Mingfeng Cao , Shivalika Khanduja , Winnie Liu , Shi Nan Feng , Jin Kook Kang , Khalil S. Husari , Eva Katharina Ritzl , Glenn Whitman , Nitish Thakor , Sung-Min Cho
{"title":"Using high-frequency oscillation to detect acute brain injury in extracorporeal membrane oxygenation supported patients","authors":"Mingfeng Cao , Shivalika Khanduja , Winnie Liu , Shi Nan Feng , Jin Kook Kang , Khalil S. Husari , Eva Katharina Ritzl , Glenn Whitman , Nitish Thakor , Sung-Min Cho","doi":"10.1016/j.clinph.2025.2110769","DOIUrl":"10.1016/j.clinph.2025.2110769","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to utilize HFO analysis to enhance existing SSEP modality and develop it as a bedside diagnostic tool for acute brain injury (ABI) detection in Extracorporeal Membrane Oxygenation (ECMO) patients.</div></div><div><h3>Significance</h3><div>Timely diagnosis of ABI in ECMO patients is challenging due to logistical complexities with computed tomography (CT) and magnetic resonance imaging (MRI). Integrating time–frequency analysis into routine SSEP monitoring for early ABI detection can facilitate timely medical decisions.</div></div><div><h3>Method</h3><div>Consecutive SSEP data were collected from Johns Hopkins Intensive Care Units (ICUs), including 31 ECMO and 45 non-ECMO patients from 2016 to 2022. ABIs were determined using CT and MRI as clinically indicated. Using wavelet techniques, two SSEP-HFO components were quantified: HFOL (80–200 Hz) and HFOH (200–600 Hz), which were later fed to a Support Vector Machine (SVM) with a linear kernel.</div></div><div><h3>Result</h3><div>ECMO patients with ABI (N = 22) exhibited suppressed HFOH (Median = −9.09, Interquartile Range (IQR) = [ −13.5; −4.73] dB) compared to patients without (N = 9, Median = −4.39, IQR = [−6.35; −3.28] dB, P = 0.035). The SVM classifier achieved an accuracy of 75 % and a sensitivity of 82 % for detecting ABI, outperforming SSEP-N20.</div></div><div><h3>Conclusion</h3><div>SSEP-HFO can potentially improve early detection of ABI in ECMO patients at the bedside.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110769"},"PeriodicalIF":3.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin M. Lyons , Mitchell R. Goldsworthy , Brenton Hordacre
{"title":"Exploring neural variability, movement variability and motor learning in healthy adults and people with stroke","authors":"Erin M. Lyons , Mitchell R. Goldsworthy , Brenton Hordacre","doi":"10.1016/j.clinph.2025.2110759","DOIUrl":"10.1016/j.clinph.2025.2110759","url":null,"abstract":"<div><h3>Objective</h3><div>Investigate the association between neural variability, movement variability and motor learning in people with chronic stroke and healthy adults.</div></div><div><h3>Methods</h3><div>Thirty participants (17 healthy, 13 stroke) underwent assessments involving transcranial magnetic stimulation and a novel pinch-grip task. Neural variability was approximated as trial-to-trial amplitude variability of motor evoked potentials recorded at the hand following transcranial magnetic stimulation to the motor cortex. Movement variability was assessed as trial-to-trial deviations when performing a pinch grip task. Motor learning was assessed on a pinch grip task to trace an unknown shape, with reward scores provided to performance.</div></div><div><h3>Results</h3><div>Healthy adults performed better on the motor learning task (t<sub>(28)</sub> = -1.70, <em>p</em> = 0.05). Greater movement variability was associated with better motor learning in people with stroke (r = -0.68, <em>p</em> = 0.015), but not healthy adults. Neural variability was not found to predict movement variability or motor learning in healthy adults or people with stroke (all <em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>Increased movement variability supports better motor learning in people with chronic stroke, possibly due to increased exploration of successful movement solutions.</div></div><div><h3>Significance</h3><div>Movement variability appears worthy of investigation to improve motor learning and recovery from stroke.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110759"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donald L. Gilbert , David A. Huddleston , Karlee Y. Migneault , Deana Crocetti , Paul S. Horn , Steve W. Wu , Stewart H. Mostofsky
