2025.2111388
Zino H. Wellauer , Deniza Avdi , Payam S. Shabestari , Allegra Preisig , Jessica Fritzsche , Nicole Peter , Martin Meyer , Tobias Kleinjung , Patrick K.A. Neff
Objective:
To assess the combined effect of high-definition transcranial random noise stimulation (HD-tRNS) of bilateral auditory cortex and acoustic stimulation (AS) on auditory evoked potentials and tinnitus perception.
Methods:
A double-blind, randomized, controlled, within-subject crossover trial was conducted with thirteen adults with chronic tinnitus. Each participant completed four sessions, at least 48 h apart, consisting of active HD-tRNS + AS, active HD-tRNS alone, sham HD-tRNS + sham AS and sham HD-tRNS alone. Auditory evoked potentials (including mismatch negativity) and tinnitus characteristics were measured before and after each session.
Results:
Active electric and bimodal stimulation significantly modulated auditory evoked potentials, unlike their sham equivalents. Bimodal stimulation produced significant changes in MMN amplitude that countered the tinnitus-related alteration in processing intensity deviants. However, these effects did not survive family-wise correction in this complex design. Bimodal and bimodal-sham stimulation reduced objective loudness by >3 dB.
Conclusion:
HD-tRNS, particularly when combined with AS, may induce changes in auditory-system excitability and acutely alter neural processing and loudness perception in tinnitus.
Significance:
Combining acoustic and electric stimulation is a promising approach for basic research and clinical applications in auditory neuroscience, providing new insights into neuroplasticity in an altered auditory system. This is the first study to measure the modifiability of evoked neural correlates in tinnitus.
{"title":"Modulating altered sensory prediction using bilateral auditory cortex high-definition transcranial random noise stimulation and acoustic masking","authors":"Zino H. Wellauer , Deniza Avdi , Payam S. Shabestari , Allegra Preisig , Jessica Fritzsche , Nicole Peter , Martin Meyer , Tobias Kleinjung , Patrick K.A. Neff","doi":"10.1016/j.clinph.2025.2111388","DOIUrl":"10.1016/j.clinph.2025.2111388","url":null,"abstract":"<div><h3>Objective:</h3><div>To assess the combined effect of high-definition transcranial random noise stimulation (HD-tRNS) of bilateral auditory cortex and acoustic stimulation (AS) on auditory evoked potentials and tinnitus perception.</div></div><div><h3>Methods:</h3><div>A double-blind, randomized, controlled, within-subject crossover trial was conducted with thirteen adults with chronic tinnitus. Each participant completed four sessions, at least 48 h apart, consisting of active HD-tRNS + AS, active HD-tRNS alone, sham HD-tRNS + sham AS and sham HD-tRNS alone. Auditory evoked potentials (including mismatch negativity) and tinnitus characteristics were measured before and after each session.</div></div><div><h3>Results:</h3><div>Active electric and bimodal stimulation significantly modulated auditory evoked potentials, unlike their sham equivalents. Bimodal stimulation produced significant changes in MMN amplitude that countered the tinnitus-related alteration in processing intensity deviants. However, these effects did not survive family-wise correction in this complex design. Bimodal and bimodal-sham stimulation reduced objective loudness by >3 dB.</div></div><div><h3>Conclusion:</h3><div>HD-tRNS, particularly when combined with AS, may induce changes in auditory-system excitability and acutely alter neural processing and loudness perception in tinnitus.</div></div><div><h3>Significance:</h3><div>Combining acoustic and electric stimulation is a promising approach for basic research and clinical applications in auditory neuroscience, providing new insights into neuroplasticity in an altered auditory system. This is the first study to measure the modifiability of evoked neural correlates in tinnitus.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111388"},"PeriodicalIF":3.6,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602214","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 : 2025-11-15DOI: 10.1016/j.clinph.2025.2111440
Zian Pei , Lin Zhu , Huixia Ren , Yumei Liu , Xue Shi , Yun Lin , Jing Wang , Pan Li , Pan Wang , Yong Ji , Yuying Zhou , Xiaoying Tang , Xin Jiang , Xiaoguang Tong , Yi Guo
Objective
Clinical cognitive and pathological marker stratification systems have evolved separately, causing mismatches that limit their clinical use. This study retrospectively validated the link between EEG and clinical symptoms, pathological markers, and the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS).
Methods
This multicenter study involved 308 Alzheimer’s patients (AD), 176 with Parkinson’s (PD), and 181 normal controls. Resting-state EEG were analyzed to identify four oscillation modes. An EEG-based cognitive risk system was created and validated, also evaluating its effect on rTMS therapy effectiveness.
Results
EEG oscillation changes correlated with cognitive decline, revealing distinct brain network disruptions in AD and PD. These oscillation changes were associated with AD biomarkers, particularly tau hyperphosphorylation. Multicenter validation showed an 83% concordance with the Clinical Dementia Rating Scale, and EEG stratification enhanced rTMS therapeutic efficacy.
Conclusions
This study showed that EEG-based stratification can assess cognitive function, track disease progression, identify key intervention periods, and improve patient selection for better treatment outcomes in clinical settings.
Significance
This study demonstrates that EEG can connect disease processes to clinical symptoms at a molecular level, offering a unified framework for improved dementia management. This method allows for dynamic monitoring and precise neuromodulation, enhancing personalized care for neurodegenerative diseases.
{"title":"EEG-based stratification in Alzheimer’s disease: Cognitive progression, pathological marker associations, and therapeutic interventions","authors":"Zian Pei , Lin Zhu , Huixia Ren , Yumei Liu , Xue Shi , Yun Lin , Jing Wang , Pan Li , Pan Wang , Yong Ji , Yuying Zhou , Xiaoying Tang , Xin Jiang , Xiaoguang Tong , Yi Guo","doi":"10.1016/j.clinph.2025.2111440","DOIUrl":"10.1016/j.clinph.2025.2111440","url":null,"abstract":"<div><h3>Objective</h3><div>Clinical cognitive and pathological marker stratification systems have evolved separately, causing mismatches that limit their clinical use. This study retrospectively validated the link between EEG and clinical symptoms, pathological markers, and the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS).</div></div><div><h3>Methods</h3><div>This multicenter study involved 308 Alzheimer’s patients (AD), 176 with Parkinson’s (PD), and 181 normal controls. Resting-state EEG were analyzed to identify four oscillation modes. An EEG-based cognitive risk system was created and validated, also evaluating its effect on rTMS therapy effectiveness.</div></div><div><h3>Results</h3><div>EEG oscillation changes correlated with cognitive decline, revealing distinct brain network disruptions in AD and PD. These oscillation changes were associated with AD biomarkers, particularly tau hyperphosphorylation. Multicenter validation showed an 83% concordance with the Clinical Dementia Rating Scale, and EEG stratification enhanced rTMS therapeutic efficacy.</div></div><div><h3>Conclusions</h3><div>This study showed that EEG-based stratification can assess cognitive function, track disease progression, identify key intervention periods, and improve patient selection for better treatment outcomes in clinical settings.</div></div><div><h3>Significance</h3><div>This study demonstrates that EEG can connect disease processes to clinical symptoms at a molecular level, offering a unified framework for improved dementia management. This method allows for dynamic monitoring and precise neuromodulation, enhancing personalized care for neurodegenerative diseases.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111440"},"PeriodicalIF":3.6,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616621","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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