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Association of TMS-EEG interhemispheric imbalance with upper limb motor impairment in chronic stroke patients: An exploratory study
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2024.12.027
Alex Martino Cinnera , Elias Paolo Casula , Valentina Pezzopane , Alessia D’Acunto , Michele Maiella , Sonia Bonnì , Matteo Ferraresi , Marcella Guacci , Marco Tramontano , Marco Iosa , Stefano Paolucci , Giovanni Morone , Giuseppe Vannozzi , Giacomo Koch

Objective

We aimed to investigate the involvement of interhemispheric cortical dynamics as measured by combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) in recovery of upper limb (UL) motor functions in chronic stroke patients.

Methods

Ten patients with a history of single ischemic chronic stroke were enrolled (4F, 63.8 ± 9.9 years). Each patient underwent TMS-EEG recordings to evaluate interhemispheric cortical dynamics as well as a reaching task recorded with inertial measurement units, and a series of clinical assessments. TMS-EEG neurophysiological data were analysed considering spatiotemporal, power response, and interhemispheric balance (IHB) dynamics.

Results

We found that IHB index (IHBi) and low-frequency power (LFP) (4–13 Hz) in the affected hemisphere were associated with the degree of UL impairment.

Conclusion

Increased IHBi due to stroke is an unfavourable factor of UL’ functions. Similarly, LFP of both hemispheres is strongly correlated with clinical and kinematic outcomes.

Significance

TMS-EEG biomarkers of interhemispheric unbalance could be used to estimate functional recovery and drive tailored neuromodulation and neurorehabilitation approaches.
{"title":"Association of TMS-EEG interhemispheric imbalance with upper limb motor impairment in chronic stroke patients: An exploratory study","authors":"Alex Martino Cinnera ,&nbsp;Elias Paolo Casula ,&nbsp;Valentina Pezzopane ,&nbsp;Alessia D’Acunto ,&nbsp;Michele Maiella ,&nbsp;Sonia Bonnì ,&nbsp;Matteo Ferraresi ,&nbsp;Marcella Guacci ,&nbsp;Marco Tramontano ,&nbsp;Marco Iosa ,&nbsp;Stefano Paolucci ,&nbsp;Giovanni Morone ,&nbsp;Giuseppe Vannozzi ,&nbsp;Giacomo Koch","doi":"10.1016/j.clinph.2024.12.027","DOIUrl":"10.1016/j.clinph.2024.12.027","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to investigate the involvement of interhemispheric cortical dynamics as measured by combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) in recovery of upper limb (UL) motor functions in chronic stroke patients.</div></div><div><h3>Methods</h3><div>Ten patients with a history of single ischemic chronic stroke were enrolled (4F, 63.8 ± 9.9 years). Each patient underwent TMS-EEG recordings to evaluate interhemispheric cortical dynamics as well as a reaching task recorded with inertial measurement units, and a series of clinical assessments. TMS-EEG neurophysiological data were analysed considering spatiotemporal, power response, and interhemispheric balance (IHB) dynamics.</div></div><div><h3>Results</h3><div>We found that IHB index (IHB<em>i)</em> and low-frequency power (LFP) (4–13 Hz) in the affected hemisphere were associated with the degree of UL impairment.</div></div><div><h3>Conclusion</h3><div>Increased IHB<em>i</em> due to stroke is an unfavourable factor of UL’ functions. Similarly, LFP of both hemispheres is strongly correlated with clinical and kinematic outcomes.</div></div><div><h3>Significance</h3><div>TMS-EEG biomarkers of interhemispheric unbalance could be used to estimate functional recovery and drive tailored neuromodulation and neurorehabilitation approaches.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"171 ","pages":"Pages 95-106"},"PeriodicalIF":3.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074323","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}
引用次数: 0
Radiofrequency evoked potentials: A new window into the nociceptive system
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2024.12.022
Christian Ariel Mista , Elizabeth Loreley Young , Silvio Jorge Laugero , José Alberto Biurrun Manresa

Objective

To describe the cortical evoked potentials in response to radiofrequency stimulation (RFEPs) in human volunteers.

