Clinical Neurophysiology最新文献_第9页

Machine learning predicts cognitive outcome from preterm infants’ EEG 机器学习预测早产儿脑电图的认知结果

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.2025.2111433

Tom A. Campbell

引用次数: 0

Potassium channel dysfunction and distinct sensory axonal profiles in painful type 2 diabetes 疼痛性2型糖尿病的钾通道功能障碍和不同的感觉轴突分布

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI: 10.1016/j.clinph.2025.2111450

Cindy Shin-Yi Lin , Jowy Tani , Ting Wei Hsu , Yi-Chen Lin , Yun-Ru Liu , Jia-Ying Sung M.D. PhD.

Objective

This study aims to characterize sensory axonal changes in patients with non-painful and painful type 2 diabetes mellitus (T2DM) to explore the mechanisms underlying diabetic neuropathic pain in relation to pregabalin treatment.

Methods

Clinical evaluations, including nerve conduction studies, nerve excitability testing (NET) and visual analogue scale (VAS), were conducted on 200 T2DM, resulting 131 qualifying for inclusion. Cohort stratification utilized VAS scores: 43 had VAS ≥ 4 (painful), and 88 had VAS < 4 (non-painful). The painful cohort was categorized into low pain (4 ≤ VAS < 7) and high pain (VAS ≥ 7). A subgroup receiving pregabalin (15) was assessed to investigate neurophysiological differences.

Results

The painful cohort differed significantly from the non-painful cohort in sensory nerve excitability parameters including stimulus for 50% maximum amplitude, refractoriness, superexcitability, subexcitability, and depolarization thresholds. Higher VAS scores correlated with reduced TEd⁴⁰(Accom) and TEh(overshoot). Pregabalin-treated patients demonstrated improved stimulus–response slope, S2 accommodation and TEd⁴⁰(Accom) compared to untreated patients.

Conclusions

Our findings suggest that diabetic neuropathic pain may be associated with axonal hyperpolarization and accommodative properties with implications to potassium channel dysfunction.

Significance

These findings elucidate mechanisms of diabetic pain pathophysiology, highlighting the clinical significance of sensory NET and the role of potassium channel modulation in T2DM pain management.

目的观察非疼痛性和疼痛性2型糖尿病（T2DM）患者感觉轴突的变化，探讨普瑞巴林治疗对糖尿病神经性疼痛的影响机制。方法对200例T2DM患者进行神经传导、神经兴奋性测试（NET）和视觉模拟评分（VAS）等临床评价，其中131例符合纳入标准。队列分层采用VAS评分：43例VAS≥4（疼痛），88例VAS <； 4（无疼痛）。疼痛组分为低疼痛组（4≤VAS < 7）和高疼痛组（VAS≥7）。接受普瑞巴林治疗的亚组（15）评估神经生理差异。结果疼痛组与非疼痛组的感觉神经兴奋性参数有显著差异，包括50%最大振幅的刺激、难阻性、超兴奋性、亚兴奋性和去极化阈值。较高的VAS评分与降低的TEd40（Accom）和TEh（超调）相关。与未治疗的患者相比，接受普瑞巴林治疗的患者表现出更好的刺激反应斜率、S2调节和TEd40（Accom）。结论糖尿病神经性疼痛可能与轴突超极化和调节特性有关，并与钾通道功能障碍有关。这些发现阐明了糖尿病疼痛的病理生理机制，强调了感觉NET的临床意义和钾通道调节在T2DM疼痛管理中的作用。

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引用次数: 0

Intraoperative Ultrasound-Assisted 3D-Electrocorticography for resection of type II focal cortical dysplasias 术中超声辅助3d皮质电成像切除II型局灶性皮质发育不良

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.2025.2111443

Giuseppe Didato , Nicolò Castelli , Chiara Pastori , Paola Lanteri , Ambra Dominese , Michele Introna , Rita Garbelli , Fabio Martino Doniselli , Gianluca Marucci , Elena Freri , Angelo Del Sole , Valeria Cuccarini , Francesco Deleo , Andrea Stabile , Roberta Di Giacomo , Francesca Ragona , Laura Rossini , Carla Carozzi , Massimiliano Del Bene , Vittoria Nazzi , Michele Rizzi

Objective

Type II focal cortical dysplasias (FCDII) present a clear-cut anatomo-electro-clinical profile and are associated with optimal surgical outcome when completely resected. Alongside presurgical planning and neuroimaging, intraoperative electrocorticography (ECoG) can aid in delineating FCDII boundaries. We report outcomes from patients undergoing FCDII resection using 3D-ECoG with an intracerebral electrode guided by intraoperative ultrasound (ioUS).

