Pub Date : 2025-01-23DOI: 10.1016/j.neucli.2025.103045
Silvia Oddo , Brenda Giagante , Eduardo Seoane, Pablo Seoane, Juan P Princich, Nuria Campora, Alejandro Nasimbera, Silvia Kochen
Objectives
The aim of this study is to describe a population of patients with drug resistant epilepsy who underwent stereoelectroencephalography (SEEG) for epilepsy presurgical evaluation in a high complexity public hospital in Argentina.
Methods
We included patients from 2014 to 2023. We conducted a retrospective study of patients with drug-resistant epilepsy admitted to the Video-EEG unit. We selected patients who underwent SEEG and analyzed those patients in whom surgery was performed. The variables studied were MRI findings, epileptogenic zone (EZ) location, type of surgery performed, neuropsychological evaluation, post-surgical evolution and histopathology.
Results
In the study period, 49 patients underwent SEEG. Magnetic resonance imaging (MRI) was normal in 21/49 (43 %). Eighteen patients (37.5 %) had bilateral implantation, 16 (32.7 %) had unilateral right hemisphere implantation and 15 (31.3 %) unilateral left sided implantation. Surgical treatment was indicated in 30 (61,2 %) patients. Post-surgery outcome according to the International League Against Epilepsy (ILAE) classification, was ILAE I 26.6 % and ILAE II 30 %.
Conclusion
Our experience highlights that, with proper training and resource allocation, high-quality epilepsy care, including advanced diagnostic procedures like SEEG, is achievable in Argentina and may be possible in other developing regions.
{"title":"Enhancing epilepsy care in Argentina: Use of SEEG in a developing setting","authors":"Silvia Oddo , Brenda Giagante , Eduardo Seoane, Pablo Seoane, Juan P Princich, Nuria Campora, Alejandro Nasimbera, Silvia Kochen","doi":"10.1016/j.neucli.2025.103045","DOIUrl":"10.1016/j.neucli.2025.103045","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study is to describe a population of patients with drug resistant epilepsy who underwent stereoelectroencephalography (SEEG) for epilepsy presurgical evaluation in a high complexity public hospital in Argentina.</div></div><div><h3>Methods</h3><div>We included patients from 2014 to 2023. We conducted a retrospective study of patients with drug-resistant epilepsy admitted to the Video-EEG unit. We selected patients who underwent SEEG and analyzed those patients in whom surgery was performed. The variables studied were MRI findings, epileptogenic zone (EZ) location, type of surgery performed, neuropsychological evaluation, post-surgical evolution and histopathology.</div></div><div><h3>Results</h3><div>In the study period, 49 patients underwent SEEG. Magnetic resonance imaging (MRI) was normal in 21/49 (43 %). Eighteen patients (37.5 %) had bilateral implantation, 16 (32.7 %) had unilateral right hemisphere implantation and 15 (31.3 %) unilateral left sided implantation. Surgical treatment was indicated in 30 (61,2 %) patients. Post-surgery outcome according to the International League Against Epilepsy (ILAE) classification, was ILAE I 26.6 % and ILAE II 30 %.</div></div><div><h3>Conclusion</h3><div>Our experience highlights that, with proper training and resource allocation, high-quality epilepsy care, including advanced diagnostic procedures like SEEG, is achievable in Argentina and may be possible in other developing regions.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 2","pages":"Article 103045"},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143040528","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}
Pub Date : 2025-01-14DOI: 10.1016/j.neucli.2025.103048
Huimin Zhang , Shuting Chai , Dawei Shan, Gang Liu, Yan Zhang
Objective
To explore the application of the neuronal recovery model (i.e., the ABCD model derived from EEG power spectral analysis) in forecasting outcomes for patients with acute disorders of consciousness (DOC).
Methods
Patients with acute DOC were enrolled, and clinical assessments, including the Glasgow Coma Scale (GCS), Full Outline of UnResponsiveness (FOUR), and Coma Recovery Scale-Revised (CRS-R) scores, along with electroencephalography (EEG), were documented on the first day post-enrollment. The ABCD model, derived from EEG power spectral data reflecting frequency bands, categorized brain activity into four distinct groups (A, B, C, D). Outcome prognoses were evaluated using the Glasgow Outcome Scale-Extended (GOSE) six months after enrollment. Statistical analyses were performed to assess the correlation between the ABCD model and clinical assessments, and to investigate the predictive value of EEG and clinical assessments for the long-term prognosis.
