Clinical Neurophysiology最新文献_第8页

Brain network modulation in response to directional and Non-Directional Cues: Insights from EEG connectivity and graph theory

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-24 DOI: 10.1016/j.clinph.2025.01.007

Fabrizio Vecchio , Francesca Miraglia , Chiara Pappalettera , Paolo Maria Rossini

Objective

Directional cues have a profound impact on cognitive processes and behavior, and studying the involved brain networks can provide insights into their processing. This research aimed to investigate the neural network modulation associated with cognitive processing after the administration of directional cues using connectivity and graph theory.

Methods

Twenty healthy volunteers were enrolled and underwent EEG recording while they were asked to perform a visuomotor task, such as directional (DS) and non-directional (nDS). From EEG data, network parameters such as Small-World (SW) and Lagged linear connectivity across different EEG frequency bands were evaluated, analyzing the response to DS and nDS.

Results

The results revealed significant differences in the SW index, particularly in the Alpha 1 band, where participants exhibited a higher SW index when presented with DS compared to nDS. Moreover, the analysis of Alpha 1 band Lagged linear connectivity revealed close to statistically significant differences predominantly in the frontal and central regions.

Conclusions

This research contributes to our understanding of the neural mechanisms underlying the processing of directional cues.

Significance

It has potential implications for rehabilitation settings, for example in the rehabilitation of visual dysfunction and motor impairment following a stroke, by optimizing cognitive processing to enhance functional outcomes.

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引用次数: 0

Machine learning-based algorithm of drug-resistant prediction in newly diagnosed patients with temporal lobe epilepsy

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-24 DOI: 10.1016/j.clinph.2025.01.008

Lingyan Mao , Gaoxing Zheng , Yang Cai , Wenyi Luo , Yijun Zhang , Kuidong Wu , Jing Ding , Xin Wang

Objectives

To develop a predicted algorithm for drug-resistant epilepsy (DRE) in newly diagnosed temporal lobe epilepsy (TLE) patients.

Methods

A total of 139 newly diagnosed TLE patients were prospectively enrolled, and long-term video EEG monitoring was recorded. Clinical evaluations, including seizure frequency and antiseizure medications (ASMs) usage, were collected and prospectively followed up for 24 months. Interictal EEG data were used for feature extraction, identifying 216 EEG network features. Traditional machine learning and ensemble learning techniques were employed to predict DRE outcomes.

Results

Over two years, TLE patients with DRE exhibited significant EEG differences, particularly in frontotemporal θ-band networks, characterized by increased connectivity metrics such as phase lag index (P = 0.000), etc. The predictive algorithm based on EEG features achieved accuracies between 59.2 %-84.6 % (AUC: 0.60–0.87). When compared to the whole brain, EEG features of the frontotemporal network showed improved classification performance in Naïve Bayes (P = 0.032), Tree Bagger (P = 0.021), and Subspace Discriminant (P = 0.022) models. The ensemble learning technique (Tree Bagger) delivered the best prediction results, achieving 91.5 % accuracy, 97 % sensitivity, 81 % specificity, and AUC of 0.92.

Conclusions

Increased frontotemporal EEG connectivity was observed in TLE patients with 2-year DRE. A predictive model based on routine EEG provides an accessible method for forecasting ASMs efficacy.

Significance

This study highlights the clinical utility of EEG-based algorithms in identifying DRE early, aiding personalized treatment strategies and improving patient outcomes.

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引用次数: 0

Electrophysiological correlates of visual short-term memory binding deficits in community-dwelling seniors at risk of dementia

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-24 DOI: 10.1016/j.clinph.2025.01.009

Rodrigo Alberto Gonzalez-Montealegre , Alfredis González-Hernández , Jasmin Bonilla-Santos , Dorian Yisela Cala-Martínez , Mario Alfredo Parra

Background

Visual Short-Term Memory Binding (VSTMB) is a preclinical marker of Alzheimer’s disease (AD). Reduced early event-related potentials (ERPs) (100–250 ms) over fronto-central (FC) and parieto-occipital (PO) regions have been reported in patients with Mild Cognitive Impairment (MCI) seen in the clinic. We investigated such ERPs in a larger sample of community-dwelling older adults who had not sought medical advice.

Methods

Participants (n = 215) were assessed with a neuropsychological battery and the VSTMB Task. The latter assessed the ability to detect changes between two consecutive arrays of shapes or colored shapes (the Binding condition). Time-locked EEG signals were collected during the task.