Methods

Patients with suspected FCDII underwent 3D-ECoG during surgery to record intracerebral interictal epileptiform discharges (IEDs) classified as: 1) rhythmic spikes (RS), and 2) periodic bursts of polyspikes (PBOP).

Results

Ten patients (5 male, 5 female; median age 19.5 years, median epilepsy duration 16 years) were included. Bottom-of-sulcus dysplasia (BOSD) was found in 60 %. 3D-ECoG identified RS in 30 % and PBOP in 70 %. Total IED removal was achieved in 60 %. Histopathology revealed FCDII in 80 %, while 20 % had a diagnosis of “no definite FCD on histopathology”. After a median 24-month follow-up, 90 % achieved ILAE class 1 outcome (seizure free), 10 % had class 2 (only auras). No major complications occurred.

Conclusions

IoUS-assisted 3D-ECoG is a safe procedure for intraoperative delineation of FCDII, supporting complete resection.

Significance

Integrating IoUS with 3D-ECoG can offer substantial benefits for surgical management of FCDII-related epilepsy.

目的II型局灶性皮质发育不良（FCDII）具有明确的解剖-电-临床特征，并与完全切除后的最佳手术结果相关。除了术前计划和神经成像外，术中皮质电图（ECoG）可以帮助划定FCDII边界。我们报告了术中超声（iou）引导下脑内电极3D-ECoG切除FCDII患者的结果。方法疑似FCDII患者术中行3D-ECoG记录脑内癫痫样间期放电（IEDs），分为：1)节律性尖峰（RS）和2)多尖峰周期性爆发（PBOP）。结果纳入患者10例，男5例，女5例，中位年龄19.5岁，中位癫痫持续时间16年。沟底发育不良（BOSD）占60%。3D-ECoG鉴定RS为30%，PBOP为70%。总IED清除率为60%。组织病理学检查显示FCDII的占80%，而20%的组织病理学诊断为“没有明确的FCD”。中位随访24个月后，90%达到ILAE 1级结果（无癫痫发作），10%达到2级结果（仅有先兆）。无重大并发症发生。结论辅助3D-ECoG是术中描绘FCDII的安全方法，支持完全切除。意义将借据与3D-ECoG相结合可以为fcdii相关癫痫的手术治疗提供实质性的好处。

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引用次数: 0

Hemispheric asymmetry of the ipsilateral silent period following voluntary movement of the opposite hand 另一只手自主运动后同侧沉默期的半球不对称。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI: 10.1016/j.clinph.2025.2111444

Sabira Alibhai-Najarali , John P. de Grosbois , Aaron E. Philipp-Muller , Jennifer Shao , Matthew J. Hawken , Matea Skenderija , Jed A. Meltzer

Objective

To investigate whether post-movement beta rebound (PMBR), a proposed marker of cortical inhibition, reflects interhemispheric inhibition as measured by the ipsilateral silent period (iSP) following voluntary movement and to assess hemispheric asymmetries.

Methods

Twenty right-handed participants underwent transcranial magnetic stimulation (TMS) to elicit iSPs at baseline (no button-press) and eight timepoints following movement of the opposite hand, iSPs and motor-evoked potentials (MEPs) were recorded for both hemispheres. Six participants completed magnetoencephalography (MEG) to characterize beta oscillatory activity during the task. Five participants completed the task without the TMS as a control.

Results

iSP magnitude did not significantly change during PMBR period. Instead, post-movement iSP increased in the right hemisphere and decreased in the left, yielding a significant hemispheric difference (p = 0.014). MEG data confirmed symmetrical PMBR across hemispheres. MEPs showed increased excitability post-movement, particularly at early timepoints. Movement alone, without TMS, did not account for hemispheric asymmetry.

Conclusions

PMBR and iSP appear to reflect distinct inhibitory mechanisms. The dissociation suggests PMBR does not index transcallosal inhibition (TCI). Hemispheric asymmetry in iSP suggests stronger TCI following non-dominant hand movements.

Significance

The dissociation between iSP and PMBR underscores the complexity of motor control, informs understanding lateralized motor function and rehabilitation.