Results
A total of 93 patients with acute DOC were included; the median age was 64 years (interquartile range 52, 72), of which 52 patients had favorable outcomes. Significant correlations were observed between the ABCD model and both the FOUR and CRS-R scores. The CRS-R and ABCD model demonstrated relatively good predictive value for six-month prognoses, with Area Under the Curve (AUC) values of 0.695 and 0.678, respectively (P < 0.05). Furthermore, the combination of the CRS-R score and ABCD model exhibited the highest predictive value with an AUC of 0.746.
Conclusions
The ABCD model effectively predicted the prognosis of patients with acute DOC in combination with CRS-R.
目的：探讨神经元恢复模型（即基于脑电功率谱分析的ABCD模型）在急性意识障碍（DOC）患者预后预测中的应用。方法：纳入急性DOC患者，并在入组后第一天记录临床评估，包括格拉斯哥昏迷量表（GCS）、无反应性全大纲（FOUR）和昏迷恢复量表-修订（CRS-R）评分以及脑电图（EEG）。ABCD模型来源于反映频带的脑电图功率谱数据，将脑活动分为四组（A、B、C、D）。入组后6个月，使用格拉斯哥结局量表扩展（GOSE）评估预后。通过统计学分析ABCD模型与临床评价的相关性，探讨脑电图和临床评价对远期预后的预测价值。结果：共纳入93例急性DOC患者；中位年龄为64岁（四分位数范围52,72），其中52例患者预后良好。ABCD模型与FOUR和CRS-R评分之间存在显著相关性。CRS-R和ABCD模型对6个月预后具有较好的预测价值，曲线下面积（Area Under The Curve， AUC）分别为0.695和0.678 （P < 0.05）。此外，CRS-R评分与ABCD模型的组合预测价值最高，AUC为0.746。结论：ABCD模型联合CRS-R可有效预测急性DOC患者的预后。
{"title":"Combining quantified EEG with clinical measures to better predict outcomes of acute disorders of consciousness","authors":"Huimin Zhang , Shuting Chai , Dawei Shan, Gang Liu, Yan Zhang","doi":"10.1016/j.neucli.2025.103048","DOIUrl":"10.1016/j.neucli.2025.103048","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the application of the neuronal recovery model (i.e., the ABCD model derived from EEG power spectral analysis) in forecasting outcomes for patients with acute disorders of consciousness (DOC).</div></div><div><h3>Methods</h3><div>Patients with acute DOC were enrolled, and clinical assessments, including the Glasgow Coma Scale (GCS), Full Outline of UnResponsiveness (FOUR), and Coma Recovery Scale-Revised (CRS-R) scores, along with electroencephalography (EEG), were documented on the first day post-enrollment. The ABCD model, derived from EEG power spectral data reflecting frequency bands, categorized brain activity into four distinct groups (A, B, C, D). Outcome prognoses were evaluated using the Glasgow Outcome Scale-Extended (GOSE) six months after enrollment. Statistical analyses were performed to assess the correlation between the ABCD model and clinical assessments, and to investigate the predictive value of EEG and clinical assessments for the long-term prognosis.</div></div><div><h3>Results</h3><div>A total of 93 patients with acute DOC were included; the median age was 64 years (interquartile range 52, 72), of which 52 patients had favorable outcomes. Significant correlations were observed between the ABCD model and both the FOUR and CRS-R scores. The CRS-R and ABCD model demonstrated relatively good predictive value for six-month prognoses, with Area Under the Curve (AUC) values of 0.695 and 0.678, respectively (<em>P</em> < 0.05). Furthermore, the combination of the CRS-R score and ABCD model exhibited the highest predictive value with an AUC of 0.746.</div></div><div><h3>Conclusions</h3><div>The ABCD model effectively predicted the prognosis of patients with acute DOC in combination with CRS-R.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 2","pages":"Article 103048"},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008869","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}
Pub Date : 2025-01-12DOI: 10.1016/j.neucli.2025.103044
Yu-Chen Lin , Hui-An Lin , Ming-Long Chang , Sheng-Feng Lin
Aim
To evaluate the diagnostic accuracy of reduced montage electroencephalography (EEG) for seizure detection and provide evidence-based recommendations.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a diagnostic meta-analysis to assess the sensitivity and specificity of reduced EEG montages in detecting seizure activity. A hierarchical summary receiver operating characteristic curve (HSROC) model was used to estimate the area under the curve (AUC). Subgroup analyses were conducted to identify sources of heterogeneity. Bayesian estimates were used for validation.
