Clinical Neurophysiology Practice最新文献_第8页

Prognostic factors of mechanical ventilation in Guillain–Barré syndrome among adults and children in Vietnam 越南成人和儿童格林-巴- <s:1>综合征机械通气预后因素分析

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-03-05 DOI: 10.1016/j.cnp.2025.02.009

Hung Hoang Dang , Khang Vinh Nguyen , Si Tri Le , Thuy Thi Vu , Vy Thi Yen Le , Thang Ba Nguyen , Hieu Le Trung Nguyen

Objective

Numerous studies have investigated predictors for mechanical ventilation (MV) in Guillain-Barré syndrome (GBS), with varying results. This study identifies factors associated with MV in both populations in Vietnam.

Methods

We retrospectively collected data on GBS patients at Children’s Hospital 2 and the University Medical Center Ho Chi Minh City from 2017 to 2021. Clinical characteristics were analyzed using multivariable logistic regression to identify predictors of MV. A bootstrapping stepwise approach was used to select the most appropriate predictors for the model.

Results

A total of 108 adults and 112 children were included, with 15 adults (13.8 %) and 10 children (8.9 %) requiring MV. Dysautonomia and facial palsy/bulbar weakness were more common in ventilated patients (P < 0.05). Multivariable analysis identified dysautonomia as the only significant predictor for MV in both adults (OR: 7.43, 95 % CI: 1.78–30.98) and children (OR: 13.6, 95 % CI: 1.20–154.79).

Conclusions

Dysautonomia is a significant predictor of MV in adults and children with GBS. Although facial palsy and bulbar weakness were not statistically significant predictors, their presence warrants careful monitoring.

Significance

This study provides insights into GBS in Vietnam and underscores dysautonomia as a predictor for MV, distinguishing it from findings in previous prognostic models.

大量研究调查了格林-巴-罗综合征（GBS）机械通气（MV）的预测因素，结果各不相同。本研究确定了越南两种人群中与MV相关的因素。方法回顾性收集2017年至2021年在胡志明市第二儿童医院和大学医学中心就诊的GBS患者资料。采用多变量logistic回归分析临床特征以确定MV的预测因素。采用自举逐步方法为模型选择最合适的预测因子。结果成人108例，儿童112例，其中成人15例（13.8%），儿童10例（8.9%）。自主神经异常和面瘫/球无力在通气患者中更为常见(P <；0.05)。多变量分析发现自主神经异常是成人（OR: 7.43, 95% CI: 1.78-30.98）和儿童（OR: 13.6, 95% CI: 1.20-154.79）中唯一显著的MV预测因子。结论自主神经系统紊乱是成人和儿童GBS患者MV的重要预测因子。虽然面瘫和球无力并不是统计上显著的预测因素，但它们的存在值得仔细监测。这项研究为越南的GBS提供了见解，并强调自主神经异常是MV的预测因子，将其与以前的预后模型的发现区别开来。

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引用次数: 0

Changing characteristics of somatosensory evoked potentials in adolescents 青少年体感诱发电位的变化特征

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-04-05 DOI: 10.1016/j.cnp.2025.03.004

Aoi Mase , Manabu Shibasaki , Hiroki Nakata

Objective

We investigated changing characteristics of somatosensory processing in adolescents, particularly sex differences, by comparing children, young adults, and males and females.

Methods

Participants included 26 elementary school children (ESC), 36 adolescents (ADO), and 36 college students (CS). We recorded somatosensory evoked potentials (SEPs) using electrical stimulation of the right median nerve. Peak latencies and amplitudes were measured for P12, N15, P18, and N30 at Fz, and for P12 (P1), N18 (N1), P22 (P2), N27 (N2), P3, N3, P45 (P4), and N60 (N4) at C3′.

Results

The P22 (P2) amplitude at C3′ decreased with age. The N15 amplitude at Fz was larger in females across all groups. P3 and N3 occurrence at C3′ decreased with age but remained high in ADO compared to CS. Correlation analysis showed a significant negative correlation between P22 (P2) amplitude at C3′ and age in ADO boys, but not in ADO girls, ESC boys, or ESC girls.

