Neurophysiologie Clinique/Clinical Neurophysiology最新文献

英文中文

Evaluation of cortical excitability with transcranial magnetic stimulation in patients with obstructive sleep apnea syndrome 经颅磁刺激对阻塞性睡眠呼吸暂停综合征患者皮质兴奋性的评价。

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-10-06 DOI: 10.1016/j.neucli.2025.103111

Tuğçe Akçadağ Çaman , İnan Özdemir , Mahmut Bilal Çaman , Serkan Aksu , Semai Bek , Gülnihal Kutlu

Objectives

Cognitive impairment constitutes one of the most prevalent sequelae associated with obstructive sleep apnea (OSA). Given the established correlation between chronic hypoxia in patients with OSA and the deterioration of cortical functions, this study hypothesize that levels of cortical excitability diminish in direct relation to the severity of hypoxic episodes.

Methods

A cohort of 102 individuals diagnosed with OSA participated. Patients exhibiting a T90 value of ≥30 % were categorized into the desaturated cohort, whereas those with a T90 value of <30 % were designated as the non-desaturated cohort. To evaluate alterations in cortical excitability, Transcranial Magnetic Stimulation (TMS) was employed to quantify various parameters including resting muscle motor evoked potential (MEP) latency and amplitude, resting motor threshold, active muscle MEP latency andamplitude, and active motor threshold in both the dominant and non-dominant abductor pollicis brevis (APB) muscles.

Results

The findings indicated that resting dominant APB muscle MEP latency (t=-2.659; p = 0.009), active dominant APB muscle MEP latency (Z=-2.322; p = 0.020), resting non-dominant APB muscle MEP latency (Z=-2.666; p = 0.008), and active motor threshold for dominant APB (Z=-2.410; p = 0.016) were significantly elevated in the desaturated cohort compared to the non-desaturated cohort.

Conclusion

This study showed that chronic hypoxia in patients with OSA is associated with modifications in cortical excitability as assessed through TMS. A marked decrease in cortical excitability was identified in the desaturated cohort. It is hypothesized that a disturbance in gamma-aminobutyric acid (GABA) and glutamate transmission could be crucial to understanding OSA and cortical excitability.

目的：认知障碍是与阻塞性睡眠呼吸暂停（OSA）相关的最常见的后遗症之一。鉴于OSA患者慢性缺氧与皮质功能恶化之间的相关性，本研究假设皮质兴奋性水平的降低与缺氧发作的严重程度直接相关。方法：对102例OSA患者进行队列研究。结果：研究结果表明，静息优势型APB肌MEP潜伏期（t=-2.659, p = 0.009）、活动优势型APB肌MEP潜伏期（Z=-2.322, p = 0.020）、静息非优势型APB肌MEP潜伏期（Z=-2.666, p = 0.008）、活动优势型APB肌MEP阈值(Z=-2.410；P = 0.016)在去饱和组中与非去饱和组相比显著升高。结论：本研究表明，经颅磁刺激评估的OSA患者慢性缺氧与皮质兴奋性改变有关。在去饱和队列中，皮质兴奋性明显降低。据推测，γ -氨基丁酸（GABA）和谷氨酸传递的紊乱可能是理解OSA和皮质兴奋性的关键。

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引用次数: 0

Investigation of predictors of pain relief with high-frequency repetitive motor cortex transcranial magnetic stimulation among people with fibromyalgia 纤维肌痛患者高频重复运动皮质经颅磁刺激缓解疼痛的预测因素研究

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-10-04 DOI: 10.1016/j.neucli.2025.103109

Catarina Couras Lins , Alessandra S. Fonseca , Pedro Nascimento Martins , Julio Cesar Barbour Oliveira , Ana Mércia Fernandes , Abrahão Fontes Baptista , Gabriel T. Kubota , Valquíria Aparecida da Silva , Manoel Jacobsen Teixeira , Daniel Ciampi de Andrade

Objectives

To identify baseline predictors of clinical response to the primary motor cortex high-frequency repetitive transcranial magnetic stimulation (M1 HF-rTMS) in patients with fibromyalgia.

Materials and methods

We performed a secondary analysis of 32 women with fibromyalgia from a randomized, double-blind, sham-controlled international multicenter trial registered at clinicaltrials.gov (NCT03658694). Enrolled participants received active or HF-rTMS-over the primary motor cortex (M1). Baseline demographic data, psychological assessments (Hospital Anxiety and Depression Scale, Brief Pain Inventory, Fibromyalgia Impact Questionnaire, Toronto Alexithymia Scale, and Interoception Questionnaire), psychophysical measures (Conditioned Pain Modulation), and structural brain MRI variables were collected and analyzed. Responders were defined as patients who achieved a ≥ 50 % reduction in pain on a numerical rating scale eight weeks after treatment. Associations between baseline variables and response were analyzed using Wilcoxon Rank Sum tests, chi-square tests, and logistic regression where appropriate.