Results
Across 8 studies encompassing 3,458 reduced EEG montage samples, all studies used a reduced EEG montage with 7 to 10 electrodes. The pooled sensitivity was 0.75 (95 % CI: 0.68–0.80), and the pooled specificity was 0.97 (95 % CI: 0.95–0.98). The HSROC model had an AUC of 0.96 (95 % CI: 0.93–0.97). Variations in study results were attributed to factors such as the number of electrodes (pooled sensitivity of 0.66 for studies employing <8 leads and 0.77 for studies employing ≥8 leads) and montage design coverage (pooled sensitivity of 0.64 for studies employing subhairline montage and 0.77 for studies employing above-hairline montage). The Bayesian and frequentist findings agreed with each other and had a pooled sensitivity of 0.74 (95 % HPD: 0.65–0.83) and pooled specificity of 0.97 (95 % highest posterior density 0.95–0.98).
Conclusion
Reduced EEG montages with 8 or more electrodes are feasible for seizure detection, especially in emergency settings where rapid detection is crucial.
{"title":"Diagnostic accuracy of reduced electroencephalography montages for seizure detection: A frequentist and Bayesian meta-analysis","authors":"Yu-Chen Lin , Hui-An Lin , Ming-Long Chang , Sheng-Feng Lin","doi":"10.1016/j.neucli.2025.103044","DOIUrl":"10.1016/j.neucli.2025.103044","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the diagnostic accuracy of reduced montage electroencephalography (EEG) for seizure detection and provide evidence-based recommendations.</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a diagnostic meta-analysis to assess the sensitivity and specificity of reduced EEG montages in detecting seizure activity. A hierarchical summary receiver operating characteristic curve (HSROC) model was used to estimate the area under the curve (AUC). Subgroup analyses were conducted to identify sources of heterogeneity. Bayesian estimates were used for validation.</div></div><div><h3>Results</h3><div>Across 8 studies encompassing 3,458 reduced EEG montage samples, all studies used a reduced EEG montage with 7 to 10 electrodes. The pooled sensitivity was 0.75 (95 % CI: 0.68–0.80), and the pooled specificity was 0.97 (95 % CI: 0.95–0.98). The HSROC model had an AUC of 0.96 (95 % CI: 0.93–0.97). Variations in study results were attributed to factors such as the number of electrodes (pooled sensitivity of 0.66 for studies employing <8 leads and 0.77 for studies employing ≥8 leads) and montage design coverage (pooled sensitivity of 0.64 for studies employing subhairline montage and 0.77 for studies employing above-hairline montage). The Bayesian and frequentist findings agreed with each other and had a pooled sensitivity of 0.74 (95 % HPD: 0.65–0.83) and pooled specificity of 0.97 (95 % highest posterior density 0.95–0.98).</div></div><div><h3>Conclusion</h3><div>Reduced EEG montages with 8 or more electrodes are feasible for seizure detection, especially in emergency settings where rapid detection is crucial.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 2","pages":"Article 103044"},"PeriodicalIF":2.7,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979302","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}
Pub Date : 2025-01-01DOI: 10.1016/j.neucli.2024.103040
Du Cai , Xiu Wang , Wenhan Hu , Jiajie Mo , Baotian Zhao , Zhong Zheng , Lin Sang , Xiaoqiu Shao , Chao Zhang , Jianguo Zhang , Kai Zhang
Objectives
In the present study with a large cohort, we aimed to characterize intracerebral seizure onset patterns (SOP) of mesial temporal lobe epilepsy (mTLE), with or without hippocampal sclerosis (HS) as identified via magnetic resonance imaging (MRI).