Methods

Seventeen healthy volunteers participated in an experimental session in which radiofrequency (RF) and electrical (ES) stimulation were applied to the dorsum of the hands and feet. EEG was recorded to evaluate evoked responses for each stimulus modality and stimulation site.

Results

Electrophysiological results showed highly synchronous responses compatible with activation of heat-sensitive nociceptors. Latencies of the N2 and P2 peaks in the RFEPs were longer compared to EPs evoked by ES. Furthermore, the latency of the P2 peak was also longer after stimulation of the feet compared to the hand.

Conclusions

RF stimulation is capable of selective activation of nociceptive fibres by means of rapid skin heating. RFEPs showed the highest degree of synchronicity achieved to date for evoked cortical responses to thermal stimulation.

Significance

RF stimulation represents a viable alternative in the experimental and clinical assessment of the nociceptive system.
{"title":"Radiofrequency evoked potentials: A new window into the nociceptive system","authors":"Christian Ariel Mista ,&nbsp;Elizabeth Loreley Young ,&nbsp;Silvio Jorge Laugero ,&nbsp;José Alberto Biurrun Manresa","doi":"10.1016/j.clinph.2024.12.022","DOIUrl":"10.1016/j.clinph.2024.12.022","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the cortical evoked potentials in response to radiofrequency stimulation (RFEPs) in human volunteers.</div></div><div><h3>Methods</h3><div>Seventeen healthy volunteers participated in an experimental session in which radiofrequency (RF) and electrical (ES) stimulation were applied to the dorsum of the hands and feet. EEG was recorded to evaluate evoked responses for each stimulus modality and stimulation site.</div></div><div><h3>Results</h3><div>Electrophysiological results showed highly synchronous responses compatible with activation of heat-sensitive nociceptors. Latencies of the N2 and P2 peaks in the RFEPs were longer compared to EPs evoked by ES. Furthermore, the latency of the P2 peak was also longer after stimulation of the feet compared to the hand.</div></div><div><h3>Conclusions</h3><div>RF stimulation is capable of selective activation of nociceptive fibres by means of rapid skin heating. RFEPs showed the highest degree of synchronicity achieved to date for evoked cortical responses to thermal stimulation.</div></div><div><h3>Significance</h3><div>RF stimulation represents a viable alternative in the experimental and clinical assessment of the nociceptive system.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"171 ","pages":"Pages 21-30"},"PeriodicalIF":3.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037480","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}
引用次数: 0
Ulnar artery arteriovenous malformation with an intraneural ulnar nerve component; case report and literature review
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2025.01.003
G.V. Anguelova , J. VanderEnde , C.I.A. van Houdt , C.G.J. Saris
{"title":"Ulnar artery arteriovenous malformation with an intraneural ulnar nerve component; case report and literature review","authors":"G.V. Anguelova ,&nbsp;J. VanderEnde ,&nbsp;C.I.A. van Houdt ,&nbsp;C.G.J. Saris","doi":"10.1016/j.clinph.2025.01.003","DOIUrl":"10.1016/j.clinph.2025.01.003","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"171 ","pages":"Pages 18-20"},"PeriodicalIF":3.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036759","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}
引用次数: 0
The role of the somatosensory cortex in self-paced movement impairment in Parkinson’s disease
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2025.01.001
Natalia Madetko-Alster , Piotr Alster , Martin Lamoš , Lucia Šmahovská , Tomáš Boušek , Ivan Rektor , Martina Bočková

Objective

The aim of this work was to study the differences at the whole-brain level between self-paced and cued movement processing in Parkinson’s disease (PD).

Methods

High density electroencephalogram (HD-EEG) was recorded during the performance of self-paced movements (Bereitschaftspotential − BP) and visually cued movements (VMT) in PD patients (n = 38) and in a group of healthy controls (HC, n = 23). Oscillatory changes in the alpha, beta, and gamma frequencies were evaluated and correlated to the clinical scales- MDS-UPDRS and Freezing of Gait Questionnaire (FOGQ).

