To investigate the neural networks involved in idiomatic expressions (IE) comprehension in healthy controls and patients with drug-resistant temporal lobe epilepsy (TLE), with a functional magnetic resonance imaging (fMRI) task.
Methods
Thirty-two patients with TLE (left or right) and seventeen healthy controls were evaluated. Activated nodes in the fMRI task were defined as Regions of Interest (ROIs) for a posterior functional connectivity analysis.
Results
All participants completed the task successfully. We found a bilateral fronto-temporal network, lateralized to the right, during IE processing in the overall sample. Compared to controls, patients additionally activated frontal, temporal, and insular areas in both hemispheres. Controls exhibited fewer connections but greater inhibitory connectivity, while the opposite (more connections and increased excitatory connectivity) occurred in patients. Compared to controls, TLE patients recruited additional brain areas on top of the expected bilateral frontotemporal network. The connectivity analysis revealed that controls exhibited more effective inhibitory connectivity, with more modular ROIs. In contrast, patients demonstrated greater excitatory connectivity.
Conclusion
The results suggest compensatory neural recruitment in additional areas in TLE during IE comprehension.
Significance
Exacerbated connections in TLE may reflect the need to recruit alternative regions, resulting in higher costs and lower efficiency of the neural network.
{"title":"Reorganization of pragmatic language networks in patients with temporal lobe epilepsy","authors":"Bautista Elizalde Acevedo , Silvia Kochen , Lucy Alba-Ferrara , Mariana Bendersky","doi":"10.1016/j.clinph.2024.12.012","DOIUrl":"10.1016/j.clinph.2024.12.012","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the neural networks involved in idiomatic expressions (IE) comprehension in healthy controls and patients with drug-resistant temporal lobe epilepsy (TLE), with a functional magnetic resonance imaging (fMRI) task.</div></div><div><h3>Methods</h3><div>Thirty-two patients with TLE (left or right) and seventeen healthy controls were evaluated. Activated nodes in the fMRI task were defined as Regions of Interest (ROIs) for a posterior functional connectivity analysis.</div></div><div><h3>Results</h3><div>All participants completed the task successfully. We found a bilateral fronto-temporal network, lateralized to the right, during IE processing in the overall sample. Compared to controls, patients additionally activated frontal, temporal, and insular areas in both hemispheres. Controls exhibited fewer connections but greater inhibitory connectivity, while the opposite (more connections and increased excitatory connectivity) occurred in patients. Compared to controls, TLE patients recruited additional brain areas on top of the expected bilateral frontotemporal network. The connectivity analysis revealed that controls exhibited more effective inhibitory connectivity, with more modular ROIs. In contrast, patients demonstrated greater excitatory connectivity.</div></div><div><h3>Conclusion</h3><div>The results suggest compensatory neural recruitment in additional areas in TLE during IE comprehension.</div></div><div><h3>Significance</h3><div>Exacerbated connections in TLE may reflect the need to recruit alternative regions, resulting in higher costs and lower efficiency of the neural network.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 194-205"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913821","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}
{"title":"Experience with salbutamol treatment in a family with congenital myasthenia due to CHRNE mutation","authors":"Didem Tezen , Esra Koçhan Kızılkılıç , Nursena Erener , Zakhiriddin Khojakulov , Veysi Demirbilek , Ayşe Nazlı Başak","doi":"10.1016/j.clinph.2024.12.010","DOIUrl":"10.1016/j.clinph.2024.12.010","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 120-122"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871605","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.2024.11.020
Rig Das , Stephen V. Gliske , Dulce Maroni , Miguel Situ-Kcomt , Leslie C West , Michael O Summers , Siqun Tang , Pavan A. Vaswani , Casey H. Halpern , John A. Thompson , Clete A. Kushida , Aviva Abosch
Objective
Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) is a common treatment for motor symptoms of Parkinson’s disease but its influence on non-motor symptoms is less clear. Sleep spindles are known to be reduced in patients with Parkinson’s disease, but the effect of STN DBS is unknown. The objective of our study was to address this knowledge gap.