Conclusions

Somatosensory processing in ADO is not as mature as in CS, with sex differences between ADO boys and girls.

Significance

Our findings may aid understanding of neural activity in children with developmental disorders, supporting sensory-based therapies.

目的通过对儿童、青年、男性和女性的比较，研究青少年体感加工的变化特征，特别是性别差异。方法调查对象包括26名小学生（ESC）、36名青少年（ADO）和36名大学生（CS）。我们用电刺激右正中神经记录体感诱发电位（SEPs）。在Fz处测量P12、N15、P18和N30的峰值潜伏期和振幅，在C3 '处测量P12 （P1）、N18 （N1）、P22 （P2）、N27 （N2）、P3、N3、P45 （P4）和N60 （N4）的峰值潜伏期和振幅。结果C3′处P22 （P2）振幅随年龄增大而减小。Fz点N15波幅在各组中均较大。P3和N3在C3 '的发生率随着年龄的增长而下降，但在ADO中与CS相比仍然很高。相关分析显示，ADO男孩C3′处P22 （P2）振幅与年龄呈显著负相关，而ADO女孩、ESC男孩和ESC女孩无显著负相关。结论ADO的体感加工不如CS成熟，且存在性别差异。我们的发现可能有助于理解发育障碍儿童的神经活动，支持基于感觉的治疗。

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引用次数: 0

The diagnostic yield of a first EEG in children with suspected epilepsy: A retrospective age-related comparison between awake and sleep recordings 怀疑癫痫的儿童首次脑电图的诊断率：清醒和睡眠记录之间的回顾性年龄相关比较

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-06-08 DOI: 10.1016/j.cnp.2025.05.002

Greta Gustafsson , Anders Broström , Eva Svanborg , Magnus Vrethem , Martin Ulander

Objectives

Previous research has indicated a low diagnostic yield of initial EEGs in epilepsy diagnosis in children. This study aimed at exploring factors affecting the diagnostic yield of a first EEG in different ages, and factors affecting the choice of EEG method.

Methods

1097 EEGs performed as first recordings in children with suspected epilepsy were retrospectively analysed and divided into age groups: ≤ 5, 6–11 and 12–17 years. EEGs were classified as wake recordings with or without provocations, and sleep recordings: spontaneous sleep, sleep induced by deprivation or by melatonin premedication.

Results

Epileptiform activity was found in 18 % of all patients, most common (30 %) in children 6–11 years old. It was more likely to be detected in melatonin-induced sleep EEGs compared to other types of sleep EEG. Presence of epileptiform discharges were positively associated to age, sleep, neurological and/or intellectual comorbidity in all children.

Conclusions

The prevalence of epileptiform activity varies depending on the child́s age. Sleep EEG is advantageous as first recording, especially in very young children or with neurological comorbidity.

Significance

Melatonin-induced sleep EEG has higher diagnostic yield compared to other types of sleep EEG. Age, seizure semiology and comorbidity affect the choice of EEG method.

目的以往的研究表明，早期脑电图在儿童癫痫诊断中的诊断率较低。本研究旨在探讨影响不同年龄段首次脑电图诊断率的因素，以及影响脑电图方法选择的因素。方法回顾性分析1097例疑似癫痫患儿首次记录的脑电图，并将其分为≤5岁、6 ~ 11岁和12 ~ 17岁年龄组。脑电图分为有或没有刺激的清醒记录和睡眠记录：自发睡眠、剥夺睡眠或褪黑素预用药引起的睡眠。结果有18%的患者有尿样活性，其中以6-11岁儿童最为常见（30%）。与其他类型的睡眠脑电图相比，褪黑激素诱发的睡眠脑电图更容易检测到它。癫痫样放电的存在与所有儿童的年龄、睡眠、神经和/或智力合并症呈正相关。结论癫痫样活动的发生率随儿童年龄的不同而不同。睡眠脑电图是有利的第一次记录，特别是在非常年幼的儿童或有神经系统合并症。意义褪黑素诱发的睡眠脑电图与其他类型的睡眠脑电图相比具有更高的诊断率。年龄、癫痫符号学和合并症影响脑电图方法的选择。

