Neurophysiologie Clinique/Clinical Neurophysiology最新文献_第6页

Reduced montage electroencephalography: A choice between pragmatism and conventionalism 减少蒙太奇脑电图：实用主义与传统主义之间的选择

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-02-26 DOI: 10.1016/j.neucli.2025.103063

Josef Parvizi , Kapil Gururangan

引用次数: 0

EMG filling analysis, a new method for the assessment of recruitment of motor units with needle EMG 肌电信号填充分析，一种针刺肌电信号评价运动单元恢复的新方法

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-02-20 DOI: 10.1016/j.neucli.2025.103059

Cristina Mariscal , Javier Navallas , Armando Malanda , Silvia Recalde-Villamayor , Javier Rodriguez-Falces

Objectives

The progression of recruitment of motor unit potentials (MUPs) during increasing voluntary contraction can provide important information about the motor units (MUs) innervating a muscle. Here, we described a method to quantitate the recruitment level of the intramuscular electromyographic (iEMG) signal during an increasing force level.

Methods

Concentric needle EMG signals were recorded from the tibialis anterior of healthy subjects as force was gradually increased from 0 to maximum force. The iEMG filling process was analyzed by measuring the EMG filling factor (FF), calculated from the mean rectified iEMG and the root mean square iEMG.

Results

(1) The iEMG activity at low contraction forces was “discrete” (FF<0.3) for all participants. (2) The iEMG activity at maximal effort was “full” (FF>0.5) for 83 % of the participants, whereas it was “incompletely-reduced” (0.3<FF< 0.5) for 17 % of the participants. (3) The FF increased rapidly for forces up to 20 % MVC, and then levelled off for higher forces: thus, the FF curve had a typical exponential shape.

Conclusions

The iEMG filling method can be considered of general applicability since the FF increased over a wide range in all healthy participants.

Significance

The EMG filling analysis may have potential to detect scenarios of MU loss and remodelling in neurogenic and motor neuron diseases.

目的观察自发性收缩增强过程中运动单位电位（MUPs）募集的进展，为了解支配肌肉的运动单位（mu）提供重要信息。在这里，我们描述了一种方法来量化肌肉内肌电图（iEMG）信号在增加力水平期间的补充水平。方法记录健康受试者胫骨前肌的同心针肌电图信号，用力从0逐渐增加到最大。通过测量EMG填充因子（FF）来分析iEMG填充过程，FF是由平均校正iEMG和均方根iEMG计算得出的。结果(1)所有参与者在低收缩力下的iEMG活动都是“离散的”（FF<0.3）。(2) 83%的参与者在最大努力时的iEMG活动为“充分”（FF>0.5），而在最大努力时的iEMG活动为“不完全减少”(0.3<FF<；0.5)，为17%的参与者。(3)在荷载为20% MVC时，FF迅速增加，在较高的荷载下趋于平稳，因此FF曲线呈典型的指数型。结论iEMG填充法具有普遍适用性，因为所有健康参与者的FF都在大范围内增加。意义肌电图填充分析在神经源性疾病和运动神经元疾病中可能具有检测MU丢失和重构的潜力。

{"title":"EMG filling analysis, a new method for the assessment of recruitment of motor units with needle EMG","authors":"Cristina Mariscal , Javier Navallas , Armando Malanda , Silvia Recalde-Villamayor , Javier Rodriguez-Falces","doi":"10.1016/j.neucli.2025.103059","DOIUrl":"10.1016/j.neucli.2025.103059","url":null,"abstract":"<div><h3>Objectives</h3><div>The progression of recruitment of motor unit potentials (MUPs) during increasing voluntary contraction can provide important information about the motor units (MUs) innervating a muscle. Here, we described a method to quantitate the recruitment level of the intramuscular electromyographic (iEMG) signal during an increasing force level.</div></div><div><h3>Methods</h3><div>Concentric needle EMG signals were recorded from the <em>tibialis anterior</em> of healthy subjects as force was gradually increased from 0 to maximum force. The iEMG filling process was analyzed by measuring the EMG filling factor (FF), calculated from the mean rectified iEMG and the root mean square iEMG.</div></div><div><h3>Results</h3><div>(1) The iEMG activity at low contraction forces was “discrete” (FF<0.3) for all participants. (2) The iEMG activity at maximal effort was “full” (FF>0.5) for 83 % of the participants, whereas it was “incompletely-reduced” (0.3<FF< 0.5) for 17 % of the participants. (3) The FF increased rapidly for forces up to 20 % MVC, and then levelled off for higher forces: thus, the FF curve had a typical exponential shape.</div></div><div><h3>Conclusions</h3><div>The iEMG filling method can be considered of general applicability since the FF increased over a wide range in all healthy participants.</div></div><div><h3>Significance</h3><div>The EMG filling analysis may have potential to detect scenarios of MU loss and remodelling in neurogenic and motor neuron diseases.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 4","pages":"Article 103059"},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453035","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}

引用次数: 0

Does hyperventilation increase the diagnostic sensitivity of routine electroencephalography in adults with suspected epilepsy? 过度通气是否会增加疑似癫痫的成人常规脑电图的诊断敏感性？

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-02-18 DOI: 10.1016/j.neucli.2025.103060

Seyda Erdoğan, Gökhan Pek, Canan Duman İlki, Cem Dinler, İlke Şahin, Ali Cem Ekşi, Musap Rasim Ceylan, Nijat Abbaszade, Eray Ergül, Özden Şener

Objective

We aimed to explore the role of hyperventilation (HV) during routine EEG recordings in the diagnosis of adults with epilepsy.