Methods
We retrospectively analyzed 255 seizures of 76 consecutive patients with mTLE explored by stereoelectroencephalography (SEEG), including HS-mTLE (n = 52) and non-HS- mTLE (n = 24). Relevant results were obtained by a combination of spectral analysis and manual review. High-frequency oscillations (HFO) were quantified across different SOP by an automatic detection method.
Results
We identified six SOP according to previous work by Lagarde et al.: (1) Low-voltage fast activity (LVFA); (2) Rhythmic spikes followed by LVFA; (3) Burst of spikes followed by LVFA; (4) Periodic spikes or spike-wave followed by LVFA; (5) Rhythmic spike or spike-wave; (6) Theta or alpha sharp activity. Notably, Periodic spikes or spike-wave followed by LVFA had a high prevalence in all seizures (37 %). A significant association was established between Periodic spike followed by LVFA and HS-mTLE ( < 0.05). Furthermore, the counts of ripples and fast ripples were significantly higher in SOP displaying LVFA compared to those that did not (P < 0.05). Rhythmic spikes followed by LVFA had the best prognosis (92 % seizure-free), while Burst of spikes followed by LVFA were linked to poorest prognosis (67 % SF).
Conclusion
HS-mTLE and non-HS-mTLE exhibit distinct SOP characteristics, which can offer valuable prognostic insights with a more informative interpretation of ictal iEEG for clinical guidance.
{"title":"SEEG seizure onset patterns in mesial temporal lobe epilepsy: A cohort study with 76 patients","authors":"Du Cai , Xiu Wang , Wenhan Hu , Jiajie Mo , Baotian Zhao , Zhong Zheng , Lin Sang , Xiaoqiu Shao , Chao Zhang , Jianguo Zhang , Kai Zhang","doi":"10.1016/j.neucli.2024.103040","DOIUrl":"10.1016/j.neucli.2024.103040","url":null,"abstract":"<div><h3>Objectives</h3><div>In the present study with a large cohort, we aimed to characterize intracerebral seizure onset patterns (SOP) of mesial temporal lobe epilepsy (mTLE), with or without hippocampal sclerosis (HS) as identified via magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 255 seizures of 76 consecutive patients with mTLE explored by stereoelectroencephalography (SEEG), including HS-mTLE (<em>n</em> = 52) and non-HS- mTLE (<em>n</em> = 24). Relevant results were obtained by a combination of spectral analysis and manual review. High-frequency oscillations (HFO) were quantified across different SOP by an automatic detection method.</div></div><div><h3>Results</h3><div>We identified six SOP according to previous work by Lagarde et al.: (1) Low-voltage fast activity (LVFA); (2) Rhythmic spikes followed by LVFA; (3) Burst of spikes followed by LVFA; (4) Periodic spikes or spike-wave followed by LVFA; (5) Rhythmic spike or spike-wave; (6) Theta or alpha sharp activity. Notably, Periodic spikes or spike-wave followed by LVFA had a high prevalence in all seizures (37 %). A significant association was established between Periodic spike followed by LVFA and HS-mTLE (<span><math><mi>P</mi></math></span> < 0.05). Furthermore, the counts of ripples and fast ripples were significantly higher in SOP displaying LVFA compared to those that did not (<em>P</em> < 0.05). Rhythmic spikes followed by LVFA had the best prognosis (92 % seizure-free), while Burst of spikes followed by LVFA were linked to poorest prognosis (67 % SF).</div></div><div><h3>Conclusion</h3><div>HS-mTLE and non-HS-mTLE exhibit distinct SOP characteristics, which can offer valuable prognostic insights with a more informative interpretation of ictal iEEG for clinical guidance.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103040"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927699","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}
Pub Date : 2025-01-01DOI: 10.1016/j.neucli.2024.103033
Michael W.K. Fong , Kheng-Seang Lim , Si Lei Fong , Chien Chen , Shang-Yeong Kwan , Cheng-Chia Lee , Piradee Suwanpakdee , Charcrin Nagangchang , Minh-An Thuy Le , Yee-Mon Khine , Deepak Gill , Chong H. Wong
Background
Invasive/ intracranial EEG forms an important component of assessment for epilepsy surgery in many patients with Drug-Resistant Epilepsy (DRE). Intracranial EEG has been poorly utilized though Southeast Asia (SEA) and Oceania. This study aimed to document the development of stereo-EEG (SEEG) across the region and highlight regional barriers to utilization and access.
