Clinical Neurophysiology Practice最新文献

英文中文

Educational needs and training conditions of young clinical neurophysiologists: survey of IFCN-young neurophysiologists network 青年临床神经生理学家的教育需求和培训条件：ifcn -青年神经生理学家网络调查

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-02-01 DOI: 10.1016/j.cnp.2026.01.009

Orsolya Györfi , Thananan Thammongkolchai , Ricardo Kienitz , Nortina Shahrizaila , Hatice Tankisi , Anita Kamondi

Objectives

In 2022, the International Federation of Clinical Neurophysiology (IFCN) launched the Young Neurophysiologists Network to support the representation of its younger members. This survey assessed the training of early-career clinical neurophysiologists and identify unmet needs.

Methods

A 31-item online questionnaire was distributed to IFCN members under 40 years of age, evaluating educational goals, mentorship, expertise levels, and preferences for e-learning.

Results

From 57 countries 331 participants responded. Marked regional differences emerged in training quality, confidence, and needs. In high-income countries, satisfaction with core modules—EEG, ENG–EMG, and video-EEG—was highest, while lower ratings were reported in low-income countries, especially for EEG. Training priorities also varied: neuromuscular ultrasound was the most requested topic in both high- and middle-income countries, while low-income countries prioritized video-EEG and evoked potentials. Mentorship significantly improved continued training. Online education was used by 58%, with 64% preferring IFCN Masterclasses.

Conclusion

Young neurophysiologists show strong interest in advanced training, particularly in neuromuscular ultrasound. Expanding mentorship and access to IFCN resources could help address global disparities.

Significance

This survey highlights significant regional differences in young neurophysiologists’ training and underscores the need to expand mentorship and equitable access to advanced educational resources.

2022年，国际临床神经生理学联合会（IFCN）启动了青年神经生理学家网络，以支持其年轻成员的代表。这项调查评估了早期职业临床神经生理学家的培训，并确定了未满足的需求。方法向40岁以下的IFCN会员发放31项在线问卷，评估其教育目标、指导、专业水平和对电子学习的偏好。结果来自57个国家的331名参与者做出了回应。在培训质量、信心和需求方面出现了明显的地区差异。在高收入国家，对核心模块（脑电图、ENG-EMG和视频脑电图）的满意度最高，而在低收入国家，尤其是脑电图的满意度较低。培训的重点也各不相同：在高收入和中等收入国家，神经肌肉超声是最需要的主题，而低收入国家则优先考虑视频脑电图和诱发电位。师徒关系显著改善了持续培训。58%的人使用在线教育，64%的人更喜欢IFCN大师班。结论年轻的神经生理学家对高级训练表现出强烈的兴趣，特别是在神经肌肉超声方面。扩大对IFCN资源的指导和获取可以帮助解决全球差距问题。这项调查突出了青年神经生理学家培训的显著地区差异，强调了扩大指导和公平获得先进教育资源的必要性。

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引用次数: 0

Selective loss of ulnar somatosensory evoked potentials revealing a focal cervical cord plaque in multiple sclerosis 多发性硬化症患者尺侧体感诱发电位选择性丧失显示局灶性颈髓斑块

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2025-12-08 DOI: 10.1016/j.cnp.2025.12.002

Julian Cheron , Bernard Dachy

引用次数: 0

A comment on “Electrodiagnostic criteria for neuromuscular transmission disorders suggested by a European consensus group” 对“欧洲共识小组提出的神经肌肉传导障碍电诊断标准”的评论

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 DOI: 10.1016/j.cnp.2025.12.009

Leyla Das Pektezel , Mehmet Yasir Pektezel

引用次数: 0

Symptomatic palatal myoclonus as a rare manifestation of neuro-behcet́s disease: A case report 症状性腭肌阵挛是神经白塞病的一种罕见表现：1例报告。

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-02-11 DOI: 10.1016/j.cnp.2026.02.004

Andrés Hormaza-Jaramillo , Valentina Quintana-Peña , Harry Pachajoa , Estephania Candelo , Sara Alejandra Benavides-Ibarra , Jorge Luis Orozco