Results

The main difference in the alpha range was an activation in the basal ganglia area during VMT performance as compared to BP performance; this activation was present only in HC. The most important finding was observed in the high beta range: a higher activation of the right postcentral area during BP performance in PD subjects as compared to HC, correlating to the severity of FOG. Moreover, PD patients had lower gamma activation of the right frontal areas.

Conclusion

A simplification of motor circuits and a hyperactivation of the right somatosensory cortex were observed in PD subjects.

Significance

Future studies should be focused on this area to confirm or disprove its role in FOG.
{"title":"The role of the somatosensory cortex in self-paced movement impairment in Parkinson’s disease","authors":"Natalia Madetko-Alster ,&nbsp;Piotr Alster ,&nbsp;Martin Lamoš ,&nbsp;Lucia Šmahovská ,&nbsp;Tomáš Boušek ,&nbsp;Ivan Rektor ,&nbsp;Martina Bočková","doi":"10.1016/j.clinph.2025.01.001","DOIUrl":"10.1016/j.clinph.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this work was to study the differences at the whole-brain level between self-paced and cued movement processing in Parkinson’s disease (PD).</div></div><div><h3>Methods</h3><div>High density electroencephalogram (HD-EEG) was recorded during the performance of self-paced movements (Bereitschaftspotential − BP) and visually cued movements (VMT) in PD patients (n = 38) and in a group of healthy controls (HC, n = 23). Oscillatory changes in the alpha, beta, and gamma frequencies were evaluated and correlated to the clinical scales- MDS-UPDRS and Freezing of Gait Questionnaire (FOGQ).</div></div><div><h3>Results</h3><div>The main difference in the alpha range was an activation in the basal ganglia area during VMT performance as compared to BP performance; this activation was present only in HC. The most important finding was observed in the high beta range: a higher activation of the right postcentral area during BP performance in PD subjects as compared to HC, correlating to the severity of FOG. Moreover, PD patients had lower gamma activation of the right frontal areas.</div></div><div><h3>Conclusion</h3><div>A simplification of motor circuits and a hyperactivation of the right somatosensory cortex were observed in PD subjects.</div></div><div><h3>Significance</h3><div>Future studies should be focused on this area to confirm or disprove its role in FOG.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"171 ","pages":"Pages 11-17"},"PeriodicalIF":3.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037481","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}
引用次数: 0
Brain changes in sleep-related hypermotor epilepsy observed from wakefulness and N2 sleep: A matched case-control study
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-20 DOI: 10.1016/j.clinph.2024.12.020
Changqiong Zhou , Chenxi Qiu , Chunge Pan , Yan Li , Yingying Tang , Ziyi Chen , Ying Liu , Sijia Guo , Jing Lu , Bo Yan , Xiaoting Hao

Objective

Sleep-related hypermotor epilepsy (SHE) is a relatively uncommon epilepsy syndrome, characterized by seizures closely related to the sleep cycle. This study aims to explore interictal electroencephalographic (EEG) characteristics in SHE.

Methods

We compared EEG data from 20 patients with SHE, 20 patients with focal epilepsy (FE), and 14 healthy controls, carefully matched for age, sex, education level, epilepsy duration, and drug-resistant epilepsy.

Results

Our findings revealed distinct patterns of power spectral density in SHE patients during wakefulness and N2 sleep compared to other groups, suggesting potential diagnostic value. During wakefulness, SHE patients showed enhanced frontal lobe power across all frequency bands, but decreased frontal lobe power in low-frequency bands during N2 sleep. Additionally, a positive correlation was found between frontal γ band power and epilepsy duration in SHE patients during N2 sleep but not during wakefulness.

Conclusions

These findings suggest that interictal EEG abnormalities during wakefulness and N2 sleep might be used as potential biomarkers for the diagnosis of SHE.

