Clinical Neurophysiology Practice最新文献_第4页

Beyond the triad: Review of Miller Fisher Syndrome in a tertiary neurological centre 超越三联征：三级神经学中心对米勒-费雪综合征的回顾

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.06.006

Muhammad Rehman , Chris Gyan , Chinar Osman , Ramamurthy Arunachalam

引用次数: 0

Spinal excitability is enhanced by transcranial magnetic stimulation of the motor cortex in children and adolescents 脊髓兴奋性增强经颅磁刺激运动皮层在儿童和青少年

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.06.009

Essi J. Marttinen Rossi , Päivi Nevalainen , Jussi Toppila , Helena Mäenpää , Jessica Guzmán-López , Harri Piitulainen , Leena Lauronen

Objective

To investigate the modulation of spinal excitability to sub-motor threshold transcranial magnetic stimulation (TMS) in healthy children and adolescents.

Methods

We paired sub-motor threshold TMS (conditioning) with electrical tibial nerve stimulation (test) to assess changes in the soleus H-reflex at eleven conditioning-test (C-T) intervals. Eleven participants (7.5–16.2 years) were studied under three conditions: rest, voluntary agonist activation (ankle plantar flexion), and voluntary antagonist activation (ankle dorsiflexion).

Results

TMS-induced supraspinal volley facilitated the soleus H-reflex amplitude significantly during rest and agonist activation, but not during antagonist activation. The facilitation of H-reflex was similar during rest and agonist activation between C-T intervals from –2 ms (i.e. peripheral stimulation before cortical) to +18 ms (i.e. cortical stimulation before peripheral). Specific to rest condition, a later facilitation occurred at C-T intervals of approximately +60 ms.

Conclusions

Spinal excitability modulation in children and adolescents showed similarities to earlier evidence in adults, with the distinction that, unlike in the adults, agonist activity did not further enhance the supraspinal facilitation of the H-reflex compared to the rest condition in children.

Significance

These results provide insight into the maturation of motor control and regulation of spinal excitability, offering possibilities to identify typical and atypical developmental trajectories.

目的探讨经颅磁刺激（TMS）对健康儿童和青少年脊髓兴奋性的调节作用。方法将亚运动阈值TMS（条件反射）与胫神经电刺激（测试）配对，观察11次条件反射测试（C-T）间隔时比目鱼h反射的变化。11名参与者（7.5-16.2岁）在三种条件下进行了研究：休息，自愿激动剂激活（踝关节足底屈曲）和自愿拮抗剂激活（踝关节背屈）。结果stms诱导的棘上截射在休息和激动剂激活时显著促进比目鱼h反射振幅，而在拮抗剂激活时无明显促进作用。从-2 ms（外周刺激前皮层刺激）到+18 ms（外周刺激前皮层刺激）的C-T间隔中，休息和激动剂激活时h反射的促进作用相似。结论：儿童和青少年的脊髓兴奋性调节与成人的早期证据相似，不同的是，与儿童的休息条件相比，激动剂活性并没有进一步增强h反射的棘上促进作用。这些结果为运动控制和脊髓兴奋性调节的成熟提供了见解，为识别典型和非典型发育轨迹提供了可能性。

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引用次数: 0

The underlying mechanism of mirror visual feedback in stroke. In reply to: challenging the electrophysiological interpretation of mirror visual feedback in stroke 卒中中镜像视觉反馈的潜在机制。回应：挑战脑卒中中镜像视觉反馈的电生理解释

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.08.007

Jinyang Zhuang

引用次数: 0

Cortical response to proprioceptive stimulation in primary orthostatic tremor – a magnetoencephalography study 原发性直立性震颤的皮层对本体感觉刺激的反应-脑磁图研究

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.04.002

Karolina af Edholm , Mikkel C. Vinding , Christoph Pfeiffer , Anders Svenningsson , Erik Fransén , Mathias Sundgren , Henrik Sjöström , Niklas Edvall , Daniel Lundqvist , Josefine Waldthaler

Objective

Patients with primary orthostatic tremor (OT) are affected by a strong feeling of instability. Our aim was to investigate whether cortical response to proprioceptive information is altered in OT compared with healthy control subjects (HC) using magnetoencephalography (MEG).

Methods

Fifteen OT patients and 15 HCs were examined using whole-head MEG. Proprioceptive stimulation was evoked by passive movements of the right index finger and right foot. Time-frequency responses were extracted in the frequency range of 8–30 Hz. The MEG sensor with the highest amplitude change time-locked to the proprioceptive stimulus was used to calculate the amplitude of event-related desynchronization (ERD) and subsequent event-related re-synchronization (ERS).

