Clinical Neurophysiology Practice最新文献

英文中文

Tibial to ulnar nerve amplitude ratio as a marker of length-dependent neuropathy 胫尺神经振幅比作为长度依赖性神经病变的标志

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-10-25 DOI: 10.1016/j.cnp.2025.10.006

Chikashi Yano , Tomonori Nakamura , Masahiro Ando , Yujiro Higuchi , Jun-Hui Yuan , Akiko Yoshimura , Takahiro Hobara , Fumikazu Kojima , Yu Hiramatsu , Satoshi Nozuma , Yusuke Sakiyama , Akihiro Hashiguchi , Raymond L. Rosales , Kimiyoshi Arimura , Hiroshi Takashima

Objective

To evaluate the utility of nerve conduction studies as a marker of length-dependent neuropathy.

Methods

We conducted a retrospective study of 44 chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients and 365 genetically confirmed Charcot-Marie-Tooth disease (CMT) patients, including those with PMP22 duplications or mutations in GJB1, MFN2, MPZ, and MME. Nerve conduction study parameters were compared, with subgroup analyses of CIDP-mimicking CMT (genetically confirmed CMT with a prior clinical diagnosis of CIDP) and gene-based classifications. Receiver operating characteristic (ROC) analysis assessed the sensitivity and specificity of these parameters.

Results

The tibial to ulnar nerve distal compound muscle action potential (T/U CMAP) amplitude ratio was significantly higher in CIDP patients compared to those with genetically confirmed CMT, CIDP-mimicking CMT, and gene-based subgroups. This ratio yielded the highest area under the curve (AUC: 0.95) among all evaluated parameters, with a cutoff value of 0.385 demonstrating high diagnostic sensitivity (95.5%) and specificity (85.5%). In CIDP-mimicking CMT group, a similar sensitivity and specificity were observed.

Conclusions

The T/U CMAP amplitude ratio is a simple, robust electrophysiological index of length-dependent neuropathy.

Significance

This marker offers a reliable and accessible way to distinguish between acquired and inherited neuropathies, improving diagnostic accuracy and helping prioritize genetic testing.

目的评价神经传导检查作为长度依赖性神经病变标志物的应用价值。方法对44例慢性炎症性脱髓鞘性多根神经病变（CIDP）患者和365例遗传确诊的沙克-玛丽-图斯病（CMT）患者进行回顾性研究，包括GJB1、MFN2、MPZ和mme中PMP22重复或突变的患者。神经传导研究参数进行比较，并对模拟CIDP的CMT（既往临床诊断为CIDP的遗传确诊CMT）进行亚组分析和基于基因的分类。受试者工作特征（ROC）分析评估这些参数的敏感性和特异性。结果cdp患者胫尺神经远端复合肌动作电位（T/U CMAP）振幅比明显高于遗传确诊CMT、cdp模拟CMT和基因亚组。该比值在所有评估参数中产生最高的曲线下面积（AUC: 0.95），截止值为0.385，具有较高的诊断敏感性（95.5%）和特异性（85.5%）。在模拟CMT组中，观察到相似的敏感性和特异性。结论T/U CMAP振幅比是一种简单、可靠的长度依赖性神经病变电生理指标。该标记提供了一种可靠且易于获取的方法来区分获得性和遗传性神经病变，提高诊断准确性并帮助优先进行基因检测。

{"title":"Tibial to ulnar nerve amplitude ratio as a marker of length-dependent neuropathy","authors":"Chikashi Yano , Tomonori Nakamura , Masahiro Ando , Yujiro Higuchi , Jun-Hui Yuan , Akiko Yoshimura , Takahiro Hobara , Fumikazu Kojima , Yu Hiramatsu , Satoshi Nozuma , Yusuke Sakiyama , Akihiro Hashiguchi , Raymond L. Rosales , Kimiyoshi Arimura , Hiroshi Takashima","doi":"10.1016/j.cnp.2025.10.006","DOIUrl":"10.1016/j.cnp.2025.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the utility of nerve conduction studies as a marker of length-dependent neuropathy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 44 chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients and 365 genetically confirmed Charcot-Marie-Tooth disease (CMT) patients, including those with <em>PMP22</em> duplications or mutations in <em>GJB1</em>, <em>MFN2</em>, <em>MPZ</em>, and <em>MME</em>. Nerve conduction study parameters were compared, with subgroup analyses of CIDP-mimicking CMT (genetically confirmed CMT with a prior clinical diagnosis of CIDP) and gene-based classifications. Receiver operating characteristic (ROC) analysis assessed the sensitivity and specificity of these parameters.</div></div><div><h3>Results</h3><div>The tibial to ulnar nerve distal compound muscle action potential (T/U CMAP) amplitude ratio was significantly higher in CIDP patients compared to those with genetically confirmed CMT, CIDP-mimicking CMT, and gene-based subgroups. This ratio yielded the highest area under the curve (AUC: 0.95) among all evaluated parameters, with a cutoff value of 0.385 demonstrating high diagnostic sensitivity (95.5%) and specificity (85.5%). In CIDP-mimicking CMT group, a similar sensitivity and specificity were observed.</div></div><div><h3>Conclusions</h3><div>The T/U CMAP amplitude ratio is a simple, robust electrophysiological index of length-dependent neuropathy.</div></div><div><h3>Significance</h3><div>This marker offers a reliable and accessible way to distinguish between acquired and inherited neuropathies, improving diagnostic accuracy and helping prioritize genetic testing.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 499-506"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473741","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}

