Clinical Neurophysiology最新文献_第7页

Quantitative intraoperative lateral spread response amplitudes in hemifacial Spasm: Associations with vascular burden 术中面肌痉挛的定量侧展反应振幅：与血管负荷的关系

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-12-01 DOI: 10.1016/j.clinph.2025.2111466

Minsoo Kim , Soung Wook Park , Hyun Seok Lee , Sang-Ku Park , Kwan Park

Objective

To determine whether intraoperative lateral spread response (LSR) amplitudes reflect vascular burden and configuration in hemifacial spasm.

Methods

We retrospectively reviewed consecutive microvascular decompressions at a single center. LSR I (mentalis) and LSR II (frontalis) were recorded using a standardized protocol. The primary exposure was arterial vessel count (single vs. multiple); vein-only cases were exploratory owing to imbalance. Amplitudes and derived indices (I/II ratio, I–II difference) were compared using variance-aware parametric and nonparametric tests.

Results

LSRs were obtained in most patients. LSR I exceeded LSR II with a significant paired effect. Arterial burden showed a graded pattern in LSR I, with higher amplitudes in multiple-vessel compression; however, differences across vessels counts were not significant after adjustment. No differences were observed for LSR II. Derived indices better reflected vascular burden, showing significant contrasts where raw amplitudes did not, including single-versus-multiple comparisons. Vein-only cases appeared lower but remained exploratory.

Conclusions

Intraoperative LSR amplitudes, especially at the mentalis muscle, reflect arterial burden, and derived indices improve discrimination. Findings support amplitude-based monitoring, with multicenter studies needed to confirm underlying mechanisms and predictive utility.

Significance

LSR monitoring offers a practical marker of vascular burden, potentially guiding surgical decisions and improving outcomes.

目的探讨术中侧张反应（LSR）振幅是否反映了面肌痉挛患者的血管负荷和形态。方法回顾性分析单中心连续微血管减压术。LSR I（颏部）和LSR II（额部）采用标准化记录。主要暴露是动脉血管计数（单个vs多个）；由于不平衡，单纯静脉病例是探索性的。振幅和衍生指数（I/II比率，I - II差异）通过方差感知参数和非参数检验进行比较。结果大多数患者均获得slrs。LSR I超过LSR II，具有显著的配对效应。动脉负荷在LSR I中呈分级模式，在多血管受压时呈较高振幅；然而，调整后血管计数差异不显著。LSR II没有观察到差异。衍生指数更好地反映了血管负荷，在原始振幅没有的情况下显示出显著的对比，包括单次与多次比较。只有静脉的病例似乎较低，但仍是探索性的。结论术中LSR波幅，尤其是颏肌处的LSR波幅，反映了动脉负荷，其衍生指标有助于鉴别。研究结果支持基于振幅的监测，需要多中心研究来确认潜在的机制和预测效用。elsr监测提供了血管负荷的实用标记物，可能指导手术决策和改善预后。

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引用次数: 0

Ipsilateral and contralateral cortical control of the external oblique muscles revealed by TMS 经颅磁刺激揭示的外斜肌同侧和对侧皮质控制

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-10-24 DOI: 10.1016/j.clinph.2025.2111400

Ryoji Miyano , Yuichiro Shirota , Satoshi Kodama , Tatsushi Toda , Masashi Hamada

Objectives

Transcranial magnetic stimulation (TMS) is used widely to explore human motor function. This study was conducted to investigate the differences between contralateral and ipsilateral cortical control on trunk muscles for eliciting contralateral and ipsilateral motor evoked potentials (MEPs) in the external oblique muscles.

Methods

Twenty healthy participants were examined: 10 younger and 10 older adults. They underwent TMS to locate contralateral and ipsilateral hot spots. For the identified hot spots in the younger group, the coil was positioned in eight orientations, each separated by 45 degrees, to measure active motor threshold (AMT) and onset latencies.

Results

Contralateral MEPs were obtained from all participants, whereas ipsilateral MEPs were detected in 14 out of 20 participants. The ipsilateral hot spots were located more laterally from Cz (p < 0.05). Coil orientation that induced an antero-medially directed current in the brain produced the shortest onset latency and lowest AMT for both stimulations. However contralateral MEPs required lower AMT and exhibited shorter onset latency than ipsilateral MEPs (p < 0.05).

Conclusions

Ipsilateral motor pathways of the external oblique muscles have physiological features unlike those of contralateral motor pathways.