Methods
A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.
Results
Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.
Conclusion
The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.
{"title":"The development of Stereo-Electroencephalography (SEEG) in Southeast Asia and Oceania: Challenges to equity across the region.","authors":"Michael W.K. Fong , Kheng-Seang Lim , Si Lei Fong , Chien Chen , Shang-Yeong Kwan , Cheng-Chia Lee , Piradee Suwanpakdee , Charcrin Nagangchang , Minh-An Thuy Le , Yee-Mon Khine , Deepak Gill , Chong H. Wong","doi":"10.1016/j.neucli.2024.103033","DOIUrl":"10.1016/j.neucli.2024.103033","url":null,"abstract":"<div><h3>Background</h3><div>Invasive/ intracranial EEG forms an important component of assessment for epilepsy surgery in many patients with Drug-Resistant Epilepsy (DRE). Intracranial EEG has been poorly utilized though Southeast Asia (SEA) and Oceania. This study aimed to document the development of stereo-EEG (SEEG) across the region and highlight regional barriers to utilization and access.</div></div><div><h3>Methods</h3><div>A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.</div></div><div><h3>Results</h3><div>Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.</div></div><div><h3>Conclusion</h3><div>The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103033"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792080","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}
Pub Date : 2025-01-01DOI: 10.1016/j.neucli.2024.103038
Debayan Dasgupta , Aswin Chari , Mehdi Khan , Friederike Moeller , Zubair Tahir , Andrew W McEvoy , Anna Miserocchi , John S Duncan , Rachel E. Sparks , Martin Tisdall
Objectives
Computer-assisted planning (CAP) allows faster SEEG planning and improves grey matter sampling, orthogonal drilling angles to the skull, reduces risk scores and minimises intracerebral electrode length. Incorporating prior SEEG trajectories enhances CAP planning, refining output with centre-specific practices. This study significantly expands on the previous work, compares priors libraries between two centres, and describes differences between SEEG in adults and children in these centres.
Methods
98 adults and 61 children who underwent SEEG implantation as part of epilepsy surgery investigations were included. Priors libraries were created for each population, clustered by target regions and subdivided by cortical approaches. The libraries were coregistered and quantitatively and qualitatively compared.
Results
The average number of implanted electrodes per patient was higher in paediatric patients than adults (13.6 vs 8.0). Paediatric implantations focused more on the insula than adult implantations (38.0 % vs 13.5 %), with similar proportions of electrodes implanted in the temporal and parietal lobes, and a higher proportion of adult electrodes in the frontal and orbitofrontal regions (40.6 % vs 24.0 %). Correspondence between the priors libraries was high. We present an example of a complex insular implantation planned with paediatric spatial priors and illustrate resultant SEEG recordings.
Discussion
The use of centre-specific spatial priors allows the incorporation of surgeon-specific and unit-specific preferences into automated planning. We compare implantation styles between a paediatric and an adult centre, discussing similarities and differences. This tool allows centres to compare practice and represents an effective way to analyse implantation strategies that is agnostic to method of implantation.