Method
Polysomnograms were recorded for three consecutive nights in 15 patients with advanced Parkinson’s disease (11 male, 4 female; age: 53–75 years), including at least one night each of unilateral STN DBS stimulation ON and OFF. Stimulation ON was set to 70 % of clinical amplitude to mitigate sleep being altered via changing motor symptoms or due to patient awareness of stimulation. Sleep spindles were detected in electroencephalogram (EEG) data by two previously published, validated automated sleep spindle detection algorithms: Ferrarelli et al. (2007) and Martin et al. (2013).
Results
Sleep spindle density was higher during stimulation ON than OFF nights in 11 of 12 subjects using either sleep spindle detection algorithm (p<=0.01, Wilcoxon rank sum). Stimulation ON versus OFF had no statistically significant effect on sleep spindle duration or amplitude.
Conclusion
Our analysis indicates that a single night of sub-optimal STN stimulation significantly increases sleep spindle density in Parkinson’s disease patients.
Significance
These results further our understanding of how DBS impacts non-motor symptoms of Parkinson’s disease.
{"title":"Sleep spindle variation in patients with Parkinson’s disease on first nights of sub-optimal deep brain stimulation","authors":"Rig Das , Stephen V. Gliske , Dulce Maroni , Miguel Situ-Kcomt , Leslie C West , Michael O Summers , Siqun Tang , Pavan A. Vaswani , Casey H. Halpern , John A. Thompson , Clete A. Kushida , Aviva Abosch","doi":"10.1016/j.clinph.2024.11.020","DOIUrl":"10.1016/j.clinph.2024.11.020","url":null,"abstract":"<div><h3>Objective</h3><div>Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) is a common treatment for motor symptoms of Parkinson’s disease but its influence on non-motor symptoms is less clear. Sleep spindles are known to be reduced in patients with Parkinson’s disease, but the effect of STN DBS is unknown. The objective of our study was to address this knowledge gap.</div></div><div><h3>Method</h3><div>Polysomnograms were recorded for three consecutive nights in 15 patients with advanced Parkinson’s disease (11 male, 4 female; age: 53–75 years), including at least one night each of unilateral STN DBS stimulation ON and OFF. Stimulation ON was set to 70 % of clinical amplitude to mitigate sleep being altered via changing motor symptoms or due to patient awareness of stimulation. Sleep spindles were detected in electroencephalogram (EEG) data by two previously published, validated automated sleep spindle detection algorithms: Ferrarelli et al. (2007) and Martin et al. (2013).</div></div><div><h3>Results</h3><div>Sleep spindle density was higher during stimulation ON than OFF nights in 11 of 12 subjects using either sleep spindle detection algorithm (p<=0.01, Wilcoxon rank sum). Stimulation ON versus OFF had no statistically significant effect on sleep spindle duration or amplitude.</div></div><div><h3>Conclusion</h3><div>Our analysis indicates that a single night of sub-optimal STN stimulation significantly increases sleep spindle density in Parkinson’s disease patients.</div></div><div><h3>Significance</h3><div>These results further our understanding of how DBS impacts non-motor symptoms of Parkinson’s disease.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 91-97"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871606","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.2024.12.014
Roos F. Meijer , Xiaowan Wang , Inge M. van Ooijen, Bauke van der Velde, Jeroen Dudink, Manon J.N.L. Benders, Maria Luisa Tataranno
Objective
To systematically review the literature on the associations between electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) measures in preterm infants (gestational age < 37 weeks).
Methods
A comprehensive search was performed in PubMed and EMBASE databases up to February 12th, 2024. Non-relevant studies were eliminated following the PRISMA guidelines.