Methods

During the COVID-19 pandemic we removed HV from routine EEG recordings due to the transmission risks. Routine EEGs conducted in the year before and after the COVID-19 pandemic were re-evaluated.

Results

A total of 167 HV + and 199 HV - EEGs were analyzed. To ensure comparability between the two groups with respect to age and conditions that could contraindicate HV, patients ≥ 55 years and with any conditions contraindicating HV were excluded from both groups. In patients with a diagnosis of epilepsy the prevalence of epileptiform abnormalities was 26.7 % in the HV + and 24.5 % in the HV - group (p = 0.727).

Conclusions

This study did not reveal any evidence indicating that HV improves the diagnostic sensitivity of routine EEG in adults with epilepsy. In adults, hyperventilation during routine EEG recordings may be most useful in incre in patients with a history of absence seizures or seizures triggered by hyperventilation.

目的探讨常规脑电图记录中过度通气（HV）在成人癫痫诊断中的作用。方法在2019冠状病毒病大流行期间，由于存在传播风险，我们从常规脑电图记录中删除了HV。重新评估2019冠状病毒病大流行前后一年的常规脑电图。结果共分析HV +脑电图167例，HV -脑电图199例。为了确保两组之间在年龄和可能禁忌HV的条件方面的可比性，两组均排除年龄≥55岁且有任何禁忌HV条件的患者。在诊断为癫痫的患者中，HV +组癫痫样异常发生率为26.7%，HV -组为24.5% （p = 0.727）。结论本研究未发现任何证据表明HV可提高成人癫痫常规脑电图的诊断敏感性。在成人中，常规脑电图记录时的过度通气可能对有失神癫痫发作史或过度通气引发癫痫发作的患者最有用。

{"title":"Does hyperventilation increase the diagnostic sensitivity of routine electroencephalography in adults with suspected epilepsy?","authors":"Seyda Erdoğan, Gökhan Pek, Canan Duman İlki, Cem Dinler, İlke Şahin, Ali Cem Ekşi, Musap Rasim Ceylan, Nijat Abbaszade, Eray Ergül, Özden Şener","doi":"10.1016/j.neucli.2025.103060","DOIUrl":"10.1016/j.neucli.2025.103060","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to explore the role of hyperventilation (HV) during routine EEG recordings in the diagnosis of adults with epilepsy.</div></div><div><h3>Methods</h3><div>During the COVID-19 pandemic we removed HV from routine EEG recordings due to the transmission risks. Routine EEGs conducted in the year before and after the COVID-19 pandemic were re-evaluated.</div></div><div><h3>Results</h3><div>A total of 167 HV + and 199 HV - EEGs were analyzed. To ensure comparability between the two groups with respect to age and conditions that could contraindicate HV, patients ≥ 55 years and with any conditions contraindicating HV were excluded from both groups. In patients with a diagnosis of epilepsy the prevalence of epileptiform abnormalities was 26.7 % in the HV + and 24.5 % in the HV - group (<em>p</em> = 0.727).</div></div><div><h3>Conclusions</h3><div>This study did not reveal any evidence indicating that HV improves the diagnostic sensitivity of routine EEG in adults with epilepsy. In adults, hyperventilation during routine EEG recordings may be most useful in incre in patients with a history of absence seizures or seizures triggered by hyperventilation.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 4","pages":"Article 103060"},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429812","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}

引用次数: 0

Cortical Stimulation for brain mapping and seizure stimulation, pediatric practices throughout Canada: A national survey and systematic literature review 皮质刺激的脑部绘图和癫痫发作刺激，儿科实践在加拿大：全国调查和系统的文献综述

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-02-07 DOI: 10.1016/j.neucli.2025.103043

Margarita Maltseva , Juan Pablo Appendino , Pavlina Cabounova , Andrea Andrade , Michelle Kregel , Aris Hadjinicolaou , Alexander G. Weil , Puneet Jain , Elizabeth Donner , Felippe Borlot , David Dufresne , Linda Huh , Natarie Liu , Kenneth A. Myers , Julia Jacobs

Introduction

Diagnostic cortical stimulation (CS) in intracranial electroencephalography (iEEG) is an established epilepsy presurgical assessment tool to delineate relevant brain functions and elicit habitual epileptic seizures. Currently, no consensus exists as to whether CS should be routinely performed in pediatric patients. A significant challenge is their limited ability to cooperate during the procedure or to describe non-observable seizure semiology features. Our goal was to identify the spectrum of CS practices in Canada, for both eloquent cortex mapping and seizure stimulation.