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引用次数: 0

Correlation between decremental responses in repetitive nerve stimulation and disease progression rate in patients with amyotrophic lateral sclerosis 肌萎缩性脊髓侧索硬化症患者重复性神经刺激的递减反应与疾病进展率之间的相关性

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-02-22 DOI: 10.1016/j.cnp.2025.02.003

Yuki Fujii , Takamichi Kanbayashi , Kazusa Takahashi , Yuichi Hamada , Shunsuke Kobayashi , Masahiro Sonoo

Objective

Decrement responses in repetitive nerve stimulation (RNS) are theoretically expected to correlate with the disease progression speed in amyotrophic lateral sclerosis (ALS). However, actual results have been controversial. We investigated this issue using ΔFS calculated from the ALS functional rating scale revised version (ALSFRS-R) and the duration of illness.

Methods

RNS results of the abductor pollicis brevis, trapezius, and deltoid muscles in our previous study were reviewed. We investigated correlations and multiple regressions regarding decremental percentage (Decr%), the amplitude of the initial compound muscle action potential (Amp), and progression speed parameters, i.e. ΔFS or ΔUL-FS, the latter being the ΔFS for the upper-limb questions in ALSFRS-R.

Results

Included subjects were 124 patients with ALS, 47 of whom were upper-limb onset. Multiple regression analyses revealed that Decr% is largely determined by Amp and that Δ FS or ΔUL-FS showed no or little contributions to Decr%.

Conclusions

Decremental responses in RNS does not predict the speed of progression of the functional impairment in patients with ALS.

Significance

This study suggests that the decremental responses in RNS in ALS are contributed by the impaired neuromuscular transmission in chronic sprouts following extensive reinnervation, as well as by the immature sprouts.

目的：重复神经刺激（RNS）的减量反应理论上与肌萎缩侧索硬化症（ALS）的疾病进展速度有关。然而，实际结果一直存在争议。我们使用ALS功能评定量表修订版（ALSFRS-R）计算的ΔFS和疾病持续时间来调查这一问题。方法回顾以往外展拇短肌、斜方肌和三角肌的srns结果。我们研究了递减百分比（Decr%）、初始复合肌肉动作电位（Amp）的振幅和进展速度参数的相关性和多元回归，即ΔFS或ΔUL-FS，后者是ALSFRS-R中上肢问题的ΔFS。结果纳入124例ALS患者，其中47例为上肢发病。多元回归分析表明，12 %在很大程度上由Amp决定，Δ FS或ΔUL-FS对12 %的贡献不大或没有贡献。结论RNS的递减反应不能预测ALS患者功能损害的进展速度。意义：本研究提示ALS患者RNS反应的减少与神经再生后慢性芽的神经肌肉传递受损以及未成熟芽有关。

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引用次数: 0

Shear wave elastography as a marker of anisotropy in denervated muscle tissue 剪切波弹性图作为去神经支配肌肉组织各向异性的标志

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-03-05 DOI: 10.1016/j.cnp.2025.02.007

Olli Kutvonen , Sari-Leena Himanen , Katri Mäkelä

Objectives

To assess the capability of shear wave elastography (SWE) to detect muscle denervation.

Methods

36 patients underwent electrodiagnostic studies (EDX) of the lower limbs and volunteered to undergo ultrasound examination of the Tibialis anterior (TA) and the Gastrocnemius medialis (GCM) muscles. A variable reflecting the level of anisotropy was created by calculating the difference between the longitudinal and transverse shear wave velocity (SWE-D).

Results

In the TA muscles, SWE-D correlated negatively with the quantity of fibrillation potentials (FP) and the degree of interference pattern (IP) reduction (p = 0.032, r = -0.185 and p = 0.006, r = -0.236, respectively). In the GCM muscles, SWE-D only correlated with the amount of IP reduction among patients of normal weight (p = 0.030, r = -0.285). There was also a significant difference in the overall SWE-D values in the GCM muscles between patients of normal weight and obese patients (p = 0.007).