目的：计算机辅助规划（CAP）允许更快的SEEG规划，改善灰质采样，与颅骨正交钻孔角度，降低风险评分并最小化脑内电极长度。结合先前的SEEG轨迹可以增强CAP计划，通过特定于中心的实践来精炼输出。这项研究显著扩展了之前的工作，比较了两个中心之前的图书馆，并描述了这些中心成人和儿童SEEG之间的差异。方法：98例成人和61例儿童接受SEEG植入作为癫痫手术调查的一部分。为每个种群创建先验文库，按目标区域聚类，并按皮质方法细分。对这些文库进行了共登记，并进行了定量和定性比较。结果：儿童患者的平均植入电极数高于成人（13.6 vs 8.0）。与成人相比，儿童植入更多地集中于脑岛（38.0% vs 13.5%），在颞叶和顶叶植入的电极比例相似，在额叶和眶额区植入的比例更高（40.6% vs 24.0%）。以前的图书馆之间的通信非常频繁。我们提出了一个复杂的岛植入与儿科空间先验计划的例子，并说明了由此产生的SEEG记录。讨论：使用特定中心的空间先验允许将特定外科医生和特定单位的偏好纳入自动化规划。我们比较植入风格之间的儿科和成人中心，讨论异同。该工具允许中心比较实践，并代表了一种有效的方法来分析植入策略，是不可知的植入方法。
{"title":"Refining computer-assisted SEEG planning with spatial priors – A novel comparison of implantation strategies across adult and paediatric centres","authors":"Debayan Dasgupta , Aswin Chari , Mehdi Khan , Friederike Moeller , Zubair Tahir , Andrew W McEvoy , Anna Miserocchi , John S Duncan , Rachel E. Sparks , Martin Tisdall","doi":"10.1016/j.neucli.2024.103038","DOIUrl":"10.1016/j.neucli.2024.103038","url":null,"abstract":"<div><h3>Objectives</h3><div>Computer-assisted planning (CAP) allows faster SEEG planning and improves grey matter sampling, orthogonal drilling angles to the skull, reduces risk scores and minimises intracerebral electrode length. Incorporating prior SEEG trajectories enhances CAP planning, refining output with centre-specific practices. This study significantly expands on the previous work, compares priors libraries between two centres, and describes differences between SEEG in adults and children in these centres.</div></div><div><h3>Methods</h3><div>98 adults and 61 children who underwent SEEG implantation as part of epilepsy surgery investigations were included. Priors libraries were created for each population, clustered by target regions and subdivided by cortical approaches. The libraries were coregistered and quantitatively and qualitatively compared.</div></div><div><h3>Results</h3><div>The average number of implanted electrodes per patient was higher in paediatric patients than adults (13.6 vs 8.0). Paediatric implantations focused more on the insula than adult implantations (38.0 % vs 13.5 %), with similar proportions of electrodes implanted in the temporal and parietal lobes, and a higher proportion of adult electrodes in the frontal and orbitofrontal regions (40.6 % vs 24.0 %). Correspondence between the priors libraries was high. We present an example of a complex insular implantation planned with paediatric spatial priors and illustrate resultant SEEG recordings.</div></div><div><h3>Discussion</h3><div>The use of centre-specific spatial priors allows the incorporation of surgeon-specific and unit-specific preferences into automated planning. We compare implantation styles between a paediatric and an adult centre, discussing similarities and differences. This tool allows centres to compare practice and represents an effective way to analyse implantation strategies that is agnostic to method of implantation.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103038"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the relationship between electrophysiological findings of diabetic neuropathy (DN) and patients' quality of life, neuropathic pain levels, and well-being.
Materials and Methods
A cross-sectional study was conducted in 12 centers in Turkey. DN patients were categorized into four stages based on electrophysiological findings using the Baba classification. Scales such as Short Form-36 (SF-36), Douleur Neuropathique 4-Questions (DN4), Brief Pain Inventory (BPI), and WHO-5 Well-Being (WHO-5 WB) were used to assess quality of life, pain, and well-being. Additional factors like HbA1c levels and diabetes duration were analyzed.
Results
Among 323 DN patients, 90 were in stage 1, 84 in stage 2, 72 in stage 3, and 77 in stage 4. There were no significant differences in age or gender between the stages. Diabetes duration and HbA1c levels were significantly lower in stage 1 compared to later stages. SF-36 and WHO-5 WB scores declined, while DN4 and BPI pain interference scores increased in the later stages. These findings persisted after adjusting for confounders such as age, BMI, comorbidities, and diabetes duration.
Conclusion
Patients with advanced-stage DN experienced a poorer quality of life, greater pain, and more frequent comorbidities compared to early-stage patients. Electrophysiological findings should be considered in the clinical management of DN.
