{"title":"A movie in the operating theater: Guided story narration as a pragmatic language screening tool during awake craniotomy","authors":"Nishanth Sampath , Sunil Kapilavayi Raghavendra , Vishwaraj Ratha , Gomathi Sivakumar , Vijay Sankaran , Suresh Bapu K.R.","doi":"10.1016/j.cnp.2026.01.002","DOIUrl":"10.1016/j.cnp.2026.01.002","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 36-37"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cnp.2025.12.001
Abduladhim Ashtaiwi , Mohamed Eltwayeb
Objective:
This study aims to develop and evaluate ACF-SAP, a machine learning (ML) framework for predicting obstructive sleep apnea (OSA) severity using non-invasive, routinely collected clinical features.
Methods:
The proposed approach leverages common anthropometric and clinical variables, including sex, body mass index (BMI), height, weight, neck circumference, and nocturia. The methodology integrates machine-learning–based feature selection to identify the most informative predictors, followed by unsupervised clustering to generate data-driven sleep severity labels. These labeled data are then used to train and evaluate the ACF-SAP framework.
Results:
ACF-SAP, implemented with ensemble classifiers, achieved a classification accuracy of 0.84, with strong F1-scores and balanced sensitivity across OSA severity levels.
Conclusions:
The ACF-SAP model supports early identification of patients at high risk for OSA and may serve as a first-line screening tool to prioritize referrals for polysomnography (PSG).
Significance:
This work presents a scalable, low-cost screening framework that can improve triage efficiency and facilitate timely diagnosis, particularly in resource-constrained healthcare environments.
{"title":"ACF-SAP: A machine learning framework for predicting obstructive sleep apnea severity using anthropometric and clinical features","authors":"Abduladhim Ashtaiwi , Mohamed Eltwayeb","doi":"10.1016/j.cnp.2025.12.001","DOIUrl":"10.1016/j.cnp.2025.12.001","url":null,"abstract":"<div><h3>Objective:</h3><div>This study aims to develop and evaluate ACF-SAP, a machine learning (ML) framework for predicting obstructive sleep apnea (OSA) severity using non-invasive, routinely collected clinical features.</div></div><div><h3>Methods:</h3><div>The proposed approach leverages common anthropometric and clinical variables, including sex, body mass index (BMI), height, weight, neck circumference, and nocturia. The methodology integrates machine-learning–based feature selection to identify the most informative predictors, followed by unsupervised clustering to generate data-driven sleep severity labels. These labeled data are then used to train and evaluate the ACF-SAP framework.</div></div><div><h3>Results:</h3><div>ACF-SAP, implemented with ensemble classifiers, achieved a classification accuracy of 0.84, with strong F1-scores and balanced sensitivity across OSA severity levels.</div></div><div><h3>Conclusions:</h3><div>The ACF-SAP model supports early identification of patients at high risk for OSA and may serve as a first-line screening tool to prioritize referrals for polysomnography (PSG).</div></div><div><h3>Significance:</h3><div>This work presents a scalable, low-cost screening framework that can improve triage efficiency and facilitate timely diagnosis, particularly in resource-constrained healthcare environments.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 45-53"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cnp.2025.12.008
Yuichiro Shirota , Juuri Otsuka , Masashi Hamada
Objective
To investigate precision, accuracy, and reliability of a threshold hunting method to estimate resting motor threshold (RMT) using parameter estimation by sequential testing and maximum likelihood estimation (PEST-MLE).
Methods
In 53 healthy participants, single pulse transcranial magnetic stimulation was delivered to estimate RMT with cutoff values of 0.05 mV and 0.2 mV. RMT was inferred from 30-trial PEST-MLE algorithm for at maximum two days with two estimation sessions per day, comprising Sessions 1 to 4. Precision and accuracy were assessed within each session. Repeatability was assessed using intraclass correlation coefficient (ICC), reproducibility coefficient (RC), and standard error of measurement (SEM).
Results
For both 0.05 mV and 0.2 mV, 18 trials were needed to have good accuracy. ICC greater than 0.8 was achieved for within-day comparison but the ICC of between-day comparison was lower. RC and SEM were around 10 % and 5 %, respectively.
