Neurophysiologie Clinique/Clinical Neurophysiology最新文献

英文中文

Characterizing repeater F waves using the compound muscle action potential scan and machine learning techniques 使用复合肌肉动作电位扫描和机器学习技术表征重复F波

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-05-08 DOI: 10.1016/j.neucli.2025.103076

Xiaoyan Li , Maoqi Chen , Paul E. Barkhaus , Sanjeev D. Nandedkar , Marek Cierny , Caitlin Moore , Ping Zhou

Objectives

The purpose of this study is to introduce a new analytical technique on repeater F waves (RFws) using compound muscle action potential (CMAP) scan and new features to differentiate the nerves innervating hand muscles.

Methods

Twenty-four healthy subjects participated in the CMAP scan study. Tests were performed on the abductor pollicis brevis (APB) and abductor digit minimi (ADM) muscles. RFws were extracted using unsupervised machine learning and analyzed through conventional characteristics such as amplitude, latency, indices of F repeaters and total F repeaters, as well by new variables, including relative stimulus intensity (ReSI), relative F/M ratio (RF/MR), and range of stimulation intensity (RaSI).

Results

Significantly higher indices of F repeaters (APB: 18.42±4.92 %, ADM: 13.58±4.68 %, p < 0.005) and total F repeaters (APB: 34.75±7.8 %, ADM: 26.67±8.56 %, p < 0.005) were observed in the APB compared with the ADM muscles. The ReSI (Z = 13.81, p < 0.001) and RaSI (Z=-2.46, p < 0.05) showed significant differences between the two muscles.

Discussion and Conclusion

This study provides normative data for RFws based on the CMAP scan recording and identifies different characteristics of repeaters between APB and ADM muscles. Findings of the study improve understanding of motoneuron physiological properties in hand muscles. The CMAP scan-based F wave analysis can be combined with motor unit number estimation technique to provide insights into surviving motoneuron function in neurological disorders.

目的介绍一种利用复合肌肉动作电位（CMAP）扫描的重复F波（RFws）分析新技术，并结合新特征对支配手部肌肉的神经进行鉴别。方法24名健康受试者参与CMAP扫描研究。对外展拇短肌（APB）和外展极小指肌（ADM）进行了测试。使用无监督机器学习提取RFws，并通过振幅、潜伏期、F中继器指数和总F中继器等常规特征以及相对刺激强度（ReSI）、相对F/M比（RF/MR）和刺激强度范围（RaSI）等新变量进行分析。结果APB: 18.42±4.92%,ADM: 13.58±4.68%,p <；0.005)和总F重复器(APB: 34.75±7.8%,ADM: 26.67±8.56%,p <；与ADM肌肉相比，APB肌肉的心肌密度为0.005)。ReSI (Z = 13.81, p <；0.001)和RaSI (Z=-2.46, p <；0.05)，差异有统计学意义。讨论与结论本研究基于CMAP扫描记录为RFws提供了规范性数据，并确定了APB和ADM肌肉之间中继器的不同特征。研究结果提高了对手部肌肉运动神经元生理特性的认识。基于CMAP扫描的F波分析可以与运动单元数估计技术相结合，以提供对神经系统疾病中存活的运动神经元功能的见解。

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引用次数: 0

Differential electroencephalogram findings depending on type of praxis in reflex epilepsy 反射性癫痫不同类型的脑电图表现

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-05-07 DOI: 10.1016/j.neucli.2025.103077

Ryota Sasaki , Masako Kinoshita , Nahomi Osugi , Kentaro Tamura , Kiyoshi Nagata , Ichiro Nakagawa

引用次数: 0

SEEG around the world 放眼世界

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-04-16 DOI: 10.1016/j.neucli.2025.103074

Aileen McGonigal , Philippe Kahane , Louis Maillard , Giorgio Lo Russo , Patrick Chauvel

引用次数: 0

Evaluating postoperative motor function using postoperative navigated transcranial magnetic stimulation motor mapping 利用术后导航经颅磁刺激运动图谱评估术后运动功能

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-04-15 DOI: 10.1016/j.neucli.2025.103072

Thomas Eibl, Adrian Liebert, Leonard Ritter, Karl-Michael Schebesch

Objective

Navigated transcranial magnetic stimulation (nTMS) motor mapping has been established in the preoperative workflow of brain tumor patients. This study aimed to evaluate the use of postoperative nTMS motor mapping, which has been rarely performed to evaluate surgery-associated corticospinal tract injuries and functional outcome.