Conclusions

Loss of anisotropy caused by denervation of muscle tissue may be measured quantitatively by calculating the differences between longitudinal and transverse shear wave velocities. However, obesity seems to hinder the SWE-based assessment of muscle denervation.

Significance

Being able to measure anisotropy caused by denervation acts as a base for further development of SWE methods to evaluate neurogenic injury.

目的评价横波弹性成像（SWE）检测肌肉失神经的能力。方法36例患者均行下肢电诊断检查（EDX），并自愿行胫骨前肌（TA）和腓肠肌内侧肌（GCM）超声检查。通过计算纵向和横向横波速度（swed）之差，创建了一个反映各向异性水平的变量。结果在TA肌中，SWE-D与纤颤电位（FP）数量和干涉图（IP）减少程度分别呈负相关（p = 0.032, r = -0.185和p = 0.006, r = -0.236）。在GCM肌肉中，swed仅与正常体重患者的IP减少量相关（p = 0.030, r = -0.285）。正常体重患者与肥胖患者GCM肌肉的总体SWE-D值也有显著差异（p = 0.007）。结论肌肉组织失神经支配引起的各向异性丧失可通过计算纵、横横波速度之差来定量测量。然而，肥胖似乎阻碍了基于swed的肌肉去神经支配评估。意义：能够测量由去神经支配引起的各向异性是进一步发展SWE方法评估神经源性损伤的基础。

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引用次数: 0

The Eastern Association of Electroencephalographers: A Canadian/USA success story 东部脑电图医师协会：加拿大/美国的成功故事

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-09-01 DOI: 10.1016/j.cnp.2025.08.002

Michael H. Goodman , Paul Hwang , Carole D. Burnham , Solomon L. Moshé , Jeremy M. Barry , Gregory L. Holmes

Objective/methods

The Eastern Association of Electroencephalographers (EAEEG), founded in 1946, is recognized as the world’s oldest EEG society. This review traces its history, highlighting contributions from notable members and the significance of the Kirshman and Milner lectureships in advancing the field.

Results

Although established in Hartford, Connecticut, the society’s intellectual roots lie at the Montreal Neurological Institute, home to pioneering EEG researchers Wilder Penfield and Herbert Jasper. Over more than seven decades, the EAEEG has played a pivotal role in fostering research, education, and collaboration across the United States and Canada. Its conferences have featured distinguished keynote lectures, including presentations by three Nobel Laureates, emphasizing the society’s prominence in neurophysiological advancements. The society has successfully facilitated transnational collaboration, offering a platform for both trainees and experienced clinicians and scientists to exchange knowledge and promote progress in clinical and basic neurophysiology.

Conclusions/Significance

Despite the prominence of large international conferences, the EAEEG’s influence underscores the importance of smaller, multinational societies in shaping neurophysiological research and practice. Its history exemplifies how collaborative efforts between the US and Canada can drive scientific innovation and education within a supportive, collegial environment, reinforcing the enduring impact of specialized professional societies on the field.

目的/方法东方脑电图医师协会（EAEEG）成立于1946年，是公认的世界上最古老的脑电图学会。这篇回顾回顾了它的历史，突出了著名成员的贡献，以及科什曼和米尔纳在推进该领域的重要意义。尽管该协会成立于康涅狄格州的哈特福德，但其学术根基却在蒙特利尔神经学研究所，脑电图研究先驱怀尔德·彭菲尔德和赫伯特·贾斯帕的故乡。70多年来，EAEEG在促进美国和加拿大的研究、教育和合作方面发挥了关键作用。它的会议以杰出的主题演讲为特色，其中包括三位诺贝尔奖获得者的演讲，强调了该学会在神经生理学进步方面的突出地位。该学会成功地促进了跨国合作，为实习生和经验丰富的临床医生和科学家提供了一个交流知识的平台，促进了临床和基础神经生理学的进步。结论/意义尽管大型国际会议占有突出地位，但EAEEG的影响强调了较小的跨国社会在塑造神经生理学研究和实践方面的重要性。它的历史证明了美国和加拿大之间的合作努力如何在一个支持性的、合议的环境中推动科学创新和教育，加强专业专业协会在该领域的持久影响。