Results

Finger stimulation induced reliable ERD and ERS, as expected, in both OT patients and HC. Foot stimulation induced weaker ERS in both groups. Cluster-based permutation tests did not reveal any significant differences between the OT and HC groups.

Discussion

We did not find evidence supporting a generally altered cortical response to proprioceptive stimulation in patients with OT.

Significance

This is the first study on proprioceptive cortical processing in OT. The results do not support the interpretation that the characteristic intense feeling of instability in OT is linked to altered cortical response to proprioceptive information.

目的原发性直立性震颤（OT）患者有强烈的不稳定感。我们的目的是利用脑磁图（MEG）研究与健康对照组（HC）相比，OT患者对本体感觉信息的皮质反应是否发生了改变。方法对15例OT患者和15例hc患者进行全头部MEG检查。右食指和右脚被动运动可诱发本体感觉刺激。提取8 ~ 30 Hz频率范围内的时频响应。利用本体感觉刺激时振幅变化最大的MEG传感器计算事件相关去同步（ERD）和随后的事件相关再同步（ERS）的振幅。结果如预期的那样，手指刺激在OT患者和HC患者中均可诱导可靠的ERD和ERS。两组足部刺激均引起较弱的ERS。基于簇的排列测试没有发现OT组和HC组之间的任何显著差异。讨论：我们没有发现证据支持OT患者对本体感觉刺激的皮层反应普遍改变。意义本研究首次对OT中本体感觉皮层加工进行了研究。结果不支持OT中特征性的强烈不稳定感与皮层对本体感觉信息的反应改变有关的解释。

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引用次数: 0

High-frequency oscillations in scalp EEG lateralize to the epileptogenic hemisphere in children and adults 儿童和成人头皮脑电图的高频振荡向致痫半球偏侧

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.09.004

Dhruva P. Achar , Karunakar A. Kotegar , Kurupath Radhakrishnan

Objectives:

High-frequency oscillations (HFO) in scalp electroencephalography (EEG) are promising biomarkers for localizing epileptogenic zones. Prior studies mainly used high sampling frequencies (

>

1000 Hz), whereas clinical monitoring often employs lower rates (

<

512 Hz). We assessed scalp EEG HFO detection feasibility at 512 Hz, examining whether HFO rates lateralize the epileptogenic hemisphere (EH) and localize seizure onset zone (SOZ).

Methods:

We retrospectively analyzed EEG from 32 patients during sleep, and seizures in 10 patients. A semi-automated algorithm combining band-pass filtering, sliding-window thresholding, and time-frequency validation was applied. HFO rates were compared between EH versus contralateral hemisphere (CH), and SOZ versus non-SOZ channels.

Results:

HFOs were detected in 27 patients, with higher rates in EH than CH (p = 0.0002). The asymmetry index lateralized EH in 22 patients (p = 0.0003). SOZ channels had higher HFO rates in 11 of 18 patients, though not significantly (p = 0.32). Pre-ictal HFO rates increased (p = 0.02), were higher in EH (p = 0.05), and decreased post-ictally (p = 0.004). Age-dependent decline was observed, with younger patients exhibiting higher median HFO rates than adults (

\geq

18 years).

Conclusions:

Scalp EEG at 512 Hz reliably detects HFOs and lateralizes the EH, though SOZ localization remains limited.

Significance

: Routine 512 Hz EEG can analyze HFOs, potentially enhancing presurgical evaluation.

目的：头皮脑电图（EEG）的高频振荡（HFO）是定位癫痫区有希望的生物标志物。先前的研究主要使用高采样频率（> 1000hz），而临床监测通常使用较低的采样频率（< 512hz）。我们评估了512 Hz下头皮脑电图HFO检测的可行性，考察了HFO率是否使致痫半球（EH）偏侧，并定位了癫痫发作区（SOZ）。方法：回顾性分析32例睡眠时脑电图及10例癫痫发作的脑电图。采用带通滤波、滑动窗阈值和时频验证相结合的半自动算法。比较EH与对侧半球（CH）、SOZ与非SOZ通道之间的HFO率。结果：27例患者检出hfo， EH高于CH （p = 0.0002）。22例患者的不对称指数偏侧化EH （p = 0.0003）。18例患者中有11例SOZ通道HFO发生率较高，但差异无统计学意义（p = 0.32）。发作前HFO发生率升高（p = 0.02）， EH较高（p = 0.05），发作后HFO发生率降低（p = 0.004）。观察到年龄依赖性下降，年轻患者表现出高于成人（≥18岁）的中位HFO发生率。结论：512 Hz的头皮脑电图可靠地检测到HFOs并使EH偏侧，尽管SOZ定位仍然有限。意义：常规512 Hz脑电图可分析HFOs，有可能增强术前评价。