Methods

An online survey, answered by all 8 Canadian pediatric epilepsy centers, enquired about implantation, stimulation methods, and use of standardized protocols. A systematic literature review extracted detailed stimulation parameters.

Results

Most of the institutions (n = 7/8) reported performing CS during presurgical evaluation. Four institutions indicated they perform stimulation in all implanted patients for the purpose of eloquent cortex mapping and seizure stimulation. The majority of physicians had their individual approach to CS. A largely variable approach to CS, mainly in the choice of stimulation parameters (i.e., train and pulse duration), was observed, with the highest variance concerning the purpose of seizure stimulation. The literature review highlighted an overall small sample size and minimal number of publications. Even though there is a rising trend towards stereotactic iEEG implantation, more data were available on subdural EEGs.

Conclusion

This study shows individual and sparsely validated approach to CS in pediatric epilepsy. The literature review underscores the urgent need to harmonize pediatric intracranial EEG practices. More multicenter studies are needed to identify safe stimulation thresholds and allow implementation of evidence-based guidelines.

颅内脑电图（iEEG）中的诊断性皮质刺激（CS）是一种成熟的癫痫术前评估工具，用于描述相关脑功能和引发习惯性癫痫发作。目前，对于CS是否应该常规应用于儿科患者，尚未达成共识。一个重要的挑战是他们在手术过程中的合作能力有限或描述不可观察到的癫痫符号学特征。我们的目标是确定在加拿大的CS实践的频谱，包括有效的皮层映射和癫痫刺激。方法对加拿大所有8家儿童癫痫中心进行在线调查，了解植入、刺激方法和标准化方案的使用情况。系统的文献综述提取了详细的刺激参数。结果大多数机构（n = 7/8）报告在术前评估中使用了CS。四家机构表示，他们对所有植入的患者进行刺激，目的是进行有效的皮层映射和癫痫刺激。大多数医生对CS有自己的治疗方法。观察到，CS的方法变化很大，主要是在刺激参数（即训练和脉冲持续时间）的选择上，与癫痫发作刺激的目的相关的差异最大。文献综述强调总体样本量小，出版物数量少。尽管立体定向脑电图植入有上升的趋势，但更多的数据可用于硬膜下脑电图。结论：本研究为儿童癫痫的CS治疗提供了个体化和稀疏验证的方法。文献综述强调了协调儿童颅内脑电图实践的迫切需要。需要更多的多中心研究来确定安全的刺激阈值，并允许实施循证指南。

{"title":"Cortical Stimulation for brain mapping and seizure stimulation, pediatric practices throughout Canada: A national survey and systematic literature review","authors":"Margarita Maltseva , Juan Pablo Appendino , Pavlina Cabounova , Andrea Andrade , Michelle Kregel , Aris Hadjinicolaou , Alexander G. Weil , Puneet Jain , Elizabeth Donner , Felippe Borlot , David Dufresne , Linda Huh , Natarie Liu , Kenneth A. Myers , Julia Jacobs","doi":"10.1016/j.neucli.2025.103043","DOIUrl":"10.1016/j.neucli.2025.103043","url":null,"abstract":"<div><h3>Introduction</h3><div>Diagnostic cortical stimulation (CS) in intracranial electroencephalography (iEEG) is an established epilepsy presurgical assessment tool to delineate relevant brain functions and elicit habitual epileptic seizures. Currently, no consensus exists as to whether CS should be routinely performed in pediatric patients. A significant challenge is their limited ability to cooperate during the procedure or to describe non-observable seizure semiology features. Our goal was to identify the spectrum of CS practices in Canada, for both eloquent cortex mapping and seizure stimulation.</div></div><div><h3>Methods</h3><div>An online survey, answered by all 8 Canadian pediatric epilepsy centers, enquired about implantation, stimulation methods, and use of standardized protocols. A systematic literature review extracted detailed stimulation parameters.</div></div><div><h3>Results</h3><div>Most of the institutions (<em>n</em> = 7/8) reported performing CS during presurgical evaluation. Four institutions indicated they perform stimulation in all implanted patients for the purpose of eloquent cortex mapping and seizure stimulation. The majority of physicians had their individual approach to CS. A largely variable approach to CS, mainly in the choice of stimulation parameters (i.e., train and pulse duration), was observed, with the highest variance concerning the purpose of seizure stimulation. The literature review highlighted an overall small sample size and minimal number of publications. Even though there is a rising trend towards stereotactic iEEG implantation, more data were available on subdural EEGs.</div></div><div><h3>Conclusion</h3><div>This study shows individual and sparsely validated approach to CS in pediatric epilepsy. The literature review underscores the urgent need to harmonize pediatric intracranial EEG practices. More multicenter studies are needed to identify safe stimulation thresholds and allow implementation of evidence-based guidelines.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 2","pages":"Article 103043"},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143282721","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}