Significance

This study is the first to simultaneously characterize EEG during sleep and wakefulness in SHE patients during interictal periods, with potential utility for diagnosis.
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引用次数: 0
Spontaneous muscle activity in multifocal motor neuropathy - Insights from axonal excitability testing.
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-17 DOI: 10.1016/j.clinph.2024.12.019
Christian Krarup, Nils Wolfram, Siska Frahm-Falkenberg, Carolina C Graffe, Tina Dysgaard, Ali Al-Zuhairy, Johannes K Jakobsen, Mihai Moldovan

Objective: To investigate motor axonal excitability in multifocal motor neuropathy (MMN) associated with involuntary muscle activity.

Methods: Two MMN patients with continuous involuntary finger movements (MMNifm) were compared to 11 patients without movements (MMNnfm). Clinical examination, EMG of the abductor pollicis brevis muscle, nerve conduction studies, motor unit number estimation, excitability studies, and mathematical modeling were conducted in the patients with MMN and compared to controls.

Results: Weakness, axonal loss, conduction block, or both occurred in the median nerve in the MMNifm and the MMNnfm patients. Ultrasound studies (US) in MMNifm showed enlargement of the nerves at the axilla/brachial plexus at the site of the conduction block. In MMNifm, EMG and the US showed continuous involuntary contractions, and excitability studies of the median nerve at the wrist showed increased threshold reduction during early depolarizing electrotonus and at early recovery cycle (superexcitability). Mathematical modeling was consistent with reduced fast K+ current more pronounced in MMNifm than in MMNnfm.

Conclusions: MMN may have a spectrum of changes associated with instability of the axonal membrane which may be due to paranodal myelin loosening.

Significance: In addition to motor conduction block and axonal loss, MMN has pathophysiological changes that suggest more widespread involvement of motor myelinated fibers.

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引用次数: 0
Shapes of direct cortical responses vs. short-range axono-cortical evoked potentials: The effects of direct electrical stimulation applied to the human brain 皮层直接反应与短程轴突皮层诱发电位的形状:直接电刺激对人脑的影响。
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinph.2024.10.016
Clotilde Turpin , Olivier Rossel , Félix Schlosser-Perrin , Sam Ng , Riki Matsumoto , Emmanuel Mandonnet , Hugues Duffau , François Bonnetblanc

Objective

Direct cortical responses (DCR) and axono-cortical evoked potentials (ACEP) are generated by electrically stimulating the cortex either directly or indirectly through white matter pathways, potentially leading to different electrogenic processes. For ACEP, the slow conduction velocity of axons (median ≈ 4 m.s−1) is anticipated to induce a delay. For DCR, direct electrical stimulation (DES) of the cortex is expected to elicit additional cortical activity involving smaller and slower non-myelinated axons. We tried to validate these hypotheses.

Methods

DES was administered either directly on the cortex or to white matter fascicles within the resection cavity, while recording DCR or ACEP at the cortical level in nine patients.

Results

Short but significant delays (≈ 2 ms) were measurable for ACEP immediately following the initial component (≈ 7 ms). Subsequent activities (≈ 40 ms) exhibited notable differences between DCR and ACEP, suggesting the presence of additional cortical activities for DCR.

Conclusion

Distinctions between ACEPs and DCRs can be made based on a delay at the onset of early components and the dissimilarity in the shape of the later components (>40 ms after the DES artifact).

