Pub Date : 2025-04-01Epub Date: 2024-12-13DOI: 10.1016/j.neucli.2024.103036
Marion Trousselard
Objectives
The stress reaction is an integrated response to a change in the environment that enables each individual to adapt to demand. While this response is physiologically coordinated by the brain, its phenomenology is expressed in the field of psychology and psychopathology. This interrelation between neurophysiological mechanisms and psychological processes is complex as dynamic interpersonal, biological, and psychocognitive systems interact with contextual and environmental factors to shape adaptation over the life constraints.
Method
This article aims to present the actors of the adjusted stress response, such as coping and coping flexibility, mindfulness and resilience, and their respective neurophysiology.
Results
A model of the relationship between resilience, mindfulness and coping was proposed for optimizing adaptation to stress response.
Discussion
These focuses are prerequisites for understanding and supporting human adaptation in the everyday environment and promoting efficient management of stress for mental and physical health.
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Pub Date : 2025-04-01Epub Date: 2025-01-29DOI: 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.
{"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":"2025-04-01","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}
Pub Date : 2025-04-01Epub Date: 2025-02-07DOI: 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.
{"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":"2025-04-01","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}
Pub Date : 2025-04-01Epub 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":"2025-04-01","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 : 2025-04-01Epub 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.
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":"2025-04-01","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 : 2025-01-01Epub Date: 2025-01-03DOI: 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 : 2025-01-01Epub Date: 2024-12-06DOI: 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}
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 : 2025-01-01Epub Date: 2025-01-13DOI: 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}
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