{"title":"Associations between stages of diabetic polyneuropathy and quality of life, neuropathic pain, and well-being: A multicenter, cross-sectional analysis based on electroneuromyographic findings","authors":"Emine Kılıçparlar Cengiz , Yasemin Ekmekyapar Fırat , Sibel Karşıdağ , Abdurrahman Neyal , Ali Kemal Erdemoğlu , Nilgün Çınar , Tuba Ekmekyapar , Sibel Canbaz Kabay , Fatma Akkoyun Arıkan , Gönül Akdağ , Gülsüm Çomruk , Miruna Ateş , Sude Kendirli Aslan , Burcu Gökçe Çokal , Bünyamin Tosunoğlu , Naci Emre Bolu , Ece Yanık , Feray Savrun , Zeliha Tülek , Kimya Kılıçaslan , Ayşe Münife Neyal","doi":"10.1016/j.neucli.2024.103025","DOIUrl":"10.1016/j.neucli.2024.103025","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to investigate the relationship between electrophysiological findings of diabetic neuropathy (DN) and patients' quality of life, neuropathic pain levels, and well-being.</div></div><div><h3>Materials and Methods</h3><div>A cross-sectional study was conducted in 12 centers in Turkey. DN patients were categorized into four stages based on electrophysiological findings using the Baba classification. Scales such as Short Form-36 (SF-36), Douleur Neuropathique 4-Questions (DN4), Brief Pain Inventory (BPI), and WHO-5 Well-Being (WHO-5 WB) were used to assess quality of life, pain, and well-being. Additional factors like HbA1c levels and diabetes duration were analyzed.</div></div><div><h3>Results</h3><div>Among 323 DN patients, 90 were in stage 1, 84 in stage 2, 72 in stage 3, and 77 in stage 4. There were no significant differences in age or gender between the stages. Diabetes duration and HbA1c levels were significantly lower in stage 1 compared to later stages. SF-36 and WHO-5 WB scores declined, while DN4 and BPI pain interference scores increased in the later stages. These findings persisted after adjusting for confounders such as age, BMI, comorbidities, and diabetes duration.</div></div><div><h3>Conclusion</h3><div>Patients with advanced-stage DN experienced a poorer quality of life, greater pain, and more frequent comorbidities compared to early-stage patients. Electrophysiological findings should be considered in the clinical management of DN.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103025"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794973","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}
Pub Date : 2025-01-01DOI: 10.1016/j.neucli.2024.103031
Agnès JACQUIN-PIQUES
Food pleasantness is largely based on the palatability of food and is linked to taste. Along with homeostatic and cognitive control, it forms part of the control of food intake (hedonic control), and does not only correspond to the pleasure that can be described of food intake. There are many factors that cause variations in eating pleasantness between individuals, such as age, sex, culture, co-morbidities, treatments, environmental factors or the specific characteristics of foods. The control of food intake is based on four determinants: conditioned satiety, the reward system, sensory specific satiety and alliesthesia. These four determinants follow one another over time, in the per-prandial and inter-prandial periods, and complement one another. There are many cerebral areas involved in the hedonic control of food intake. The most involved brain areas are the orbitofrontal and anterior cingulate cortices, which interact with deep neural structures (amygdala, striatum, substantia nigra) for the reward circuit, with the hippocampi for memorising pleasant foods, and even with the hypothalamus and insula, brain areas more recently involved in the physiology of food pleasantness. Changes in brain activity secondary to modulation of food pleasantness can be measured objectively by recording taste-evoked potentials, an electroencephalography technique with very good temporal resolution.
