Clinical EEG and neuroscience最新文献

Early clinical response to electroconvulsive therapy (ECT) varies substantially across patients. The physiological expression of ECT-induced seizures, captured by routinely recorded EEG seizure duration and suppression indices together with autonomic responses, reflects interactions among cortical excitability, inhibitory processes, and peripheral activation. In younger patients, these systems may operate within a distinct physiological range, making early-session responses a particularly informative window for examining how seizure dynamics and cortical suppression relate to antidepressant effects, yet the clinical relevance of coordinated early physiological patterns remains unclear. We studied 28 young patients with major depressive disorder receiving ECT. Five routinely recorded physiological measures-stimulus dose, EEG seizure duration, EEG suppression index, systolic blood pressure change, and pulse rate change-were averaged across the first three ECT sessions and standardized. Unsupervised k-means clustering characterized early physiological response patterns, and exploratory logistic regression examined associations with early clinical improvement, defined as a ≥ 5-point reduction in HAMD-17 score by the third session. Two early physiological patterns were identified. A pattern characterized by longer seizure duration and lower EEG suppression was associated with greater early symptom improvement, despite heterogeneous autonomic responses. In regression analyses, seizure duration was positively associated with improvement, whereas EEG suppression index showed a strong negative association. Collectively, early physiological features showed clear within-sample separation between patients with and without early improvement (apparent AUC = 0.86). These findings suggest that early ECT physiology in young patients reflects coordinated response states rather than isolated markers, highlighting the potential value of multivariate interpretation of routine EEG-derived indices.

BackgroundNeurology residency time constraints limit requisite EEG training, contributing to discomfort with this core skill. EEG interpretation is a procedural skill, and educational models utilizing cognitive and procedural elements may increase education efficacy and efficiency. We applied the Fitts-Posner procedural model to create a condensed EEG curriculum and assessed feasibility and efficacy.MethodsWe identified EEG education barriers then designed a curriculum including asynchronous didactics, EEG reading/staffing, and report writing. The curriculum was incorporated 2023-2024 into a 2-week (adult neurology) or 4-week (child neurology) epilepsy rotation. We evaluated EEG interpretation knowledge and confidence before, after and following a 3-month delay and solicited feedback.ResultsPrimary barriers to EEG education were insufficient practice and clinical responsibility. Ninety percent (19/21) of residents completed the curriculum. Residents identified reading/staffing EEGs and writing reports as instrumental curriculum components. Compared with pre-rotation, confidence and knowledge increased immediately post-rotation and following a 3-month delay but were lower at 3-months than immediately post-rotation. Child neurology residents had higher confidence than adult residents on post and 3-month surveys despite no knowledge differences.ConclusionsA condensed EEG curriculum using a procedural learning model was associated with improved confidence and knowledge after a 3-month delay. Confidence and knowledge were lower at 3-months than immediately post-rotation, indicating the need for reinforcing activities. Confidence was higher for child neurology residents with two extra rotation weeks suggesting additional training may also enhance confidence gains. Asynchronous didactics maximized efficiency, but residents valued reading/staffing EEGs and writing reports, highlighting the importance of sociocultural approaches.

IntroductionSporadic Creutzfeldt-Jakob Disease (sCJD) is a rapidly progressive prion disease that can be challenging to distinguish from other dementias, especially in early stages or when classical EEG findings, such as periodic sharp wave complexes (PSWCs), are absent. This study aimed to assess the utility of quantitative EEG (QEEG) features-derived from Food and Drug Administration-approved software-in differentiating sCJD from non-sCJD dementias.MethodsEEG data from 78 participants were retrospectively analyzed: 19 sCJD patients, 49 non-sCJD dementia patients, and 10 healthy controls. sCJD cases were sourced from three centers, while matched non-sCJD cases and controls were selected from a single-center EEG database. Sixty seconds of artifact-free EEG during wakefulness or drowsiness were selected per participant. QEEG parameters-amplitude-integrated EEG (aEEG) and rhythmicity spectrogram (RS)-were extracted using Persyst^® software. Intergroup comparisons were conducted using the Kruskal-Wallis test with Holm-Sidák correction. Group-level rhythmicity patterns were also evaluated visually.ResultssCJD patients had significantly higher aEEG and RS values than non-sCJD patients across both hemispheres (aEEG: left p = .001, right p = .010; RS: left p = .001, right p = .003). A distinct "tri-band rhythmicity" pattern involving delta, theta, and low beta frequencies was uniquely observed in sCJD patients, including those without PSWCs on conventional EEG.ConclusionQEEG using clinically available software can reveal disease-specific electrophysiological features in sCJD. Tri-band rhythmicity may serve as a non-invasive adjunctive marker for early or atypical sCJD diagnosis, warranting further validation in prospective studies.