目的：研究运动后β反弹（PMBR），一种被提出的皮层抑制标志物，是否反映了自主运动后同侧沉默期（iSP）测量的半球间抑制，并评估半球不对称性。方法：采用经颅磁刺激（TMS）诱发20名右撇子参与者在基线（不按按钮）和对侧手运动后8个时间点的iSPs，记录双脑的iSPs和运动诱发电位（MEPs）。六名参与者完成了脑磁图（MEG）来表征任务期间的β振荡活动。五名参与者在没有经颅磁刺激作为对照的情况下完成了任务。结果：PMBR期间iSP大小无明显变化。相反，运动后的iSP在右半球增加，在左半球减少，产生显著的半球差异（p = 0.014）。脑磁图数据证实了跨半球的对称PMBR。mep在运动后表现出兴奋性增强，尤其是在早期。单独运动，不经颅磁刺激，不能解释半球不对称。结论：PMBR和iSP似乎反映了不同的抑制机制。分离表明PMBR不能反映经胼胝体抑制（TCI）。iSP的半球不对称表明非优势手运动后TCI增强。意义：iSP和PMBR之间的分离强调了运动控制的复杂性，有助于理解侧化运动功能和康复。

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引用次数: 0

The complementary use of muscle ultrasound and MRI in FSHD: Early versus later disease stage follow-up 前列腺增生症患者肌肉超声和核磁共振成像的互补使用：疾病早期与晚期的随访对比

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2024-03-07 DOI: 10.1016/j.clinph.2024.02.036

Sanne C.C. Vincenten , Nicol C. Voermans , Donnie Cameron , Baziel G.M. van Engelen , Nens van Alfen , Karlien Mul

Objectives

Muscle MRI and ultrasound provide complementary techniques for characterizing muscle changes and tracking disease progression in facioscapulohumeral muscular dystrophy (FSHD). In this cohort study, we provide longitudinal data that compares both imaging modalities head-to-head.

Methods

FSHD patients were assessed at baseline and after five years. Standardized muscle MRI and ultrasound images of five leg muscles were assessed bilaterally. Fat replacement was quantified using MRI fat-fraction (FF) and ultrasound Heckmatt and echogenicity z-scores (EZ-score). Muscle edema was evaluated using T₂-weighted turbo inversion recovery magnitude (TIRM) MRI.

Results

Twenty FSHD patients were included. Muscles with normal baseline imaging showed increases in ultrasound EZ-scores (≥1; in 17%) more often than MRI FF increases (≥10%; in 7%) over time. Muscles with only baseline ultrasound abnormalities often showed considerable FF increases (in 22%), and TIRM positivity at follow-up (44%). Muscles with increased FF at baseline showed stable (80%) or increasing FF (20%) over time. EZ-scores of those muscles either increased (23%), decreased (33%) or remained stable (44%).

Conclusions

Muscle ultrasound may capture accelerated pathological muscle changes in FSHD in early disease, while muscle MRI appears better-suited to detecting and monitoring pathology in later stages.

Significance

Our results help establish each techniques’ optimal use as imaging biomarker.

肌肉核磁共振成像（MRI）和超声波是表征面岬肱肌营养不良症（FSHD）患者肌肉变化和追踪疾病进展的互补技术。在这项队列研究中，我们提供了纵向数据，对这两种成像模式进行了正面比较。我们对 FSHD 患者进行了基线评估和五年后的评估。对双侧五块腿部肌肉的标准化肌肉磁共振成像和超声波图像进行了评估。使用核磁共振成像脂肪率（FF）和超声 Heckmatt 及回声z-score（EZ-score）对脂肪替代进行量化。肌肉水肿采用T加权涡轮反转恢复幅度（TIRM）核磁共振成像进行评估。共纳入 20 例 FSHD 患者。随着时间的推移，基线成像正常的肌肉显示超声EZ-scores增加（≥1；占17%）的频率高于核磁共振FF增加（≥10%；占7%）的频率。仅有基线超声异常的肌肉往往显示出相当大的 FF 增加（22%），并在随访时显示出 TIRM 阳性（44%）。随着时间的推移，基线 FF 增加的肌肉显示出稳定（80%）或增加（20%）的 FF。这些肌肉的 EZ 分数要么增加（23%），要么减少（33%），要么保持稳定（44%）。肌肉超声可在疾病早期捕捉到前列腺肥大症肌肉的加速病理变化，而肌肉核磁共振成像似乎更适合在疾病晚期检测和监测病理变化。我们的研究结果有助于确定每种技术作为成像生物标志物的最佳用途。