Methods

Patients undergoing resection of brain tumors, who received pre- and postoperative nTMS motor mapping were retrospectively evaluated. Further inclusion criteria were postoperative deterioration in motor function or the presence of a preoperative motor deficit MRC ≤3/5 without significant improvement after surgery. Postoperative nTMS was conducted within 14 days after tumor surgery. Corticospinal tracts (CST) were visualized using pre- and postoperative diffusion tensor imaging (DTI). Distances between the tumor and the CST as well as the resection cavity and the CST were measured. Primary outcome was a functionally adequate (MRC ≥4/5) motoric status after 3 months.

Results

Seventeen patients were included, mean age was 59.5 ± 14.9 years. Motor evoked potentials (MEP) of at least one extremity were recorded in 14 cases (82.4 %). The positive predictive value (PPV) for motor recovery of postoperative nTMS mapping was 90.5 %, the negative predictive value (NPV) was 38.5 %. Motor thresholds of the operated hemisphere increased significantly after surgery (p = 0.008), whereas the motor thresholds of the contralateral hemisphere remained stable (p = 0.11). Pre- and postoperative CST-visualizations did not differ concerning the distance between CST and lesion or resection cavity.

Conclusion

nTMS potentially predicts functional recovery of transient postoperative motor deficits. Further studies are warranted to prove this effect. Motor deficits significantly improved if it was possible to elicit MEPs with nTMS postoperatively.

目的建立导航经颅磁刺激（nTMS）运动定位在脑肿瘤患者术前工作流程中的应用。本研究旨在评估术后nTMS运动定位的应用，该方法很少用于评估手术相关的皮质脊髓束损伤和功能结果。方法回顾性分析脑肿瘤切除术患者术前和术后的nTMS运动图谱。进一步的纳入标准是术后运动功能恶化或术前运动缺陷MRC≤3/5，术后无明显改善。术后nTMS于肿瘤术后14天内进行。采用术前和术后弥散张量成像（DTI）观察皮质脊髓束（CST）。测量肿瘤与CST之间的距离以及切除腔与CST之间的距离。主要终点是3个月后功能充足（MRC≥4/5）的运动状态。结果纳入17例患者，平均年龄59.5±14.9岁。14例（82.4%）至少记录到一条肢体的运动诱发电位（MEP）。术后运动恢复的阳性预测值（PPV）为90.5%，阴性预测值（NPV）为38.5%。手术半球运动阈值术后明显升高（p = 0.008），而对侧半球运动阈值保持稳定（p = 0.11）。术前和术后CST图像在CST与病变或切除腔的距离上没有差异。结论ntms可预测术后短暂性运动障碍的功能恢复。需要进一步的研究来证明这种效应。如果术后用nTMS诱导mep，运动缺陷显著改善。

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引用次数: 0

SEEG guided hippocampus-sparing resection in mesial temporal lobe epilepsy SEEG引导下内侧颞叶癫痫保留海马切除术

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-04-08 DOI: 10.1016/j.neucli.2025.103073

Mathieu Dhoisne , Maxime Chochoi , Morgane Gérard , Iulia Peciu-Florianu , Nicolas Reyns , Hélène Catenoix , Lucie Plomhause , Philippe Derambure

Objectives

Describe the clinical, neurophysiological, and radiological characteristics of patients with mesial temporal lobe epilepsy (TLE) who underwent hippocampus-sparing anterior temporal lobectomy with a particular emphasis on the stereoelectroencephalographic (SEEG) findings that guided the decision to spare the hippocampus.

Methods

We included patients who underwent hippocampus-sparing anterior temporal lobectomy and stereoelectroencephalography at Lille University Hospital. We reported their clinical, characteristics as well as the results of their presurgical evaluation, neuroimaging data, and SEEG findings.

Results

We report four patients with mesial TLE (three with dominant hemisphere TLE and one with non-dominant hemisphere TLE). In three patients, SEEG captured several seizures originating from the amygdala, with a consistent delay before hippocampal involvement. In the fourth patient, no spontaneous seizure was recorded during monitoring. However, stimulation of the amygdala successfully reproduced a full habitual seizure. All patients underwent hippocampus-sparing anterior temporal lobectomy and have been seizure-free since surgery (two Engel IA and two Engel IB). Post-surgery neuropsychological evaluations were stable or showed improvement in pre-surgical deficits.

Discussion

Hippocampus-sparing anterior temporal lobectomy is a safe and effective treatment for patients in whom the hippocampus is not part of the seizure onset zone. SEEG is invaluable when considering hippocampus-sparing resection, as it provides definitive evidence that the hippocampus is not the primary site of seizure onset. Thorough and meticulous SEEG exploration is essential to accurately delineate the seizure onset zone. The decision-making process should integrate SEEG findings with neuroimaging and neuropsychological assessments, relying on a multidisciplinary approach tailored to each patient.