引用次数: 0

Description of an alternative method for the electrodiagnostic evaluation of the sensory radial nerve 描述一种替代方法的电诊断评估感觉桡神经

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-02-06 DOI: 10.1016/j.neucli.2025.103058

Martin Moussy , Julie Rode , Thierry Maisonobe , Nagham Khanafer , Françoise Bouhour , Antoine Pegat

Objectives

The aim of this study was to describe an alternative method for the electrodiagnostic (EDX) evaluation of the sensory radial nerve (SRN).

Methods

In this retrospective study, all patients from a French EDX center (November 2022-April 2023) for whom SNAP amplitudes of the same SRN were obtained through both a conventional and an alternative method were included. In the conventional method, the active recording electrode was placed at the base of the snuff box, whereas in the alternative method, it was placed 3-4 cm proximally on the lateral border of the radial bone. The SNAP amplitudes of both methods were compared and the ratio of alternative to conventional amplitude was determined within the same patient. A secondary objective was to compare SNAP amplitudes and ratios between patients with peripheral neuropathy and those without (control group).

Results

Among the 117 patients included, the mean ± SD SNAP amplitude was 50.0±28.9 µV in the alternative method compared to 31.0±17.9 µV in the conventional method. The ratio of alternative to conventional amplitudes was 1.64±0.4 in all patients. No significant difference in amplitude ratios was found between the peripheral neuropathy group (1.63 ± 0.4) and the control group (1.65 ± 0.3; p =0.75).

Discussion

The alternative method, based on a more proximal placement of the recording electrodes, consistently provided larger SNAP amplitudes than the conventional method. This method could be useful in particular clinical settings but could prove more challenging in obese or muscular patients.

目的本研究的目的是描述一种电诊断（EDX）评估感觉桡神经（SRN）的替代方法。方法在这项回顾性研究中，所有来自法国EDX中心（2022年11月- 2023年4月）的患者均通过常规方法和替代方法获得了相同SRN的SNAP振幅。在常规方法中，将主动记录电极放置在鼻烟壶底部，而在替代方法中，将其放置在桡骨侧缘近端3-4 cm处。比较两种方法的SNAP振幅，并确定同一患者内替代振幅与常规振幅的比值。次要目的是比较周围神经病变患者和非周围神经病变患者（对照组）的SNAP振幅和比值。结果117例患者中，替代方法的SNAP振幅平均值±SD为50.0±28.9µV，而常规方法的SNAP振幅平均值为31.0±17.9µV。所有患者的替代振幅与常规振幅之比为1.64±0.4。周围神经病变组（1.63±0.4）与对照组（1.65±0.3）的振幅比差异无统计学意义；p = 0.75)。基于更近距离放置记录电极的替代方法始终提供比传统方法更大的SNAP振幅。这种方法在特定的临床环境中可能有用，但在肥胖或肌肉发达的患者中可能更具挑战性。

{"title":"Description of an alternative method for the electrodiagnostic evaluation of the sensory radial nerve","authors":"Martin Moussy , Julie Rode , Thierry Maisonobe , Nagham Khanafer , Françoise Bouhour , Antoine Pegat","doi":"10.1016/j.neucli.2025.103058","DOIUrl":"10.1016/j.neucli.2025.103058","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to describe an alternative method for the electrodiagnostic (EDX) evaluation of the sensory radial nerve (SRN).</div></div><div><h3>Methods</h3><div>In this retrospective study, all patients from a French EDX center (November 2022-April 2023) for whom SNAP amplitudes of the same SRN were obtained through both a conventional and an alternative method were included. In the conventional method, the active recording electrode was placed at the base of the snuff box, whereas in the alternative method, it was placed 3<del>-4</del> cm proximally on the lateral border of the radial bone. The SNAP amplitudes of both methods were compared and the ratio of alternative to conventional amplitude was determined within the same patient. A secondary objective was to compare SNAP amplitudes and ratios between patients with peripheral neuropathy and those without (control group).</div></div><div><h3>Results</h3><div>Among the 117 patients included, the mean ± SD SNAP amplitude was 50.0±28.9 µV in the alternative method compared to 31.0±17.9 µV in the conventional method. The ratio of alternative to conventional amplitudes was 1.64±0.4 in all patients. No significant difference in amplitude ratios was found between the peripheral neuropathy group (1.63 ± 0.4) and the control group (1.65 ± 0.3; p =0.75).</div></div><div><h3>Discussion</h3><div>The alternative method, based on a more proximal placement of the recording electrodes, consistently provided larger SNAP amplitudes than the conventional method. This method could be useful in particular clinical settings but could prove more challenging in obese or muscular patients.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 3","pages":"Article 103058"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143327918","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}