{"title":"Reliability of short interval cortical inhibition in children with attention deficit hyperactivity disorder","authors":"Donald L. Gilbert , David A. Huddleston , Karlee Y. Migneault , Deana Crocetti , Paul S. Horn , Steve W. Wu , Stewart H. Mostofsky","doi":"10.1016/j.clinph.2025.2110750","DOIUrl":"10.1016/j.clinph.2025.2110750","url":null,"abstract":"<div><h3>Objective</h3><div>Utility of biomarkers depends on test–retest consistency. Reduced Short Interval Cortical Inhibition (SICI) has emerged as a consistent finding in children with Attention Deficit Hyperactivity Disorder (ADHD); however, test–retest has not been established for children with ADHD. This is particularly crucial given that Transcranial Magnetic Stimulation (TMS) motor evoked potential (MEP)-based measures have high intra-subject variability and susceptibility to state-effects on motor cortex excitability. Addressing this, the objective of this study was to estimate test–retest reliability of paired-pulse SICI and of Intracortical Facilitation (ICF) in children, including those with ADHD and typically developing (TD) controls.</div></div><div><h3>Methods</h3><div>Sixty-four 8-to-12-year-old children (28 female; 35 ADHD; 29 TD) were recruited at two sites and SICI and ICF measured across two visits separated by 21 days. Intraclass correlations (ICCs) were calculated.</div></div><div><h3>Results</h3><div>Good reliability for SICI (ICC > 0.75), but only moderate for ICF (ICC > 0.50), was found among ADHD children, after accounting for test-pulse MEP amplitudes (>0.25 mV) and outliers.</div></div><div><h3>Conclusions</h3><div>These findings support the potential for SICI as a biomarker of ADHD in school-aged children.</div></div><div><h3>Significance</h3><div>This research addresses a critical gap in clinical neurophysiology, as estimating the reliability of SICI is needed to utilize it in interventional or longitudinal studies.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110750"},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luciana Pelosi , Zsuzsanna Arányi , Daniele Coraci , Alexander Grimm , Ingrid Herraets , Lisa D. Hobson-Webb , Antonios Kerasnoudis , Ruth Leadbetter , Simon Podnar , Neil Simon , Johan Telleman , Nens van Alfen , Leo Visser , Francis O. Walker , Natalie Winter , Eppie M. Yiu , Craig Zaidman , Michael S. Cartwright
{"title":"Expert consensus on the combined investigation of polyneuropathies with electrodiagnostic tests and neuromuscular ultrasound","authors":"Luciana Pelosi , Zsuzsanna Arányi , Daniele Coraci , Alexander Grimm , Ingrid Herraets , Lisa D. Hobson-Webb , Antonios Kerasnoudis , Ruth Leadbetter , Simon Podnar , Neil Simon , Johan Telleman , Nens van Alfen , Leo Visser , Francis O. Walker , Natalie Winter , Eppie M. Yiu , Craig Zaidman , Michael S. Cartwright","doi":"10.1016/j.clinph.2025.2110749","DOIUrl":"10.1016/j.clinph.2025.2110749","url":null,"abstract":"<div><div>Consensus was sought from 17 nominated global expert leaders to provide guidance on the combined use of neuromuscular ultrasound (NMUS) and electrodiagnostic tests (EDX) in the investigation of peripheral neuropathy (PN) in clinical practice.</div><div>Consensus was based on an initial systematic review of the literature by the experts themselves, followed by three anonymised surveys, using the Delphi method. No consensus was defined as < 60 % rating frequency.</div><div>The panel agreed that NMUS should be used if EDX cannot differentiate an axonal from a demyelinating process or an acquired from a hereditary process, and in the investigation of vasculitic neuropathy; NMUS of the brachial plexus should be used in Guillain-Barre’ syndrome if EDX is negative; when NMUS is used, at least two nerves of the upper limbs should be scanned; NMUS should be used for screening or repeat testing for carpal tunnel syndrome in children with mucopolysaccharidoses.</div><div>Areas of disagreement exposed gaps in current knowledge and informed the direction of future research, which should aim to identify situations in which NMUS can stand alone as a diagnostic test, particularly for screening or repeat testing and especially in vulnerable individuals and paediatric populations.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110749"},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arianna Brancaccio , Davide Tabarelli , David Baur , Johanna Roesch , Wala Mahmoud , Ulf Ziemann , Paolo Belardinelli
