Neurophysiologie Clinique/Clinical Neurophysiology最新文献

{"title":"The split elbow sign in amyotrophic lateral sclerosis: A systematic review and meta-analysis","authors":"Vasiliki Poulidou ,&nbsp;Vasilis-Spyridon Tseriotis ,&nbsp;Alessandro Bombaci ,&nbsp;Steve Vucic ,&nbsp;Nathan Pavey ,&nbsp;Sotirios Papagiannopoulos ,&nbsp;Vasilios K Kimiskidis ,&nbsp;Marianthi Arnaoutoglou","doi":"10.1016/j.neucli.2025.103134","DOIUrl":"10.1016/j.neucli.2025.103134","url":null,"abstract":"<div><h3>Introduction</h3><div>Amyotrophic lateral sclerosis (ALS) patients can exhibit split phenomena, with preferential weakness of specific muscle groups. The aim of this review is to investigate the split elbow (SE) phenomenon (different weakness/wasting pattern between biceps and triceps) as a potential clinical and neurophysiological feature in ALS.</div></div><div><h3>Methods</h3><div>Our study was reported according to the PRISMA statement and registered in PROSPERO (CRD42024528359). MEDLINE, SCOPUS, Web of Science, and grey literature sources were searched using the terms “split elbow” and “amyotrophic lateral sclerosis” up to April 2025. English-written peer-reviewed, randomized, non-randomized, observational, diagnostic accuracy, and case-control studies were included. Study quality was assessed using Joanna Briggs Institute critical appraisal tool. Regarding muscle strength, we pooled the standardized mean difference of normalized Medical Research Council (MRC) scores using random effects. We used a bivariate random-effects model to evaluate SE index (SEI_CMAP, compound muscle action potential of biceps/triceps) in distinguishing ALS from controls.</div></div><div><h3>Results</h3><div>Seven studies with 1941 ALS patients (61.8 % male) met inclusion criteria. Pooled standardized mean difference (triceps – biceps MRC scores) was -0.17 [95 % CI, -1.03 to 0.69], <em>p</em> = 0.63, indicating no significant difference in muscle strength between elbow flexion and extension. Between-study heterogeneity was high (I² = 97.1 % [95.5 %; 98.2 %], <em>p</em> &lt; 0.0001). The SEI_CMAP demonstrated only moderate accuracy in distinguishing ALS from controls (pooled sensitivity, specificity, and AUC of 0.789 [0.655–0.880], 0.580 [0.487–0.668], and 0.661, respectively).</div></div><div><h3>Conclusions</h3><div>Current evidence does not support a consistent SE pattern in ALS. Methodological variability and small sample sizes limit the generalizability of available findings, indicating that the SE is unlikely to provide meaningful diagnostic utility in routine clinical practice.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 2","pages":"Article 103134"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurophysiology of pleasant touch: From peripheral mechanisms to clinical implications of caressing","authors":"Jean-Pascal Lefaucheur","doi":"10.1016/j.neucli.2025.103135","DOIUrl":"10.1016/j.neucli.2025.103135","url":null,"abstract":"<div><div>While tactile perception has long been studied through the lens of discriminative touch, recent research has highlighted the existence of a distinct affective touch system. Pleasant touch refers to specific forms of light tactile stimulation, such as gentle stroking or caressing applied to hairy skin. This type of sensation is primarily conveyed by unmyelinated C-tactile (CT) afferents expressing a subclass of mechanoreceptors with low-threshold activation and slow-to-intermediate adaptation. Importantly, CT firing correlates strongly with subjective pleasantness ratings but not with intensity or localization accuracy, indicating a preferential role in affective rather than perceptual encoding. After reaching the superficial layers of the dorsal horn of the spinal cord, the projections ascend via pathways associated with interoception. Following thalamic relay, pleasant tactile information induces strong activation of a vast network including the posterior and anterior insula, the orbitofrontal cortex, the medial prefrontal cortex, the anterior cingulate cortex, and the ventral striatum. The literature converges on the idea that pleasant touch relies on a specialized neurophysiological system integrating peripheral CT afferents, insular processing, and neurochemical modulation, mainly involving oxytocin, dopamine, and opioid transmission. It impacts on autonomic nervous system regulation and physiological homeostasis, as shown by anti-stress effects of skin-to-skin contact in infants. Affective touch conveyed by CT afferents supports emotional regulation, social bonding, and well-being. In addition, pleasant touch has a therapeutic potential, especially in the pain domain, but also in other conditions dominated by negative thoughts, such as depressive disorders. Thus, the clinical utility of \"affective touch therapy\", even by means of robotic haptic stimulation, offers promising prospects for the treatment of anxiety-depressive or pain disorders, based on the neurophysiological effects of CT afferent activation.