Clinical Neurophysiology最新文献

{"title":"Deep learning-based EEG source imaging is robust under varying electrode configurations","authors":"Jesse Rong ,&nbsp;Rui Sun ,&nbsp;Boney Joseph ,&nbsp;Greg Worrell ,&nbsp;Bin He","doi":"10.1016/j.clinph.2025.04.009","DOIUrl":"10.1016/j.clinph.2025.04.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous research has underscored the necessity of high-density EEG for accurate and reliable EEG source imaging (ESI) results with conventional ESI methods, limiting their utility in clinical settings with only low-density EEG available. In recent years, deep learning-based ESI methods have exhibited robust performance by directly learning spatiotemporal brain activity patterns from data.</div></div><div><h3>Methods</h3><div>This study investigates the impact of EEG electrode number on a newly proposed Deep Learning-based Source Imaging Framework (DeepSIF). Through computer simulations and clinical data analysis, we assess ESI performance across various channel configurations (16, 21, 32, 64, and 75 channels) comparing DeepSIF and conventional methods against the simulated ground truth and clinical reference regions.</div></div><div><h3>Results</h3><div>Our results indicate that DeepSIF consistently delivers accurate source localization and extent estimations across different channel counts and noise levels, surpassing conventional methods. In a cohort of 27 drug-resistant epilepsy patients, the average spatial dispersions for DeepSIF, sLORETA and LCMV are 7.9/9.0 mm, 21.9/28.1 mm, and 20.0/28.9 mm, respectively when using 75/16 electrodes.</div></div><div><h3>Conclusions</h3><div>Our results indicate the robust performance of DeepSIF algorithm for source imaging with low-density EEG.</div></div><div><h3>Significance</h3><div>Our findings suggest broad applications of the deep-learning based source imaging in clinical settings without the need for high-density EEG devices.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2010730"},"PeriodicalIF":3.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895820","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":"Subclinical involvement of small hand muscles in early amyotrophic lateral sclerosis: Selective susceptibility leads to ‘split hand’ phenomenon","authors":"Mamede de Carvalho ,&nbsp;Miguel Oliveira Santos ,&nbsp;Michael Swash","doi":"10.1016/j.clinph.2025.04.007","DOIUrl":"10.1016/j.clinph.2025.04.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Split-hand phenomenon is common in patients with amyotrophic lateral sclerosis (ALS), but it is unknown if first dorsal interosseous (FDI) and abductor pollicis brevis (ABP) are affected earlier than abductor digiti minimi (ADM). We aimed to address this issue.</div></div><div><h3>Methods</h3><div>One clinically normal hand from ALS patients was investigated, including needle EMG of the FDI, motor amplitude, distal latency, F-waves, neurophysiological index (NI) and split-hand index (SHI). Hands were categorised as G1 (normal FDI) and G2 (FDI with neurogenic changes). In patients who agreed EMG of the 3 muscles was done. A subset of G1 patients underwent a second evaluation 4–5 months later.</div></div><div><h3>Results</h3><div>We studied 133 patients; EMG of the 3 muscles was done in 77 patients. There was no evidence for an earlier loss of motor units in FDI/ABP. In G2 patients, CMAP amplitude and NI were significantly lower (p &lt; 0.001), but ADM changes were minor. Reassessment of G1 patients confirmed significant SHI, and amplitude and NI decrease in all muscles, but F-waves frequency remained stable in ADM.</div></div><div><h3>Conclusions</h3><div>Loss of motor units in the 3 hand muscles began in parallel, but ADM spinal motoneurons showed stronger resistance to degeneration.</div></div><div><h3>Significance</h3><div>Dysfunction of intrinsic spinal circuits can influence split-hand phenomenon.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 173-177"},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863487","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":"Towards early diagnosis of amyotrophic lateral sclerosis using near fibre EMG","authors":"Oscar Garnés-Camarena ,&nbsp;Ignacio Mahíllo-Fernández ,&nbsp;Pedro Martínez-Ulloa ,&nbsp;Ross Mandeville ,&nbsp;Oscar Lorenzo ,&nbsp;Daniel W. Stashuk","doi":"10.1016/j.clinph.2025.04.006","DOIUrl":"10.1016/j.clinph.2025.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of motor neurons and diagnosis is usually delayed several months. The continuous denervation and reinnervation associated with ALS are manifest in EMG signals as changes in motor unit potential (MUP) size, temporal dispersion and instability. Near Fibre EMG is a novel method to assess early changes in MUP temporal dispersion and instability using routinely recorded EMG signals in a semi-automated manner.