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引用次数: 0

Respiratory muscle activity and fatigue response during respiratory endurance testing in patients with spinal muscular atrophy 脊髓性肌萎缩症患者呼吸耐力试验中的呼吸肌活动和疲劳反应。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1016/j.clinph.2025.2111408

Kim Kant-Smits , Lisa Pomp , Laura E. Habets , Erik H.J. Hulzebos , Jeroen A.L. Jeneson , Fay-Lynn Asselman , Janke F. de Groot , C. Kors van der Ent , Ruben P.A. van Eijk , W. Ludo van der Pol , Bart Bartels

Objective

To explore respiratory muscle activity and fatigue response during a respiratory endurance test (RET) in patients with spinal muscular atrophy (SMA).

Methods

Fifty-five participants with SMA types 2 and 3 performed a respiratory endurance test (RET) at 20 %-70 % of their maximum inspiratory mouth pressure (PImax). We recorded surface electromyography (sEMG) of the diaphragm, intercostal, and scalene muscles and evaluated muscle activity at onset and during the test. Respiratory muscle fatigability (RMF) was defined as the inability to complete 60 consecutive breaths during the RET.

Results

The diaphragm showed a significantly lower variance in activity at onset of the test compared to the intercostal and scalene muscles (p = 0.002). Participants with RMF showed fatigue of the diaphragm, indicated by a significant decrease in root mean square amplitude (p = 0.012) and median frequency (p < 0.001), compared to those without RMF.

Conclusion

The relative activity of the diaphragm at onset of a RET remained stable at higher intensity levels, while the activity of the intercostal and scalene muscles became more variable. The diaphragm showed significant electrophysiological signs of fatigue, while accessory inspiratory muscles showed no clear electrophysiological fatigue signs.

Significance

The results of this study provide more insight into respiratory muscle function and fatigability in patients with SMA.

目的：探讨脊髓性肌萎缩症（SMA）患者呼吸耐力试验（RET）时呼吸肌活动和疲劳反应。方法：55名2型和3型SMA患者在其最大吸气口压（PImax）的20% - 70%进行呼吸耐力试验（RET）。我们记录了膈肌、肋间肌和斜角肌的表面肌电图（sEMG），并评估了开始时和测试期间的肌肉活动。呼吸肌疲劳（RMF）被定义为在测试期间无法完成60次连续呼吸。结果：与肋间肌和斜角肌相比，横膈膜在测试开始时的活动差异显著降低（p = 0.002）。RMF的参与者表现出膈肌疲劳，这是由均方根振幅（p = 0.012）和中位数频率(p)的显著下降所表明的。结论：RET开始时膈肌的相对活动在高强度水平下保持稳定，而肋间肌和斜角肌的活动变得更加可变。膈肌有明显的疲劳电生理征象，而副吸气肌无明显的疲劳电生理征象。意义：本研究结果对SMA患者的呼吸肌功能和疲劳有了更深入的了解。

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引用次数: 0

Ocular motor dysfunction in patients with multiple system atrophy and Parkinson’s disease 多系统萎缩和帕金森病患者的眼运动功能障碍

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-02 DOI: 10.1016/j.clinph.2025.2111413

Xia Ling , Xinyan Ma , Zhirong Wan , Yunchuang Sun , Fan Li , Luhua Wei , Kai Li , Jing Chen , Guiping Zhao , Ji-Soo Kim , Xu Yang , Zhaoxia Wang

Objective

Differentiating multiple system atrophy (MSA) from Parkinson’s disease (PD) remains challenging. This study aimed to investigate the utility of specific ocular motor features in distinguishing MSA from PD, as these dysfunctions may offer valuable diagnostic clues.

Methods

We used video-oculography to assess spontaneous nystagmus, saccadic intrusions or oscillations, gaze, saccades, head shaking, positional nystagmus, and vestibulo-ocular reflex (VOR) cancellation in 23 MSA patients and 49 PD patients.

Results

Spontaneous downbeat nystagmus, saccadic intrusions/oscillations, and perverted head shaking nystagmus (pHSN) didn’t differ between groups. Horizontal gaze-evoked nystagmus (GEN) occurred in MSA patients but not in PD (P = 0.009). MSA showed significantly more prolonged saccade latency (both horizontal and vertical) and vertical saccadic hypermetria than PD (all P < 0.05). Central positional nystagmus (CPN) was more common in MSA (P = 0.046). Impaired VOR cancellation was significantly higher in MSA than in PD (95.7 % vs. 32.7 %, P < 0.001).

