Pub Date : 2025-01-01DOI: 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。
{"title":"Shear wave elastography as a marker of anisotropy in denervated muscle tissue","authors":"Olli Kutvonen , Sari-Leena Himanen , Katri Mäkelä","doi":"10.1016/j.cnp.2025.02.007","DOIUrl":"10.1016/j.cnp.2025.02.007","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the capability of shear wave elastography (SWE) to detect muscle denervation.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Significance</h3><div>Being able to measure anisotropy caused by denervation acts as a base for further development of SWE methods to evaluate neurogenic injury.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 95-103"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619967","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}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.10.002
L. Pelosi, A. Garvey, J. Kao, R. Roxburgh
{"title":"Nerve ultrasound abnormality in RFC1 positive isolated sensory neuropathy is milder than in the full RFC1 canvas phenotype","authors":"L. Pelosi, A. Garvey, J. Kao, R. Roxburgh","doi":"10.1016/j.cnp.2025.10.002","DOIUrl":"10.1016/j.cnp.2025.10.002","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 487-488"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361831","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}
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.
{"title":"What is the best electrode setting to elicit motor evoked potentials in the muscles of lower extremities during supratentorial surgery?","authors":"Fares Komboz , Jan-Bernd Wemhoff , Andrea Szelényi , Beate Kranawetter , Tatiana Chacon , Angelina Nazarenus , Caspar Stephani , Veit Rohde , Tammam Abboud","doi":"10.1016/j.cnp.2025.10.005","DOIUrl":"10.1016/j.cnp.2025.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>While electrical stimulation at C3 ↔ C4 requires the lowest MT to elicit LE-tcMEPs, stimulation at C3/4 ↔ Cz + 6 was the most selective.</div></div><div><h3>Significance</h3><div>C3/4 ↔ Cz + 6 may be a superior choice in supratentorial surgery, avoiding bypass-stimulation of deeper (e.g. brainstem) corticospinal fibers.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 493-498"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.11.005
Gabriele Diamanti , Julien Colin , Roland Hasler , Tomas Ros , Nader Perroud , Marie-Pierre Deiber
Objective
Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) face stigma in a society that values efficiency and self-control, with their behaviors often misattributed to inattention or recklessness rather than neurophysiological mechanisms. This study examined error processing deficits in adults with ADHD using event-related potentials (ERPs).
Methods
Twenty-eight adults with ADHD and 22 healthy controls completed a Continuous Performance Task (CPT) while undergoing EEG recording. ERP analysis focused on error-related negativity (Ne/ERN), linked to automatic error detection, and error positivity (Pe), associated with conscious error evaluation.
Results
Although reaction times did not differ significantly, ADHD patients showed greater response variability, increased omission and commission errors, and reduced stimulus detectability. After adjusting for anxiety, depression, and the number of valid trials, Ne amplitude did not differ between groups, whereas individuals with ADHD showed significantly reduced Pe amplitude. Within the ADHD group, prolonged Ne latency correlated with increased commission errors and faster responses, while lower Pe amplitude was linked to more commission errors and higher reaction time variability. Ne amplitude was negatively associated with motor impulsivity.
Conclusions
These findings highlight primary deficits in conscious error-monitoring processes, shedding light on altered neurophysiological mechanisms underlying impulsivity in adult ADHD.
Significance
This study provides insights into ADHD-related impulsivity, potentially informing future interventions for executive dysfunction.