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引用次数: 0

Asymptomatic tarsal tunnel syndrome in rheumatoid Arthritis: An electrophysiological perspective with insights into clinical and laboratory correlates 类风湿关节炎的无症状跗骨隧道综合征：电生理观点与临床和实验室相关的见解

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-09-02 DOI: 10.1016/j.cnp.2025.08.005

Hosna Elshony , Mohamed H. Aly , Abdelgaffar Mohammed , Abdulrahman M. Hassan , Abdulrahman A. Alshehri , Mohamed Hedak , Rakan Almuhanna , Abdulaziz Al-Ghamdi , Rasha Elsaadawy

引用次数: 0

Brachial radiculopathy with intact central nervous system imaging following carbon monoxide poisoning: A case report 一氧化碳中毒后神经根病伴完整中枢神经系统影像学1例

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-07-26 DOI: 10.1016/j.cnp.2025.07.004

Zhiyong Lin , Jierong Mo , Peiyi Liu , Zhiquan Li , Ran Zhan , Jun Jiang , Tianen Zhou

Objective

To report and analyze a unique case of selective brachial plexopathy following carbon monoxide poisoning without central nervous system involvement.

Methods

Clinical examination, laboratory tests, neuroimaging, serial electrophysiological studies, and functional assessments were performed on a 25-year-old female presenting with severe left upper extremity weakness after CO exposure. Treatment included hyperbaric oxygen therapy, steroid therapy, and rehabilitation.

Results

Following carbon monoxide poisoning, the patient developed complete left upper extremity paralysis with selective C5-C7 motor deficits and preserved sensory function. Brain MRI showed no abnormalities. Electrophysiological studies confirmed preganglionic radiculopathy with reduced motor nerve amplitudes and normal sensory conduction. Ultrasonography demonstrated C5-C7 nerve root swelling. Following hyperbaric oxygen therapy, corticosteroids, and rehabilitation, motor function gradually recovered with distal grip strength reaching 86% of the unaffected side at 120-day follow-up.

Conclusions

This case demonstrates an uncommon manifestation of carbon monoxide poisoning characterized by isolated brachial radiculopathy with preserved central nervous system function on neuroimaging. These findings expand the recognized spectrum of carbon monoxide neurotoxicity.

Significance

This case expands our understanding of CO neurotoxicity beyond the traditional basal ganglia paradigm, emphasizing the importance of peripheral nervous system assessment even when central neuroimaging is normal.

目的报告并分析一例一氧化碳中毒后未累及中枢神经系统的选择性臂丛病。方法对1例25岁女性一氧化碳暴露后出现严重左上肢无力的患者进行临床检查、实验室检查、神经影像学、一系列电生理检查和功能评估。治疗包括高压氧治疗、类固醇治疗和康复治疗。结果一氧化碳中毒后，患者出现左上肢完全性麻痹，伴有选择性C5-C7运动障碍，感觉功能保留。脑MRI未见异常。电生理研究证实神经节前神经根病伴有运动神经振幅降低和感觉传导正常。超声检查显示C5-C7神经根肿胀。经过高压氧治疗、皮质类固醇和康复治疗，运动功能逐渐恢复，在120天的随访中，远端握力达到未受影响侧的86%。结论本病例表现为罕见的一氧化碳中毒，表现为孤立的臂神经根病，神经影像学显示中枢神经系统功能保留。这些发现扩大了一氧化碳神经毒性的公认范围。本病例扩展了我们对CO神经毒性的理解，超越了传统的基底神经节范式，强调了即使在中枢神经影像学正常的情况下，周围神经系统评估的重要性。

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引用次数: 0

Comments on “Asymptomatic tarsal tunnel syndrome in rheumatoid arthritis: an electrophysiological perspective with insights into clinical and laboratory correlates” “类风湿性关节炎无症状跗骨隧道综合征：电生理学视角与临床和实验室相关性的见解”评论