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引用次数: 0

The spatio-functional cortical representation of muscles innervated by the accessory nerve using nTMS 副神经支配肌肉的空间功能表征

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.11.004

J. Reinsch , M. Denker , M. Engelhardt , A. Zdunczyk , D. Huscher , P. Vajkoczy , T. Picht , N.F. Dengler

Objective

The accessory nerve is frequently affected by injury which causes disability due to a loss of function in the trapezius muscle and the sternocleidomastoid muscle. Navigated transcranial magnetic stimulation (nTMS) may be a valuable tool to quantify aspects of cortical motor reorganization.

Methods

nTMS was used to stimulate the motor cortex in 15 healthy volunteers and 3 accessory nerve lesion patients to determine the representation of the sternocleidomastoid muscle, trapezius, deltoid, biceps, first dorsal interosseus and zygomatic major muscles.

Results

The center of gravitiy (CoG) of the sternocleidomastoid muscle was located between the face (zygomatic major muscle) and hand (first dorsal interosseus muscle). CoG of the trapezius muscle was located superiorly to the hand. Distances to the lateral sulcus differed significantly (median: trapezius muscle 54.9 [9.4] mm, sternocleidomastoid muscle 30.1 [15.7] mm, p < 0.001). The radius (in mm) of the area of the sternocleidomastoid muscle was significantly larger compared to the trapezius (14.3 [5.7] and 11.5 [6.9], p = 0.004).

Conclusion

This study describes the detailed spatio-functional representation of trapezius and sternocleidomastoid muscle in comparison to four other muscles.

Significance

Our data may serve as a baseline for future studies on patients with accessory nerve injuries and a decision-making tool for the indication and timing for reconstructive surgery.

目的：副神经常因斜方肌和胸锁乳突肌功能丧失而损伤。导航经颅磁刺激（nTMS）可能是量化皮质运动重组方面的有价值的工具。方法15例健康志愿者和3例副神经病变患者，采用单脉冲磁刺激（sntms）对运动皮层进行刺激，确定胸锁乳突肌、斜方肌、三角肌、二头肌、第一背骨间肌和颧大肌的表现。结果胸锁乳突肌的重心位于面部（颧大肌）和手部（第一背骨间肌）之间。斜方肌的CoG位于手的上方。到外侧沟的距离差异显著（中位数：斜方肌54.9 [9.4]mm，胸锁乳突肌30.1 [15.7]mm, p < 0.001）。胸锁乳突肌面积的半径（mm）明显大于斜方肌（14.3[5.7]和11.5 [6.9],p = 0.004）。结论本研究详细描述了斜方肌和胸锁乳突肌与其他四种肌肉的空间功能表征。意义：我们的数据可以作为未来研究副神经损伤患者的基线，并为重建手术的适应证和时机提供决策工具。

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引用次数: 0

A new method to evaluate staircase phenomenon in skeletal muscle using piezoelectric sensor 一种利用压电传感器评价骨骼肌阶梯现象的新方法。

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2024.12.002

Bungo Hirose , Tomihiro Imai , Kazuna Ikeda , Emiko Tsuda , Rika Yamauchi , Tatsuya Abe , Shin Hisahara

Objective

The staircase phenomenon, which refers to the increases in the force of contraction with repetitive stimulation of the muscle, has been studied for many years, but the method is difficult and not widely used. Our objective was to evaluate the staircase phenomenon in skeletal muscle using a piezoelectric sensor.

Methods

Thirty-five subjects without neuromuscular diseases (normal controls), 11 patients with Becker muscular dystrophy (BMD), and 19 patients with myotonic dystrophy type 1 (MyD) were studied. Compound muscle action potential (CMAP) and movement-related potential (MRP) waveforms were recorded using piezoelectric sensors during repetitive stimulation of the median nerve, and the amplitudes and durations were measured. Excitation-contraction (E-C) coupling time (ECCT) was calculated from the difference between onset latencies of CMAP and MRP.

Results

In normal controls, MRP amplitude ratio (relative to baseline) increased significantly with increase in stimulation duration and with increase in stimulation frequency. In BMD and MyD, however, MRP amplitude ratio did not change significantly with increase in stimulation duration. Especially, in MyD, there was no change in MRP amplitude ratio with increase in frequency.

Conclusion

Staircase phenomenon abnormalities can be evaluated easily using piezoelectric sensors, indicating their potential utility for evaluating E-C coupling impairment in myopathies.