引用次数: 0

Stereoelectroencephalography at Sainte-Anne Hospital, Paris, France 法国巴黎圣安妮医院的立体脑电图

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-02-05 DOI: 10.1016/j.neucli.2025.103057

Cristina Filipescu , Elisabeth Landré , Marc Zanello , Alessandro Moiraghi , Charles Mellerio , Magali Boutin , Benoît Crépon , Estelle Pruvost-Robieux , Anaïs Llorens , Johan Pallud , Martine Gavaret

Stereoelectroencephalography (SEEG), which combines the exploration of identified intracerebral structures using depth electrodes and provides direct recording of local field potentials from multiple brain sites, was designed and developed in the 1950s by Jean Talairach and Jean Bancaud, in Sainte-Anne Hospital, Paris.

For patients with focal drug-resistant epilepsy, when the non-invasive phase is insufficiently concordant or when relationships between the epileptogenic network and eloquent areas remain to be defined, the main purpose of SEEG is the optimal electrode implantation based on a main hypothesis and questions formulated during the non-invasive phase.

Following an initial historical overview, the different steps of this non-invasive phase are described. Some of these steps, like semiology analysis, have remained relatively preserved, while others have considerably evolved, such as positron emission tomography combined with 3 Tesla magnetic resonance imaging (MRI), functional MRI (fMRI) and high-resolution EEG.

We then outline the different steps of the SEEG procedure as performed in our institution. Here also, some steps remain quite unchanged such as intracerebral stimulation, amitriptyline and benzodiazepine tests while some others have strikingly evolved such as frameless robot-assisted, MRI-based implantation, depth-signal analyses and quantifications, and radio-frequency thermocoagulation.

立体脑电图（SEEG）是20世纪50年代由巴黎圣安妮医院的Jean Talairach和Jean Bancaud设计和开发的，它结合了使用深度电极对已识别的脑内结构的探索，并提供了来自多个脑部位的局部场电位的直接记录。对于局灶性耐药癫痫患者，当非侵入性阶段不充分协调或当致痫网络与言语区域之间的关系仍未明确时，SEEG的主要目的是基于非侵入性阶段制定的主要假设和问题进行最佳电极植入。在最初的历史概述之后，描述了这个非侵入性阶段的不同步骤。其中一些步骤，如符号学分析，相对保留了下来，而其他步骤则有了相当大的发展，如正电子发射断层扫描结合3特斯拉磁共振成像（MRI），功能磁共振成像（fMRI）和高分辨率脑电图。然后，我们概述了在我们机构中执行的SEEG程序的不同步骤。在这方面，一些步骤仍然保持不变，如脑内刺激，阿米替林和苯二氮卓类药物测试，而其他一些步骤则有了惊人的发展，如无框架机器人辅助，基于核磁共振的植入，深度信号分析和量化，以及射频热凝。

{"title":"Stereoelectroencephalography at Sainte-Anne Hospital, Paris, France","authors":"Cristina Filipescu , Elisabeth Landré , Marc Zanello , Alessandro Moiraghi , Charles Mellerio , Magali Boutin , Benoît Crépon , Estelle Pruvost-Robieux , Anaïs Llorens , Johan Pallud , Martine Gavaret","doi":"10.1016/j.neucli.2025.103057","DOIUrl":"10.1016/j.neucli.2025.103057","url":null,"abstract":"<div><div>Stereoelectroencephalography (SEEG), which combines the exploration of identified intracerebral structures using depth electrodes and provides direct recording of local field potentials from multiple brain sites, was designed and developed in the 1950s by Jean Talairach and Jean Bancaud, in Sainte-Anne Hospital, Paris.</div><div>For patients with focal drug-resistant epilepsy, when the non-invasive phase is insufficiently concordant or when relationships between the epileptogenic network and eloquent areas remain to be defined, the main purpose of SEEG is the optimal electrode implantation based on a main hypothesis and questions formulated during the non-invasive phase.</div><div>Following an initial historical overview, the different steps of this non-invasive phase are described. Some of these steps, like semiology analysis, have remained relatively preserved, while others have considerably evolved, such as positron emission tomography combined with 3 Tesla magnetic resonance imaging (MRI), functional MRI (fMRI) and high-resolution EEG.</div><div>We then outline the different steps of the SEEG procedure as performed in our institution. Here also, some steps remain quite unchanged such as intracerebral stimulation, amitriptyline and benzodiazepine tests while some others have strikingly evolved such as frameless robot-assisted, MRI-based implantation, depth-signal analyses and quantifications, and radio-frequency thermocoagulation.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 3","pages":"Article 103057"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134078","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}

引用次数: 0

How can emotion and familiarity improve own-name oddball paradigms? 情感和熟悉度如何改善自己的名字古怪的范式？

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-01-31 DOI: 10.1016/j.neucli.2025.103050