Conclusions
At 18th trial the estimations were converged in terms of precision and accuracy, and good reliability was achieved at that stage.
Significance
RMT estimation with the PEST-MLE is a rapid and reliable approach that can be implemented for future clinical and scientific studies.
{"title":"Precision, accuracy, and reliability of a threshold hunting method for transcranial magnetic stimulation","authors":"Yuichiro Shirota , Juuri Otsuka , Masashi Hamada","doi":"10.1016/j.cnp.2025.12.008","DOIUrl":"10.1016/j.cnp.2025.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate precision, accuracy, and reliability of a threshold hunting method to estimate resting motor threshold (RMT) using parameter estimation by sequential testing and maximum likelihood estimation (PEST-MLE).</div></div><div><h3>Methods</h3><div>In 53 healthy participants, single pulse transcranial magnetic stimulation was delivered to estimate RMT with cutoff values of 0.05 mV and 0.2 mV. RMT was inferred from 30-trial PEST-MLE algorithm for at maximum two days with two estimation sessions per day, comprising Sessions 1 to 4. Precision and accuracy were assessed within each session. Repeatability was assessed using intraclass correlation coefficient (ICC), reproducibility coefficient (RC), and standard error of measurement (SEM).</div></div><div><h3>Results</h3><div>For both 0.05 mV and 0.2 mV, 18 trials were needed to have good accuracy. ICC greater than 0.8 was achieved for within-day comparison but the ICC of between-day comparison was lower. RC and SEM were around 10 % and 5 %, respectively.</div></div><div><h3>Conclusions</h3><div>At 18th trial the estimations were converged in terms of precision and accuracy, and good reliability was achieved at that stage.</div></div><div><h3>Significance</h3><div>RMT estimation with the PEST-MLE is a rapid and reliable approach that can be implemented for future clinical and scientific studies.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 24-31"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Discrimination between EMG activity such as fibrillation potentials/positive sharp waves (Fib/PSW), end plate spikes (EPS), fasciculation potentials (FP), and contaminating voluntary motor unit potentials (MUP) is mandatory for EMG diagnosis. Discharge rhythm is the key for discrimination. We devised a new parameter, Random Index (RI), which quantifies the rhythm and takes a value from 0 to 1, smaller for regular trains of discharges. This study evaluated the utility of RI as well as modified versions of the regularity indices proposed in past reports.
Methods
EMG records of patients with amyotrophic lateral sclerosis were retrospectively reviewed. EPS were collected also from a healthy volunteer. The EMG activity was classified by an expert. RI and other regularity indices as well as the median instantaneous firing rate (IFRm) were calculated.
Results
Analyzed sequences were 73 Fib/PSW, 27 EPS, 24 FP, and 36 MUP. The four types were clearly separated over the 2-dimensional plots of regularity indices vs. IFRm. Especially, Fib/PSW and EPS were far separated in these plots. RI achieved significantly better discrimination between Fib/PSW and MUP than other indices.
Conclusion
RI is a robust tool for discriminating EMG activity.
Significance
RI and other regularity indices would be useful for educational purpose.