Significance

Piezoelectric sensors may be a useful tool to evaluate staircase phenomenon in skeletal muscle.

目的：楼梯现象是指随着肌肉的反复刺激收缩力的增加，这一现象已被研究多年，但方法难度大，应用不广泛。我们的目的是利用压电传感器来评估骨骼肌的阶梯现象。方法：选取35例无神经肌肉疾病（正常对照）、11例贝克肌营养不良症（BMD）和19例1型肌强直性营养不良症（MyD）患者作为研究对象。利用压电传感器记录正中神经重复刺激过程中复合肌肉动作电位（CMAP）和运动相关电位（MRP）波形，并测量其振幅和持续时间。根据CMAP和MRP发作潜伏期的差值计算兴奋-收缩耦合时间（ECCT）。结果：在正常对照中，MRP振幅比（相对于基线）随刺激持续时间的增加和刺激频率的增加而显著增加。然而，在BMD和MyD中，MRP振幅比随刺激时间的增加没有显著变化。特别是在MyD中，MRP振幅比没有随频率的增加而变化。结论：利用压电传感器可以很容易地评估楼梯现象异常，表明其在评估肌病E-C偶联损伤方面的潜在用途。意义：压电传感器可作为评估骨骼肌阶梯现象的有效工具。

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引用次数: 0

Competence of healthcare professionals performing electroencephalography test: A systematic review 医疗保健专业人员执行脑电图测试的能力：系统回顾

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.03.001

Elina Linnavuori , Irina Virtanen , Minna Stolt

Objective

To describe the EEG competence of healthcare professionals and how this competence has been measured in previous literature.

Methods

A systematic review following the preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted in CINAHL, PubMed, Scopus, and Web of Science databases focusing on studies that empirically examined the EEG competence of healthcare professionals.

Results

A total of 28 studies were included. EEG competence consists of two main categories: knowledge and skills of EEG, and attitudes and values towards EEG. The EEG competence of healthcare professionals was assessed in three different settings: tests, simulations, and real life. The data collection methods were knowledge tests, self-assessments, and observations. The tools were developed by a researcher(s) for the single study and were not psychometrically tested.

Conclusion

EEG competence is a multidimensional concept that includes knowledge, skills, attitudes, and values that need to be considered when defining EEG competence and developing tools to measure it.

Significance

This systematic review provides information to the educators of healthcare professionals and healthcare organizations involved in developing comprehensive EEG training programs and assessments to foster professional development and ensure reliable diagnostic test results for patients.

目的描述卫生保健专业人员的脑电图能力，以及在以往文献中如何测量这种能力。方法根据系统评价和元分析的首选报告项目进行系统评价。在CINAHL、PubMed、Scopus和Web of Science数据库中进行了文献检索，重点研究了医疗保健专业人员脑电图能力的实证研究。结果共纳入28项研究。脑电能力包括两大类：脑电知识和技能，以及对脑电的态度和价值观。在三种不同的环境中评估医疗保健专业人员的脑电图能力：测试、模拟和现实生活。资料收集方法为知识测验、自我评估和观察。这些工具是由研究人员为单个研究开发的，没有进行心理测量学测试。结论脑电能力是一个多维的概念，包括知识、技能、态度和价值观，在定义脑电能力和开发测量工具时需要考虑这些因素。本系统综述为参与制定全面脑电图培训计划和评估的医疗保健专业人员和医疗保健组织的教育者提供了信息，以促进专业发展并确保患者的诊断测试结果可靠。

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引用次数: 0

Two-year experience of a newly established epilepsy monitoring unit in a resource-limited setting 在资源有限的环境中新建立的癫痫监测单位的两年经验

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.012

Fridha V. Villalpando-Vargas , Fabrizio A. Mortola , Juan C. Barrera de León , Tania P. Sánchez-Murguía , Ilse M. Mora-Rodríguez , Jonathan A. Cisneros-Orozco , Andrea Enríquez-Zaragoza , Karla López-Jiménez , Alioth Guerrero-Aranda