Results
Ten out of 991 identified studies were included. Brain MRI metrics used in these studies include volumes, cortical features, microstructural integrity, visual assessments, and cerebral linear measurements. EEG parameters were classified as qualitative (Burdjalov maturity score, seizure burden, and background activity) or quantitative (discontinuity, spectral content, amplitude, and connectivity). Among them, discontinuity and the Burdjalov score were most frequently examined. Higher discontinuity was associated with reduced brain volume, cortical surface, microstructural integrity, and linear measurements. The Burdjalov score related to brain maturation qualitatively assessed on MRI. No other consistent correlations could be established due to the variability across studies.
Conclusions
The reviewed studies utilized a variety of EEG and MRI measurements, while discontinuity and the Burdjalov score stood out as significant indicators of structural brain development.
Significance
This review, for the first time, provides an extensive overview of EEG-MRI associations in preterm infants, potentially facilitating their clinical application.
{"title":"The relationship between early life EEG and brain MRI in preterm infants: A systematic review","authors":"Roos F. Meijer , Xiaowan Wang , Inge M. van Ooijen, Bauke van der Velde, Jeroen Dudink, Manon J.N.L. Benders, Maria Luisa Tataranno","doi":"10.1016/j.clinph.2024.12.014","DOIUrl":"10.1016/j.clinph.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review the literature on the associations between electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) measures in preterm infants (gestational age < 37 weeks).</div></div><div><h3>Methods</h3><div>A comprehensive search was performed in PubMed and EMBASE databases up to February 12th, 2024. Non-relevant studies were eliminated following the PRISMA guidelines.</div></div><div><h3>Results</h3><div>Ten out of 991 identified studies were included. Brain MRI metrics used in these studies include volumes, cortical features, microstructural integrity, visual assessments, and cerebral linear measurements. EEG parameters were classified as qualitative (Burdjalov maturity score, seizure burden, and background activity) or quantitative (discontinuity, spectral content, amplitude, and connectivity). Among them, discontinuity and the Burdjalov score were most frequently examined. Higher discontinuity was associated with reduced brain volume, cortical surface, microstructural integrity, and linear measurements. The Burdjalov score related to brain maturation qualitatively assessed on MRI. No other consistent correlations could be established due to the variability across studies.</div></div><div><h3>Conclusions</h3><div>The reviewed studies utilized a variety of EEG and MRI measurements, while discontinuity and the Burdjalov score stood out as significant indicators of structural brain development.</div></div><div><h3>Significance</h3><div>This review, for the first time, provides an extensive overview of EEG-MRI associations in preterm infants, potentially facilitating their clinical application.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 168-179"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892602","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.2024.12.011
S.A.J.E.A. Lagerweij , J.C. van Zijl , M. Smit , H. Eggink , D.L.M. Oterdoom , J.M.C. van Dijk , M.E. van Egmond , J.W. Elting , M.A.J. Tijssen
Objective
Clinical rating scales often fail to capture the full spectrum of dystonic symptoms. Deep brain stimulation of the globus pallidus interna (GPi-DBS) effectively treats dystonia, but response variability necessitates a reliable biomarker. Intermuscular coherence (4–12 Hz) has been linked to abnormal activity in the cortico-basal ganglia-thalamo-cortical (CBGTC) loop and may serve as an objective measure of dystonia and GPi-DBS effectiveness.
Methods
A retrospective cohort study included 12 dystonia patients undergoing GPi-DBS implantation. Clinical rating scales and a neurophysiological assessment were performed before and one year post-DBS. Coherence in the 4–12 Hz range was analyzed from electromyography (EMG) of antagonistic arm muscles. Comparisons were made between patients with and without arm dystonia, t-tests evaluated the differences between pre- and post-DBS, and correlations between coherence and clinical scales were performed.
Results
Seven patients with arm dystonia appeared to have higher pre-operative intermuscular coherence compared to those without. Coherence was significantly decreased after GPi-DBS in the arm dystonia group. No strong correlations were found between coherence and clinical rating scales.
Conclusion
Intermuscular coherence is present in dystonic muscles and decreases following GPi-DBS. Correlations with motor scores were inconclusive due to patient heterogeneity and ill-fitting clinical scales.