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 2","pages":"Article 103135"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can neurophysiology help us to decipher emotion(s)?","authors":"Sarah Dominique Rosenberg ,&nbsp;Jean-Pascal Lefaucheur","doi":"10.1016/j.neucli.2026.103136","DOIUrl":"10.1016/j.neucli.2026.103136","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 2","pages":"Article 103136"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing breach rhythm in EEG: Insights into its variability and clinical impact.","authors":"Seyda Erdoğan, Filiz Azman İste, Merve Melodi Cakar, Eray Ergül, F İrsel Tezer","doi":"10.1016/j.neucli.2026.103160","DOIUrl":"https://doi.org/10.1016/j.neucli.2026.103160","url":null,"abstract":"<p><strong>Objective: </strong>Breach rhythm (BR) is an EEG phenomenon typically associated with skull defects. While its continuous form is well recognized, the significance of intermittent BR has not been systematically studied.</p><p><strong>Methods: </strong>This cross-sectional, multicenter observational study included 90 patients with BR on routine EEGs. Patients were categorized based on BR continuity (continuous BR, CBR vs. intermittent BR, IBR). Structural imaging parameters, including residual lesion volume (RLV) and skull defect measurements, were also analyzed.</p><p><strong>Results: </strong>Of 90 patients, 55 (61.1%) had CBR and 35 (38.9%) had IBR. There were no significant differences in demographic or seizure characteristics between groups. Residual lesion volumes were significantly larger in the CBR group, while skull defect size and surface area did not differ between groups. Interictal epileptiform discharges within BR regions were common in both groups (52.7% vs. 65.7%, p= 0.224). However, non-epileptiform interictal abnormalities outside BR regions were significantly more frequent in the IBR group (37.1% vs. 5.5%, p< 0.01). Right-sided BR was more often (70.2%) continuous than left-sided BR (48.8%) (p= 0.040).</p><p><strong>Conclusions: </strong>Breach rhythm on EEG can present as a continuous or intermittent pattern. Continuous BR appears associated with greater residual lesion burden and focal neurological findings, whereas intermittent BR is linked to smaller residual lesions but more widespread cortical abnormalities beyond the breach region. These findings suggest that BR reflects not only skull defects but also the functional state of underlying cortex.</p><p><strong>Significance: </strong>This study is the first to systematically differentiate intermittent from continuous BR, demonstrating that intermittent BR is common and BR may serve as a marker of distributed or dynamic cortical dysfunction in addition to structural cranial abnormalities.</p>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 3","pages":"103160"},"PeriodicalIF":2.4,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodology of SEEG functional mapping of the sensory-motor regions using electrical brain stimulation.","authors":"Hélène Catenoix, Cristina Filipescu, Chipaux Mathilde, Cuny Marie-Laure, Nica Anca, Elisabeth Landré","doi":"10.1016/j.neucli.2026.103146","DOIUrl":"https://doi.org/10.1016/j.neucli.2026.103146","url":null,"abstract":"<p><p>Intracerebral electrical stimulation during stereoelectroencephalography (SEEG) is a key technique for functional mapping in the presurgical evaluation of patients with drug-resistant epilepsy. This article presents a concise anatomical overview and outlines standardized methodologies for SEEG-guided stimulation in motor, premotor, somatosensory, and operculo-insular regions. In these areas, functional stimulations are generally feasible under optimal conditions, yielding clear and reproducible clinical responses. We detail stimulation protocols, patient task paradigms, and the range of motor, sensory, and speech effects elicited, providing practical guidance for accurate and safe functional mapping in this eloquent cortex.</p>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 2","pages":"103146"},"PeriodicalIF":2.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative EEG enhances early assessment and prognostic stratification of brain dysfunction in infants with abusive head trauma","authors":"Valentin Hess ,&nbsp;Matthieu Doyen ,&nbsp;Rima Nabbout ,&nbsp;Thomas Blauwblomme ,&nbsp;Benjamin Serrand ,&nbsp;Martine Balençon ,&nbsp;Claire Bar ,&nbsp;Olivier Brissaud ,&nbsp;Olivier Klein ,&nbsp;Arnaud Wiedemann ,&nbsp;Mathieu Kuchenbuch","doi":"10.1016/j.neucli.2025.103132","DOIUrl":"10.1016/j.neucli.2025.103132","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the value of quantitative EEG (qEEG) as a diagnostic and prognostic biomarker in infants with abusive head trauma (AHT). Despite its central role in monitoring encephalopathy, EEG remains underused in multimodal evaluations, and its quantitative analysis may provide objective, real-time insights into cerebral dysfunction and long-term outcome.