{"title":"Discrimination of spontaneous activity in needle EMG based on the quantitative assessment of the discharge rhythm using “Random Index”","authors":"Taiji Mukai , Takamichi Kanbayashi , Masahito Kobayashi , Masamichi Peter Okano , Keisuke Tachiyama , Yosuke Miyaji , Yuki Hatanaka , Shunsuke Kobayashi , Masahiro Sonoo","doi":"10.1016/j.cnp.2026.01.003","DOIUrl":"10.1016/j.cnp.2026.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>Discrimination between EMG activity such as fibrillation potentials/positive sharp waves (Fib/PSW), end plate spikes (EPS), fasciculation potentials (FP), and contaminating voluntary motor unit potentials (MUP) is mandatory for EMG diagnosis. Discharge rhythm is the key for discrimination. We devised a new parameter, Random Index (RI), which quantifies the rhythm and takes a value from 0 to 1, smaller for regular trains of discharges. This study evaluated the utility of RI as well as modified versions of the regularity indices proposed in past reports.</div></div><div><h3>Methods</h3><div>EMG records of patients with amyotrophic lateral sclerosis were retrospectively reviewed. EPS were collected also from a healthy volunteer. The EMG activity was classified by an expert. RI and other regularity indices as well as the median instantaneous firing rate (IFRm) were calculated.</div></div><div><h3>Results</h3><div>Analyzed sequences were 73 Fib/PSW, 27 EPS, 24 FP, and 36 MUP. The four types were clearly separated over the 2-dimensional plots of regularity indices vs. IFRm. Especially, Fib/PSW and EPS were far separated in these plots. RI achieved significantly better discrimination between Fib/PSW and MUP than other indices.</div></div><div><h3>Conclusion</h3><div>RI is a robust tool for discriminating EMG activity.</div></div><div><h3>Significance</h3><div>RI and other regularity indices would be useful for educational purpose.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 65-71"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cnp.2025.12.007
Brin E. Freund , Khalil S. Husari , José L. Fernández-Torre , Philippe Gélisse , Peter W. Kaplan
{"title":"Response to CNP-D-25–204 “Triphasic waves: To treat or not to treat?”: Do not overlook COVID-19 and Creutzfeldt-Jakob disease","authors":"Brin E. Freund , Khalil S. Husari , José L. Fernández-Torre , Philippe Gélisse , Peter W. Kaplan","doi":"10.1016/j.cnp.2025.12.007","DOIUrl":"10.1016/j.cnp.2025.12.007","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 34-35"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cnp.2025.12.009
Leyla Das Pektezel , Mehmet Yasir Pektezel
{"title":"A comment on “Electrodiagnostic criteria for neuromuscular transmission disorders suggested by a European consensus group”","authors":"Leyla Das Pektezel , Mehmet Yasir Pektezel","doi":"10.1016/j.cnp.2025.12.009","DOIUrl":"10.1016/j.cnp.2025.12.009","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 32-33"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cnp.2026.01.004
Hiroki Ito , Hideaki Yamaguchi , Kazumasa Ukai , Ryosuke Yamauchi , Ken Kitai , Takayuki Kodama
Objective
Active ankle dorsiflexion (AAD) has been proposed as a surrogate measure for gait-related motor control. However, whether the neural coupling between motor preparation and execution during AAD predicts gait ability remains unclear. This study examined whether μ–γ coupling was evaluated as a practical neurophysiological marker of gait performance.
Methods
In this study, 12 healthy adults and 4 patients with chronic stroke performed an AAD task and an overground walking task. Ankle kinematics, surface electromyography, and electroencephalography were simultaneously recorded. Corticomuscular coherence (CMC) and phase–amplitude coupling (PAC) were analyzed as indices of motor preparation–execution coupling. Gait performance was assessed based on gait speed and a Gait Assessment and Intervention Tool (G.A.I.T.).
Results
Patients with stroke showed significantly lower gait speed (0.60 vs. 1.24 m/s, p < 0.001) and G.A.I.T. scores compared to controls. In the AAD task, patients with stroke exhibited significantly reduced ankle angular velocity and lower CMC between Cz and the tibialis anterior compared to controls (p < 0.05). Source localization revealed diminished activity in the middle temporal gyrus, inferior parietal lobule, and insula in patients with stroke. Notably, the PAC-derived modulation index (MI) at Cz was markedly reduced in patients with stroke (0.03) compared to controls (1.50, p < 0.001), clearly discriminating between the groups.
Conclusions & significance
Motor preparation–execution coupling during AAD strongly reflects gait capacity after stroke. PAC-MI is a novel neurophysiological marker; requires validation biomarker for the early and objective evaluation of gait-related motor control with potential utility in stroke rehabilitation.