Estelle Pruvost-Robieux , Sarah Benghanem , Camille Des Lauriers , Anaïs Llorens , Martine Gavaret

The own-name paradigm is used to assess the depth of consciousness disorders in patients in intensive care units. This auditory oddball paradigm elicits a positive event-related potential at 300 ms (named P300) after the presentation of a deviant auditory stimulus, here the subject's own-name. This P300 likely reflects the neural processing of the novel stimulus, which can trigger a behavioral response. Presence of a P300 response is considered to be indicative of a good prognosis for recovering to wakefulness in post-anoxic coma patients. However, its prognostic performance is insufficient and some disorders of consciousness patients without a P300 response will nevertheless awake. The auditory P300 response is influenced by the acoustic characteristics of the stimuli. The use of stimuli with an emotional valence may recruit additional brain networks besides the auditory and attentional ones and potentially improve the prognostic value of the P300 response. Moreover, better characterization of the recruitment of different brain networks involved in these P300 responses in response to emotional stimuli would help in understanding the surface event-related potentials. Here, we present two kind of emotional acoustic features that can be used in these paradigms: “smiling” versus “rough” voice and the familiarity of the voice.

自名范式用于评估重症监护病房患者的意识障碍深度。在出现异常的听觉刺激（这里是被试自己的名字）后300毫秒，这种听觉怪异范式引发了一个积极的事件相关电位（称为P300）。这个P300可能反映了神经对新刺激的处理，它可以引发行为反应。P300反应的存在被认为是缺氧后昏迷患者恢复清醒的良好预后的指示。然而，它的预后表现不足，一些没有P300反应的意识障碍患者仍然会醒来。听觉P300反应受刺激的声学特性影响。使用具有情绪效价的刺激可能会在听觉和注意网络之外招募额外的大脑网络，并可能提高P300反应的预后价值。此外，更好地描述在情绪刺激下参与P300反应的不同脑网络的募集将有助于理解表面事件相关电位。在这里，我们提出了两种可用于这些范式的情感声学特征：“微笑”与“粗糙”的声音和声音的熟悉度。

{"title":"How can emotion and familiarity improve own-name oddball paradigms?","authors":"Estelle Pruvost-Robieux , Sarah Benghanem , Camille Des Lauriers , Anaïs Llorens , Martine Gavaret","doi":"10.1016/j.neucli.2025.103050","DOIUrl":"10.1016/j.neucli.2025.103050","url":null,"abstract":"<div><div>The own-name paradigm is used to assess the depth of consciousness disorders in patients in intensive care units. This auditory oddball paradigm elicits a positive event-related potential at 300 ms (named P300) after the presentation of a deviant auditory stimulus, here the subject's own-name. This P300 likely reflects the neural processing of the novel stimulus, which can trigger a behavioral response. Presence of a P300 response is considered to be indicative of a good prognosis for recovering to wakefulness in post-anoxic coma patients. However, its prognostic performance is insufficient and some disorders of consciousness patients without a P300 response will nevertheless awake. The auditory P300 response is influenced by the acoustic characteristics of the stimuli. The use of stimuli with an emotional valence may recruit additional brain networks besides the auditory and attentional ones and potentially improve the prognostic value of the P300 response. Moreover, better characterization of the recruitment of different brain networks involved in these P300 responses in response to emotional stimuli would help in understanding the surface event-related potentials. Here, we present two kind of emotional acoustic features that can be used in these paradigms: “smiling” versus “rough” voice and the familiarity of the voice.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 3","pages":"Article 103050"},"PeriodicalIF":2.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075143","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}

引用次数: 0

Intraoperative recordings from the posterior superior insula in awake humans with peripheral neuropathic pain 清醒的周围神经性疼痛患者术中脑岛后上的记录。

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-01-30 DOI: 10.1016/j.neucli.2025.103056

Raíssa Benocci Thibes , Pedro Henrique Martins da Cunha , Jorge Dornellys da Silva Lapa , Liu Dongyang , Denise Spinola Pinheiro , Ricardo Ferrareto Iglesio , Kleber Paiva Duarte , Valquiria Aparecida Silva , Gabriel Taricani Kubota , Manoel Jacobsen Teixeira , Luis Garcia-Larrea , Hélène Bastiji , João Ricardo Sato , Daniel Ciampi de Andrade

Background and Objectives

The activity profile of the posterior insula in neuropathic pain (NeP) remains largely unexplored. To address this and examine its modulation by somatosensory stimulation, we recorded local field potentials (LFP) in awake patients with NeP undergoing deep brain stimulation (DBS) electrode implantation to the posterior-superior insula (PSI) for analgesic purposes.

Materials and Methods

Six patients (one woman; 32–45 years), experiencing refractory peripheral NeP and having previously responded to non-invasive stimulation of the PSI underwent stereotactic implantation of DBS electrodes to the PSI as part of a phase II clinical trial. The averaged power of frequencies of LFP and their peaks were calculated during rest and under thermal painful and mechanical non-painful stimulation.