Results

At the end of the treatment period, 15 out of 32 participants (47 %) in the active M1 HF-rTMS group and 7 out of 30 (23 %) in the sham group achieved ≥50 % reduction in pain. None of the baseline demographic, clinical, psychological, psychophysical, or neuroimaging variables evaluated were significantly associated with clinical response to M1 HF-rTMS. Although M1 HF-rTMS induced significant antinociceptive effects measured by psychophysical assessments (heat pain threshold), these effects did not predict clinical outcomes.

Conclusions

No clear baseline predictors of response to M1 HF-rTMS were identified in patients with fibromyalgia, emphasizing the heterogeneity and complexity of the disorder. Further research incorporating larger samples and additional biomarkers is necessary to establish individualized prediction strategies for M1 HF-rTMS therapy in fibromyalgia.

目的探讨纤维肌痛患者对初级运动皮质高频重复经颅磁刺激（M1 HF-rTMS）临床反应的基线预测因素。材料和方法我们对32名纤维肌痛女性患者进行了二次分析，这些患者来自一项随机、双盲、假对照的国际多中心试验，注册于clinicaltrials.gov （NCT03658694）。参与者在初级运动皮层（M1）接受活跃或高频rtms治疗。收集和分析基线人口统计数据、心理评估（医院焦虑和抑郁量表、简短疼痛量表、纤维肌痛影响问卷、多伦多述情障碍量表和内感受问卷）、心理物理测量（条理性疼痛调节）和脑结构MRI变量。应答者被定义为治疗后8周在数值评定量表上疼痛减轻≥50%的患者。基线变量与反应之间的关联分析使用Wilcoxon秩和检验、卡方检验和适当的逻辑回归。结果治疗期结束时，活跃M1 HF-rTMS组32名参与者中有15名（47%）和假手术组30名参与者中有7名（23%）的疼痛减轻≥50%。基线人口统计学、临床、心理、心理物理或神经影像学变量均未与M1 HF-rTMS的临床反应显著相关。尽管M1 HF-rTMS通过心理物理评估（热痛阈值）产生了显著的抗伤害感受效应，但这些效应并不能预测临床结果。结论纤维肌痛患者对M1 HF-rTMS治疗的反应没有明确的基线预测因素，强调了该疾病的异质性和复杂性。需要进一步的研究纳入更大的样本和更多的生物标志物，以建立M1 HF-rTMS治疗纤维肌痛的个性化预测策略。

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引用次数: 0

Evaluating the efficacy of rTMS for the management of pain and psychological aspects in non-central nervous system cancer patients: a systematic review 评价rTMS治疗非中枢神经系统癌症患者疼痛和心理方面的疗效：一项系统综述

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-10-03 DOI: 10.1016/j.neucli.2025.103110

Jenny Luisi , Benedetta Capetti , Lorenzo Conti , Roberto Grasso , Gabriella Pravettoni

Objectives

Non-invasive brain stimulation techniques—particularly repetitive transcranial magnetic stimulation (rTMS) have emerged as promising alternatives to traditional pharmacological treatments for pain management in non-central nervous system cancer patients. By modulating neural circuits involved in pain processing through mechanisms of neuroplasticity, these interventions may also improve cognitive functioning, psychological aspects, and quality of life (QoL). The present systematic review aims to investigate the use of rTMS for cancer-related pain and psychological aspects.

Methods

A comprehensive search was conducted in three electronic scientific databases-PubMed, Scopus, and Embase. Six studies were identified and included, comprising pilot studies, randomized controlled trials, and one randomized clinical trial. PRISMA 2020 guidelines for systematic review were followed.

Results

All these studies investigated the use of rTMS to manage pain and psychological aspects such as QoL in patients with different types of oncological conditions, including breast, non-small cell lung, and gynecological cancer, multiple myeloma, and cell glioma. The results suggest a multidimensional improvement in QoL, well-being, and emotional dimension. Notably, a significant reduction in pain intensity was observed following rTMS treatment across all studies.

Conclusion

Although limited in number, current studies suggest that rTMS is a promising non-pharmacological intervention for managing cancer-related pain and enhancing psychological well-being. Further high-quality trials are needed to confirm these findings and establish standardized treatment protocols.