Aims and Objectives: It has been hypothesised that vestibular stimulation may have a modulatory effect on anxiety. The aim of this randomised, double blind, sham-controlled trial was to determine the efficacy and safety of a non-invasive electrical vestibular nerve stimulation (VeNS) device as a treatment for anxiety compared to a sham stimulation device. Materials and methods: A total of 60 participants (mean age [SD]: 35.6 [8.1]) with a generalized anxiety disorder assessment (GAD-7) score of ≥10 were randomised to receive either an active VeNS device (n = 34) or a sham control device (n = 26). Both groups were asked to complete 20 stimulation sessions (30 min duration) at a rate of 3-5 sessions per week at a research clinic. The primary outcome was change in GAD-7 score from baseline to the end of study (when each participant finished their 20 stimulation sessions). Secondary outcomes were change in Insomnia Severity Index (ISI), and the Short Form 36 Health Survey (SF-36) scores (8 domains). Results: One participant allocated to the sham group withdrew from the study. The mean (SD) number of weeks it took to complete the 20 stimulation sessions was 5.8. The active group had a statistically greater reduction in GAD-7 score compared to the sham group (-7.4 versus -2.2, P < .001; respectively). A total of 97% (n = 33) of the active group achieved a clinically meaningful reduction (defined as ≥4-point reduction) in GAD-7 from baseline to the follow up visit compared to 24% (n = 6) of the sham group (P < .001). Additionally, the active group showed a significant improvement in ISI (-4.9 versus 2.2, P < .001) and greater improvements on all eight SF36 domains (P < .001) compared with the sham group. There was no device related reported adverse events. Conclusion: Regular non-invasive electrical vestibular nerve stimulation appears to have a clinically meaningful benefit when used as an intervention for Generalized Anxiety Disorder.

Autism is a neurodevelopmental condition that impacts individuals' communication and social interaction skills. Autistic children often have smaller N170 amplitudes in response to faces than neurotypical children. Autistic children also avoid the salient areas of the face. Technology-based interventions have been developed to teach autistic children how to recognise facial expressions, but the results have exhibited considerable variability across studies. The current study explored the effectiveness of an iPad app designed to support autistic children in recognising facial expressions by examining how participants process facial information through event-related potentials (ERP) and eye-tracking recordings. ERPs and eye tracking were recorded from 20 neurotypical and 15 autistic children aged between 6 and 12 years. The results replicated previous work, with the autistic group having smaller N170 and Vertex Positive Potential amplitudes and more scan time off the face when compared to non-autistic children. Following the intervention, some changes were observed in facial feature scanning among autistic participants, characterised by increased time spent on the face and decreased fixations. These findings add to the work, indicating that eye tracking may be a valuable biomarker for intervention outcomes in autism. Further research into N170 as a biomarker is needed.

ObjectivesWe aimed to clarify the occurrence pattern of icDCs (ictal direct-current shifts), its recording parameters, polarity, and amplitude and to elucidate whether icDCs correlated with histology and the resection of the core area of icDCs is associated with favorable outcomes. Methods We carried out a systematic review according to the PRISMA statement. We searched for studies describing intracranial direct current shift, intracranial slow potential shift (SPS), or intracranial infralow activity AND surgical outcome. Results There is a marked heterogenicity in the recording parameters of icDCs, and in the method of intracranial evaluation (SEEG, subdural electrodes or both); icDCs can be obtained in more than 90% of patients with epilepsy evaluated with intracranial electrodes and in more than 90% of the seizures; icDCs is an electrical phenomenon with very high amplitude, with positive or negative polarity and prolonged duration, seen before or during seizure onset; IcDCs are best recorded with a time constant of 10 s, and setting LFF at 0.01 to 0.016 Hz and variable HFF; it seems preferable to evaluate them with an epoch of 300 s. IcDCs are not specific to any subjacent pathology. icDCs increases the probability of being seizure-free by 30.5. Conclusion Infralow activity can be assessed during intracranial recording with sEEG or subdural electrodes. Infralow activity is a prolonged baseline shift, with a very high amplitude appearing before or with the seizure onset. This might not be related to the subjacent pathology, but it helps delineate the zone to remove.

Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) are synucleinopathy syndromes with similar symptom profiles that are distinguished clinically based on the arbitrary rule of the time of symptom onset. Identifying reliable electroencephalographic (EEG) biomarkers would provide a precise method for better diagnosis, treatment, and monitoring of treatment response in these two types of dementia. From April 2015 to March 2021, the records of new referrals to a neurology clinic were retrospectively reviewed and 28 DLB(70.3% male) and 20 PDD (80.8% male) patients with appropriate EEG were selected for this study. Artifact-free 60-s EEG signals (21 channels) at rest with eyes closed were analyzed using EEGLAB, and regional spectral power ratios were extracted. Marked diffuse slowing was found in DLB patients compared to PDD patients in all regions in terms of decrease in alpha and increase in theta band. Although, these findings demean between groups after adjusting for MMSE scores, the significant difference still remained in terms of the mean relative alpha powers, particularly in the anterior and central regions. QEEG measures may have the potential to discriminate between these two syndromes. However, further prospective and longitudinal studies are required to improve the early differentiation of these dementia syndromes and to elucidate the underlying causes and pathogenesis and specific treatment.

BackgroundLance-Adams Syndrome (LAS) is a rare neurological complication of hypoxic brain injury, characterized by action- and stimulus-sensitive myoclonus in patients who have regained consciousness. Although often misinterpreted as a sign of poor prognosis, LAS can lead to significant long-term disability but also shows potential for functional recovery with appropriate management.MethodologyA narrative review was conducted using a predefined search strategy across PubMed and ScienceDirect databases to identify peer-reviewed studies on LAS published between January 2000 and April 2025. A total of 47 studies were included in the final synthesis, comprising 34 case reports, 7 narrative or scoping reviews, 2 systematic reviews and 4 original clinical studies.ResultsThe pathophysiology of LAS remains multifactorial, involving cortical hyperexcitability, subcortical disinhibition, and neurotransmitter imbalances. Electroencephalographic and imaging studies provide important diagnostic clues. Management remains largely symptomatic, based on empirical evidence. Clonazepam and valproate remain first-line therapies, while agents such as perampanel, sodium oxybate, cannabidiol, and intrathecal baclofen have been trialed in refractory cases. Multidisciplinary rehabilitation plays a crucial role in long-term outcomes.ConclusionGreater awareness and earlier recognition of LAS can improve diagnostic accuracy and therapeutic outcomes. Despite its rarity, clinicians should remain alert to LAS as a potentially reversible disorder when appropriately diagnosed and managed. Standardized treatment guidelines remain a future priority.

This study investigated perceptual differences between adolescents with Autism Spectrum Disorder (ASD) and neurotypical individuals using a multidimensional approach involving quantitative electroencephalography (qEEG), biomechanical analysis with Movement Element Decomposition (MED), and facial microexpression tracking via FaceReader software. The study included 22 adolescents (8 with ASD and 14 controls), evaluated under four experimental conditions: rest (eyes open and closed) and exposure to visual/auditory stimuli. Findings indicated increased Delta band activity in the ASD group, absence of Alpha band reactivity, greater postural instability, altered oscillation patterns, and a predominance of neutral emotional expressions. The results suggest that individuals with ASD exhibit distinct patterns of sensory, motor, and emotional processing, highlighting the potential of these tools as biomarkers for diagnosis and intervention.

ObjectiveThe present study investigated the neural correlates of cognitive control in youth with Attention Deficit Hyperactivity disorder (ADHD) and comorbid learning disability (N = 75, ages 11-17 years) who participated in a 20-week mindfulness martial arts intervention compared to a waitlist control.MethodEEG was recorded pre and post intervention during a blocked Go/NoGo task. Peak amplitude was measured for the inhibitory NoGo N2 and P3 ERP components.ResultsA significant group by time interaction was found for NoGo N2 amplitudes, indicating that waitlist control participants had significantly attenuated N2 amplitudes over time whereas the intervention group maintained similar levels of medial frontal activity during response inhibition. The maintenance of the individual differences in N2 amplitudes were robust in the intervention group.ConclusionsThese findings suggest that participation in mindfulness martial arts may buffer against reductions in N2 activity during adolescence for youth with ADHD.