Results

Those who met the MCI criteria (n = 108) showed binding impairment. ERP analyses revealed significant Group x Time Windows interactions. Early ERP showed reduced neural recruitment (MCI < healthy controls (HC)) over the right FC regions, left PO, and right centro-parietal (CP) regions during Binding encoding, and over PO regions bilaterally and left FC during retrieval. Late ERP showed increased neural recruitment (MCI > HC) on left FC and PO regions during retrieval.

Conclusions

Hyper-recruitment may reflect functional reorganization aimed at behavioral compensation in the early stages of MCI. The role of such amplitude shifts as pointers of transition points in the AD continuum needs further investigation.

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引用次数: 0

Increase in EEG functional connectivity and power during wakefulness in self-limited epilepsy with centrotemporal spikes

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-24 DOI: 10.1016/j.clinph.2024.12.028

David Garnica-Agudelo , Stuart D.W. Smith , Daniel van de Velden , Dagmar Weise , Knut Brockmann , Niels K. Focke

Objective

Examine power and functional connectivity (FC) in children with Self-limited Epilepsy with Centrotemporal Spikes (SeLECTS) during resting-state.

Methods

We retrospectively analyzed 37 children with SeLECTS and 34 matched controls. Fifty seconds of awake resting-state source-reconstructed EEG per subject were selected to compare groups using power and weighted phase lag index (wPLI). We compared patients’ epochs with and without interictal epileptiform discharges (IEDs) between each other and to controls’ epochs. Additionally, we compared epochs without IEDs from recent-onset SeLECTS and longer-duration SeLECTS patients between each other and to controls’ epochs.

Results

SeLECTS patients demonstrated widespread and significant power increases compared to controls. FC analyses of epochs without IEDs revealed predominantly left-sided increases in the beta band and decreases in theta band compared to controls. In epochs with IEDs, there were further FC increases in the delta band compared to epochs without IEDs located in bilateral fronto-centrotemporal regions. Patients with recent-onset SeLECTS had significant bilateral temporo-parietal FC increases in beta1 relative to controls. Patients with longer-duration SeLECTS showed significant left centrotemporal FC increases in beta and bilateral centrotemporal decreases in delta compared to controls.

Conclusions

SeLECTS patients exhibit atypical power and FC patterns during wakefulness, even in epochs without IEDs. These were more pronounced in recent-onset cases and epochs with IEDs, suggesting an association between IEDs frequency and the disease course.

Significance

Studying power and FC abnormalities in children with SeLECTS provides insight into disease evolution and the influence of IEDs on brain networks.

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引用次数: 0

EEG signature orchestrating expression of ictal behavior in mesial temporal lobe epilepsy

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-24 DOI: 10.1016/j.clinph.2024.12.029

Chenmin He , Wenhan Hu , Kai Xiong , Lingqi Ye , Hongyi Ye , Lingli Hu , Yi Ge , Meng Wang , Cong Chen , Bo Jin , Cenglin Xu , Yi Wang , Sha Xu , Yao Ding , Yingcai Wu , Hongjie Jiang , Junming Zhu , Meiping Ding , Wenling Li , Kai Zhang , Shan Wang

Objectives

We investigated EEG features differentiating clinical seizures (CSs) from subclinical seizures (SCSs) to explore the mechanisms underlying the generation of ictal behavior in mesial temporal lobe epilepsy (mTLE).

Methods

Peri-ictal state of power spectral density (PSD) within seizure onset zone (SOZ) and propagation zone (PZ) were compared between SCSs and CSs. Functional connectivity was analyzed using the nonlinear correlation coefficient h², outgoing links (OUT) and ingoing links (IN). The EEG epochs of CSs-early part and SCSs were equally divided into four segments to reveal dynamic EEG changes.

Results

During pre-ictal state, PSD at 30–80 Hz in SOZ was higher in CSs than in SCSs. The preictal OUT and IN values in SOZ at 30–80 Hz were greater in CSs than in SCSs. During CSs-early part, PSD displayed an initial increase in SOZ but a late increase in PZ, with enhanced high-frequency activity in temporal regions and increased low-frequency activity in insula.

Conclusion

The enhanced pre-ictal gamma activity within the epileptic network was able to distinguish CSs from SCSs. The unique temporospatial alterations within the epileptic network drive the expression of ictal behavior in mTLE.

Significance

The distinct EEG features between SCSs and CSs offer transformative insights into the mechanisms driving ictal behavior.