Significance

These findings suggest differential cortical control between contralateral and ipsilateral pathways in trunk muscles and provide bases for additional investigations into ipsilateral motor control.

目的颅磁刺激（TMS）被广泛应用于人体运动功能的研究。本研究旨在探讨对侧和同侧皮层控制躯干肌肉对侧和同侧外斜肌运动诱发电位（MEPs）的差异。方法对20名健康参与者进行了检查：10名年轻人和10名老年人。他们接受TMS定位对侧和同侧热点。对于年轻组中确定的热点，线圈定位在八个方向上，每个方向间隔45度，以测量主动运动阈值（AMT）和发作潜伏期。结果所有参与者均获得对侧MEPs，而20名参与者中有14名检测到同侧MEPs。同侧热点位置较Cz偏外侧（p < 0.05）。线圈定向在大脑中诱导的前正中定向电流在两种刺激中产生了最短的发作潜伏期和最低的AMT。然而，与同侧MEPs相比，对侧MEPs需要更低的AMT，并且表现出更短的发病潜伏期（p < 0.05）。结论腹外斜肌单侧运动通路具有不同于对侧运动通路的生理特征。这些发现表明躯干肌肉对侧和同侧通路的皮层控制存在差异，为进一步研究同侧运动控制提供了基础。

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引用次数: 0

Spike density in children with self-limited focal epilepsies affects memory performance and slow wave-spindle coupling during sleep 自限性局灶性癫痫儿童的脑电波密度影响睡眠时的记忆表现和慢波-纺锤体耦合

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-01 DOI: 10.1016/j.clinph.2025.2111406

Elena C. Schmidt , Sarah Storz , Jelena Skorucak , Georgia Ramantani , Bigna K. Bölsterli , Sara Fattinger , Reto Huber

Objective

Precise coupling of slow waves and spindles during non-rapid eye movement (NREM) sleep is crucial for memory consolidation. Children with self-limited focal epilepsies (SelFE) show epileptic spike waves during NREM sleep and often have impaired sleep-related memory. We investigated for the first time how spikes affect slow wave–spindle coupling and its impact on overnight memory.

Methods

Fourteen SelFE patients (mean age: 8.7 years) underwent overnight high-density EEG (128 channels) and completed a word-pair memory task before and after sleep. Spikes, spindles, and slow waves were automatically detected. Coupling precision was defined as the ratio of spindles during the ascending versus descending phase of the slow wave. Cluster-corrected topographical correlations examined relationships between spike density, coupling precision, and memory outcomes.

Results

Higher spike density was associated with poorer memory performance in a left centro-parietal region. Better memory was linked to greater coupling precision during the ascending phase in a left centro-frontal area. Increased spike density also correlated with reduced coupling precision in a central region.

Conclusion

Spikes may disrupt thalamocortical activity, impairing slow wave–spindle coupling and memory consolidation.

Significance

These findings suggest a mechanistic link between epileptic sleep activity and cognitive deficits in SelFE.

目的非快速眼动（NREM）睡眠中慢波和纺锤波的精确耦合对记忆巩固至关重要。患有自限性局灶性癫痫的儿童在非快速眼动睡眠期间表现出癫痫性尖峰波，并且通常有睡眠相关记忆受损。我们首次研究了尖波如何影响慢波-主轴耦合及其对夜间记忆的影响。方法14例患者（平均年龄8.7岁）进行夜间高密度脑电图（128通道），并在睡眠前后完成单词对记忆任务。尖峰波、纺锤波和慢波被自动检测到。耦合精度定义为慢波上升与下降阶段主轴的比值。簇校正的地形相关性检验了尖峰密度、耦合精度和记忆结果之间的关系。结果高尖峰密度与左中顶叶区较差的记忆表现相关。在上升阶段，更好的记忆力与更高的耦合精度在左中央额叶区有关。增加的尖峰密度也与中心区域的耦合精度降低相关。结论峰电位可破坏丘脑皮层活动，损害慢波-纺锤体耦合和记忆巩固。这些发现表明癫痫性睡眠活动与自我认知缺陷之间存在机制联系。

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引用次数: 0

C3-C4 transcranial direct current stimulation montage stimulates lower limb region better than C1-C2 montage C3-C4经颅直流电刺激蒙太奇对下肢区域的刺激优于C1-C2蒙太奇

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-05 DOI: 10.1016/j.clinph.2025.2111416