引用次数: 0

Practical assessment of motor preparation–execution coupling during active ankle dorsiflexion in post-stroke gait: A pilot study 卒中后步态中主动踝关节背屈运动准备-执行耦合的实际评估：一项试点研究

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-01-19 DOI: 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。

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引用次数: 0

Neuronavigation‑guided rTMS of the facial motor cortex for atypical facial pain: Two case reports 神经导航引导的面部运动皮质rTMS治疗非典型面部疼痛：2例报告

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-01-10 DOI: 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。

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引用次数: 0

Electrodiagnostic criteria for neuromuscular transmission disorders suggested by a European consensus group 欧洲共识小组提出的神经肌肉传递障碍的电诊断标准

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-03-07 DOI: 10.1016/j.cnp.2025.02.011

H. Tankisi , K. Pugdahl , B. Johnsen , J.P. Camdessanché , M. de Carvalho , P. Fawcett , A. Labarre-Vila , R. Liguori , W. Nix , I. Schofield , A. Fuglsang-Frederiksen

Objective

Electrodiagnostic testing plays an important role in diagnosing disorders of neuromuscular transmission (NMT), especially in seronegative myasthenia gravis. However, electrodiagnostic criteria for the diagnosis are sparse. This study aimed at inferring evidence-based recommendations for the electrodiagnostic examination of NMT disorders.

Methods

A total of 164 cases with a consensus diagnosis of NMT disorder obtained by peer review by eight experienced neurophysiologists were analysed for differences in examination strategy, the sensitivity of different tests, and inferring minimal criteria. The diagnostic performance of the suggested criteria was validated on 24 MG patients and 50 patients with neuropathy (17), myopathy (15), or fatigue (18).

Results

We recommend as minimal electrodiagnostic criteria for NMT disorders, either (a) 2 abnormal repetitive nerve stimulation (RNS), (b) 1 abnormal RNS and 1 abnormal single fiber electromyography (SFEMG) or (c) 2 abnormal SFEMG. These showed a good diagnostic performance with a sensitivity of 87.5 % and a specificity of 100 %.

Conclusion

Recommendations with high diagnostic sensitivity and specificity for the minimum number of RNS and SFEMG studies to diagnose NMT disorders developed by an international consensus group are suggested.

Significance

The suggested electrodiagnostic recommendations for diagnosing NMT disorders are reliable and suitable for use at different centres.

目的电诊断在诊断神经肌肉传递障碍（NMT），特别是血清阴性重症肌无力中具有重要意义。然而，诊断的电诊断标准是稀疏的。本研究旨在推断NMT疾病电诊断检查的循证建议。方法对经8位经验丰富的神经生理学家同行评议的164例一致诊断为NMT障碍的病例进行分析，分析其检查策略、不同检查方法的敏感性以及推断最小标准的差异。建议的诊断标准在24名MG患者和50名神经病变（17名）、肌病（15名）或疲劳（18名）患者中得到了验证。结果我们推荐NMT障碍的最低电诊断标准为：(a) 2个异常的重复神经刺激（RNS）， (b) 1个异常的重复神经刺激（RNS）和1个异常的单纤维肌电图（SFEMG）或(c) 2个异常的SFEMG。结果表明，该方法具有良好的诊断性能，敏感性为87.5%，特异性为100%。结论国际共识小组提出了诊断NMT疾病的高诊断敏感性和特异性的RNS和SFEMG研究的最少数量的建议。建议的诊断NMT疾病的电诊断建议是可靠的，适合在不同的中心使用。

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引用次数: 0

Favorable outcomes of epilepsy with gait-induced seizures after resection of the unilateral supplementary motor area 切除单侧辅助运动区后伴有步态性癫痫发作的良好结果

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-10-17 DOI: 10.1016/j.cnp.2025.10.004

Satoshi Kodama , Naoto Kunii , Yuichiro Shirota , Takusei Chou , Mizuho Kawai , Seijiro Shimada , Meiko Maeda , Hiroyuki Ishiura , Masashi Hamada , Masako Ikemura , Yuko Saito , Naoki Akamatsu , Taira Uehara , Nobuhito Saito , Tatsushi Toda

Background

Gait-induced seizures are a rare manifestation of reflex epilepsy. Pathophysiology of this phenomenon has not been fully understood.