Significance

The comparison of different types of evoked potentials allows to better understand the effects of DES.
目的:直接皮层反应(DCR)和轴皮层诱发电位(ACEP)是通过直接或间接白质通路电刺激皮层产生的,可能导致不同的电原过程。对于 ACEP,轴突的慢传导速度(中位数≈ 4 m.s-1)预计会引起延迟。对于 DCR,对大脑皮层的直接电刺激(DES)预计会引起额外的皮层活动,其中涉及较小和较慢的非髓鞘轴突。我们试图验证这些假设:方法:在九名患者的皮层水平记录 DCR 或 ACEP 的同时,直接在皮层或切除腔内的白质束上进行 DES:在初始成分(≈ 7 毫秒)之后,ACEP 可立即测量到短暂但明显的延迟(≈ 2 毫秒)。随后的活动(≈ 40 毫秒)在 DCR 和 ACEP 之间表现出明显的差异,表明 DCR 存在额外的皮层活动:结论:ACEP 和 DCR 之间的区别可以根据早期成分开始时的延迟和后期成分(DES 伪影之后大于 40 毫秒)形状的不同来区分:意义:通过比较不同类型的诱发电位,可以更好地了解 DES 的影响。
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引用次数: 0
Unraveling prefrontal cortical inhibitory dynamics: A novel approach to investigate GABAergic function with TMS-EEG 揭示前额皮质抑制动力学:一种利用TMS-EEG研究gaba能功能的新方法。
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinph.2024.11.016
Fabio Ferrarelli
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引用次数: 0
Towards a shared electrogenesis mechanism in direct cortical responses, axono-cortical evoked potentials, and cortico-cortical evoked potentials 在皮层直接反应、轴突-皮层诱发电位和皮层-皮层诱发电位中建立共同的电生成机制
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinph.2024.11.006
Davide Giampiccolo
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引用次数: 0
Influences of speaking task demands on sensorimotor oscillations in adults who stutter: Implications for speech motor control 说话任务要求对口吃成人感觉运动振荡的影响:对言语运动控制的影响
IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-01-01 DOI: 10.1016/j.clinph.2024.10.017
Edward C. Brown , Andrew Bowers , M.Blake Rafferty , Devin M. Casenhiser , Kevin Reilly , Ashley Harkrider , Tim Saltuklaroglu

Objective

Motivated by previous inconsistent findings, this study aims to improve understanding of sensorimotor beta (β; 15–30 Hz) and alpha (α; 8–14 Hz) speech-related power differences between stuttering and non-stuttering adults.

Methods

Electroencephalography was recorded as adults who stutter (AWS) and matched fluent controls answered questions in Quiet and Informational Masked backgrounds. Bilateral sensorimotor β and α power during speech planning and execution were measured from mu (μ) rhythm components.

Results

Compared to controls, AWS exhibited reduced left hemisphere β and α power in both speaking conditions during speech planning and execution. AWS displayed reduced left α power in the Informational Masking compared to Quiet. Within AWS β and α power, which were tightly coupled, oppositely predicted stuttering severity and β-α dissociation (β minus α) was the strongest predictor.

Conclusion

Neither β nor α power are reliable markers of speech motor stability due to their sensitivity to speech task automaticity. However, relationships between these two sensorimotor rhythms warrant further investigation for understanding motor control.

Significance

Data help explain previous mixed findings in reference to extant models of speech motor control in stuttering and may have clinical implications for developing neurostimulation protocols targeting improved speech fluency.
研究目的由于以前的研究结果不一致,本研究旨在加深对口吃成人和非口吃成人之间与言语相关的感觉运动β(β;15-30赫兹)和α(α;8-14赫兹)功率差异的理解:在口吃成人(AWS)和匹配的流利对照组在安静和信息掩蔽背景下回答问题时记录脑电图。结果:与对照组相比,口吃成人在语言计划和执行过程中的双侧感觉运动 β 和 α 功率降低:结果:与对照组相比,AWS 在语音规划和执行过程中的两种说话条件下都表现出左半球 β 和 α 功率减弱。与安静时相比,AWS 在信息屏蔽时显示出左半球 α 功率降低。在AWS中,β和α功率是紧密联系在一起的,它们对口吃严重程度的预测是相反的,β-α分离(β减α)是最强的预测因素:结论:β 和 α 功率都不是言语运动稳定性的可靠标志,因为它们对言语任务的自动性非常敏感。然而,这两种感觉运动节奏之间的关系值得进一步研究,以了解运动控制:数据有助于解释以前关于口吃患者言语运动控制的现有模型的混合研究结果,并可能对开发以改善言语流利性为目标的神经刺激方案具有临床意义。
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引用次数: 0
期刊
Clinical Neurophysiology
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