Ziping Huang , Riki Shimizu , Saurabh R. Sinha , Derek Southwell , Charalambos C. Charalambous , Angel V. Peterchev , Wuwei Feng , Pratik Y. Chhatbar , Taewon Kim

引用次数: 0

Isolated hippocampal sclerosis and focal dysplasia type IIIa: Comparative study of anatomo-electro-clinical profile and seizure outcome 孤立海马硬化症和局灶性IIIa型发育不良：解剖-电-临床特征和癫痫结果的比较研究

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-29 DOI: 10.1016/j.clinph.2025.2111461

Mariem Ben Mahmoud , Adrien Benard , Delphine Taussig , Pascale Trebon , Dan Cristian Chiforeanu , Yves Sahler , Arnaud Biraben , Anca Nica , Mihai Dragos Maliia

Objective

Distinguishing drug-resistant temporal lobe epilepsy (TLE) caused by isolated hippocampal sclerosis (iHS) from focal cortical dysplasia type IIIa (FCD IIIa) remains a presurgical challenge. This study aimed to compare the clinical characteristics, electrophysiological data, and postsurgical seizure outcomes between these pathologies.

Methods

We retrospectively analyzed a cohort of 50 consecutive TLE patients (mean duration of disease of 22 years) who underwent surgery. The histopathology confirmed either iHS (n = 22) or FCD IIIa (n = 28) and a minimum follow-up of 12 months. The groups were compared on complex presurgical data, surgery type, and outcome.

Results

A history of febrile seizures (p = 0.02, OR = 4.7) was more frequent in the FCD IIIa group, which also had significantly lower intelligence quotient (IQ) scores in all domains. The mean total IQ score for FCD IIIa/iHS was 86/94 (p = 0.02); verbal IQ was 85/92 (p = 0.03); performance IQ was 89/98 (p = 0.02). The effect size was considered medium for all three (Cohen’s d = 0.7, 0.63 and 0.68 respectively). Scalp EEG showed shorter seizures in FCD IIIa (p = 0.03), in SEEG, the temporal pole was more implanted in this group (p = 0.02, 50 % difference, OR = ∞). At a mean follow-up of 8.5 years, similar seizure-freedom rates was found between groups (82 % for FCD IIIa, 95 % for iHS; p = 0.48). Follow-up EEG and neuropsychological assessment at 6 months post-surgery showed no statistical differences.

Significance

FCD IIIa and iHS exhibit several distinct electro-clinical features. The most important is a more impaired general cognitive profile associated with FCD IIIa, without differences in language or global memory.

目的区分孤立性海马硬化（iHS）引起的耐药颞叶癫痫（TLE）和局灶性皮质发育不良IIIa型（FCD IIIa）仍然是手术前的一个挑战。本研究旨在比较这些病理之间的临床特征、电生理数据和术后癫痫发作结果。方法回顾性分析50例连续接受手术治疗的TLE患者（平均病程22年）。组织病理学证实为iHS （n = 22）或FCD IIIa (n = 28)，至少随访12个月。比较两组复杂的术前资料、手术类型和结果。结果FCD IIIa组发热惊厥史发生率较高（p = 0.02, OR = 4.7），且各领域智商得分均显著低于FCD IIIa组。FCD IIIa/iHS患者的平均总智商得分为86/94 (p = 0.02)；语言智商为85/92 (p = 0.03)；表现智商为89/98 （p = 0.02）。三者的效应量均为中等（Cohen’s d分别为0.7、0.63和0.68）。FCD IIIa组头皮脑电图显示癫痫发作时间较短（p = 0.03）， SEEG组颞极植入较多（p = 0.02，差异50%，OR =∞）。在平均8.5年的随访中，两组之间的癫痫自由率相似（FCD IIIa组为82%，iHS组为95%；p = 0.48）。术后6个月随访脑电图及神经心理评估无统计学差异。efcd IIIa和iHS表现出几种不同的电临床特征。最重要的是，与FCD IIIa相关的一般认知状况受损更严重，在语言或整体记忆方面没有差异。

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引用次数: 0

EEG dynamics under anesthetics-induced loss and return of responsiveness with A constant rate infusion 恒速输注麻醉引起的反应性丧失和恢复的脑电图动力学

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-01 DOI: 10.1016/j.clinph.2025.2111411

Xiaoge Liu , Yu Chang , Xin Wang , Shitong Li , Zhenhu Liang , Jun Zhang

Objective

This study aims to characterize the electroencephalographic dynamics during the transition to and from loss of responsiveness (LOR) induced by three anesthetics.