Significance
Intermuscular coherence has potential to aid GPi-DBS patient selection and optimization but larger studies are needed to validate its use.
{"title":"Intermuscular coherence during co-contraction eliciting tasks as a biomarker for dystonia and GPi-DBS efficacy","authors":"S.A.J.E.A. Lagerweij , J.C. van Zijl , M. Smit , H. Eggink , D.L.M. Oterdoom , J.M.C. van Dijk , M.E. van Egmond , J.W. Elting , M.A.J. Tijssen","doi":"10.1016/j.clinph.2024.12.011","DOIUrl":"10.1016/j.clinph.2024.12.011","url":null,"abstract":"<div><h3>Objective</h3><div>Clinical rating scales often fail to capture the full spectrum of dystonic symptoms. Deep brain stimulation of the globus pallidus interna (GPi-DBS) effectively treats dystonia, but response variability necessitates a reliable biomarker. Intermuscular coherence (4–12 Hz) has been linked to abnormal activity in the cortico-basal ganglia-thalamo-cortical (CBGTC) loop and may serve as an objective measure of dystonia and GPi-DBS effectiveness.</div></div><div><h3>Methods</h3><div>A retrospective cohort study included 12 dystonia patients undergoing GPi-DBS implantation. Clinical rating scales and a neurophysiological assessment were performed before and one year post-DBS. Coherence in the 4–12 Hz range was analyzed from electromyography (EMG) of antagonistic arm muscles. Comparisons were made between patients with and without arm dystonia, t-tests evaluated the differences between pre- and post-DBS, and correlations between coherence and clinical scales were performed.</div></div><div><h3>Results</h3><div>Seven patients with arm dystonia appeared to have higher pre-operative intermuscular coherence compared to those without. Coherence was significantly decreased after GPi-DBS in the arm dystonia group. No strong correlations were found between coherence and clinical rating scales.</div></div><div><h3>Conclusion</h3><div>Intermuscular coherence is present in dystonic muscles and decreases following GPi-DBS. Correlations with motor scores were inconclusive due to patient heterogeneity and ill-fitting clinical scales.</div></div><div><h3>Significance</h3><div>Intermuscular coherence has potential to aid GPi-DBS patient selection and optimization but larger studies are needed to validate its use.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 70-79"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863369","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.2024.11.017
Satoru Ikemoto , Nicolás von Ellenrieder , Jean Gotman
Objective
To examine the blood oxygen level-dependent (BOLD) responses in the default mode network (DMN) and subcortical regions in relation to epileptic events in scalp EEG and intracranial EEG (iEEG).
Methods
We retrospectively compared BOLD responses in the DMN and subcortical regions to interictal epileptiform discharge (IED) characteristics of the scalp and iEEG in consecutive patients with focal epilepsy. All voxels were used as the denominator to assess the positive and negative BOLD ratios in each region, and the percentage of voxels with significant activation or deactivation was assessed.
Results
Seventy-one EEG-fMRI studies were included. The widespread IED group showed a higher negative BOLD ratio in the DMN than did the focal IED group. Spike and ripple spreads in iEEG positively correlated with a positive BOLD ratio in the DMN and subcortical regions and a negative BOLD ratio in the DMN. Fast ripple spread showed no correlation with the BOLD ratio in any region.
Conclusions
IEDs affect local regions, as well as distant neocortical (DMN) and subcortical regions, depending on their localization and characteristics.
Significance
Our findings showed both positive and negative IED-related BOLD responses in subcortical regions and new evidence of network dysfunction related to focal epileptic activity.