Results

At rest, amplitude peaks within the delta (average min-max.: 2.2 Hz; 1.3–3.7) and theta (6.1 Hz, varying between 5.7 and 6.8 Hz) bands were identified. Compared to rest, both tonic thermal painful, and mechanical non-painful stimulation led to similar mean decreases in gamma power (-24.46 ± 70.56, and -19.56 ± 3.08; respectively). Painful stimuli caused an increase in all the other frequency bands, mainly in alpha and beta ranges, while non-painful stimulation led to decreases in power in all frequencies above 4Hz. Painful tonic stimulation was associated with a significantly greater power variability, both in amplitude and frequency, compared to nonpainful mechanical stimulation.

Conclusion

The posterior insula resting state activity in awake patients with chronic NeP was characterized by predominant theta oscillations. Painful and innocuous stimulation led to opposite spectral changes, with a much larger variability across the whole frequency spectrum for painful stimuli, relative to both resting state and non-painful stimulation.

背景和目的：在神经性疼痛（NeP）中，脑岛后叶的活动特征在很大程度上仍未被探索。为了解决这一问题，并检查其通过体感觉刺激的调节，我们记录了清醒的NeP患者在脑深部刺激（DBS）电极植入后上岛（PSI）镇痛时的局部场电位（LFP）。材料与方法：6例患者(女性1例；32-45岁)，经历难治性外周NeP并且之前对PSI的非侵入性刺激有反应，作为II期临床试验的一部分，将DBS电极立体定向植入PSI。计算静息、热痛和机械非痛刺激下LFP频率的平均功率及其峰值。结果：静息时，振幅峰值在δ（平均min-max）范围内。： 2.2 Hz；确定了1.3-3.7)和theta （6.1 Hz，在5.7和6.8 Hz之间变化）波段。与休息相比，强直性热痛和机械性无痛刺激导致的伽马功率平均下降相似（-24.46±70.56,-19.56±3.08）；分别)。疼痛刺激导致所有其他频段的功率增加，主要是在α和β范围内，而非疼痛刺激导致4Hz以上所有频率的功率下降。与非疼痛性机械刺激相比，疼痛性强直性刺激在振幅和频率上都与更大的功率变异性相关。结论：清醒状态下慢性NeP患者脑岛后部静息状态活动以θ波振荡为主。疼痛刺激和无害刺激导致相反的频谱变化，相对于静息状态和非疼痛刺激，疼痛刺激在整个频谱上的可变性要大得多。

{"title":"Intraoperative recordings from the posterior superior insula in awake humans with peripheral neuropathic pain","authors":"Raíssa Benocci Thibes , Pedro Henrique Martins da Cunha , Jorge Dornellys da Silva Lapa , Liu Dongyang , Denise Spinola Pinheiro , Ricardo Ferrareto Iglesio , Kleber Paiva Duarte , Valquiria Aparecida Silva , Gabriel Taricani Kubota , Manoel Jacobsen Teixeira , Luis Garcia-Larrea , Hélène Bastiji , João Ricardo Sato , Daniel Ciampi de Andrade","doi":"10.1016/j.neucli.2025.103056","DOIUrl":"10.1016/j.neucli.2025.103056","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>The activity profile of the posterior insula in neuropathic pain (NeP) remains largely unexplored. To address this and examine its modulation by somatosensory stimulation, we recorded local field potentials (LFP) in awake patients with NeP undergoing deep brain stimulation (DBS) electrode implantation to the posterior-superior insula (PSI) for analgesic purposes.</div></div><div><h3>Materials and Methods</h3><div>Six patients (one woman; 32–45 years), experiencing refractory peripheral NeP and having previously responded to non-invasive stimulation of the PSI underwent stereotactic implantation of DBS electrodes to the PSI as part of a phase II clinical trial. The averaged power of frequencies of LFP and their peaks were calculated during rest and under thermal painful and mechanical non-painful stimulation.</div></div><div><h3>Results</h3><div>At rest, amplitude peaks within the delta (average min-max.: 2.2 Hz; 1.3–3.7) and theta (6.1 Hz, varying between 5.7 and 6.8 Hz) bands were identified. Compared to rest, both tonic thermal painful, and mechanical non-painful stimulation led to similar mean decreases in gamma power (-24.46 ± 70.56, and -19.56 ± 3.08; respectively). Painful stimuli caused an increase in all the other frequency bands, mainly in alpha and beta ranges, while non-painful stimulation led to decreases in power in all frequencies above 4Hz. Painful tonic stimulation was associated with a significantly greater power variability, both in amplitude and frequency, compared to nonpainful mechanical stimulation.</div></div><div><h3>Conclusion</h3><div>The posterior insula resting state activity in awake patients with chronic NeP was characterized by predominant theta oscillations. Painful and innocuous stimulation led to opposite spectral changes, with a much larger variability across the whole frequency spectrum for painful stimuli, relative to both resting state and non-painful stimulation.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 3","pages":"Article 103056"},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075145","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}