Methods

High-density EEG was recorded in 60 patients randomly receiving propofol, dexmedetomidine, or ketamine with a constant rate infusion. Spectral power, phase-amplitude coupling (PAC), coherence and directed phase transfer entropy during awake, LOR and recovery (ROR) states were analyzed to evaluate neural dynamics associated with altered conscious states.

Results

Propofol increased global alpha power and low-frequency slow oscillations (SO) without “alpha anteriorization” during LOR. Dexmedetomidine increased SO but decreased alpha power. Ketamine reduced alpha power and increased occipital theta and gamma power. Further, three anesthetic displayed distinct PAC patterns and induced region-specific and frequency-specific long-range functional connectivity patterns. Directed connectivity analysis indicated propofol and ketamine rather than dexmedetomidine inhibited feedback connectivity during LOR.

Conclusions

Three anesthetics induced differential spectral power, PAC, and network connectivity during the transition to and from LOR when infused with a constant rate, suggesting that EEG dynamics vary not only among anesthetics, but also among regimens of their administration.

Significance

Anesthetic-specific neural signatures and administration-dependent EEG patterns, advance precision anesthesia monitoring and deepen understanding of conscious state transitions under distinct pharmacologic modulations.

目的研究三种麻醉药致反应性丧失前后的脑电图动态特征。方法对60例随机接受异丙酚、右美托咪定或氯胺酮等速输注的患者进行高密度脑电图记录。分析了清醒、LOR和恢复（ROR）状态下的谱功率、相幅耦合（PAC）、相干性和定向相转移熵，以评估与意识状态改变相关的神经动力学。结果异丙酚增加了LOR期间的总α功率和低频慢振荡（SO），但没有“α前化”。右美托咪定增加了SO，但降低了α功率。氯胺酮降低了α能量，增加了枕部θ和γ能量。此外，三种麻醉剂显示出不同的PAC模式，并诱导区域特异性和频率特异性的远程功能连接模式。定向连通性分析表明异丙酚和氯胺酮而不是右美托咪定抑制LOR期间的反馈连通性。结论三种麻醉药在注入恒定剂量时，会引起脑电信号功率、PAC和网络连通性的差异，表明脑电图动态不仅在麻醉药之间存在差异，而且在给药方案之间也存在差异。麻醉特异性神经特征和给药依赖性脑电图模式，促进了麻醉的精确监测，加深了对不同药物调节下意识状态转变的理解。

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引用次数: 0

The role of electrode placement in subthalamic nucleus deep brain stimulation for improving gait in Parkinson’s Disease 在丘脑下核深部脑刺激中电极放置对改善帕金森病步态的作用。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-12-02 DOI: 10.1016/j.clinph.2025.2111468

Zhongke Mei , Anna-Sophie Hofer , Christian Baumann , Mechtild Uhl , Navrag Singh , William R. Taylor , Lennart Stieglitz , Deepak K. Ravi

Objective

To investigate the relationship between the spatial location of active electrode contacts in subthalamic nucleus deep brain stimulation (STN-DBS) and changes in gait performance in patients with Parkinson’s disease (PwPD).

Methods

This observational study included 49 PwPD who underwent bilateral STN-DBS. Spatiotemporal gait parameters were assessed before surgery and six months post-implantation using motion capture. Both mean values and variability of gait parameters were analyzed. Active contact locations were normalized using a voxel-based approach and statistically associated with gait outcomes.

Results

STN-DBS led to significant reductions in stride time, stance time, swing time, and step time, alongside increased step width and temporal gait variability. Gait improvements were associated with specific stimulation sites: the postero-superior STN region was most effective for enhancing mean spatial parameters (e.g., stride length, walking speed), while the antero-superior region was optimal for reducing temporal variability. Patients stimulated in these regions showed significantly better gait outcomes than those stimulated elsewhere.

Conclusions

Gait improvements were differentially associated with the spatial location of stimulation electrode within the STN, suggesting region-specific modulation of mean spatial and temporal variability gait parameters.

Significance

These findings support precision targeting of stimulation sites to optimize patient-specific gait outcomes, advancing personalized DBS therapy in Parkinson’s disease.