引用次数: 0

The effects of multi-session dual-tDCS on the bilateral transfer of motor skill learning in patients with stroke 多期双tdcs对脑卒中患者双侧运动技能学习转移的影响

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-07-01 DOI: 10.1016/j.cnp.2025.06.005

Mohammad Mahdi Talimkhani , Ailin Talimkhani , Vida Dinarvand , Somayeh Mohamadi , Hamzeh Baharlouei

Objective

This study investigates the potential effects of combining motor skill learning transfer from the unaffected to the affected hand with multiple sessions of dual-transcranial direct current stimulation (tDCS) over the primary motor cortex to enhance motor skills in stroke patients.

Methods

Eleven stroke patients participated in a randomized, sham-controlled, double-blind crossover study. Over two periods separated by a 3-week washout, participants underwent either sham or dual-tDCS concurrently with serial response time tasks (SRTT). Each intervention included 20 min of stimulation during SRTT for three consecutive days. The skill index, the primary variable, was assessed pre-intervention, immediately post-intervention, and 24 h later.

Results

Both groups showed significant improvement in motor skill learning across the three intervention days (P < 0.001). The dual-tDCS group demonstrated significantly greater skill improvement in the affected hand compared to the sham group (P < 0.01), while no significant differences were found for the unaffected hand (P = 0.98).

Conclusions

Multi-session dual-tDCS combined with motor learning tasks significantly enhances motor skill transfer to the affected hand in stroke patients, with greater and more durable effects compared to sham stimulation.

Significance

This approach may improve bilateral motor skill transfer and hand fatigue management in stroke rehabilitation.

目的探讨脑卒中患者运动技能学习转移与多期双经颅直流电刺激（tDCS）对初级运动皮质的潜在影响。方法采用随机、假对照、双盲交叉研究。在为期3周的洗脱期中，参与者接受假tdcs或双tdcs同时进行系列反应时间任务（SRTT）。每次干预包括连续三天SRTT期间20分钟的刺激。主要变量技能指数分别在干预前、干预后和24小时后进行评估。结果两组在干预3天内运动技能学习均有显著改善(P <；0.001)。与假手术组相比，双tdcs组在患手的技能提高明显更大(P <；0.01)，而未受影响的手无显著差异（P = 0.98）。结论多阶段双tdcs联合运动学习任务可显著提高脑卒中患者患手的运动技能转移，且效果比假刺激更显著、更持久。意义该方法可改善脑卒中康复患者的双侧运动技能转移和手部疲劳管理。

{"title":"The effects of multi-session dual-tDCS on the bilateral transfer of motor skill learning in patients with stroke","authors":"Mohammad Mahdi Talimkhani , Ailin Talimkhani , Vida Dinarvand , Somayeh Mohamadi , Hamzeh Baharlouei","doi":"10.1016/j.cnp.2025.06.005","DOIUrl":"10.1016/j.cnp.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates the potential effects of combining motor skill learning transfer from the unaffected to the affected hand with multiple sessions of dual-transcranial direct current stimulation (tDCS) over the primary motor cortex to enhance motor skills in stroke patients.</div></div><div><h3>Methods</h3><div>Eleven stroke patients participated in a randomized, sham-controlled, double-blind crossover study. Over two periods separated by a 3-week washout, participants underwent either sham or dual-tDCS concurrently with serial response time tasks (SRTT). Each intervention included 20 min of stimulation during SRTT for three consecutive days. The skill index, the primary variable, was assessed pre-intervention, immediately post-intervention, and 24 h later.</div></div><div><h3>Results</h3><div>Both groups showed significant improvement in motor skill learning across the three intervention days (P < 0.001). The dual-tDCS group demonstrated significantly greater skill improvement in the affected hand compared to the sham group (P < 0.01), while no significant differences were found for the unaffected hand (P = 0.98).</div></div><div><h3>Conclusions</h3><div>Multi-session dual-tDCS combined with motor learning tasks significantly enhances motor skill transfer to the affected hand in stroke patients, with greater and more durable effects compared to sham stimulation.</div></div><div><h3>Significance</h3><div>This approach may improve bilateral motor skill transfer and hand fatigue management in stroke rehabilitation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 236-245"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562781","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}