</div></div><div><h3>Methods</h3><div>This retrospective monocentric case–control study included infants under two years with confirmed AHT and age- and sex-matched controls. Clinical and early EEG data were collected. Patients’ outcome was stratified by Pediatric Overall Performance Category score (POPC_1–3 vs. _4–6). Quantitative EEG features were analyzed, and two neural networks were trained using five-fold cross-validation for diagnosis and outcome prediction.</div></div><div><h3>Results</h3><div>84 EEGs from 75 participants were analyzed (46 EEGs from 40 AHT; 38 EEGs from 35 controls). Compared with controls, AHT EEGs showed significantly reduced entropy and Hurst exponent values and increased low-frequency power, reflecting diffuse cortical dysfunction. Within the AHT group, reduced signal complexity and loss of interhemispheric asymmetry correlated with unfavorable outcomes (POPC_4–6, p&lt; 0.01). Machine learning perfectly classified AHT cases versus controls and classified patients into POPC_1-3 or POPC_4-6 groups with 73±14 % accuracy. Combined models distinguished control, POPC_1-3, and POPC_4-6 groups with 90±5 % accuracy.</div></div><div><h3>Discussion</h3><div>Early qEEG provides functional information that complements imaging and clinical findings. qEEG-derived biomarkers may enable early risk stratification, guide neuroprotective strategies, and improve prognostic counseling in infants with AHT. Larger multicenter prospective studies are warranted to validate these exploratory findings and define their clinical applicability.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 1","pages":"Article 103132"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and neurophysiological effects of rTMS on chronic post-stroke hand spasticity","authors":"José Luis Guerrero Solano ,&nbsp;Oscar Ayo-Martin ,&nbsp;Tomas Segura","doi":"10.1016/j.neucli.2025.103125","DOIUrl":"10.1016/j.neucli.2025.103125","url":null,"abstract":"<div><div>This observational open-label study evaluates the clinical and neurophysiological effects of multiple sessions of contralesional motor cortex low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on seventeen patients with chronic post-stroke hand spasticity. Results: LF-rTMS improved spasticity (Modified Ashworth Scale, <em>p</em> &lt; 0.001), strength (tip pinch, <em>p</em> = 0.002; grip force, <em>p</em> &lt; 0.001), flexibility (finger tapping test, <em>p</em> = 0.014; tapping test, <em>p</em> = 0.008), motor threshold difference (<em>p</em> &lt; 0.001), and motor evoked potential latency (<em>p</em> = 0.004), with no adverse events reported. Improvement in spasticity persisted after 3 months. Conclusion: LF-rTMS is a safe and effective therapy for chronic post-stroke hand spasticity.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 1","pages":"Article 103125"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping emotion with cortical electrical stimulations: A disrupted landscape","authors":"Olivier Aron","doi":"10.1016/j.neucli.2025.103133","DOIUrl":"10.1016/j.neucli.2025.103133","url":null,"abstract":"<div><div>Cortical electrical stimulation (CES) provides a unique window into the neural architecture supporting human emotion by perturbing local circuits while revealing distributed network dynamics. Yet despite decades of clinical use in stereo-EEG and subdural mapping, the emotional phenomena elicited by CES remain conceptually heterogeneous and methodologically inconsistent, reflecting the absence of a unified interpretative framework.</div><div>Here, by outlining the conceptual foundations of emotion and examining the scattered evidence from CES, we show how definitional and methodological divergences undermine cumulative insight. We first situate CES findings relative to competing models of emotion, highlighting how assumptions about discreteness, appraisal, and construction shape the interpretation of evoked responses. We then assess how theoretical stance, emotion features, stimulation parameters, anatomical constraints, and task conditions are reported across studies, revealing major inconsistencies in methodological transparency than may account for systematic biases in affective outcomes.