{"title":"The neurobehavioral correlates of error processing in adult attention-deficit/hyperactivity disorder and their relationship with impulsivity","authors":"Gabriele Diamanti , Julien Colin , Roland Hasler , Tomas Ros , Nader Perroud , Marie-Pierre Deiber","doi":"10.1016/j.cnp.2025.11.005","DOIUrl":"10.1016/j.cnp.2025.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) face stigma in a society that values efficiency and self-control, with their behaviors often misattributed to inattention or recklessness rather than neurophysiological mechanisms. This study examined error processing deficits in adults with ADHD using event-related potentials (ERPs).</div></div><div><h3>Methods</h3><div>Twenty-eight adults with ADHD and 22 healthy controls completed a Continuous Performance Task (CPT) while undergoing EEG recording. ERP analysis focused on error-related negativity (Ne/ERN), linked to automatic error detection, and error positivity (Pe), associated with conscious error evaluation.</div></div><div><h3>Results</h3><div>Although reaction times did not differ significantly, ADHD patients showed greater response variability, increased omission and commission errors, and reduced stimulus detectability. After adjusting for anxiety, depression, and the number of valid trials, Ne amplitude did not differ between groups, whereas individuals with ADHD showed significantly reduced Pe amplitude. Within the ADHD group, prolonged Ne latency correlated with increased commission errors and faster responses, while lower Pe amplitude was linked to more commission errors and higher reaction time variability. Ne amplitude was negatively associated with motor impulsivity.</div></div><div><h3>Conclusions</h3><div>These findings highlight primary deficits in conscious error-monitoring processes, shedding light on altered neurophysiological mechanisms underlying impulsivity in adult ADHD.</div></div><div><h3>Significance</h3><div>This study provides insights into ADHD-related impulsivity, potentially informing future interventions for executive dysfunction.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 550-557"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.06.002
Julian Ostertag , Aleksandra Migal , David P. Obert , Gerhard Schneider , Pablo Sepúlveda , Matthias Kreuzer
Objective
Evaluating age-related dependencies in the electroencephalogram (EEG) during induction of general anesthesia and their impact on composite scores used to assess frailty.
Methods
A composite score was derived from spectral edge frequency, total power, alpha power, and the effect-site concentration (Ce) of propofol. All these parameters are influenced by age, brain health, and dosage and speed of drug administration. Correlation coefficients and variance inflation factors were used to determine multicollinearity. Differences in the spectral EEG features of patients with “high” and “low” composite scores were assessed by the area under the receiver operator characteristic curve (AUC) as the statistical test.
Results
The EEG features, total power and alpha power, were strongly correlated (ρ = 0.82). But alpha power (ρ = 0.17) and total power (ρ = 0.2) were only weakly correlated with propofol, indicating a weak model. Additionally, the composite score showed a moderate negative correlation with age (ρ = -0.44). We also observed significant and strong (AUC < 0.3) differences in total power and the power of all EEG bands except gamma between patients with a ”high” and a ”low” score before loss of responsiveness (LOR).
Conclusion
Patient age significantly influences EEG-based parameters within the score. Importantly, significant differences in spectral EEG features between the groups were already observable before LOR. These differences could allow for early assessment of a patient’s brain state and to titrate anesthetic dose before LOR. The study also shows that age should be considered as it can drive models for ”frailty”.
Significance
Age moderately influenced all subcomponents and should consequently be factored into score interpretation.
{"title":"Age-dependent changes in the power spectrum conflate composite scores to assess brain frailty","authors":"Julian Ostertag , Aleksandra Migal , David P. Obert , Gerhard Schneider , Pablo Sepúlveda , Matthias Kreuzer","doi":"10.1016/j.cnp.2025.06.002","DOIUrl":"10.1016/j.cnp.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluating age-related dependencies in the electroencephalogram (EEG) during induction of general anesthesia and their impact on composite scores used to assess frailty.</div></div><div><h3>Methods</h3><div>A composite score was derived from spectral edge frequency, total power, alpha power, and the effect-site concentration (Ce) of propofol. All these parameters are influenced by age, brain health, and dosage and speed of drug administration. Correlation coefficients and variance inflation factors were used to determine multicollinearity. Differences in the spectral EEG features of patients with “high” and “low” composite scores were assessed by the area under the receiver operator characteristic curve (AUC) as the statistical test.</div></div><div><h3>Results</h3><div>The EEG features, total power and alpha power, were strongly correlated (<em>ρ</em> = 0.82). But alpha power (<em>ρ</em> = 0.17) and total power (<em>ρ</em> = 0.2) were only weakly correlated with propofol, indicating a weak model. Additionally, the composite score showed a moderate negative correlation with age (<em>ρ</em> = -0.44). We also observed significant and strong (AUC <em><</em> 0.3) differences in total power and the power of all EEG bands except gamma between patients with a ”high” and a ”low” score before loss of responsiveness (LOR).</div></div><div><h3>Conclusion</h3><div>Patient age significantly influences EEG-based parameters within the score. Importantly, significant differences in spectral EEG features between the groups were already observable before LOR. These differences could allow for early assessment of a patient’s brain state and to titrate anesthetic dose before LOR. The study also shows that age should be considered as it can drive models for ”frailty”.</div></div><div><h3>Significance</h3><div>Age moderately influenced all subcomponents and should consequently be factored into score interpretation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 209-217"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.08.004
Peyman Roomizadeh , Ayushi Chugh
{"title":"Comments on “Asymptomatic tarsal tunnel syndrome in rheumatoid arthritis: an electrophysiological perspective with insights into clinical and laboratory correlates”","authors":"Peyman Roomizadeh , Ayushi Chugh","doi":"10.1016/j.cnp.2025.08.004","DOIUrl":"10.1016/j.cnp.2025.08.004","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Page 346"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2024.12.004
Jinyang Zhuang , Xiyuan Lei , Xiaoli Guo , Li Ding , Jie Jia
Objective
To elucidate the immediate electrophysiological effects of mirror visual feedback (MVF) combined with or without touch task in subacute stroke.