引用次数: 0

Challenging the electrophysiological interpretation of mirror visual feedback in stroke 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 Epub Date: 2025-09-07 DOI: 10.1016/j.cnp.2025.08.008

Brijesh Sathian , Javed Iqbal , Hanadi Al Hamad

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 Epub Date: 2025-10-04 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。

{"title":"High-frequency oscillations in scalp EEG lateralize to the epileptogenic hemisphere in children and adults","authors":"Dhruva P. Achar , Karunakar A. Kotegar , Kurupath Radhakrishnan","doi":"10.1016/j.cnp.2025.09.004","DOIUrl":"10.1016/j.cnp.2025.09.004","url":null,"abstract":"<div><h3>Objectives:</h3><div>High-frequency oscillations (HFO) in scalp electroencephalography (EEG) are promising biomarkers for localizing epileptogenic zones. Prior studies mainly used high sampling frequencies (<span><math><mo>></mo></math></span>1000 Hz), whereas clinical monitoring often employs lower rates (<span><math><mo><</mo></math></span>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).</div></div><div><h3>Methods:</h3><div>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.</div></div><div><h3>Results:</h3><div>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 (<span><math><mo>≥</mo></math></span>18 years).</div></div><div><h3>Conclusions:</h3><div>Scalp EEG at 512 Hz reliably detects HFOs and lateralizes the EH, though SOZ localization remains limited.</div></div><div><h3>Significance</h3><div>: Routine 512 Hz EEG can analyze HFOs, potentially enhancing presurgical evaluation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 440-452"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264929","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}

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 Epub Date: 2025-05-02 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。

{"title":"Cortical response to proprioceptive stimulation in primary orthostatic tremor – a magnetoencephalography study","authors":"Karolina af Edholm , Mikkel C. Vinding , Christoph Pfeiffer , Anders Svenningsson , Erik Fransén , Mathias Sundgren , Henrik Sjöström , Niklas Edvall , Daniel Lundqvist , Josefine Waldthaler","doi":"10.1016/j.cnp.2025.04.002","DOIUrl":"10.1016/j.cnp.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>We did not find evidence supporting a generally altered cortical response to proprioceptive stimulation in patients with OT.</div></div><div><h3>Significance</h3><div>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.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 159-166"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923885","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}

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 Epub Date: 2025-09-09 DOI: 10.1016/j.cnp.2025.08.007

Jinyang Zhuang

引用次数: 0

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 Epub Date: 2025-07-01 DOI: 10.1016/j.cnp.2025.06.006

Muhammad Rehman , Chris Gyan , Chinar Osman , Ramamurthy Arunachalam

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 Epub Date: 2025-11-26 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。

{"title":"The spatio-functional cortical representation of muscles innervated by the accessory nerve using nTMS","authors":"J. Reinsch , M. Denker , M. Engelhardt , A. Zdunczyk , D. Huscher , P. Vajkoczy , T. Picht , N.F. Dengler","doi":"10.1016/j.cnp.2025.11.004","DOIUrl":"10.1016/j.cnp.2025.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>This study describes the detailed spatio-functional representation of trapezius and sternocleidomastoid muscle in comparison to four other muscles.</div></div><div><h3>Significance</h3><div>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.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 540-549"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623398","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}

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 Epub Date: 2025-07-06 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。

{"title":"Spinal excitability is enhanced by transcranial magnetic stimulation of the motor cortex in children and adolescents","authors":"Essi J. Marttinen Rossi , Päivi Nevalainen , Jussi Toppila , Helena Mäenpää , Jessica Guzmán-López , Harri Piitulainen , Leena Lauronen","doi":"10.1016/j.cnp.2025.06.009","DOIUrl":"10.1016/j.cnp.2025.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the modulation of spinal excitability to sub-motor threshold transcranial magnetic stimulation (TMS) in healthy children and adolescents.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Significance</h3><div>These results provide insight into the maturation of motor control and regulation of spinal excitability, offering possibilities to identify typical and atypical developmental trajectories.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 278-285"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632001","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}

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 Epub Date: 2025-03-07 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。

{"title":"Two-year experience of a newly established epilepsy monitoring unit in a resource-limited setting","authors":"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","doi":"10.1016/j.cnp.2025.02.012","DOIUrl":"10.1016/j.cnp.2025.02.012","url":null,"abstract":"<div><h3>Objective</h3><div>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. <em>Methods</em><strong>:</strong> 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. <em>Results</em><strong>:</strong> 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. <em>Conclusion</em><strong>:</strong> The implementation of a high-quality EMU is achievable in resource-limited settings. <em>Significance</em>: 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.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 84-89"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Clinical Neurophysiology Practice

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