</div><div>Finally, we propose the <em>eMAP operational framework</em>—a minimal reporting structure organised around four pillars: <em>Emotion, Modulation, Architecture</em>, and <em>Phenomenology</em>. This framework aims to guide future research by allowing perturbational evidence to be interpreted in a cumulative and comparable manner, while improving the clinical utility of CES for probing the functional architecture of emotion and refining surgical risk assessment.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 1","pages":"Article 103133"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effectiveness of transcranial direct current stimulation and transcutaneous tibial nerve stimulation on the urgency and frequency of women with overactive bladder syndrome: A randomized controlled trial","authors":"Zahra Gorji ,&nbsp;Mohammad Reza Hadian Rasanani ,&nbsp;Michael Nitsche ,&nbsp;Tannaz Ahadi ,&nbsp;Roya Khanmohammadi ,&nbsp;Anahita Torkzadeh","doi":"10.1016/j.neucli.2025.103116","DOIUrl":"10.1016/j.neucli.2025.103116","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent findings suggest that key areas in the brain, particularly the medial prefrontal cortex (mPFC), are important for regulating bladder function. This research explores the potential of transcranial direct current stimulation (tDCS) on the mPFC as an emerging approach to alleviate overactive bladder (OAB) symptoms, in comparison to transcutaneous tibial nerve stimulation (TTNS).</div></div><div><h3>Methods</h3><div>This single-blind, two-arm, parallel, randomized controlled clinical trial with a 1:1 allocation ratio was conducted at Firoozgar Hospital. A total of forty-four women diagnosed with overactive bladder (OAB) were randomly divided into two groups: one group received tDCS (transcranial Direct Current Stimulation) combined with PFMT (Pelvic Floor Muscle Training), and the other received TTNS(Trancutaneous Tibial Nerve Stimulation) combined with PFMT. The primary outcome measure was the quality of life through the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol). Secondary outcome measures included the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB), a three-day bladder diary, and assessment of pelvic floor muscle strength using a perineometer.</div></div><div><h3>Results</h3><div>Both groups exhibited improvements in OAB symptoms; however, the tDCS group appeared to show greater reductions in ICIQ-OAB scores and symptom bother (p &lt; 0.05). As measured by the ICIQ-LUTSqol questionnaire, quality of life improved in both groups, with indications of comparatively greater improvements in the tDCS group after treatment and at the one-month follow-up (p = 0.05 and p &lt; 0.05 respectively). Moreover, the number of urinary incontinence episodes tended to decline more markedly in the tDCS group, and this improvement was sustained during the follow-up period (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study’s findings suggest that while both TTNS and tDCS may effectively improve the quality of life in women with overactive bladder (OAB), the improvements observed in the tDCS group appear to be greater. However, further sham-controlled studies are needed to confirm these potential benefits.</div></div><div><h3>Trial registration</h3><div>Iranian Registry of Clinical Trials (IRCT) ID: IRCT20090301001722N26, date of registration: 17 May 2023. <span><span>https://en.irct.ir/</span><svg><path></path></svg></span></div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 1","pages":"Article 103116"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief history of electrical brain stimulation in humans","authors":"Elisabeth Landré ,&nbsp;Jean-Pierre Vignal","doi":"10.1016/j.neucli.2025.103123","DOIUrl":"10.1016/j.neucli.2025.103123","url":null,"abstract":"<div><div>The concept of cerebral localization originated from cerebral electrical stimulation. Pioneering experiments conducted by Fritsch and Hitzig on dogs, Bartholow on humans and David Ferrier on macaques in the 19th century led to the discovery of the primary motor cortex. Surgical treatment of epileptic patients began with electrical stimulation of the brain by Victor Horsley in 1886. Electrical stimulation of the brain during surgical treatment produced important results in terms of understanding of the cerebral cortex and focal epilepsies. In the 20th century, major developments were the electrocorticography work of Wilder Penfield in Montreal and the stereoelectroencephalography (SEEG) work of Jean Talairach and Jean Bancaud in Paris. The evolution of cerebral electrical stimulation reflects a growing understanding of brain organization and plasticity. This historical perspective highlights how empirical observations have shaped current clinical protocols and research frontiers.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"56 1","pages":"Article 103123"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}