{"title":"Interictal epileptiform discharge-related BOLD responses in the default mode network and subcortical regions","authors":"Satoru Ikemoto , Nicolás von Ellenrieder , Jean Gotman","doi":"10.1016/j.clinph.2024.11.017","DOIUrl":"10.1016/j.clinph.2024.11.017","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the blood oxygen level-dependent (BOLD) responses in the default mode network (DMN) and subcortical regions in relation to epileptic events in scalp EEG and intracranial EEG (iEEG).</div></div><div><h3>Methods</h3><div>We retrospectively compared BOLD responses in the DMN and subcortical regions to interictal epileptiform discharge (IED) characteristics of the scalp and iEEG in consecutive patients with focal epilepsy. All voxels were used as the denominator to assess the positive and negative BOLD ratios in each region, and the percentage of voxels with significant activation or deactivation was assessed.</div></div><div><h3>Results</h3><div>Seventy-one EEG-fMRI studies were included. The widespread IED group showed a higher negative BOLD ratio in the DMN than did the focal IED group. Spike and ripple spreads in iEEG positively correlated with a positive BOLD ratio in the DMN and subcortical regions and a negative BOLD ratio in the DMN. Fast ripple spread showed no correlation with the BOLD ratio in any region.</div></div><div><h3>Conclusions</h3><div>IEDs affect local regions, as well as distant neocortical (DMN) and subcortical regions, depending on their localization and characteristics.</div></div><div><h3>Significance</h3><div>Our findings showed both positive and negative IED-related BOLD responses in subcortical regions and new evidence of network dysfunction related to focal epileptic activity.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 29-40"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812640","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.2024.12.007
Elena Lainez , Daniel Sánchez-Tejerina , Paula Fernández Alvarez , Margarida Gratacòs-Viñola , José Luis Seoane , Daniela Isabel Santa-Cruz , Lena Verdaguer , Raúl Juntas , Arnau Llauradó , Javier Sotoca , Maria Salvado , Elena García Arumi , Núria Raguer
Introduction/Objective
Biallelic expansion of the pentanucleotide AAGGG in the RFC1- gene is associated with cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS). This study aimed to comprehensively characterise this condition by conducting an in-depth neurophysiological examination of afflicted patients.
Methods
A retrospective analysis was conducted in 31 RFC1-positive patients. Assessment included clinical examination and electrodiagnostic tests: nerve conduction studies, F waves, needle electromyography, H, blink and masseter reflexes; Autonomic Nervous System (ANS): Heart Rate Variability, Sympathetic Skin Response and Electrochemical Skin Conductance, and Quantitative Sensory Test (QST). Medullar tracts were assessed using Somatosensory Evoked Potentials (SEPs) and Transcranial Magnetic Stimulation.
Results
All patients exhibited moderate to severe sensory axonal neuropathy/neuronopathy, whereas motor nerve conduction parameters and the pyramidal pathway showed no abnormalities. Tibial nerve SEPs were absent or severely attenuated in all patients, and were moderately affected by the median nerve. H-reflexes were preserved in 85.7% and blink reflex in 60% of tested patients. ANS tests yielded predominantly normal results, although 74% demonstrated impaired QST.
Conclusions
Our findings highlight the characteristic features of sensory neuropathy/neuronopathy and severe somatosensory deficits, with predominantly preserved H-reflexes and motor sparing. Thermoalgesic fibres are frequently involved, whereas the ANS is relatively preserved.
Significance
Neurophysiological examinations can objectively characterize the spectrum of RFC1-related disease.