目的主动踝关节背屈（AAD）已被提出作为步态相关运动控制的替代措施。然而，AAD期间运动准备和执行之间的神经耦合是否能预测步态能力仍不清楚。本研究考察了μ -γ偶联是否被评估为步态表现的实用神经生理标志物。方法在本研究中，12名健康成人和4名慢性脑卒中患者进行了AAD任务和地上行走任务。同时记录踝关节运动学、表面肌电图和脑电图。将皮质肌相干性（CMC）和相幅耦合性（PAC）作为运动准备-执行耦合的指标进行分析。步态性能评估基于步态速度和步态评估和干预工具（G.A.I.T.）。结果与对照组相比，卒中患者的步速（0.60 vs. 1.24 m/s, p < 0.001）和g.a.i.t评分显著降低。在AAD任务中，与对照组相比，卒中患者的踝关节角速度显著降低，Cz和胫骨前肌之间的CMC较低（p < 0.05）。脑卒中患者中颞回、下顶叶和脑岛的活动减弱。值得注意的是，与对照组（1.50,p < 0.001）相比，中风患者在Cz时pac衍生的调节指数（MI）显著降低（0.03），这在两组之间具有明显的区别。AAD期间运动准备-执行耦合强烈反映脑卒中后的步态能力。PAC-MI是一种新型的神经生理标志物；需要验证的生物标志物，以早期和客观评估步态相关的运动控制与中风康复的潜在效用。
{"title":"Practical assessment of motor preparation–execution coupling during active ankle dorsiflexion in post-stroke gait: A pilot study","authors":"Hiroki Ito , Hideaki Yamaguchi , Kazumasa Ukai , Ryosuke Yamauchi , Ken Kitai , Takayuki Kodama","doi":"10.1016/j.cnp.2026.01.004","DOIUrl":"10.1016/j.cnp.2026.01.004","url":null,"abstract":"<div><h3>Objective</h3><div>Active ankle dorsiflexion (AAD) has been proposed as a surrogate measure for gait-related motor control. However, whether the neural coupling between motor preparation and execution during AAD predicts gait ability remains unclear. This study examined whether μ–γ coupling was evaluated as a practical neurophysiological marker of gait performance.</div></div><div><h3>Methods</h3><div>In this study, 12 healthy adults and 4 patients with chronic stroke performed an AAD task and an overground walking task. Ankle kinematics, surface electromyography, and electroencephalography were simultaneously recorded. Corticomuscular coherence (CMC) and phase–amplitude coupling (PAC) were analyzed as indices of motor preparation–execution coupling. Gait performance was assessed based on gait speed and a Gait Assessment and Intervention Tool (G.A.I.T.).</div></div><div><h3>Results</h3><div>Patients with stroke showed significantly lower gait speed (0.60 vs. 1.24 m/s, p < 0.001) and G.A.I.T. scores compared to controls. In the AAD task, patients with stroke exhibited significantly reduced ankle angular velocity and lower CMC between Cz and the tibialis anterior compared to controls (p < 0.05). Source localization revealed diminished activity in the middle temporal gyrus, inferior parietal lobule, and insula in patients with stroke. Notably, the PAC-derived modulation index (MI) at Cz was markedly reduced in patients with stroke (0.03) compared to controls (1.50, p < 0.001), clearly discriminating between the groups.</div></div><div><h3>Conclusions & significance</h3><div>Motor preparation–execution coupling during AAD strongly reflects gait capacity after stroke. PAC-MI is a novel neurophysiological marker; requires validation biomarker for the early and objective evaluation of gait-related motor control with potential utility in stroke rehabilitation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 54-64"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cnp.2026.01.001
Dongsheng Xiao 肖东升 , Wei Tao 陶蔚 , Yongjie Li 李勇杰 , Matilde Balbi , Yuqing Zhang 张宇清
Objective
Evaluate safety and analgesic effect of neuronavigation-guided 10 Hz rTMS precisely targeting facial M1 in atypical facial pain (AFP).
Methods
Two adults with refractory AFP received 10 daily sessions (2,500 pulses/day) of 10 Hz rTMS at 110 % resting motor threshold. Targeting used MRI/CT-integrated neuronavigation to the facial M1. Pain severity (Barrow Neurological Institute [BNI] scale I–V) and adverse events were recorded through treatment and short follow-up.