Case presentation

A 28-year-old woman presented with a long history of “falls” following paroxysmal bilateral leg stiffness triggered by walking. Scalp electroencephalogram (EEG) revealed low-amplitude rhythmic beta activity, maximal at the Cz electrode, during these events. Magnetoencephalography demonstrated repetitive sharp waves source-localized to the right primary motor cortex. Multiple anti-seizure medications failed to improve her symptoms; however, the clinical manifestation was consistent with epilepsy with gait-induced seizures. Intracranial subdural EEG recording was performed and confirmed ictal activity originating from the right supplementary motor area. Resection of this area resulted in complete resolution of her symptoms.

Discussion

This is the first reported case of successful resective surgery for epilepsy with gait-induced seizure. Brain networks involving cortical regions responsible for the initiation or execution of walking presumably played a key role in the generation of gait-induced seizures. Careful assessment using non-invasive neurophysiological studies facilitated accurate diagnosis, successful intracranial recordings, and effective resective surgery.

背景：步态诱发癫痫是反射性癫痫的一种罕见表现。这一现象的病理生理学尚未完全了解。病例介绍：一名28岁女性，因行走引起阵发性双侧腿僵硬，长期出现“跌倒”病史。在这些事件中，头皮脑电图（EEG）显示低振幅节律性β活动，在Cz电极处最大。脑磁图显示重复的尖波源定位于右侧初级运动皮层。多种抗癫痫药物未能改善她的症状；但临床表现符合癫痫伴步态性发作。进行颅内硬脑膜下脑电图记录，证实脑电图活动起源于右侧辅助运动区。切除该区域使她的症状完全消失。讨论：这是首例成功切除癫痫伴步态性癫痫发作的病例。涉及皮层区域的大脑网络负责开始或执行行走，可能在步态诱发癫痫发作的产生中发挥了关键作用。使用非侵入性神经生理学研究的仔细评估有助于准确诊断，成功的颅内记录和有效的切除手术。

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引用次数: 0

Novel approaches to EEG and MEG in motor neurone disease: IFCN Handbook Chapter 运动神经元疾病EEG和MEG的新方法：IFCN手册章节

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-07-11 DOI: 10.1016/j.cnp.2025.07.001

Stefan Dukic , Rosanne Govaarts , Arjan Hillebrand , Marianne de Visser , Margitta Seeck , Roisin McMackin

Motor neurone diseases (MNDs) are increasingly being acknowledged as network disorders, with cortical dysfunction and degeneration extending beyond the motor cortex. Measures of this broader cortical pathophysiology are providing promising candidates in the search for diagnostic and prognostic biomarkers of the MNDs. Electroencephalography (EEG) and magnetoencephalography (MEG) offer a direct view of neural network activity by detecting changes in electromagnetic fields of the brain. Measurements based on EEG/MEG have often been overlooked in the search for MND biomarkers, largely due to their limited spatial resolution and the perceived challenges associated with noise in these signals. However, with recent developments in sensor technology and source reconstruction algorithms, alongside substantial improvement in pipelines that address noise, EEG/MEG-based measures can now be readily employed for spatiotemporally-precise, economical and non-invasive characterisation of cortical network pathophysiology in MNDs. Here, we provide an overview of how EEG/MEG signals have been employed to quantify neural network function in MND. We outline the advantages and limitations of these measurements, discuss the most clinically promising EEG/MEG studies of MNDs to date, and highlight future directions warranted to harness the full potential of these technologies for understanding and assessing MNDs.

运动神经元疾病（mnd）越来越多地被认为是一种网络疾病，其皮层功能障碍和退化延伸到运动皮层以外。这种更广泛的皮层病理生理学的测量为寻找mnd的诊断和预后生物标志物提供了有希望的候选物。脑电图（EEG）和脑磁图（MEG）通过检测大脑电磁场的变化提供了对神经网络活动的直接观察。在寻找MND生物标志物的过程中，基于EEG/MEG的测量常常被忽视，这主要是由于它们有限的空间分辨率和与这些信号中的噪声相关的感知挑战。然而，随着传感器技术和声源重建算法的最新发展，以及解决噪声的管道的实质性改进，基于EEG/ meg的测量现在可以很容易地用于大脑皮层网络病理生理的时空精确、经济和非侵入性表征。在这里，我们概述了如何使用EEG/MEG信号来量化MND中的神经网络功能。我们概述了这些测量的优点和局限性，讨论了迄今为止最有临床前景的脑电/脑磁图研究，并强调了未来的方向，保证利用这些技术的全部潜力来理解和评估脑磁图。