{"title":"Motor cortex excitability states in chronic stroke patients probed by EEG-TMS","authors":"Arianna Brancaccio , Davide Tabarelli , David Baur , Johanna Roesch , Wala Mahmoud , Ulf Ziemann , Paolo Belardinelli","doi":"10.1016/j.clinph.2025.2110747","DOIUrl":"10.1016/j.clinph.2025.2110747","url":null,"abstract":"<div><h3>Objective</h3><div>In healthy subjects, the trough vs. no-trough phases of the sensorimotor µ-rhythm correspond to high- vs. low-excitability states of the motor cortex (M1). We tested this excitability differentiation in the ipsilesional (iM1) and contralesional M1 (cM1) of chronic stroke patients.</div></div><div><h3>Methods</h3><div>19 chronic stroke patients received single-pulse transcranial magnetic stimulation (TMS), separately over the iM1 and cM1, during EEG recordings. High and low M1 excitability states were defined by binning a post-hoc estimate of the µ-phase at TMS delivery. TMS-evoked EEG potentials (TEPs) and time–frequency responses were characterized for excitability states and hemispheres. The motor function of the affected arm was tested by the Fugl-Meyer Assessment Upper Extremity (FMA-UE.</div></div><div><h3>Results</h3><div>In cM1, TMS at the high- vs. low-excitability state resulted in larger TEP amplitudes and increased post-pulse power in the beta band. In iM1, these modulations were not significant except for post-pulse beta power. This retained excitability differentiation significantly correlated with FMA-UE.</div></div><div><h3>Conclusions</h3><div>The degree of excitability differentiation in iM1 depending on phase of the sensorimotor µ-rhythm correlates with individual affected upper extremity motor function.</div></div><div><h3>Significance</h3><div>The degree of excitability differentiation in iM1 might serve as a new independent marker of motor recovery.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110747"},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sarasso , S. D’Ambrosio , S. Russo , L. Bernardelli , G. Hassan , A. Comanducci , P. De Giampaulis , L.A. Dalla Vecchia , J. Lanzone , M. Massimini
{"title":"Reduction of sleep-like perilesional slow waves and clinical evolution after stroke: A TMS-EEG study","authors":"S. Sarasso , S. D’Ambrosio , S. Russo , L. Bernardelli , G. Hassan , A. Comanducci , P. De Giampaulis , L.A. Dalla Vecchia , J. Lanzone , M. Massimini","doi":"10.1016/j.clinph.2025.2110746","DOIUrl":"10.1016/j.clinph.2025.2110746","url":null,"abstract":"<div><h3>Objective</h3><div>Recent studies indicate that brain injuries often lead to the occurrence of sleep-like slow waves in perilesional cortical areas. These slow waves may disrupt local cortico-cortical interactions and contribute to behavioral impairments but are, in principle, reversible. This study employs Transcranial Magnetic Stimulation (TMS) combined with Electroencephalography (EEG) to monitor changes in perilesional slow waves and local cortical interactions examining their relation to changes in stroke severity.</div></div><div><h3>Methods</h3><div>Twelve patients with post-acute/chronic unilateral ischemic cortical stroke participated in a longitudinal study with two assessment points. Each assessment included a neurological evaluation using the National Institutes of Health Stroke Scale (NIHSS) and TMS-EEG recordings targeting perilesional cortical areas. Neurophysiological parameters, such as slow wave amplitude (SWa), high-frequency power (HFp) suppression, and the Perturbational Complexity Index-state transition (PCIst), were extracted from the perilesional EEG responses to TMS to quantify local sleep-like slow waves and<!--> <!-->cortical interactions.</div></div><div><h3>Results</h3><div>We observed a perilesional reduction in sleep-like slow waves and a restoration of local cortical interactions. Notably, these changes significantly correlated with patients’ clinical evolution as assessed by the NIHSS score.</div></div><div><h3>Conclusions</h3><div>These findings highlight the potential of TMS-EEG as an objective tool for tracking neurological evolution post-stroke.</div></div><div><h3>Significance</h3><div>Targeting sleep-like cortical dynamics may be relevant for devising post-stroke rehabilitation strategies.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110746"},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chun-Hong Shen , Wen-Jie Ming , Yin-Xi Zhang , Meng-Ting Cai , Bin-Qing Du , Ye Du , Yong-Feng Xu , Zhong-Jin Wang , Yi Guo , Yao Ding , Sha Xu , Yin Hu , Xue-Mei Zhang , Shuang Wang , Mei-Ping Ding
{"title":"Seizure and electroencephalographic characteristics in anti-LGI1 encephalitis","authors":"Chun-Hong Shen , Wen-Jie Ming , Yin-Xi Zhang , Meng-Ting Cai , Bin-Qing Du , Ye Du , Yong-Feng Xu , Zhong-Jin Wang , Yi Guo , Yao Ding , Sha Xu , Yin Hu , Xue-Mei Zhang , Shuang Wang , Mei-Ping Ding","doi":"10.1016/j.clinph.2025.2110753","DOIUrl":"10.1016/j.clinph.2025.2110753","url":null,"abstract":"<div><h3>Objective</h3><div>To delineate seizure and electroencephalographic (EEG) characteristics in a cohort of patients with anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis.</div></div><div><h3>Methods</h3><div>Sixty-six newly diagnosed anti-LGI1 encephalitis patients with seizures were consecutively recruited. EEG data was obtainable for 63 patients, including 24-hour video EEG (VEEG) for 35 participants. Demographics, seizure characteristics, EEG findings, and general clinical data were reviewed.