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引用次数: 0

Rhythmic EEG patterns: The oldest idea in the EEG world, but without an obvious definition

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-23 DOI: 10.1016/j.clinph.2024.12.024

Philippe Gélisse , William O. Tatum , Arielle Crespel , Peter W. Kaplan

The word “rhythmic” was quickly introduced in the vocabulary of the electroencephalographers with the discovery of the alpha rhythm and typical discharges of spike-and-waves at 3 Hz in childhood absence epilepsy, but without any definition until recently. In its last revision (2017), the International Federation of Clinical Neurophysiology proposed a specific definition. The word “rhythmic” is “applied to regular waves occurring at a constant period and of relatively uniform morphology.” Unfortunately, there is a serious problem of ambiguity as this definition exactly corresponds in science to the definition of a periodic function (periodic waveform). This definition of regular patterns at constant intervals (constant period) can be applied to physiological rhythms such as alpha and mu rhythms but also to unusual rhythms such as rhythmic theta bursts of drowsiness. It can also be used to describe EEG patterns, such as frontal/temporal/occipital intermittent rhythmic activities or generalized rhythmic delta activities. Except with typical absence seizures, this definition cannot be used to describe most epileptic seizures and absence status epilepticus. Identifying ’periodic’ versus ’rhythmic’ features is crucial when analyzing an EEG in critically ill patients. The importance lies in a balanced approach that frequently promotes an interpretation of an acute encephalopathy when referring to diffuse periodic EEG patterns, and status epilepticus for unreactive bilateral rhythmic patterns. To include seizures and status epilepticus in the definition of rhythmic patterns, we suggest a more “dynamic” approach in addition to the regular waves at constant intervals without interdischarge intervals between waveforms. For the observed rhythmic patterns, we propose: repetition of consecutive waves with, in case of a variation in the pattern, a dynamic approach to these waveforms. Dynamic means spatiotemporal evolution of the patterns.

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引用次数: 0

Bridging the gap to clinical use: A systematic review on TMS–EEG test-retest reliability

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-23 DOI: 10.1016/j.clinph.2025.01.002

Giacomo Bertazzoli , Elisa Dognini , Peter J. Fried , Carlo Miniussi , Petro Julkunen , Marta Bortoletto

Background

Transcranial magnetic stimulation (TMS) combined with electroencephalography (EEG) can provide insight on cortical excitability and brain circuits. TMS-evoked potentials (TEPs) are phase-locked waveforms reflecting neural activity, with potential applications in psychiatry and neurology. However, the reliability of TEPs remains underexplored, hindering clinical standardization. This systematic review evaluates TEP reliability, focusing on commonly used measures and assessments.

Methods

A systematic review was conducted on PubMed for studies from 2002 to October 10, 2024, using keywords combining TMS, EEG, and reliability terms. Systematic reviews and non-English articles were excluded.

Results

Eighteen studies met inclusion criteria, mostly assessing young, healthy populations. Late TEP components demonstrated high relative reliability, while early components exhibited lower reliability and variability across sessions. Analytical methods like the intraclass and concordance correlation coefficients, and Pearson’s correlations consistently favored late TEPs.

Discussion

Late TEPs exhibit higher reliability, while early components require further research. TMS artifacts complicate interpretation, in both late and early responses. Formal reliability assessments, standardized protocols, and diverse populations are essential for advancing TEP reliability for clinical application.

Conclusions

A more comprehensive reliability assessments is needed before the implementation of clinical applications.

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引用次数: 0

Trigeminal reflex testing abnormalities as a predictive model for distinguishing classical and idiopathic trigeminal neuralgia

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2024.12.025

Gianfranco De Stefano , Cristina Mollica , Caterina Leone , Eleonora Galosi , Giuseppe Di Pietro , Pietro Falco , Nicoletta Esposito , Daniel Litewczuk , Enrico Evangelisti , Francesca Caramia , Andrea Truini , Giulia Di Stefano

Objective

Primary trigeminal neuralgia (TN) is a representative neuropathic facial pain condition classified into classical (associated with neurovascular compression), and idiopathic (unknown etiology). Differentiating between classical and idiopathic TN based on clinical and neurophysiological findings remains challenging. In this clinical and neurophysiological study, we aimed to identify predictive clinical and neurophysiological variables that may distinguish between the two types of TN.