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引用次数: 0

Evaluating diaphragm motor response variability in electric and magnetic phrenic nerve stimulations during passive expiration 评估被动呼气时膈神经电和磁刺激下膈肌运动的反应变异性

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-11-25 DOI: 10.1016/j.cnp.2025.11.003

Ivan Chakalov , Swen Hülsmann , Perianen Ramasawmy , Lukas Diedrich , Mathias Bähr , Leif Saager , Konrad Meissner , Onnen Moerer , Caspar Stephani , Andrea Antal

Objective

This study assessed variability in cervical electrical (CEPNS) and magnetic (CMPNS) phrenic nerve stimulation alongside transcranial magnetic stimulation (diTMS) of the diaphragm, focusing on motor response latency and amplitude at individually calculated suprathreshold intensities.

Methods

Diaphragm motor responses were elicited via CEPNS and CMPNS (measuring compound muscle action potentials, CMAPs) and diTMS (measuring diaphragm motor evoked potentials, diMEPs). Latency and amplitude were recorded. Statistical analyses compared methods, evaluated variability using coefficients of variation (CV), and explored associations with height and central motor conduction time.

Results

Among 25 participants (mean age 25 ± 4 years), CMPNS evoked CMAPs in 21 subjects, CEPNS in 16, with 12 responding to both. No significant latency or amplitude differences emerged between CEPNS and CMPNS responders. TMS evoked diMEPs in 24 participants. Latency was more consistent than amplitude across all methods; CMPNS exhibited the lowest amplitude variability. Height moderately correlated positively with CMAP latency and negatively with central motor conduction time.

Conclusions

Individually adapted suprathreshold CEPNS and CMPNS assessed phrenic nerve conduction with varying success rates. Latency was a more reliable measure than amplitude. CMPNS and diTMS surpassed CEPNS in response reliability, positioning magnetic stimulations as preferable for assessing phrenic nerve conduction. CEPNS might not be suitable for examining motor response amplitudes when not applied at supramaximal intensity. Height-related anatomical factors influencing conduction merit further study.

Significance

Latency of diaphragm motor responses elicited at individually estimated stimulation intensities offers a more consistent biomarker over amplitude for assessing phrenic nerve function.

目的：本研究评估膈神经经颅磁刺激（diTMS）与宫颈电刺激（CEPNS）和磁刺激（CMPNS）的可变性，重点关注运动反应潜伏期和阈上强度单独计算的振幅。方法通过CEPNS、CMPNS（测量复合肌动作电位，CMAPs）和diTMS（测量膈肌运动诱发电位，diMEPs）诱发膈肌运动反应。记录潜伏期和振幅。统计分析比较了各种方法，使用变异系数（CV）评估了变异率，并探讨了与身高和中枢运动传导时间的关系。结果25例参与者（平均年龄25±4岁）中，CMPNS诱发cmap的21例，CEPNS诱发cmap的16例，其中12例均有反应。CEPNS和CMPNS应答者之间没有明显的潜伏期或幅度差异。经颅磁刺激诱发24例diMEPs。在所有方法中，潜伏期比振幅更一致；CMPNS表现出最低幅度的变异性。身高与CMAP潜伏期呈正相关，与中枢运动传导时间呈负相关。结论单独应用阈上CEPNS和CMPNS评估膈神经传导成功率不同。潜伏期比振幅更可靠。CMPNS和diTMS在反应可靠性上优于CEPNS，定位磁刺激作为评估膈神经传导的首选。当不以最大强度应用时，CEPNS可能不适合检查运动反应幅度。与高度相关的影响传导的解剖学因素值得进一步研究。在单独估计的刺激强度下引起的膈肌运动反应的潜伏期为评估膈神经功能提供了一个更一致的生物标志物。

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