Methods
Subacute stroke patients and healthy controls were recruited to participate in four grasping tasks (MVF or no MVF, combined with rubber ball or no ball) under electroencephalogram (EEG) monitoring. Event-related desynchronization (ERD) /event-related synchronization (ERS) and the lateralization index (LI) were utilized to observe the electrophysiological effects.
Results
MVF reduced ERD suppression in the contralateral primary motor cortex (M1) of stroke patients. This reduction was observed in the low mu band for the contralateral parietal cortex during pure MVF. The laterality effects in the low mu band under MVF was noted in M1 for stroke patients and in the parietal cortex for all participants.
Conclusions
MVF inhibits the excitability of the contralateral M1 for subacute stroke. MVF inhibit activities in the contralateral M1 and parietal cortex, and reestablished hemispheric balance in the low mu band.
Significance
MVF has an instantaneous effect on subacute stroke by inhibiting the excitability of the contralateral sensorimotor cortex. The attenuated ERD in the low mu band in contralateral M1 and parietal cortex may serve as biomarkers of MVF for stroke rehabilitation.
{"title":"Motor and parietal cortex activity responses to mirror visual feedback in patients with subacute stroke: An EEG study","authors":"Jinyang Zhuang , Xiyuan Lei , Xiaoli Guo , Li Ding , Jie Jia","doi":"10.1016/j.cnp.2024.12.004","DOIUrl":"10.1016/j.cnp.2024.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>To elucidate the immediate electrophysiological effects of mirror visual feedback (MVF) combined with or without touch task in subacute stroke.</div></div><div><h3>Methods</h3><div>Subacute stroke patients and healthy controls were recruited to participate in four grasping tasks (MVF or no MVF, combined with rubber ball or no ball) under electroencephalogram (EEG) monitoring. Event-related desynchronization (ERD) /event-related synchronization (ERS) and the lateralization index (LI) were utilized to observe the electrophysiological effects.</div></div><div><h3>Results</h3><div>MVF reduced ERD suppression in the contralateral primary motor cortex (M1) of stroke patients. This reduction was observed in the low mu band for the contralateral parietal cortex during pure MVF. The laterality effects in the low mu band under MVF was noted in M1 for stroke patients and in the parietal cortex for all participants.</div></div><div><h3>Conclusions</h3><div>MVF inhibits the excitability of the contralateral M1 for subacute stroke. MVF inhibit activities in the contralateral M1 and parietal cortex, and reestablished hemispheric balance in the low mu band.</div></div><div><h3>Significance</h3><div>MVF has an instantaneous effect on subacute stroke by inhibiting the excitability of the contralateral sensorimotor cortex. The attenuated ERD in the low mu band in contralateral M1 and parietal cortex may serve as biomarkers of MVF for stroke rehabilitation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 12-21"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013284","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}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2024.12.005
Steven Falowski , Mingyue Tang , Ashlesha Deshmukh , Ameya Nanivadekar , David Page , Mingming Zhang
Objective
This study aims to investigate the sources of later response in epidural spinal recordings (ESRs) obtained from implanted leads during spinal cord stimulation, a topic has not been widely studied in previous research.
Methods
Two patients with lower back and lower extremity pain underwent SCS implantation with intraoperative neuromonitoring (IONM). The timing of extracted peaks in ESRs and intramuscular electromyography (EMG) recordings were analyzed and compared to a Monte Carlo simulation for synchronization analysis.