目的：探讨丘脑下核深部脑刺激（STN-DBS）活动电极触点空间位置与帕金森病（PwPD）患者步态变化的关系。方法：本观察性研究纳入49例行双侧STN-DBS的PwPD患者。在手术前和植入后6个月使用动作捕捉技术评估时空步态参数。分析步态参数的平均值和变异性。主动接触位置使用基于体素的方法归一化，并与步态结果统计相关。结果：STN-DBS导致步幅时间、站立时间、摇摆时间和步幅时间显著减少，同时步幅宽度和时间步态变异性增加。步态的改善与特定的刺激部位有关：后上STN区域对提高平均空间参数（例如步幅长度、步行速度）最有效，而前上区域对减少时间变异性最有效。在这些区域受到刺激的患者比在其他地方受到刺激的患者表现出明显更好的步态结果。结论：步态改善与刺激电极在STN内的空间位置存在差异，表明步态参数的平均空间和时间变异性存在区域特异性调节。意义：这些发现支持精确定位刺激部位以优化患者特异性步态结果，推进帕金森病的个性化DBS治疗。

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引用次数: 0

Optimal parameters for reliable PMv–M1 facilitation identified with dual coil TMS 双线圈TMS鉴定可靠PMv-M1促进的最佳参数

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-11 DOI: 10.1016/j.clinph.2025.2111434

N. Bevacqua , S. Turrini , A. Avenanti

引用次数: 0

Decoding alzheimer’s: The role of EEG rhythms and aperiodic components in cognitive decline 解码阿尔茨海默病：脑电图节律和非周期性成分在认知衰退中的作用

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-13 DOI: 10.1016/j.clinph.2025.2111437

Mingyang Zhang , Xia Liu , Yanan Ren , Lixuan Li , Ruoyu Wang , Lihui Sun , Qinying Ma

Objective

To investigate detailed alterations in brain electrical activity and their relationship with cognitive decline in Alzheimer’s disease (AD) using electroencephalogram (EEG) power spectrum analysis.

Methods

EEG data from 80 AD patients and 80 healthy control (HC) were analyzed, focusing on theta and alpha band powers, aperiodic offset, and exponent. Topographic and gender-specific analyses were conducted to explore associations with disease progression and cognitive impairment.

Results

AD patients showed increased theta and alpha band powers, with theta band power exhibiting statistically significant differences. Globally elevated theta band power correlated with cognitive impairment severity. Higher aperiodic offsets and exponents were observed in AD patients, exhibiting upward trends with disease progression. Male AD patients displayed more pronounced EEG abnormalities and unique Montreal Cognitive Assessment (MOCA) score patterns.

Conclusions

Our findings highlight the critical role of theta band power in AD pathology and suggest potential EEG biomarkers for neurodegenerative changes. Gender-specific differences emphasize the importance of personalized approaches in AD diagnosis and treatment.

Significance

This study provides novel neurophysiological insights into AD, underscoring the clinical utility of EEG markers and the necessity for gender-specific considerations in precision medicine for AD.

目的利用脑电图（EEG）功率谱分析阿尔茨海默病（AD）脑电活动的详细变化及其与认知能力下降的关系。方法对80例AD患者和80例健康对照（HC）的seeg数据进行分析，重点分析theta和alpha波段功率、非周期偏移和指数。进行地形和性别分析，以探讨疾病进展和认知障碍的关系。结果ad患者theta和alpha波段功率均升高，其中theta波段功率差异有统计学意义。整体θ波段功率升高与认知障碍严重程度相关。在AD患者中观察到较高的非周期性偏移和指数，随着疾病进展呈现上升趋势。男性AD患者表现出更明显的脑电图异常和独特的蒙特利尔认知评估（MOCA）评分模式。结论我们的研究结果强调了θ波段功率在AD病理中的关键作用，并提示了神经退行性改变的潜在EEG生物标志物。性别差异强调了AD诊断和治疗中个性化方法的重要性。这项研究为阿尔茨海默病提供了新的神经生理学见解，强调了脑电图标志物的临床应用，以及在阿尔茨海默病的精准医学中考虑性别的必要性。

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引用次数: 0

Between Mind and Movement: Electrophysiological insights into functional dystonia 在意识和运动之间：功能性肌张力障碍的电生理学见解

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-17 DOI: 10.1016/j.clinph.2025.2111442

Alexey Sedov , Ulia Semenova , Anna Gamaleya , Alexey Tomskiy , Aasef G. Shaikh

引用次数: 0