Conclusion

MSA exhibits significantly more pronounced VOR cancellation deficits, horizontal GEN, CPN, saccadic hypermetria, and prolonged saccade latency than PD. These findings suggest a link to the more widespread neurodegeneration characteristic of MSA.

Significance

Impaired VOR cancellation, horizontal GEN, saccadic hypermetria, and CPN offer potential for distinguishing MSA from PD.

目的多系统萎缩（MSA）与帕金森病（PD）的鉴别仍然具有挑战性。本研究旨在探讨特异性眼运动特征在区分MSA和PD中的作用，因为这些功能障碍可能提供有价值的诊断线索。方法对23例MSA患者和49例PD患者的自发性眼球震、眼球侵犯或振荡、凝视、扫视、头摇、位置性眼球震和前庭眼反射（VOR）消除进行了观察。结果自发性下拍性眼球震颤、眼跳侵入/振荡、变态头摇型眼球震颤（pHSN）组间无明显差异。水平凝视诱发眼球震颤（GEN）发生在MSA患者中，而不发生在PD患者中（P = 0.009）。MSA显示的眼跳潜伏期（水平和垂直）和垂直眼跳高明显高于PD（均P <； 0.05）。中枢位置性眼球震颤（CPN）在MSA中更为常见（P = 0.046）。MSA中受损的VOR取消明显高于PD（95.7%比32.7%,P < 0.001）。结论msa比PD表现出更明显的VOR取消缺陷、水平GEN、CPN、跳眼高速和延长的跳眼潜伏期。这些发现表明与MSA更广泛的神经退行性变特征有关。意义：受损的VOR取消、水平GEN、跳高和CPN提供了区分MSA和PD的潜力。

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引用次数: 0

Neurophysiological indices of distinct cognitive operations during symbol digit modalities test performance in multiple sclerosis: a pilot study 多发性硬化症患者符号数字模态测试表现中不同认知操作的神经生理指标：一项初步研究

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-09-30 DOI: 10.1016/j.clinph.2025.2111376

Hope Nyarady , Marissa Tripoli , David W. Shucard , Ryan O’Donnell , Mckenzie Haller , Ralph H.B. Benedict , Bianca Weinstock-Guttman , S.Max Towers , Thomas J. Covey

Objective

The symbol digit modalities test (SDMT) is a clinically relevant and widely used measure of cognitive processing speed and efficiency in people with Multiple Sclerosis (PwMS). The present pilot study identified neurophysiological processes that underly SDMT performance in people with MS (PwMS) compared to healthy controls (HC).

Methods

We developed a novel computerized SDMT-event-related potential (cSDMT-ERP) paradigm to obtain neural indices of SDMT performance.

Results

PwMS exhibited a redistribution of N2 amplitude, and attenuated P3 amplitude during the cSDMT compared to HCs. Increased amplitude of P1, frontal N2, and parietal-occipital P3 during cSDMT performance were together associated with better standard SDMT performance. Reduced frontal-central N2 amplitude with concomitant enhancement of central P3 amplitude was also associated with better SDMT performance. Finally, more pronounced N1 amplitude was associated with heightened depression symptoms.

Conclusions

These analyses indicate that PS disturbances manifest across multiple stages of information processing in PwMS, from early attention (P1 effects), to stimulus conflict monitoring (N2 effects), through stimulus categorization (P3 effects).

Significance

The cSDMT-ERP paradigm that we developed (1) has the potential to extend the clinical utility of the SDMT, and (2) provides a theoretical anchoring for the cognitive operations that underly SDMT performance. Further work is needed to validate these preliminary findings.