目的：非侵入性脑刺激技术，特别是重复性经颅磁刺激（rTMS）已成为传统药物治疗非中枢神经系统癌症患者疼痛管理的有希望的替代方法。通过神经可塑性机制调节参与疼痛处理的神经回路，这些干预措施也可能改善认知功能、心理方面和生活质量（QoL）。本系统综述旨在探讨rTMS在癌症相关疼痛和心理方面的应用。方法在pubmed、Scopus和Embase三个电子科学数据库中进行综合检索。确定并纳入6项研究，包括初步研究、随机对照试验和1项随机临床试验。遵循PRISMA 2020系统评价指南。结果所有研究都调查了rTMS对不同类型肿瘤患者（包括乳腺癌、非小细胞肺癌、妇科癌、多发性骨髓瘤和细胞胶质瘤）疼痛和生活质量等心理方面的影响。结果表明，生活质量、幸福感和情感维度的多维度改善。值得注意的是，在所有研究中，rTMS治疗后疼痛强度显著降低。结论虽然数量有限，但目前的研究表明，rTMS是一种有希望的非药物干预方法，可用于治疗癌症相关疼痛和增强心理健康。需要进一步的高质量试验来证实这些发现并建立标准化的治疗方案。

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引用次数: 0

A novel technique to differentiate positional loss of motor function of the spinal cord from failure to obtain baseline transcranial motor evoked potential (TcMEP) in patients with pre-operative motor deficit 一种区分脊髓运动功能位置丧失与术前运动缺陷患者基线经颅运动诱发电位（TcMEP）失败的新技术。

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-10-01 DOI: 10.1016/j.neucli.2025.103107

Uditi Gupta , Heena Parihar , Ashok Kumar Jaryal , Megha Bir , Bhavuk Garg , Parin Lalwani

引用次数: 0

The placebo effect of tDCS on motor performance: A call for domain-specific methodological considerations tDCS对运动表现的安慰剂效应：对特定领域方法学考虑的呼吁

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-09-25 DOI: 10.1016/j.neucli.2025.103108

Everton Borges da Silva , Mércia Jaynne Leandro de Melo , Matheus Alves Mendonça , Daniel de Medeiros Leiros , Ehsan Amiri , Daniel Gomes da Silva Machado

引用次数: 0

Changes in brain functional connectivity associated with ongoing neuropathic pain in patients with painful polyneuropathies 疼痛性多发性神经病患者与持续神经性疼痛相关的脑功能连通性变化

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-09-01 DOI: 10.1016/j.neucli.2025.103102

Julie Bismuth , Renaud Lopes , Jérôme Hodel , Jean-Pascal Lefaucheur

Objective

To assess changes in brain functional connectivity associated with the painful nature of peripheral polyneuropathy.

Methods

Resting-state functional magnetic resonance imaging (rs-fMRI) was performed in 26 patients with painful or painless polyneuropathy. According to previously published results, connectivity was studied regarding the default mode network (DMN), intrathalamic and thalamocortical connections, and, the different brain networks (pain matrices) involved in the "nociceptive", "attentional" and "emotional" aspects of the chronic pain experience.

Results

No change in DMN connectivity was found between groups. Thalamocortical connectivity was reduced in patients with painful polyneuropathy, especially for the thalamic cluster connected to the motor cortex, while intra-thalamic (mediolateral) connectivity was increased in patients with painless polyneuropathy. Intra-connectivity was increased within the pain matrices, especially the "nociceptive" matrix, in patients with painful polyneuropathy, while inter-connectivity was increased between the "attentional" and "emotional" pain matrices in patients with painless polyneuropathy. Increased connectivity between the posterior insula and parietal operculum positively correlated with the neuropathic pain symptom score and impact of pain on daily functioning.

Conclusions

Painful polyneuropathy was characterized by increased intra-connectivity within each pain matrix and reduced thalamocortical connectivity of certain thalamic clusters, notably linked to the motor cortex. Conversely, painless polyneuropathy was characterized by increased connectivity within the thalamus and between the different pain matrices. Although various methodological limitations must be acknowledged (small sample size, lack of a control group of healthy subjects or measurement of pain intensity during neuroimaging examination), these results provide new information on the changes in brain connectivity associated with painful polyneuropathies. This study also brings new arguments to explain the efficacy of motor cortex stimulation in the treatment of chronic neuropathic pain.