{"title":"The pleasantness of foods","authors":"Agnès JACQUIN-PIQUES","doi":"10.1016/j.neucli.2024.103031","DOIUrl":"10.1016/j.neucli.2024.103031","url":null,"abstract":"<div><div>Food pleasantness is largely based on the palatability of food and is linked to taste. Along with homeostatic and cognitive control, it forms part of the control of food intake (hedonic control), and does not only correspond to the pleasure that can be described of food intake. There are many factors that cause variations in eating pleasantness between individuals, such as age, sex, culture, co-morbidities, treatments, environmental factors or the specific characteristics of foods. The control of food intake is based on four determinants: conditioned satiety, the reward system, sensory specific satiety and alliesthesia. These four determinants follow one another over time, in the per-prandial and inter-prandial periods, and complement one another. There are many cerebral areas involved in the hedonic control of food intake. The most involved brain areas are the orbitofrontal and anterior cingulate cortices, which interact with deep neural structures (amygdala, striatum, substantia nigra) for the reward circuit, with the hippocampi for memorising pleasant foods, and even with the hypothalamus and insula, brain areas more recently involved in the physiology of food pleasantness. Changes in brain activity secondary to modulation of food pleasantness can be measured objectively by recording taste-evoked potentials, an electroencephalography technique with very good temporal resolution.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103031"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792083","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}
Pub Date : 2025-01-01DOI: 10.1016/j.neucli.2024.103035
Mariana Lopes Martins , Melyssa Kellyane Cavalcanti Galdino , Daniel Soares Ferreira Silva , Eliza Carolina Dantas Valença , Mariana Braz dos Santos , Jessica Figueiredo de Medeiros , Daniel Gomes da Silva Machado , Marine Raquel Diniz da Rosa
{"title":"Standalone tDCS for tinnitus treatment: Is it a good choice?","authors":"Mariana Lopes Martins , Melyssa Kellyane Cavalcanti Galdino , Daniel Soares Ferreira Silva , Eliza Carolina Dantas Valença , Mariana Braz dos Santos , Jessica Figueiredo de Medeiros , Daniel Gomes da Silva Machado , Marine Raquel Diniz da Rosa","doi":"10.1016/j.neucli.2024.103035","DOIUrl":"10.1016/j.neucli.2024.103035","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103035"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877420","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}
Pub Date : 2025-01-01DOI: 10.1016/j.neucli.2024.103041
Laura Tassi , Veronica Pelliccia , Francesca Bisulli , Matteo Martinoni , Lorenzo Ferri , Flavio Giordano , Federico Melani , Luca de Palma , Nicola Specchio , Carlo Efisio Marras , Francesco Cardinale , Carmen Barba
Stereo-EEG is not just a diagnostic examination but a complex methodology, requiring an accurate synthesis of many data (anatomical, clinical, neurophysiological, cognitive, metabolic, and genetic). The implantation scheme is decided based on a hypothesis (or hypotheses) of epileptogenic zone localization. Subsequently, intracerebral electrical stimulation is used to define the extent of highly functional cortical regions and to reproduce the clinical symptoms and signs associated with seizures. Finally, stereo-EEG-guided thermocoagulation is used, with the dual purpose of stopping/reducing the seizures and determining the prognosis of possible resective (curative) surgery. The centers in Italy that use stereo-EEG derive from the French school of Bancaud and Talairach. Nevertheless, each one has interpreted, on the basis of its own specificity and talent, a new methodology and philosophy of implantation. The present work presents the state of the art of stereo-EEG use in Italy, with detail of the stereo-EEG program of the Munari center in Milano, as well as those of Florence, Bologna and Rome.
{"title":"Stereo-EEG around the world: State of the art in Italy","authors":"Laura Tassi , Veronica Pelliccia , Francesca Bisulli , Matteo Martinoni , Lorenzo Ferri , Flavio Giordano , Federico Melani , Luca de Palma , Nicola Specchio , Carlo Efisio Marras , Francesco Cardinale , Carmen Barba","doi":"10.1016/j.neucli.2024.103041","DOIUrl":"10.1016/j.neucli.2024.103041","url":null,"abstract":"<div><div>Stereo-EEG is not just a diagnostic examination but a complex methodology, requiring an accurate synthesis of many data (anatomical, clinical, neurophysiological, cognitive, metabolic, and genetic). The implantation scheme is decided based on a hypothesis (or hypotheses) of epileptogenic zone localization. Subsequently, intracerebral electrical stimulation is used to define the extent of highly functional cortical regions and to reproduce the clinical symptoms and signs associated with seizures. Finally, stereo-EEG-guided thermocoagulation is used, with the dual purpose of stopping/reducing the seizures and determining the prognosis of possible resective (curative) surgery. The centers in Italy that use stereo-EEG derive from the French school of Bancaud and Talairach. Nevertheless, each one has interpreted, on the basis of its own specificity and talent, a new methodology and philosophy of implantation. The present work presents the state of the art of stereo-EEG use in Italy, with detail of the stereo-EEG program of the Munari center in Milano, as well as those of Florence, Bologna and Rome.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 1","pages":"Article 103041"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066994","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号