</div></div><div><h3>Results</h3><div>Among 66 patients, facial brachial dystonic seizures (FBDS), focal non-FBDS seizures, and secondarily generalized tonic-clonic seizures (sGTCS) occurred in 27.3 %, 59.1 %, and 57.6 %, respectively. Piloerection was observed in 27.3 %, and daily focal seizures were reported in 74.2 %. Sex-related analysis indicated females exhibited younger onset age with higher prevalence of focal non-FBDS seizures, piloerection, and daily seizures, whereas males had more sGTCS and cerebrospinal fluid abnormalities (p < 0.05). Interictal EEG revealed excessive beta activity (EBA) in 40.0 %, interictal epileptiform discharges in 22.2 %, and rhythmic delta activity in 12.7 %. Quantitative analysis provided confirmation of EBA. VEEG captured clinical events in 48.6 % and subclinical seizures (SCS) in 20.0 %.</div></div><div><h3>Conclusions</h3><div>We highlight seizure characteristics in anti-LGI1 encephalitis, particularly piloerection, daily focal seizures, and sex-related differences. Beyond previously reported SCS, EBA appears to be a frequent EEG pattern.</div></div><div><h3>Significance</h3><div>These findings may facilitate the recognition of anti-LGI1 encephalitis.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110753"},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diego Orcioli-Silva , Rodrigo Vitório , Victor Spiandor Beretta , Anderson Souza Oliveira , Núbia Ribeiro da Conceição , Priscila Nóbrega-Sousa , Paulo Cezar Rocha dos Santos , Lilian Teresa Bucken Gobbi , José Angelo Barela
{"title":"Aerobic exercise acutely increases EEG gamma power in the motor/sensorimotor areas during walking in people with Parkinson’s disease","authors":"Diego Orcioli-Silva , Rodrigo Vitório , Victor Spiandor Beretta , Anderson Souza Oliveira , Núbia Ribeiro da Conceição , Priscila Nóbrega-Sousa , Paulo Cezar Rocha dos Santos , Lilian Teresa Bucken Gobbi , José Angelo Barela","doi":"10.1016/j.clinph.2025.2110755","DOIUrl":"10.1016/j.clinph.2025.2110755","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the effects of acute aerobic exercise on gait function and cortical activity during single and dual-task walking in people with Parkinson’s disease (PwPD).</div></div><div><h3>Methods</h3><div>Thirty PwPD were randomly assigned to the Experimental (EG) and Control Group (CG). Both groups completed a single 40-minute session of cycling. Exercise intensity was maintained at 65–70% of the maximum heart rate for EG and within 5% of the resting heart rate for CG. Participants performed five walking trials under each condition before and after exercise. EEG and accelerometers measured cortical activity and gait parameters.</div></div><div><h3>Results</h3><div>In the post- vs. pre-exercise, the EG increased gamma power in the C and CP channels during single and dual-task walking. Increased step length during dual-task condition was positively associated with increased gamma power at the C and CP channels.</div></div><div><h3>Conclusion</h3><div>Acute exercise enhances movement control and sensorimotor integration during walking, evidenced by increased gamma power. Changes in gamma power in the motor/sensorimotor areas may improve step length during dual-task walking.</div></div><div><h3>Significance</h3><div>This study underscores the potential of aerobic exercise to increase the involvement of motor and sensorimotor cortical regions, highlighting the relevance of aerobic exercise in the neurorehabilitation and gait functions in PwPD.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110755"},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reconsidering the management and prognostic implications of myoclonus and status epilepticus post-cardiac arrest.","authors":"Pia De Stefano","doi":"10.1016/j.clinph.2025.2110754","DOIUrl":"https://doi.org/10.1016/j.clinph.2025.2110754","url":null,"abstract":"<p><p>Status epilepticus and myoclonus are frequent findings in post-cardiac arrest patients. While traditionally associated with poor outcomes, emerging evidence highlights scenarios where aggressive and tailored interventions may alter prognosis. This paper critically evaluates the definitions, diagnostic challenges, and therapeutic strategies for SE and myoclonus in this context. It highlights the necessity of standardized EEG-based evaluations to refine prognostic models and guide treatments. The findings advocate for a nuanced approach integrating EEG background and patterns, their evolution, and clinical assessments, offering a path forward in addressing the complexities of post-cardiac arrest encephalopathy.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2110754"},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}