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-08-25 DOI: 10.1016/j.cnp.2025.08.004

Peyman Roomizadeh , Ayushi Chugh

引用次数: 0

What is the best electrode setting to elicit motor evoked potentials in the muscles of lower extremities during supratentorial surgery? 幕上手术期间，在下肢肌肉中诱发运动诱发电位的最佳电极设置是什么？

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 Epub Date: 2025-10-26 DOI: 10.1016/j.cnp.2025.10.005

Fares Komboz , Jan-Bernd Wemhoff , Andrea Szelényi , Beate Kranawetter , Tatiana Chacon , Angelina Nazarenus , Caspar Stephani , Veit Rohde , Tammam Abboud

Objective

Eliciting lower extremity transcranial motor evoked potentials (LE-tcMEP) during supratentorial surgery can be challenging, as it often requires high current intensities, bearing the risk of bypass stimulation with false positive results. The aim of this study was to evaluate a new hemispheric electrode combination (C3/4 ↔ Cz + 6), and compare it with established ones, determining the best scalp electrode setting with the minimal motor thresholds (MT) to elicit LE-tcMEP.

Methods

Patients undergoing surgery for supratentorial lesion removal requiring intraoperative neuromonitoring were prospectively included. TcMEP were elicited using montages C1 ↔ C2, C3 ↔ C4, C3/4 ↔ Cz, C3/4 ↔ Cz + 6 and Cz ↔ Cz + 6. MT was established for each muscle and montage to determine the electrode combination with the lowest MT and highest selectivity.

Results

Based on 5880 measurements (70 patients), we found that the mean MT for eliciting LE-tcMEPs was lowest for C3 ↔ C4 (83.0 mA, p = 0.001), followed by C3/4 ↔ Cz + 6 (96.5 mA). Successfully eliciting contralateral LE-tcMEP was best achieved with C3 ↔ C4 (99.2 %, p < 0.0001), followed by C3/4-Cz + 6 (98.9 %). C3/4 ↔ Cz + 6 achieved the highest side selectivity (p < 0.001).

Conclusion

While electrical stimulation at C3 ↔ C4 requires the lowest MT to elicit LE-tcMEPs, stimulation at C3/4 ↔ Cz + 6 was the most selective.

Significance

C3/4 ↔ Cz + 6 may be a superior choice in supratentorial surgery, avoiding bypass-stimulation of deeper (e.g. brainstem) corticospinal fibers.

目的幕上手术期间激发下肢经颅运动诱发电位（LE-tcMEP）是具有挑战性的，因为它通常需要高电流强度，承担旁路刺激假阳性结果的风险。本研究的目的是评价一种新的半球电极组合（C3/4↔Cz + 6），并将其与已有的组合进行比较，确定引起LE-tcMEP的最佳头皮电极设置和最小运动阈值（MT）。方法前瞻性纳入需要术中神经监测的幕上病变切除手术患者。TcMEP是用蒙太奇C1↔C2， C3↔C4, C3/4↔Cz， C3/4↔Cz + 6和Cz↔Cz + 6引起的。为每个肌肉和蒙太奇建立MT，以确定最低MT和最高选择性的电极组合。基于5880个测量值（70例患者），我们发现C3↔C4 （83.0 mA, p = 0.001）引起LE-tcMEPs的平均MT最低，其次是C3/4↔Cz + 6 （96.5 mA）。C3↔C4最能成功引起对侧LE-tcMEP (99.2%, p < 0.0001)，其次是C3/4- cz + 6（98.9%）。C3/4↔Cz + 6达到最高的边选择性（p < 0.001）。虽然C3↔C4的电刺激需要最低的MT才能引起LE-tcMEPs，但C3/4↔Cz + 6的电刺激是最有选择性的。Cz + 6在幕上手术中可能是一个较好的选择，它避免了对深层（如脑干）皮质脊髓纤维的旁路刺激。

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引用次数: 0