目的探讨周围多发性神经病疼痛性的脑功能连通性变化。方法对26例疼痛性或无痛性多发性神经病患者进行静息状态功能磁共振成像（rs-fMRI）检查。根据先前发表的结果，研究人员研究了默认模式网络（DMN）、丘脑内和丘脑皮质连接，以及参与慢性疼痛体验的“伤害性”、“注意力”和“情绪”方面的不同大脑网络（疼痛矩阵）的连通性。结果各组间DMN连通性无明显变化。疼痛性多神经病变患者的丘脑皮质连通性降低，特别是与运动皮层相连的丘脑簇，而无痛性多神经病变患者的丘脑内（中外侧）连通性增加。在疼痛性多发性神经病变患者中，疼痛基质内的连通性增加，尤其是“伤害性”基质，而在无痛性多发性神经病变患者中，“注意力”和“情绪”疼痛基质之间的连通性增加。脑岛后叶和顶盖间的连接增加与神经性疼痛症状评分和疼痛对日常功能的影响呈正相关。结论疼痛性多神经病变的特征是每个疼痛基质内连通性增加，某些丘脑簇的丘脑皮质连通性降低，特别是与运动皮质相关。相反，无痛性多神经病变的特征是丘脑内和不同疼痛基质之间的连通性增加。尽管必须承认各种方法的局限性（样本量小，缺乏健康受试者的对照组或在神经影像学检查期间测量疼痛强度），但这些结果提供了与疼痛性多神经病变相关的脑连接变化的新信息。这项研究也为解释运动皮质刺激治疗慢性神经性疼痛的疗效提供了新的论据。

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引用次数: 0

The Reticular formation: An integrative network for postural control 网状结构：姿势控制的综合网络

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-09-01 DOI: 10.1016/j.neucli.2025.103100

FJF Viseux , M Simoneau , GM Pamboris , N Sturbois-Nachef , CT Bonnet , M Martinez Carrasco , L Defebvre , M Billot , A Delval

The reticular formation (RF), a complex network within the brainstem, plays a pivotal role in postural control, by integrating multisensory information and coordinating motor responses, to maintain balance and stability. This theoretical review synthesizes current knowledge on the anatomical and functional organization of the RF, highlighting its contributions to muscle tone regulation, anticipatory postural adjustments (APA), and gaze stability. Anatomically divided into median, paramedian, and lateral columns, the RF operates through both ascending and descending pathways. The ascending reticular activating system (ARAS) regulates arousal and alertness, while the descending reticulospinal tracts modulate postural muscle tone and motor coordination. Functionally, the RF maintains baseline muscle tone via excitatory and inhibitory pathways and supports APA by preparing the body for movement-induced perturbations. Moreover, the RF is integral to the coordination of eye and head movements, ensuring visual stability during motion. Collectively, these mechanisms position the RF as a central integrator of posture and movement, with implications for understanding motor control and informing interventions in neurorehabilitation and movement optimization.

网状结构（RF）是脑干内的一个复杂网络，通过整合多感觉信息和协调运动反应，在姿势控制中起着关键作用，以保持平衡和稳定。这篇理论综述综合了目前关于RF的解剖和功能组织的知识，强调了其对肌肉张力调节、预期姿势调节（APA）和凝视稳定性的贡献。在解剖学上分为正中柱、旁正中柱和侧柱，RF通过上升和下降通路起作用。上升网状激活系统（ARAS）调节觉醒和警觉性，而下降网状脊髓束调节体位肌张力和运动协调。功能上，RF通过兴奋和抑制途径维持基线肌张力，并通过使身体为运动引起的扰动做好准备来支持APA。此外，射频是不可或缺的眼睛和头部运动的协调，确保运动过程中的视觉稳定性。总的来说，这些机制将RF定位为姿态和运动的中心整合器，这对理解运动控制和告知神经康复和运动优化干预具有重要意义。

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引用次数: 0

Effect of reference electrode position on diagnostic accuracy of split hand index in ALS 参考电极位置对ALS断手指数诊断准确性的影响

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-09-01 DOI: 10.1016/j.neucli.2025.103101

Sepideh Omidbakhsh , Hatice Tankisi

引用次数: 0

Is segmenting ECG features a viable tool for seizure detection? 分割心电图特征是检测癫痫发作的可行工具吗？

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-08-28 DOI: 10.1016/j.neucli.2025.103099

Ewan S. Nurse , Mark J. Cook

引用次数: 0

Protocol considerations for single and paired pulse transcranial magnetic stimulation in Parkinson’s disease 帕金森病单脉冲和配对脉冲经颅磁刺激的方案考虑

IF 2.4 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-08-21 DOI: 10.1016/j.neucli.2025.103097

Anjali Sivaramakrishnan , Harry T. Jordan , Cathy M. Stinear

引用次数: 0

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