{"title":"Spectrum disorder of RFC1 expansions/CANVAS: Clinical and electrophysiological characterization of a group of 31 patients","authors":"Elena Lainez , Daniel Sánchez-Tejerina , Paula Fernández Alvarez , Margarida Gratacòs-Viñola , José Luis Seoane , Daniela Isabel Santa-Cruz , Lena Verdaguer , Raúl Juntas , Arnau Llauradó , Javier Sotoca , Maria Salvado , Elena García Arumi , Núria Raguer","doi":"10.1016/j.clinph.2024.12.007","DOIUrl":"10.1016/j.clinph.2024.12.007","url":null,"abstract":"<div><h3>Introduction/Objective</h3><div>Biallelic expansion of the pentanucleotide AAGGG in the <em>RFC1-</em> gene is associated with cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS). This study aimed to comprehensively characterise this condition by conducting an in-depth neurophysiological examination of afflicted patients.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted in 31 <em>RFC1</em>-positive patients. Assessment included clinical examination and electrodiagnostic tests: nerve conduction studies, F waves, needle electromyography, H, blink and masseter reflexes; Autonomic Nervous System (ANS): Heart Rate Variability, Sympathetic Skin Response and Electrochemical Skin Conductance, and Quantitative Sensory Test (QST). Medullar tracts were assessed using Somatosensory Evoked Potentials (SEPs) and Transcranial Magnetic Stimulation.</div></div><div><h3>Results</h3><div>All patients exhibited moderate to severe sensory axonal neuropathy/neuronopathy, whereas motor nerve conduction parameters and the pyramidal pathway showed no abnormalities. Tibial nerve SEPs were absent or severely attenuated in all patients, and were moderately affected by the median nerve. H-reflexes were preserved in 85.7% and blink reflex in 60% of tested patients. ANS tests yielded predominantly normal results, although 74% demonstrated impaired QST.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the characteristic features of sensory neuropathy/neuronopathy and severe somatosensory deficits, with predominantly preserved H-reflexes and motor sparing. Thermoalgesic fibres are frequently involved, whereas the ANS is relatively preserved.</div></div><div><h3>Significance</h3><div>Neurophysiological examinations can objectively characterize the spectrum of <em>RFC1</em>-related disease.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 136-144"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892622","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.2025.01.013
Alba León Jorba , Alina Velescu , Núria Álvarez López-Herrero , Anna Mases Fernández , Lorena Romero Montana , Albert Clarà Velasco
Objective
Intraoperative neurophysiological monitoring (IONM) is used to detect cerebral ischemia during carotid endarterectomy (CEA). IONM of cranial nerves during CEA has been reported anecdotally. The aim of this study was to assess the use of IONM in identifying and preventing cranial nerve damage during CEA.
Methods
Prospective and observational study from a cohort of 81 patients undergoing CEA. Cranial nerve IONM was performed using electromyography (EMG), corticobulbar motor evoked potentials (CoMEP) and mapping techniques. Responses from spinal accessory, vagus, hypoglossal and facial nerves were recorded.
Results
CoMEP changes were detected in 49 patients (60.4 %). Most were related to indirect retraction and normalized at the end of the procedure. In 11 (13.5 %) cases, CoMEP changes persisted at the conclusion of the surgery, and 9 (11.1 %) of them showed a postoperative paresis. All patients normalized the neurological examination within a year. Cranial nerve mapping identified functional atypical nerve branches anterior to the carotid axis.
Conclusion
IONM is a safe and reliable tool for detecting cranial nerve injuries during CEA and may allow to assess the functionality of surgically inconvenient nerve branches.
Significance
IONM plays a critical role in detecting and potentially preventing cranial nerve damage during CEA leading to better surgical practices.