</div></div><div><h3>Methods</h3><div>Near Fibre EMG values from 2318 MUs, retrospectively sampled at the time of ALS diagnosis, from 96 muscles of 15 patients were compared with values from 3954 MUs sampled from 109 muscles of 84 reference subjects.</div></div><div><h3>Results</h3><div>30.1% and 46.1% of ALS MUs had MUPs with increased complexity or instability, respectively, and 17.4% had both. The potential importance and heightened sensitivity of NFEMG was highlighted when analyzing normal-sized motor units; as many as 24% of the normal-sized MUPs actually had significant instability, while 14% had increased complexity, and 7.4% had both.</div></div><div><h3>Conclusions</h3><div>Near Fibre EMG can characterize motor unit electrophysiological status and hence help quantify the degree, and course of denervation and reinnervation.</div></div><div><h3>Significance</h3><div>Near-Fiber EMG offers the potential to facilitate earlier ALS diagnosis, which, as promising therapies become available, can be consequential.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 114-122"},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859136","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":"Diagnostic utility of threshold tracking TMS paradigms in early amyotrophic lateral sclerosis","authors":"Aicee Dawn Calma ,&nbsp;Nathan Pavey ,&nbsp;Cláudia Santos Silva ,&nbsp;Mehdi A.J. van den Bos ,&nbsp;Con Yiannikas ,&nbsp;Michelle A. Farrar ,&nbsp;Matthew C Kiernan ,&nbsp;Parvathi Menon ,&nbsp;Steve Vucic","doi":"10.1016/j.clinph.2025.03.044","DOIUrl":"10.1016/j.clinph.2025.03.044","url":null,"abstract":"<div><h3>Objective</h3><div>Threshold tracking transcranial magnetic stimulation (TMS) has exhibited utility as a diagnostic technique in Amyotrophic Lateral Sclerosis (ALS). Different threshold tracking paradigms have recently been proposed. The present study assessed the diagnostic utility of serial ascending and parallel threshold tracking TMS in ALS.</div></div><div><h3>Methods</h3><div>Threshold tracking TMS was undertaken on 90 prospectively recruited participants suspected of ALS. Short interval intracortical inhibition (SICI) was recorded with serial ascending and parallel threshold tracking paradigms between Interstimulus Interval (ISI) 1-to-7 ms. The primary outcome measure was differences in diagnostic utility of the paradigms in differentiating ALS from ALS mimicking disorders using receiver operating characteristic (ROC) analysis (DeLong statistical method).</div></div><div><h3>Results</h3><div>Reduction in SICI reliably differentiated ALS from mimic disorders, irrespective of the threshold tracking paradigm. Comparison of area under the curve (AUC) established a significantly higher value for mean SICI (1–7 ms) with the serial ascending SICI paradigm (0.81, 95 % confidence interval 0.72–0.91) compared to the parallel paradigm (SICI 0.72, 95 % confidence interval 0.61–0.83, p = 0.0065). The better diagnostic utility of serial ascending paradigm was evident for SICI recorded between 1-to-5 ms, and was maintained irrespective of disease onset site, degree of functional impairment, and the degree of lower motor neuron dysfunction. A comparable diagnostic utility across threshold tracking paradigms was evident in ALS participants who presented with a relative paucity of upper motor neuron signs.</div></div><div><h3>Conclusion</h3><div>While threshold tracking TMS reliably differentiated ALS from mimic disorders, the present study established better diagnostic utility with the serial ascending threshold tracking TMS paradigm.</div></div><div><h3>Significance</h3><div>The serial ascending threshold tracking TMS should be used in a clinical setting as a diagnostic tool for ALS.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 105-113"},"PeriodicalIF":3.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844181","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":"Electrophysiological hemispheric asymmetries induced by parietal stimulation eliciting visual percepts","authors":"D. Bonfanti ,&nbsp;E. Bertacco ,&nbsp;L.C. Parra ,&nbsp;C. Mazzi ,&nbsp;S. Savazzi","doi":"10.1016/j.clinph.2025.03.041","DOIUrl":"10.1016/j.clinph.2025.03.041","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to establish if the electrophysiological activity resulting from the direct stimulation of the intraparietal sulcus and eliciting visual percepts is hemispheric-specific.