Methods

We retrospectively analyzed clinical records and neurophysiological data from 114 patients with primary TN (84 classical TN, 30 idiopathic TN). We implemented a logistic regression model to identify predictive variables for classical and idiopathic TN.

Results

The logistic regression model showed that a trigeminal reflex latency asymmetry longer than 0.5 ms between the affected and unaffected sides was predictive of classical TN (p < 0.05). Additionally, combined involvement of the second and third trigeminal divisions was predictive of idiopathic TN (p < 0.05).

Conclusions

Our findings suggesting that latency asymmetry in trigeminal reflexes differentiate between classical and idiopathic TN probably reflects the association of classical TN with neurovascular compression, while idiopathic TN may involve other factors affecting trigeminal nerve fibers.

Significance

Our results enhance our understanding of pathophysiology of TN and could improve clinical differentiation between its types.

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引用次数: 0

Vestibular function in children with neurodevelopmental disorders: A neglected sense?

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2024.12.026

Ruth Van Hecke , Frederik J.A. Deconinck , Emmely Van Acker , Maya Danneels , Ingeborg Dhooge , Hilde Van Waelvelde , Jan R. Wiersema , Leen Maes

Objective

The study aimed to explore the vestibular function in children with neurodevelopmental disorders (NDDs).

Methods

Twenty-eight participants with a NDD (6 girls, 22 boys; 6–13 years; 9;3 ± 2;4 years) were enrolled in this pilot study. Sixteen participants had a single NDD (Autism Spectrum Disorder: n = 7, Developmental Coordination Disorder: n = 3; Attention Deficit/Hyperactivity Disorder: n = 6), the remaining 12 had comorbid NDDs. The integrity of the peripheral vestibular system was evaluated using ocular and cervical Vestibular Evoked Myogenic Potentials (o/cVEMP), and a video Head Impulse Test (vHIT); motor competence was assessed with the Movement Assessment Battery for Children, and the KörperkoordinationsTest für Kinder. Results were compared to an age and sex-matched control group (n = 28; 9;7 ± 1;9 years).

Results

The NDD group exhibited significantly higher interpeak amplitudes on both VEMP tests compared to the control group (p < 0.001). No significant differences were found between the groups on vHIT measurements (p > 0.05). Among the children with NDDs, 11 (39 %) showed atypical vestibular responses, including one child with vHIT correction saccades and three children with reduced or absent otolith responses (n = 3). Additionally, eight children showed abnormally elevated otolith amplitudes (cVEMP > 4.00 µV; oVEMP > 55.00 µV).

Conclusions

Clinicians are encouraged to recognize the overlap and consider the possibility of vestibular alterations in individuals with NDD.

Significance

Incorporating vestibular assessments into routine clinical evaluations, particularly in children with NDD who exhibit delayed motor development, balance issues, hearing loss, or vestibular-related symptoms, is strongly recommended.

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引用次数: 0

Clinical and intracranial electrophysiological signatures of post-operative and post-ictal delirium

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2024.12.023

Matthew I. Banks , Emily R. Dappen , Elie Matar , Benjamin D. Hayum , Michael H. Sutherland , Bryan M. Krause , Hiroto Kawasaki , Robert D. Sanders , Kirill V. Nourski

Objectives

(1) Gain insight into the mechanisms of postoperative delirium (POD). (2) Determine mechanistic overlap with post-ictal delirium (PID). Epilepsy patients undergoing intracranial electrophysiological monitoring can experience both POD and PID, and thus are suitable subjects for these investigations.

Methods

POD was assessed daily after surgery. PID was assessed following seizures. Resting state data were collected following delirium assessments, during a control period, and during sleep. Slow-wave activity (SWA: 1–4 Hz) and resting state functional connectivity were compared between different time points and according to delirium status.

Results

POD was present in 6 of 20 participants. Post-operatively, SWA was globally elevated in all participants but highest in POD+ participants. POD+ participants exhibited altered functional connectivity compared to POD-. These differences persisted even after resolution of delirium. PID was present in 7 of 15 participants and was predicted by seizures involving prefrontal cortex. PID+ participants exhibited higher post-ictal SWA versus PID-; no differences in functional connectivity were observed. Post-operative and post-ictal SWA was comparable to sleep in some participants.

Conclusions

Elevated SWA may predispose patients to both post-operative and post-ictal delirium and may indicate overlapping mechanisms.

Significance

Delirium treatments focused on SWA may be most effective for ameliorating cognitive symptoms.

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引用次数: 0