Results
Our data show that, when using two most caudal electrodes for stimulation, late response in ESRs collected from SCS leads was not synchronized with EMG recordings from lower extremity muscles. However, parts of the late responses were synchronized with EMG recordings from abdominal muscle groups.
Conclusions
Late response in ESRs is believed to result from muscle contractions, although the exact sources have not been fully identified. They are likely to originate from muscles near the implanted leads.
Significance
This research indicates that components of the late response may originate beyond the abdominal region, potentially offering additional information for current IONM practice. Additionally, understanding the sources of the late response may be useful for emerging clinical applications in neurorehabilitation.
{"title":"Case report: Potential physiological sources of the late response in epidural spinal recordings induced by spinal cord stimulation during intraoperative neuromonitoring","authors":"Steven Falowski , Mingyue Tang , Ashlesha Deshmukh , Ameya Nanivadekar , David Page , Mingming Zhang","doi":"10.1016/j.cnp.2024.12.005","DOIUrl":"10.1016/j.cnp.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the sources of later response in epidural spinal recordings (ESRs) obtained from implanted leads during spinal cord stimulation, a topic has not been widely studied in previous research.</div></div><div><h3>Methods</h3><div>Two patients with lower back and lower extremity pain underwent SCS implantation with intraoperative neuromonitoring (IONM). The timing of extracted peaks in ESRs and intramuscular electromyography (EMG) recordings were analyzed and compared to a Monte Carlo simulation for synchronization analysis.</div></div><div><h3>Results</h3><div>Our data show that, when using two most caudal electrodes for stimulation, late response in ESRs collected from SCS leads was not synchronized with EMG recordings from lower extremity muscles. However, parts of the late responses were synchronized with EMG recordings from abdominal muscle groups.</div></div><div><h3>Conclusions</h3><div>Late response in ESRs is believed to result from muscle contractions, although the exact sources have not been fully identified. They are likely to originate from muscles near the implanted leads.</div></div><div><h3>Significance</h3><div>This research indicates that components of the late response may originate beyond the abdominal region, potentially offering additional information for current IONM practice. Additionally, understanding the sources of the late response may be useful for emerging clinical applications in neurorehabilitation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 22-29"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048233","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}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.02.005
Julian Theuriet , Adrien Bohic , Maxime Bonjour , Emilien Bernard , Florent Cluse , Juliette Svahn , Laurent Jomir , Anne-Evelyne Vallet , Marion Demia , Lucie Roux , Ioana Cristina Bârsan , Léa Alves , Matthias Dion , Lionel Meens , Martin Moussy , Françoise Bouhour , Yann Péréon , Antoine Pegat
Objective
This study aimed to compare the frequency of blink reflex’s contralateral R1 responses (R1′) between patients with amyotrophic lateral sclerosis (ALS), non-ALS motor deficit patients, and healthy volunteers.
Methods
A total of 120 participants were prospectively recruited: 40 with ALS, 40 with a non-ALS motor deficit, and 40 healthy volunteers. Blink reflexes were recorded from orbicularis oculi muscles following supraorbital nerve stimulation.
Results
R1′ was more frequent in the ALS group (42.5 %) compared to healthy volunteers (12.5 %, p = 0.00588), and compared to non-ALS patients (7.5 %, p = 0.000789). Bilateral R1′ was observed only in ALS patients (22.5 %). No clinically significant difference was found in the latencies or amplitudes of the R1, R2, or R1′ responses among groups. R1′ was more frequent in ALS patients with pseudobulbar affect (71.4 %) compared to those without (36.4 %).
Conclusions
The higher frequency of R1′ in ALS highlights its potential role in distinguishing ALS from other motor disorders. Its sensitivity was low, but bilateral R1′ was specific to ALS. The higher frequency of R1′ among ALS patients with pseudobulbar affect potentially reflects corticobulbar neuron degeneration.
Significance
The R1′, especially when bilateral, could serve as an additional diagnostic biomarker for ALS, although its clinical relevance should be considered within the broader diagnostic context.
