Pub Date : 2026-01-01Epub Date: 2025-12-01DOI: 10.1016/j.clinph.2025.2111467
Rocio Rodriguez Capilla , Aislinn M. Hurley , Karthik Kumaravelu , Jennifer J. Peters , Hui-Jie Lee , Dennis A. Turner , Warren M. Grill , Stephen L. Schmidt
Background
Deep brain stimulation reduces the motor symptoms of Parkinson’s disease (PD). Dual target deep brain stimulation (DT DBS) may better reduce symptoms and minimize side effects than single target, but the optimal parameters of DT DBS are unknown.
Objective
To quantify the frequency response of DT DBS on bradykinesia and beta oscillations, and to explore intrahemispheric pulse delay shifts as a means to reduce total energy delivered.
Methods
We applied DT DBS using the Summit RC + S in six participants with PD, varying DBS frequency. We further examined the effects of frequency in a biophysical model.
Results
DT DBS at 50 Hz was effective at reducing bradykinesia, whereas increasing DT DBS frequency up to 125 Hz also led to significantly lower beta power. This frequency effect on beta power was replicated in a biophysical model. The model suggested that 22 Hz DT DBS, with an intrahemispheric delay of 40 ms, can reduce beta power by 87 %.
Conclusion
This exploratory study (n = 6) suggests that 125 Hz DT DBS best reduced bradykinesia. However, low frequency DBS with an appropriate intrahemispheric delay could also improve symptom relief.
Significance
Both 125 Hz and tailored low-frequency DT DBS may achieve equivalent symptomatic control of PD symptoms.
{"title":"Effect of frequency on dual target deep brain stimulation","authors":"Rocio Rodriguez Capilla , Aislinn M. Hurley , Karthik Kumaravelu , Jennifer J. Peters , Hui-Jie Lee , Dennis A. Turner , Warren M. Grill , Stephen L. Schmidt","doi":"10.1016/j.clinph.2025.2111467","DOIUrl":"10.1016/j.clinph.2025.2111467","url":null,"abstract":"<div><h3>Background</h3><div>Deep brain stimulation reduces the motor symptoms of Parkinson’s disease (PD). Dual target deep brain stimulation (DT DBS) may better reduce symptoms and minimize side effects than single target, but the optimal parameters of DT DBS are unknown.</div></div><div><h3>Objective</h3><div>To quantify the frequency response of DT DBS on bradykinesia and beta oscillations, and to explore intrahemispheric pulse delay shifts as a means to reduce total energy delivered.</div></div><div><h3>Methods</h3><div>We applied DT DBS using the Summit RC + S in six participants with PD, varying DBS frequency. We further examined the effects of frequency in a biophysical model.</div></div><div><h3>Results</h3><div>DT DBS at 50 Hz was effective at reducing bradykinesia, whereas increasing DT DBS frequency up to 125 Hz also led to significantly lower beta power. This frequency effect on beta power was replicated in a biophysical model. The model suggested that 22 Hz DT DBS, with an intrahemispheric delay of 40 ms, can reduce beta power by 87 %.</div></div><div><h3>Conclusion</h3><div>This exploratory study (n = 6) suggests that 125 Hz DT DBS best reduced bradykinesia. However, low frequency DBS with an appropriate intrahemispheric delay could also improve symptom relief.</div></div><div><h3>Significance</h3><div>Both 125 Hz and tailored low-frequency DT DBS may achieve equivalent symptomatic control of PD symptoms.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111467"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub 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":"2026-01-01","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 : 2026-01-01Epub 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":"2026-01-01","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 : 2026-01-01Epub Date: 2025-12-01DOI: 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.
{"title":"Quantitative intraoperative lateral spread response amplitudes in hemifacial Spasm: Associations with vascular burden","authors":"Minsoo Kim , Soung Wook Park , Hyun Seok Lee , Sang-Ku Park , Kwan Park","doi":"10.1016/j.clinph.2025.2111466","DOIUrl":"10.1016/j.clinph.2025.2111466","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether intraoperative lateral spread response (LSR) amplitudes reflect vascular burden and configuration in hemifacial spasm.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Significance</h3><div>LSR monitoring offers a practical marker of vascular burden, potentially guiding surgical decisions and improving outcomes.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111466"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682018","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}
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.
{"title":"Ipsilateral and contralateral cortical control of the external oblique muscles revealed by TMS","authors":"Ryoji Miyano , Yuichiro Shirota , Satoshi Kodama , Tatsushi Toda , Masashi Hamada","doi":"10.1016/j.clinph.2025.2111400","DOIUrl":"10.1016/j.clinph.2025.2111400","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> < 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 (<em>p</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Ipsilateral motor pathways of the external oblique muscles have physiological features unlike those of contralateral motor pathways.</div></div><div><h3>Significance</h3><div>These findings suggest differential cortical control between contralateral and ipsilateral pathways in trunk muscles and provide bases for additional investigations into ipsilateral motor control.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111400"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-11-01DOI: 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.
{"title":"Spike density in children with self-limited focal epilepsies affects memory performance and slow wave-spindle coupling during sleep","authors":"Elena C. Schmidt , Sarah Storz , Jelena Skorucak , Georgia Ramantani , Bigna K. Bölsterli , Sara Fattinger , Reto Huber","doi":"10.1016/j.clinph.2025.2111406","DOIUrl":"10.1016/j.clinph.2025.2111406","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Spikes may disrupt thalamocortical activity, impairing slow wave–spindle coupling and memory consolidation.</div></div><div><h3>Significance</h3><div>These findings suggest a mechanistic link between epileptic sleep activity and cognitive deficits in SelFE.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111406"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-11-05DOI: 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
{"title":"C3-C4 transcranial direct current stimulation montage stimulates lower limb region better than C1-C2 montage","authors":"Ziping Huang , Riki Shimizu , Saurabh R. Sinha , Derek Southwell , Charalambos C. Charalambous , Angel V. Peterchev , Wuwei Feng , Pratik Y. Chhatbar , Taewon Kim","doi":"10.1016/j.clinph.2025.2111416","DOIUrl":"10.1016/j.clinph.2025.2111416","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111416"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-11-29DOI: 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.
{"title":"Isolated hippocampal sclerosis and focal dysplasia type IIIa: Comparative study of anatomo-electro-clinical profile and seizure outcome","authors":"Mariem Ben Mahmoud , Adrien Benard , Delphine Taussig , Pascale Trebon , Dan Cristian Chiforeanu , Yves Sahler , Arnaud Biraben , Anca Nica , Mihai Dragos Maliia","doi":"10.1016/j.clinph.2025.2111461","DOIUrl":"10.1016/j.clinph.2025.2111461","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>d =</em> 0.7, 0.63 and 0.68 respectively<em>).</em> 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.</div></div><div><h3>Significance</h3><div>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.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111461"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-02DOI: 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.
{"title":"The role of electrode placement in subthalamic nucleus deep brain stimulation for improving gait in Parkinson’s Disease","authors":"Zhongke Mei , Anna-Sophie Hofer , Christian Baumann , Mechtild Uhl , Navrag Singh , William R. Taylor , Lennart Stieglitz , Deepak K. Ravi","doi":"10.1016/j.clinph.2025.2111468","DOIUrl":"10.1016/j.clinph.2025.2111468","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Significance</h3><div>These findings support precision targeting of stimulation sites to optimize patient-specific gait outcomes, advancing personalized DBS therapy in Parkinson’s disease.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111468"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713210","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号