目的符号数字模态测试（SDMT）是一种临床相关且广泛应用于多发性硬化症（PwMS）患者认知加工速度和效率的测量方法。目前的初步研究确定了MS患者（PwMS）与健康对照组（HC）相比SDMT表现的神经生理过程。方法建立了一种新的计算机化SDMT-事件相关电位（cSDMT-ERP）范式，以获得SDMT表现的神经指标。结果与hc相比，spwms在cSDMT过程中表现出N2振幅的重新分布和P3振幅的减弱。cSDMT过程中P1、额部N2和顶骨-枕部P3振幅的增加与标准SDMT表现的改善相关。额-中央N2振幅的降低同时伴有中央P3振幅的增强，也与更好的SDMT表现相关。最后，更明显的N1振幅与加重的抑郁症状相关。结论PS干扰表现在PwMS信息加工的多个阶段，从早期注意（P1效应）到刺激冲突监测（N2效应），再到刺激分类（P3效应）。我们开发的cSDMT-ERP范式(1)具有扩展SDMT临床应用的潜力，(2)为SDMT表现背后的认知操作提供了理论锚定。需要进一步的工作来验证这些初步发现。

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引用次数: 0

Emergent technologies and applications of TMS and TMS-EEG in clinical neurophysiology for early and differential diagnosis: IFCN handbook chapter TMS和TMS- eeg在早期和鉴别诊断的临床神经生理学中的新兴技术和应用：IFCN手册章节

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-26 DOI: 10.1016/j.clinph.2025.2111459

Alberto Benussi , Steve Vucic

This chapter examines how emerging neurophysiological technologies are transforming the early and differential diagnosis of neurological disorders. While imaging and fluid biomarkers have greatly advanced the field, they remain limited by cost, invasiveness, and their inability to directly capture dynamic brain activity. Neurophysiological techniques, particularly transcranial magnetic stimulation (TMS) and TMS combined with EEG, offer a unique, non-invasive means of probing cortical excitability, connectivity, and plasticity with millisecond precision.

Recent technological and analytical breakthroughs are moving these approaches from research laboratories into clinical practice. By detecting subtle network dysfunctions that precede structural degeneration, they open the possibility of identifying disease in its prodromal or even presymptomatic stages, when interventions may be most effective. This chapter outlines the principles of advanced TMS paradigms and TMS-EEG and explores their application across a range of conditions, including amyotrophic lateral sclerosis, dementias, and movement disorders. It also highlights how integrating neurophysiological measures with blood-based biomarkers and computational tools, such as machine learning, can enhance diagnostic accuracy and guide individualized treatment strategies.

Together, these innovations establish neurophysiology as a cornerstone of precision neurology, linking mechanistic insights to clinical decision-making and enabling earlier diagnosis, improved patient stratification, and more targeted therapeutic interventions.

本章探讨了新兴的神经生理学技术如何改变神经系统疾病的早期和鉴别诊断。虽然成像和流体生物标志物在该领域取得了很大进展，但它们仍然受到成本、侵入性和无法直接捕获动态大脑活动的限制。神经生理学技术，特别是经颅磁刺激（TMS）和经颅磁刺激与脑电图相结合，提供了一种独特的、非侵入性的方法，以毫秒级的精度探测皮层的兴奋性、连通性和可塑性。最近的技术和分析突破正在将这些方法从研究实验室推向临床实践。通过检测结构退化之前的细微网络功能障碍，它们开启了在前驱甚至症状前阶段识别疾病的可能性，这时干预可能是最有效的。本章概述了先进的TMS范式和TMS- eeg的原理，并探讨了它们在肌萎缩性侧索硬化症、痴呆和运动障碍等一系列疾病中的应用。它还强调了如何将神经生理学测量与基于血液的生物标志物和计算工具（如机器学习）相结合，可以提高诊断准确性并指导个性化治疗策略。总之，这些创新使神经生理学成为精确神经学的基石，将机制见解与临床决策联系起来，使早期诊断、改善患者分层和更有针对性的治疗干预成为可能。

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引用次数: 0

Perioperative quantification of clinical bradykinesia measurements in patients with Parkinson’s disease using accelerometry 应用加速计量化帕金森病患者临床运动迟缓围手术期测量。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2026-01-01 Epub Date: 2025-11-07 DOI: 10.1016/j.clinph.2025.2111424

Annemarie Smid , Teus van Laar , Amber E. Pinkster , Jolien M. ten Kate , Naomi I. Kremer , D. L. Marinus Oterdoom , Katalin Tamasi , J. Marc C. van Dijk , Gea Drost

Objective

The gold standard for assessing bradykinesia in Parkinson’s disease (PD) is the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS), although it is inherently subjective and relies on experienced raters. Therefore, we translated MDS-UPDRS upper limb bradykinesia assessments into an objective scoring method with 3D-accelerometry.