Objective

Epilepsy Monitoring Units (EMUs) play a critical role in epilepsy management, yet they remain scarce in resource-limited settings. This study presents a 2-year experience of a newly implemented EMU in Mexico, evaluating its clinical impact, procedural metrics, and challenges. Methods: This retrospective study included 117 patients admitted to the EMU of a private hospital in central-western Mexico between February 2023 and December 2024. Patients underwent tailored protocols for long-term video-EEG monitoring for diagnostic clarification, treatment optimization, or presurgical evaluation. Diagnostic and therapeutic outcomes, seizure yield, and safety metrics were described. Results: The EMU facilitated diagnostic changes in 59% of patients, with 80.3% undergoing treatment modifications. Among presurgical evaluation patients, 80.8% exhibited seizures during admission. Seventy-two percent of patients achieved a favorable seizure outcome at one-year follow-up. Twelve patients underwent epilepsy surgery, with resective procedures being the most common. Status epilepticus and seizure clusters, occurred in 2.5% and 0.8% of patients, respectively. Conclusion: The implementation of a high-quality EMU is achievable in resource-limited settings. Significance: This study highlights the importance of tailored protocols and multidisciplinary collaboration, providing a practical framework enhancing epilepsy care and bridging gaps in epilepsy management in underserved regions.

目的癫痫监测单位（emu）在癫痫管理中发挥着至关重要的作用，但在资源有限的地区，emu仍然稀缺。本研究介绍了墨西哥新实施的EMU的2年经验，评估了其临床影响、程序指标和挑战。方法：本回顾性研究纳入了2023年2月至2024年12月在墨西哥中西部一家私立医院急诊住院的117例患者。患者接受量身定制的长期视频脑电图监测方案，以明确诊断、优化治疗或术前评估。描述了诊断和治疗结果、癫痫发作率和安全性指标。结果：EMU促进了59%的患者的诊断改变，80.3%的患者接受了治疗修改。在术前评估的患者中，80.8%在入院时出现癫痫发作。在一年的随访中，72%的患者获得了良好的癫痫发作结果。12名患者接受了癫痫手术，切除手术是最常见的。癫痫持续状态和发作集群分别发生在2.5%和0.8%的患者中。结论：在资源有限的情况下，实施高质量的EMU是可以实现的。意义：本研究强调了定制方案和多学科合作的重要性，为服务不足地区加强癫痫护理和缩小癫痫管理差距提供了实用框架。

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引用次数: 0

Intraoperative monitoring during awake craniotomy for glioblastoma resection in the second trimester of pregnancy. A case report and literature review 妊娠中期清醒开颅术中胶质母细胞瘤切除术的术中监测。病例报告及文献复习

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.006

Bayron A. Sandoval-Bonilla , Isela Valverde Luna , Aleida Arritola-Uriarte , Daniel San-Juan , Ricardo García-Iturbide , Alma Edith Gress Mendoza , Lorely Cumplido Pulido , Lizzette Hinojosa González , Alfredo Lara Bahena , Maria F. De la Cerda Vargas

Objective

To demonstrate the feasibility and safety of awake craniotomy (AC) with intraoperative neurophysiological monitoring (IONM) for glioblastoma (GB) resection in a pregnant patient, ensuring preservation of neurological functions and fetal well-being.

Methods

A 27-year-old gravida 2, para 1 woman presented at 19.4 weeks of pregnancy with severe headaches and a generalized tonic-clonic seizure. Imaging confirmed a malignant glioma, and an interdisciplinary team opted for AC with IONM to achieve maximal tumor resection while minimizing maternal and fetal risks.

Results

Surgery was performed during the second trimester with successful gross total resection of the tumor. IONM strategies preserved neurological function, and fetal well-being was maintained. Postoperative evaluations showed no complications, and the patient was discharged in improved condition.

Conclusions

AC with IONM is a viable and safe surgical approach for GB resection during pregnancy. Tailoring the surgical plan by considering gestational age, maternal health, and fetal safety is crucial.

Significance

This case highlights the importance of multidisciplinary management in optimizing outcomes for pregnant patients with GB, contributing valuable insights to the limited literature on neurosurgical interventions during pregnancy.

目的探讨清醒开颅术（AC）联合术中神经生理监测（IONM）用于妊娠患者胶质母细胞瘤（GB）切除术的可行性和安全性，确保胎儿神经功能和胎儿健康。方法1例27岁妊娠2期妇女，妊娠19.4周时出现严重头痛和全身性强直阵挛发作。影像学证实了恶性胶质瘤，一个跨学科的团队选择了AC与IONM，以实现最大程度的肿瘤切除，同时最大限度地降低了母亲和胎儿的风险。结果妊娠中期手术成功切除肿瘤。IONM策略保留了神经功能，并维持了胎儿的健康。术后评估显示无并发症，患者出院时病情好转。结论sac联合IONM是妊娠期GB切除术可行、安全的手术方式。通过考虑胎龄、产妇健康和胎儿安全来调整手术计划是至关重要的。本病例强调了多学科管理在优化妊娠期GB患者预后中的重要性，为有限的妊娠期神经外科干预文献提供了有价值的见解。

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引用次数: 0