{"title":"Contralateral R1 response in blink reflex in patients with amyotrophic lateral sclerosis","authors":"Julian Theuriet , Adrien Bohic , Maxime Bonjour , Emilien Bernard , Florent Cluse , Juliette Svahn , Laurent Jomir , Anne-Evelyne Vallet , Marion Demia , Lucie Roux , Ioana Cristina Bârsan , Léa Alves , Matthias Dion , Lionel Meens , Martin Moussy , Françoise Bouhour , Yann Péréon , Antoine Pegat","doi":"10.1016/j.cnp.2025.02.005","DOIUrl":"10.1016/j.cnp.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the frequency of blink reflex’s contralateral R1 responses (R1′) between patients with amyotrophic lateral sclerosis (ALS), non-ALS motor deficit patients, and healthy volunteers.</div></div><div><h3>Methods</h3><div>A total of 120 participants were prospectively recruited: 40 with ALS, 40 with a non-ALS motor deficit, and 40 healthy volunteers. Blink reflexes were recorded from orbicularis oculi muscles following supraorbital nerve stimulation.</div></div><div><h3>Results</h3><div>R1′ was more frequent in the ALS group (42.5 %) compared to healthy volunteers (12.5 %, p = 0.00588), and compared to non-ALS patients (7.5 %, p = 0.000789). Bilateral R1′ was observed only in ALS patients (22.5 %). No clinically significant difference was found in the latencies or amplitudes of the R1, R2, or R1′ responses among groups. R1′ was more frequent in ALS patients with pseudobulbar affect (71.4 %) compared to those without (36.4 %).</div></div><div><h3>Conclusions</h3><div>The higher frequency of R1′ in ALS highlights its potential role in distinguishing ALS from other motor disorders. Its sensitivity was low, but bilateral R1′ was specific to ALS. The higher frequency of R1′ among ALS patients with pseudobulbar affect potentially reflects corticobulbar neuron degeneration.</div></div><div><h3>Significance</h3><div>The R1′, especially when bilateral, could serve as an additional diagnostic biomarker for ALS, although its clinical relevance should be considered within the broader diagnostic context.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 47-51"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509107","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}
Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.02.008
Kai Michael Schubert, Anton Schmick, Miranda Stattmann, Marian Galovic
Epilepsy is a frequent consequence of acute brain injuries, such as stroke, brain tumors, and traumatic brain injury (TBI). Accurate prediction of epilepsy is essential for early intervention and improved patient outcomes. This review evaluates the best-established prognostic models, including the SeLECT and CAVE scores, which estimate the risk of developing seizures and epilepsy following these injuries. The review highlights their clinical applicability, predictive accuracy, and limitations for different etiologies. In addition to providing practical tables for risk estimation, we also offer user-friendly online calculators for these models at www.predictepilepsy.com to facilitate clinical implementation. These tools help identify high-risk patients and support decision-making for follow-up and treatment. Furthermore, we discuss the potential of integrating electrophysiological data, including EEG biomarkers, to further enhance prediction accuracy and patient care. These insights highlight the need for further refinement and validation of predictive models, enabling more personalized treatment strategies and better patient care.
{"title":"Prognostic models for seizures and epilepsy after stroke, tumors and traumatic brain injury","authors":"Kai Michael Schubert, Anton Schmick, Miranda Stattmann, Marian Galovic","doi":"10.1016/j.cnp.2025.02.008","DOIUrl":"10.1016/j.cnp.2025.02.008","url":null,"abstract":"<div><div>Epilepsy is a frequent consequence of acute brain injuries, such as stroke, brain tumors, and traumatic brain injury (TBI). Accurate prediction of epilepsy is essential for early intervention and improved patient outcomes. This review evaluates the best-established prognostic models, including the SeLECT and CAVE scores, which estimate the risk of developing seizures and epilepsy following these injuries. The review highlights their clinical applicability, predictive accuracy, and limitations for different etiologies. In addition to providing practical tables for risk estimation, we also offer user-friendly online calculators for these models at <span><span>www.predictepilepsy.com</span><svg><path></path></svg></span> to facilitate clinical implementation. These tools help identify high-risk patients and support decision-making for follow-up and treatment. Furthermore, we discuss the potential of integrating electrophysiological data, including EEG biomarkers, to further enhance prediction accuracy and patient care. These insights highlight the need for further refinement and validation of predictive models, enabling more personalized treatment strategies and better patient care.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 116-128"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628171","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}
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