Results
Both completed treatment without serious adverse events. Case 1 improved from BNI V at baseline to II at end of treatment, persisting BNI III for 15 days. Case 2 improved from BNI IV to I, with BNI III for 2 days after therapy; both reported better sleep and mood.
Conclusions
Neuronavigation-guided 10 Hz rTMS of facial M1 was well tolerated and associated with rapid, clinically meaningful analgesia in two AFP cases.
Significance
Pilot data support sham-controlled studies to define dose–response and durability, identify responders, and formalize navigated rTMS as a physiological screen to select candidates and targets for implanted brain stimulations.
目的评价神经导航引导下精确靶向面部M1的10hz rTMS治疗非典型面部疼痛（AFP）的安全性和镇痛效果。方法2例难治性AFP患者接受10次10 Hz rTMS治疗（2500次/天），静息运动阈值为110%。使用MRI/ ct集成神经导航定位面部M1。通过治疗和短期随访记录疼痛严重程度（Barrow Neurological Institute [BNI] I-V级）和不良事件。结果两组患者均完成治疗，无严重不良事件发生。病例1从基线时的BNI V改善到治疗结束时的II，持续BNI III 15天。病例2从BNI IV型改善到I型，治疗后2天出现BNI III型；他们都表示睡眠和情绪都有所改善。结论神经导航引导下面部M1 10hz rTMS治疗2例AFP患者耐受性良好，可快速、有临床意义的镇痛。epilot数据支持假对照研究，以确定剂量-反应和持久性，识别应答者，并将导航rTMS正规化为一种生理筛选，以选择植入式脑刺激的候选物和靶点。
{"title":"Neuronavigation‑guided rTMS of the facial motor cortex for atypical facial pain: Two case reports","authors":"Dongsheng Xiao 肖东升 , Wei Tao 陶蔚 , Yongjie Li 李勇杰 , Matilde Balbi , Yuqing Zhang 张宇清","doi":"10.1016/j.cnp.2026.01.001","DOIUrl":"10.1016/j.cnp.2026.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate safety and analgesic effect of neuronavigation-guided 10 Hz rTMS precisely targeting facial M1 in atypical facial pain (AFP).</div></div><div><h3>Methods</h3><div>Two adults with refractory AFP received 10 daily sessions (2,500 pulses/day) of 10 Hz rTMS at 110 % resting motor threshold. Targeting used MRI/CT-integrated neuronavigation to the facial M1. Pain severity (Barrow Neurological Institute [BNI] scale I–V) and adverse events were recorded through treatment and short follow-up.</div></div><div><h3>Results</h3><div>Both completed treatment without serious adverse events. Case 1 improved from BNI V at baseline to II at end of treatment, persisting BNI III for 15 days. Case 2 improved from BNI IV to I, with BNI III for 2 days after therapy; both reported better sleep and mood.</div></div><div><h3>Conclusions</h3><div>Neuronavigation-guided 10 Hz rTMS of facial M1 was well tolerated and associated with rapid, clinically meaningful analgesia in two AFP cases.</div></div><div><h3>Significance</h3><div>Pilot data support sham-controlled studies to define dose–response and durability, identify responders, and formalize navigated rTMS as a physiological screen to select candidates and targets for implanted brain stimulations.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 38-44"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.cnp.2025.12.005
Leonardo Affronte , Stefania Maffei , Mara Malerba , Giada Giovannini , Paolo Manganotti , Antonietta Coppola , Leonilda Bilo , Anna Elisabetta Vaudano , Marina Trivisano , Nicola Specchio , Stefano Meletti
Objective
Poor documentation of seizures can be a major challenge in epilepsy. Objective seizure counting with mobile devices might improve this challenge and the patient management. We investigate whether ultra long-term subcutaneous EEG improves seizure documentation and disease monitoring in adults and adolescents with developmental and epileptic encephalopathies (DEEs).