{"title":"Early detection of cranial nerve dysfunction during carotid endarterectomy through intraoperative neurophysiological monitoring","authors":"Alba León Jorba , Alina Velescu , Núria Álvarez López-Herrero , Anna Mases Fernández , Lorena Romero Montana , Albert Clarà Velasco","doi":"10.1016/j.clinph.2025.01.013","DOIUrl":"10.1016/j.clinph.2025.01.013","url":null,"abstract":"<div><h3>Objective</h3><div>Intraoperative neurophysiological monitoring (IONM) is used to detect cerebral ischemia during carotid endarterectomy (CEA). IONM of cranial nerves during CEA has been reported anecdotally. The aim of this study was to assess the use of IONM in identifying and preventing cranial nerve damage during CEA.</div></div><div><h3>Methods</h3><div>Prospective and observational study from a cohort of 81 patients undergoing CEA. Cranial nerve IONM was performed using electromyography (EMG), corticobulbar motor evoked potentials (CoMEP) and mapping techniques. Responses from spinal accessory, vagus, hypoglossal and facial nerves were recorded.</div></div><div><h3>Results</h3><div>CoMEP changes were detected in 49 patients (60.4 %). Most were related to indirect retraction and normalized at the end of the procedure. In 11 (13.5 %) cases, CoMEP changes persisted at the conclusion of the surgery, and 9 (11.1 %) of them showed a postoperative paresis. All patients normalized the neurological examination within a year. Cranial nerve mapping identified functional atypical nerve branches anterior to the carotid axis.</div></div><div><h3>Conclusion</h3><div>IONM is a safe and reliable tool for detecting cranial nerve injuries during CEA and may allow to assess the functionality of surgically inconvenient nerve branches.</div></div><div><h3>Significance</h3><div>IONM plays a critical role in detecting and potentially preventing cranial nerve damage during CEA leading to better surgical practices.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"172 ","pages":"Pages 10-16"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395214","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.2024.12.015
Nicholas T. Trapp , Anthony Purgianto , Joseph J. Taylor , Manpreet K. Singh , Lindsay M. Oberman , Brian J. Mickey , Nagy A. Youssef , Daniela Solzbacher , Benjamin Zebley , Laura Y. Cabrera , Susan Conroy , Mario Cristancho , Jackson R. Richards , Michael J. Flood , Tracy Barbour , Daniel M. Blumberger , Stephan F. Taylor , David Feifel , Irving M. Reti , Shawn M. McClintock , Mustafa M. Husain
This article updates the prior 2018 consensus statement by the National Network of Depression Centers (NNDC) on the use of transcranial magnetic stimulation (TMS) in the treatment of depression, incorporating recent research and clinical developments.
Publications on TMS and depression between September 2016 and April 2024 were identified using methods informed by PRISMA guidelines. The NNDC Neuromodulation Work Group met monthly between October 2022 and April 2024 to define important clinical topics and review pertinent literature. A modified Delphi method was used to achieve consensus.
2,396 abstracts and manuscripts met inclusion criteria for review. The work group generated consensus statements which include an updated narrative review of TMS safety, efficacy, and clinical features of use for depression. Considerations related to training, roles/responsibilities of providers, and documentation are also discussed.
TMS continues to demonstrate broad evidence for safety and efficacy in treating depression. Newer forms of TMS are faster and potentially more effective than conventional repetitive TMS. Further exploration of targeting methods, use in special populations, and accelerated protocols is encouraged.
This article provides an updated overview of topics relevant to the administration of TMS for depression and summarizes expert, consensus opinion on the practice of TMS in the United States.
{"title":"Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology","authors":"Nicholas T. Trapp , Anthony Purgianto , Joseph J. Taylor , Manpreet K. Singh , Lindsay M. Oberman , Brian J. Mickey , Nagy A. Youssef , Daniela Solzbacher , Benjamin Zebley , Laura Y. Cabrera , Susan Conroy , Mario Cristancho , Jackson R. Richards , Michael J. Flood , Tracy Barbour , Daniel M. Blumberger , Stephan F. Taylor , David Feifel , Irving M. Reti , Shawn M. McClintock , Mustafa M. Husain","doi":"10.1016/j.clinph.2024.12.015","DOIUrl":"10.1016/j.clinph.2024.12.015","url":null,"abstract":"<div><div>This article updates the prior 2018 consensus statement by the National Network of Depression Centers (NNDC) on the use of transcranial magnetic stimulation (TMS) in the treatment of depression, incorporating recent research and clinical developments.</div><div>Publications on TMS and depression between September 2016 and April 2024 were identified using methods informed by PRISMA guidelines. The NNDC Neuromodulation Work Group met monthly between October 2022 and April 2024 to define important clinical topics and review pertinent literature. A modified Delphi method was used to achieve consensus.</div><div>2,396 abstracts and manuscripts met inclusion criteria for review. The work group generated consensus statements which include an updated narrative review of TMS safety, efficacy, and clinical features of use for depression. Considerations related to training, roles/responsibilities of providers, and documentation are also discussed.</div><div>TMS continues to demonstrate broad evidence for safety and efficacy in treating depression. Newer forms of TMS are faster and potentially more effective than conventional repetitive TMS. Further exploration of targeting methods, use in special populations, and accelerated protocols is encouraged.</div><div>This article provides an updated overview of topics relevant to the administration of TMS for depression and summarizes expert, consensus opinion on the practice of TMS in the United States.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 206-233"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930750","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}
Interictal cognitive disturbances are frequent in patients with focal epilepsies and the links with alteration of resting state brain oscillations are not well known. Changes in theta oscillations, may contribute to cognitive impairment. This study aimed to investigate whether changes in theta activity are related to cognitive disturbances.