目的描述内侧颞叶癫痫（TLE）患者接受保留海马前颞叶切除术的临床、神经生理学和放射学特征，特别强调立体脑电图（SEEG）的发现，这些发现指导了保留海马的决定。方法我们纳入了在里尔大学医院行保留海马的前颞叶切除术和立体脑电图的患者。我们报道了他们的临床、特征以及手术前评估、神经影像学数据和SEEG结果。结果我们报告了4例中位颞叶颞叶综合征（3例为优势半球颞叶综合征，1例为非优势半球颞叶综合征）。在三名患者中，SEEG捕捉到几次源自杏仁核的癫痫发作，在海马受累之前持续延迟。第4例患者在监测期间无自发性癫痫发作记录。然而，杏仁核的刺激成功地再现了完全的习惯性癫痫发作。所有患者均行保留海马的前颞叶切除术，术后无癫痫发作（2例Engel IA和2例Engel IB）。术后神经心理评估稳定或显示术前缺陷改善。保留海马的前颞叶切除术对于海马不属于癫痫发作区的患者是一种安全有效的治疗方法。当考虑保留海马体切除时，SEEG是非常宝贵的，因为它提供了明确的证据表明海马体不是癫痫发作的主要部位。彻底和细致的SEEG探查对于准确划定癫痫发作区域至关重要。决策过程应将SEEG结果与神经影像学和神经心理学评估结合起来，依靠针对每位患者的多学科方法。

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引用次数: 0

Guillain-Barré syndrome in patients with Charcot-Marie-Tooth type 1A disease, probably a non-random association 1A型Charcot-Marie-Tooth病患者的格林-巴罗综合征，可能是非随机关联

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-03-21 DOI: 10.1016/j.neucli.2025.103071

Jean-Baptiste Davion , Jérôme Devaux , Céline Tard , Armelle Magot , François Cassim , Yann Péréon

Objective

To describe four cases of Charcot-Marie-Tooth disease type 1A (CMT1A) who developed Guillain-Barré syndrome (GBS), respectively the most frequent genetic and inflammatory neuropathies.

Methods

We described the patients’ clinical and electrodiagnostic characteristics.

Results

Our CMT1A patients developed typical GBS at various ages (3 to 76 years). GBS-related clinical manifestations were different within patients, with various severity degrees of seve (weakness, respiratory failure). Nerve conduction studies revealed more severe demyelinating features than expected in patients with no CMT1A. High cerebrospinal fluid protein level was found in 3 patients. GBS outcome was mainly good, although some patients only slowly improved.

Conclusions

Our cases are close to the previously described cases of acute worsening in CMT1A, and presented with many electrophysiological features of GBS. Overall, GBS prognosis does not seem worse in CMT1A patients than in other patients. If GBS and CMT1A were independent, the expected frequency of co-occurrence of GBS and CMT1A in our two French regions should be 1 case every 137 years. As we observed 4 cases in only 5 years, we suspect that CMT1A is a risk factor of GBS.

Significance

These cases bring further evidence for a non-random link between inflammatory and genetic neuropathies.

目的分析4例1A型沙科-玛丽-图斯病（CMT1A）并发吉兰-巴罗综合征（GBS）的病例，分别为最常见的遗传性和炎症性神经病变。方法对患者的临床和电诊断特点进行描述。结果我们的CMT1A患者在不同年龄（3 - 76岁）出现了典型的GBS。患者的gbs相关临床表现不同，严重程度不同（虚弱、呼吸衰竭）。神经传导研究显示，在没有CMT1A的患者中，脱髓鞘特征比预期的更严重。3例脑脊液蛋白水平升高。GBS结果主要是良好的，尽管一些患者只有缓慢的改善。结论sour病例与先前描述的CMT1A急性加重病例接近，并表现出GBS的许多电生理特征。总体而言，CMT1A患者的GBS预后似乎并不比其他患者差。如果GBS和CMT1A是独立的，那么我们的两个法国地区GBS和CMT1A同时出现的预期频率应为每137年1例。由于我们在短短5年内观察到4例病例，我们怀疑CMT1A是GBS的一个危险因素。这些病例进一步证明了炎症性神经病变与遗传性神经病变之间存在非随机联系。

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引用次数: 0

Fear in the neuropsychiatric aspects of epilepsy: What role for the amygdala? 恐惧在癫痫的神经精神方面：杏仁核的作用是什么？

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-03-17 DOI: 10.1016/j.neucli.2025.103062

Alexis Tarrada , Yassine Jamal Eddine

Fear is essential for survival; however, its dysregulation may lead to various neuropsychiatric disorders. Understanding the neural networks involved in the expression of fear is useful for elaborating therapeutic interventions (pharmacological or psychoeducation). We aimed to summarize suspected roles of amygdala, but also of other structures such as insula, frontal and temporal associative cortices, and brainstem. Three pathways can be distinguished leading to the expression of fear: indirect, direct and interoceptive, comprising the amygdala as a “hub of fear”. Moreover, temporal epilepsies that imply fear as a “spontaneous” symptom may constitute an interesting model for understanding physiological mechanisms of fear.