Methods

In this study, 44 PD-patients and 44 healthy controls (sex and age matched) were included. Two raters assessed MDS-UPDRS criteria for bradykinesia, while accelerometric measurements were conducted at the index fingers. Measurements were performed in an off-medication state. The 3D-acceleration data produced quantitative measures, like frequency and amplitude of hand movement. The algorithm for calculating accelerometric scores was based on MDS-UPDRS criteria with thresholds from healthy controls. Agreement between MDS-UPDRS bradykinesia scores and accelerometric scores was estimated with Cohen’s kappa-coefficient (κ).

Results

The accelerometric scores showed moderate agreement (κ ≥ 0.548) with MDS-UPDRS ratings. The inter-rater agreement between the two MDS-UPDRS raters was moderate for all tests (κ ≥ 0.595). Accelerometric test–retest reliability was good to excellent (ICC ≥ 0.764, p < 0.001).

Conclusions

This study introduces an accelerometric algorithm to classify upper extremity bradykinesia according to MDS-UPDRS criteria, yielding high test–retest reliability.

Significance

Given its consistency, this method could reduce MDS-UPDRS rater-dependency and improve objective monitoring of upper limb bradykinesia.

目的：评估帕金森病（PD）运动迟缓的金标准是运动障碍协会统一PD评定量表（MDS-UPDRS），尽管它本身是主观的，依赖于经验丰富的评分者。因此，我们将MDS-UPDRS上肢运动迟缓评估转化为一种带有3d加速度计的客观评分方法。方法：本研究纳入44例pd患者和44例健康对照（性别和年龄相匹配）。两名评分员评估运动迟缓的MDS-UPDRS标准，同时在食指进行加速度测量。在停药状态下进行测量。3d加速数据产生了定量测量，比如手部运动的频率和幅度。计算加速度计评分的算法基于MDS-UPDRS标准和健康对照的阈值。用Cohen's kappa系数（κ）估计MDS-UPDRS慢动评分和加速评分之间的一致性。结果：加速度计评分与MDS-UPDRS评分具有中等一致性（κ≥0.548）。两个MDS-UPDRS评分者之间的一致性在所有测试中均为中等（κ≥0.595）。结论：本研究根据MDS-UPDRS标准，引入加速度计算法对上肢运动迟缓进行分类，获得较高的重测信度。意义：该方法具有一致性，可降低MDS-UPDRS评分依赖性，改善上肢运动迟缓的客观监测。

{"title":"Perioperative quantification of clinical bradykinesia measurements in patients with Parkinson’s disease using accelerometry","authors":"Annemarie Smid , Teus van Laar , Amber E. Pinkster , Jolien M. ten Kate , Naomi I. Kremer , D. L. Marinus Oterdoom , Katalin Tamasi , J. Marc C. van Dijk , Gea Drost","doi":"10.1016/j.clinph.2025.2111424","DOIUrl":"10.1016/j.clinph.2025.2111424","url":null,"abstract":"<div><h3>Objective</h3><div>The gold standard for assessing bradykinesia in Parkinson’s disease (PD) is the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS), although it is inherently subjective and relies on experienced raters. Therefore, we translated MDS-UPDRS upper limb bradykinesia assessments into an objective scoring method with 3D-accelerometry.</div></div><div><h3>Methods</h3><div>In this study, 44 PD-patients and 44 healthy controls (sex and age matched) were included. Two raters assessed MDS-UPDRS criteria for bradykinesia, while accelerometric measurements were conducted at the index fingers. Measurements were performed in an off-medication state. The 3D-acceleration data produced quantitative measures, like frequency and amplitude of hand movement. The algorithm for calculating accelerometric scores was based on MDS-UPDRS criteria with thresholds from healthy controls. Agreement between MDS-UPDRS bradykinesia scores and accelerometric scores was estimated with Cohen’s kappa-coefficient (κ).</div></div><div><h3>Results</h3><div>The accelerometric scores showed moderate agreement (κ ≥ 0.548) with MDS-UPDRS ratings. The inter-rater agreement between the two MDS-UPDRS raters was moderate for all tests (κ ≥ 0.595). Accelerometric test–retest reliability was good to excellent (ICC ≥ 0.764, p < 0.001).</div></div><div><h3>Conclusions</h3><div>This study introduces an accelerometric algorithm to classify upper extremity bradykinesia according to MDS-UPDRS criteria, yielding high test–retest reliability.</div></div><div><h3>Significance</h3><div>Given its consistency, this method could reduce MDS-UPDRS rater-dependency and improve objective monitoring of upper limb bradykinesia.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111424"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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