Methods
Retrospective data of 23 patients with temporal/frontal lobe epilepsy were included. Theta connectivity, power and interictal spikes rate from five-minute interictal resting state stereoelectroencephalography datasets were computed. Cognitive performances were assessed by Wechsler Intelligence Scale (WAIS-IV) and Weschler Memory Scale (WMS-III). Linear regression was performed to evaluate effect of interictal activity and seizure related parameters on cognitive scores.
Results
WAIS-IV working memory score in patients with epilepsy showed negative correlation with frontotemporal theta connectivity (F(1,17) = 5,239, p = 0,036, R2 = 0,200, β = -0,497). Moreover, theta connectivity was correlated with mesial temporal spike rate and theta power (F(2,17) = 10,967, p = 0,001, adj.R2 = 0,540).
Conclusions
Patients with focal epilepsy often encounter compromised cognitive functions, particularly notable in the domain of working memory. This impairment might be attributed to physiological mechanisms involving increased theta connectivity within the frontotemporal regions and interictal spiking.
Significance
Our study highlights the relation between theta connectivity and working memory impairments in patients with focal epilepsy.
{"title":"Working memory deficit in patients with focal epilepsy is associated with higher interictal theta connectivity","authors":"Simge Aykan , Virginie Laguitton , Samuel Medina Villalon , Stanislas Lagarde , Julia Makhalova , Fabrice Bartolomei , Christian-George Bénar","doi":"10.1016/j.clinph.2024.11.019","DOIUrl":"10.1016/j.clinph.2024.11.019","url":null,"abstract":"<div><h3>Objective</h3><div>Interictal cognitive disturbances are frequent in patients with focal epilepsies and the links with alteration of resting state brain oscillations are not well known. Changes in theta oscillations, may contribute to cognitive impairment. This study aimed to investigate whether changes in theta activity are related to cognitive disturbances.</div></div><div><h3>Methods</h3><div>Retrospective data of 23 patients with temporal/frontal lobe epilepsy were included. Theta connectivity, power and interictal spikes rate from five-minute interictal resting state stereoelectroencephalography datasets were computed. Cognitive performances were assessed by Wechsler Intelligence Scale (WAIS-IV) and Weschler Memory Scale (WMS-III). Linear regression was performed to evaluate effect of interictal activity and seizure related parameters on cognitive scores.</div></div><div><h3>Results</h3><div>WAIS-IV working memory score in patients with epilepsy showed negative correlation with frontotemporal theta connectivity (F(1,17) = 5,239, p = 0,036, R<sup>2</sup> = 0,200, β = -0,497). Moreover, theta connectivity was correlated with mesial temporal spike rate and theta power (F(2,17) = 10,967, p = 0,001, adj.R<sup>2</sup> = 0,540).</div></div><div><h3>Conclusions</h3><div>Patients with focal epilepsy often encounter compromised cognitive functions, particularly notable in the domain of working memory. This impairment might be attributed to physiological mechanisms involving increased theta connectivity within the frontotemporal regions and interictal spiking.</div></div><div><h3>Significance</h3><div>Our study highlights the relation between theta connectivity and working memory impairments in patients with focal epilepsy.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"170 ","pages":"Pages 49-57"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817264","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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