引用次数: 0

Evaluating the efficacy of transcranial direct current stimulation (tDCS) in managing neuropathic pain-induced emotional consequences: Insights from animal models 评估经颅直流电刺激（tDCS）治疗神经性疼痛引起的情绪后果的疗效：来自动物模型的见解。

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-01-29 DOI: 10.1016/j.neucli.2025.103055

Bahrie Ramadan, Vincent Van Waes

Neuropathic pain is a global health concern due to its severity and its detrimental impact on patients’ quality of life. It is primarily characterized by sensory alterations, most commonly hyperalgesia and allodynia. As the disease progresses, patients with neuropathic pain develop co-occurring emotional disorders, such as anxiety and depression, which further complicate therapeutic management. While pharmacotherapy remains the first-line treatment, limitations in its efficacy and the prevalence of side effects often leave patients with insufficient pain relief. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, has recently emerged as a promising alternative for chronic pain management. This review provides an overview of preclinical studies examining the effects of tDCS in rodent models of neuropathic pain. It specifically highlights the potential of tDCS to modulate the emotional-affective component of pain, with a focus on identifying optimal cortical targets for stimulation to enhance the translational application of tDCS in managing pain-related emotional disorders.

神经性疼痛因其严重程度及其对患者生活质量的不利影响而成为全球健康关注的问题。它的主要特征是感觉改变，最常见的是痛觉过敏和异常性疼痛。随着疾病的发展，神经性疼痛患者会并发情绪障碍，如焦虑和抑郁，这进一步使治疗管理复杂化。虽然药物治疗仍然是一线治疗，但其疗效的局限性和副作用的普遍存在往往使患者疼痛缓解不足。经颅直流电刺激（tDCS）是一种非侵入性脑刺激技术，最近成为治疗慢性疼痛的一种很有前途的替代方法。本文综述了tDCS在啮齿动物神经性疼痛模型中的临床前研究。它特别强调了tDCS调节疼痛的情绪-情感成分的潜力，重点是确定最佳的皮层刺激靶点，以增强tDCS在治疗疼痛相关情绪障碍中的转化应用。

{"title":"Evaluating the efficacy of transcranial direct current stimulation (tDCS) in managing neuropathic pain-induced emotional consequences: Insights from animal models","authors":"Bahrie Ramadan, Vincent Van Waes","doi":"10.1016/j.neucli.2025.103055","DOIUrl":"10.1016/j.neucli.2025.103055","url":null,"abstract":"<div><div>Neuropathic pain is a global health concern due to its severity and its detrimental impact on patients’ quality of life. It is primarily characterized by sensory alterations, most commonly hyperalgesia and allodynia. As the disease progresses, patients with neuropathic pain develop co-occurring emotional disorders, such as anxiety and depression, which further complicate therapeutic management. While pharmacotherapy remains the first-line treatment, limitations in its efficacy and the prevalence of side effects often leave patients with insufficient pain relief. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, has recently emerged as a promising alternative for chronic pain management. This review provides an overview of preclinical studies examining the effects of tDCS in rodent models of neuropathic pain. It specifically highlights the potential of tDCS to modulate the emotional-affective component of pain, with a focus on identifying optimal cortical targets for stimulation to enhance the translational application of tDCS in managing pain-related emotional disorders.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 2","pages":"Article 103055"},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066995","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}

引用次数: 0

Enhancing epilepsy care in Argentina: Use of SEEG in a developing setting 加强阿根廷的癫痫护理：在发展中环境中使用SEEG。

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurophysiologie Clinique/Clinical Neurophysiology

Pub Date : 2025-01-23 DOI: 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.

目的：本研究的目的是描述在阿根廷一家高度复杂的公立医院接受立体脑电图（SEEG）进行癫痫术前评估的耐药癫痫患者群体。方法：纳入2014 - 2023年的患者。我们对视频脑电图单元收治的耐药癫痫患者进行了回顾性研究。我们选择了接受SEEG的患者，并分析了那些接受手术的患者。研究的变量包括MRI表现、癫痫区（EZ）位置、手术类型、神经心理评估、术后发展和组织病理学。结果：在研究期间，49例患者接受了SEEG。磁共振成像（MRI）正常者21/49（43%）。双侧种植18例（37.5%），单侧右半球种植16例（32.7%），单侧左侧种植15例（31.3%）。手术治疗30例（61.2%）。根据国际抗癫痫联盟（ILAE）的分类，术后结果为ILAE I 26.6%, ILAE II 30%。结论：我们的经验突出表明，通过适当的培训和资源分配，高质量的癫痫护理，包括SEEG等先进诊断程序，在阿根廷是可以实现的，在其他发展中地区也可能实现。

{"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}

引用次数: 0