恐惧是生存之本；然而，它的失调可能导致各种神经精神疾病。了解与恐惧表达有关的神经网络有助于制定治疗干预措施（药理学或心理教育）。我们的目的是总结杏仁核的可疑作用，以及其他结构，如脑岛、额叶和颞叶联合皮层和脑干。可以区分出导致恐惧表达的三种途径：间接的、直接的和内感受的，由杏仁核组成的“恐惧中枢”。此外，颞叶癫痫暗示恐惧是一种“自发”症状，这可能为理解恐惧的生理机制提供了一个有趣的模型。

引用次数: 0

F waves in amyotrophic lateral sclerosis: A systematic review and meta-analysis 肌萎缩性侧索硬化症的F波：系统回顾和荟萃分析

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-03-13 DOI: 10.1016/j.neucli.2025.103061

Ioannis Liampas , Dimitra Veltsista , Alexandra Germeni , Paraskevi Batzikosta , Emilia Michou , Zinovia Kefalopoulou , Elisabeth Chroni

Objective

This systematic review and meta-analysis aimed to determine the pattern of F-wave abnormalities and their potential utility in the early diagnosis of amyotrophic lateral sclerosis (ALS).

Methods

Medline and Embase were thoroughly searched. We primarily emphasized F-wave recordings from the abductor digiti minimi, following stimulation of the ulnar nerve at the wrist. Data from case-control studies involving individuals with ALS versus healthy controls (HC) or other well-defined patient groups were reviewed and -if appropriate- quantitatively synthesized.

Results

Twenty-nine studies were included in this systematic review and 17 of them in the analytic part. The pattern of F-abnormalities in ALS compared to HC was as follows: decreased persistence (MD=20.25 %,15.67–24.84 %), mildly prolonged minimum latency (MD=1.59msec,1.11–2.06msec), increased maximum amplitude (MD=196μV,106–287μV) and elevated Index total Freps (MD=33.9 %,26.0–41.8 %). Affected limbs (with substantial weakness in clinical examination and/or muscle wasting and/or abnormal nerve conduction studies) exhibited more marked abnormalities in persistence, minimum latency, and Index total Freps, whereas abnormalities in these parameters were very mild in clinically unaffected limbs. More prominent increases in maximum amplitude accompanied pyramidal dysfunction. Of note, isolated upper motor neuron (UMN) disorders exhibited a comparable increase in Index total Freps without a decrease in persistence.

Conclusions

The pattern of F wave abnormalities may raise suspicion of involvement of the under-study lower motor neuron (LMN) pool in ALS. These findings may identify LMN dysfunction even at a preclinical stage and prompt extensive electromyographic investigations. UMN involvement may to some extent differentiate the profile of F wave abnormalities in ALS.

目的：本系统综述和荟萃分析旨在确定f波异常模式及其在肌萎缩性侧索硬化症（ALS）早期诊断中的潜在应用。方法对medline和Embase进行全面检索。我们主要强调在刺激腕尺神经后，从指外展肌得到的f波记录。我们回顾了ALS患者与健康对照（HC）或其他明确定义的患者群体的病例对照研究数据，并在适当的情况下进行了定量合成。结果本系统综述共纳入29项研究，其中17项纳入分析部分。与HC相比，ALS的f -异常表现为持续时间减少（MD= 20.25%,15.67 - 24.84%），最小潜伏期轻度延长（MD=1.59 μ sec, 1.11-2.06msec），最大振幅增加（MD=196μV, 106-287μV），指数总Freps升高（MD= 33.9%,26.0 - 41.8%）。受累肢体（临床检查和/或肌肉萎缩和/或神经传导异常）在持续性、最小潜伏期和指数总Freps方面表现出更明显的异常，而在临床未受影响的肢体中，这些参数的异常非常轻微。更显著的最大振幅增加伴随锥体功能障碍。值得注意的是，孤立的上运动神经元（UMN）疾病表现出可比的指数总Freps增加，而持久性却没有下降。结论F波异常可能提示ALS患者下运动神经元（LMN）池受累。这些发现可以识别LMN功能障碍，甚至在临床前阶段，并提示广泛的肌电图调查。UMN累及可能在一定程度上区分ALS的F波异常。