Methods
Ultra long-term subcutaneous EEG Monitoring In Rare Epilepsies and DEE (EMIRE) is a multi-centre prospective interventional study with an expected duration of 6 months. 33 Adolescents and adult participants will be implanted with 24/7 EEG SubQ and collect 2-channel EEG data up to 6 months. Data will be reviewed by experts on a weekly basis and a summary sent to the treating clinician.
Results
(1) safety and tolerability of subcutaneous EEG in this special patient population; (2) seizure detection sensitivity and specificity with respect to patients’ seizure-diaries and ‘ground truth’; (3) whether and how home monitoring can affect the clinical management of the patients.
Conclusions
This project will investigate home and remote patient monitoring systems, offering an accuracy that is unthinkable today.
Significance
This trial of home monitoring is intended to be of clinical utility to the patient by allowing objective assessment of therapeutic interventions and their effectiveness.
Plain language summary.
We present a clinical trial protocol for a prospective cohort study in people with severe epilepsies across Italy. The study aims to assess whether an EEG implant placed under the skin (1) is more accurate than patient-reported seizure diary, (2) is feasible and acceptable to patients and clinicians, (3) affect the clinical management of the patients, (4) reduces the impact of epilepsy.
{"title":"Ultra long-term EEG monitoring for developmental and epileptic encephalopathies: protocol for a prospective study using subscalp EEG","authors":"Leonardo Affronte , Stefania Maffei , Mara Malerba , Giada Giovannini , Paolo Manganotti , Antonietta Coppola , Leonilda Bilo , Anna Elisabetta Vaudano , Marina Trivisano , Nicola Specchio , Stefano Meletti","doi":"10.1016/j.cnp.2025.12.005","DOIUrl":"10.1016/j.cnp.2025.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>Poor documentation of seizures can be a major challenge in epilepsy. Objective seizure counting with mobile devices might improve this challenge and the patient management. We investigate whether ultra long-term subcutaneous EEG improves seizure documentation and disease monitoring in adults and adolescents with developmental and epileptic encephalopathies (DEEs).</div></div><div><h3>Methods</h3><div>Ultra long-term subcutaneous EEG Monitoring In Rare Epilepsies and DEE (EMIRE) is a multi-centre prospective interventional study with an expected duration of 6 months. 33 Adolescents and adult participants will be implanted with 24/7 EEG SubQ and collect 2-channel EEG data up to 6 months. Data will be reviewed by experts on a weekly basis and a summary sent to the treating clinician.</div></div><div><h3>Results</h3><div>(1) safety and tolerability of subcutaneous EEG in this special patient population; (2) seizure detection sensitivity and specificity with respect to patients’ seizure-diaries and ‘ground truth’; (3) whether and how home monitoring can affect the clinical management of the patients.</div></div><div><h3>Conclusions</h3><div>This project will investigate home and remote patient monitoring systems, offering an accuracy that is unthinkable today.</div></div><div><h3>Significance</h3><div>This trial of home monitoring is intended to be of clinical utility to the patient by allowing objective assessment of therapeutic interventions and their effectiveness.</div><div>Plain language summary.</div><div>We present a clinical trial protocol for a prospective cohort study in people with severe epilepsies across Italy. The study aims to assess whether an EEG implant placed under the skin (1) is more accurate than patient-reported seizure diary, (2) is feasible and acceptable to patients and clinicians, (3) affect the clinical management of the patients, (4) reduces the impact of epilepsy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 16-23"},"PeriodicalIF":2.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.cnp.2025.12.006
Jiaojiao Guo , Ziyi Wang , Nicole van Klink , Eline Schaft , Dongqing Sun , Sandra van der Salm , Maryse van ’t Klooster , Maeike Zijlmans
{"title":"Multi-montage visualization of interictal epileptic events in high-density intraoperative electrocorticography","authors":"Jiaojiao Guo , Ziyi Wang , Nicole van Klink , Eline Schaft , Dongqing Sun , Sandra van der Salm , Maryse van ’t Klooster , Maeike Zijlmans","doi":"10.1016/j.cnp.2025.12.006","DOIUrl":"10.1016/j.cnp.2025.12.006","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 13-15"},"PeriodicalIF":2.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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