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引用次数: 0

Hereditary spastic paraplegia HSP26: clinical and electrophysiological characteristics 遗传性痉挛性截瘫HSP26：临床和电生理特征

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-03-10 DOI: 10.1016/j.neucli.2025.103070

Sezin Yılmaz , H Evren Boran , Gülsüm Kayhan , Bülent Cengiz

引用次数: 0

Temporal lobectomy in bilateral temporal lobe epilepsy: A relook at factors in selection, invasive evaluation and seizure outcome 双侧颞叶癫痫的颞叶切除术：重新审视选择、侵入性评估和癫痫结果的因素

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-03-04 DOI: 10.1016/j.neucli.2025.103064

Harish Jayakumar , Siby Gopinath , Sreelakshmi Narayanan , Srinath Rajeevan , Ramaih Rajeshkannan , Harilal Parasuram , Ashok Pillai

Objectives

We sought retrospectively to assess outcomes in bilateral temporal lobe epilepsy (BTLE) patients undergoing resective temporal lobe surgery following invasive EEG lateralization in comparison to unilateral TLE (UTLE).

Methods

Patients undergoing surgical intervention for TLE (the vast majority being mesial temporal lobe epilepsy) during a 7-year period were retrospectively categorized as suspected BTLE (sBTLE) or UTLE. Temporal lobectomy was performed in the sBTLE group on the side of maximum number of intracranial EEG seizure onsets. EEG, MRI, laterality of iEEG ictal onset (in sBTLE), seizure outcome and drug tapering data were retrospectively analyzed.

Results

Of 148 adult patients undergoing temporal lobe epilepsy surgery, 24 (16.2 %) fit the criteria of sBTLE, amongst whom iEEG ictal onset proved to be unilateral in 14 (uBTLE, 58.3 %) and bilateral in 10 (dBTLE, 41.7 %). Of operated patients in the dBTLE group, the first seizure onset was ipsilateral to the resection in 4 patients (57.1 %) and contralateral in 3 (42.9 %). In the UTLE group, seizure freedom (Engel 1) was achieved in 87.8 % at mean follow-up of 59.2 ± 27.9 months. Seizure freedom was achieved in 92.9 % of uBTLE patients at 52.8 ± 36.6 months. Seven of 10 dBTLE patients underwent resection on the side of maximum number of iEEG seizure onset, and 6 (85.7 %) remained seizure-free at 40.14 ± 25 months. There was no statistically significant difference in seizure-free outcome between UTLE and sBTLE (Pearson Chi-Square test, p-value = 0.67).

Conclusion

High seizure freedom rates were observed in both unilateral and bilateral disease following standard temporal lobectomy. However, the study lacks pre- and post-resection neuropsychological data to conclude on the cognitive sequelae of resective surgery in established bilateral mesiotemporal epilepsy.

目的回顾性评估双侧颞叶癫痫（BTLE）患者在有创脑电图侧化后接受切除颞叶手术的结果，并与单侧颞叶癫痫（UTLE）进行比较。方法回顾性分析7年来因颞叶癫痫而接受手术治疗的患者（绝大多数为内侧颞叶癫痫），并将其归类为疑似颞叶癫痫（sBTLE）或颞叶癫痫（UTLE）。sBTLE组在颅内脑电图发作次数最多的一侧行颞叶切除术。回顾性分析脑电图、MRI、脑电图侧侧性（sBTLE）、癫痫发作结果和药物减量数据。结果148例成人颞叶癫痫患者中，24例（16.2%）符合sBTLE标准，其中单侧发病14例（uBTLE, 58.3%），双侧发病10例（dBTLE, 41.7%）。在dBTLE组手术患者中，4例（57.1%）患者首次癫痫发作在切除的同侧，3例（42.9%）患者首次癫痫发作在切除的对侧。在UTLE组，平均随访59.2±27.9个月，癫痫发作自由（Engel 1）率为87.8%。在52.8±36.6个月时，92.9%的uBTLE患者癫痫发作自由。10例dBTLE患者中有7例在脑电图发作次数最多的一侧切除，6例（85.7%）在40.14±25个月时保持无癫痫发作。UTLE组与sBTLE组无癫痫发作结果差异无统计学意义（Pearson卡方检验，p值= 0.67）。结论标准颞叶切除术后，单侧和双侧患者的癫痫发作自由率均较高。然而，该研究缺乏切除前和切除后的神经心理学数据来总结切除手术对已确定的双侧中颞叶癫痫的认知后遗症。

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