</div></div><div><h3>Methods</h3><div>We tested nineteen participants. Each received 360 TMS pulses at phosphene threshold intensity over right and left IPS while recording EEG. After each pulse, participants had to report if they had seen a phosphene.</div></div><div><h3>Results</h3><div>Parietal phosphene perception is associated with hemispheric-specific activations: phosphenes elicited by left TMS involve central and frontal electrodes at about 30 ms, and frontal, central and parieto-occipital electrodes from 120 to 250 ms; phosphenes elicited by right parietal TMS involve parietal and centro-parietal electrodes at about 60 ms, and frontal, central and parietal electrodes from 150 to 250 ms. Correlated Component Analysis shows that primary visual areas are not activated when phosphenes are produced by TMS over IPS.</div></div><div><h3>Conclusions</h3><div>Our results show that direct stimulation of IPS gives rise to sustained patterns of activity specific to the stimulated hemisphere. Moreover, elicited parietal phosphenes are associated with evoked activity specific to the stimulated hemisphere and located outside early visual processing areas.</div></div><div><h3>Significance</h3><div>This study highlights hemispheric differences in the electrophysiological dynamics related to parietal phosphenes, and shows that the dorsal pathway can give rise to visual conscious percepts.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 131-147"},"PeriodicalIF":3.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859040","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":"50 Hz-Repetitive transcranial magnetic stimulation modulates brain connectivity in Parkinson’s disease","authors":"J.M. Pignat ,&nbsp;A. Patelli ,&nbsp;F.R. Herrmann ,&nbsp;E. Kaarna ,&nbsp;A. Joutsen ,&nbsp;M. Hallett ,&nbsp;D.H. Benninger","doi":"10.1016/j.clinph.2025.02.368","DOIUrl":"10.1016/j.clinph.2025.02.368","url":null,"abstract":"<div><h3>Objectives</h3><div>High-frequency repetitive transcranial magnetic stimulation (rTMS) may modulate neuronal excitability and promote the presumed “pro-kinetic” gamma frequency, while attenuating the “anti-kinetic” beta frequency. This study explores whether 50 Hz-rTMS and intermittent Theta Burst Stimulation (iTBS), of the primary motor (M1) and dorsolateral prefrontal cortex (DLPFC) enhance the gamma activity and functional connectivity within the motor circuit in Parkinson’s disease (PD).</div></div><div><h3>Methods</h3><div>We investigated pre- and post-rTMS interventional EEG in 62 PD patients following 50 Hz-rTMS and iTBS. Power spectral analysis, along with coherence and mutual information embedded in metrics of graph theory, was applied to assess the functional connectivity across the whole brain.</div></div><div><h3>Results</h3><div>We found changes in the cluster coefficient and local efficiency of gamma activity in the left M1 following iTBS, and wider-spread changes within the sensorimotor circuit following 50 Hz-rTMS. We found no changes in the power spectrum or entrainment of the gamma activity in the motor cortex or beyond.</div></div><div><h3>Conclusion</h3><div>The current 50 Hz-rTMS protocols modulate functional connectivity in PD patients, but not the power spectrum. These topological changes do not translate into clinical effects. These stimulation protocols may lack the specificity to be clinically effective.</div></div><div><h3>Significance</h3><div>High frequency rTMS provides new insights in brain connectivity in the gamma bandwidth.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 96-104"},"PeriodicalIF":3.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829629","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":"Letter to the Editor: Ephatic transmission impairs trigemino-cervical reflex monitoring during microvascular decompression surgery for hemifacial spasm","authors":"Denise Lima Medeiros de Melo ,&nbsp;Dayanne Rodrigues da Cunha Alves Bento Oliveira ,&nbsp;Denise Spinola Pinheiro ,&nbsp;Gilberto Mastrocola Manzano","doi":"10.1016/j.clinph.2025.03.039","DOIUrl":"10.1016/j.clinph.2025.03.039","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 59-60"},"PeriodicalIF":3.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817767","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":"Estimating sensor-space EEG connectivity PART 1: Identifying best performing methods for functional connectivity in simulated data","authors":"Aleksandra Miljevic ,&nbsp;Oscar W. Murphy ,&nbsp;Paul B. Fitzgerald ,&nbsp;Neil W. Bailey","doi":"10.1016/j.clinph.2025.03.043","DOIUrl":"10.1016/j.clinph.2025.03.043","url":null,"abstract":"<div><h3>Objective</h3><div>Functional brain connectivity (FC) can be estimated using electroencephalography (EEG). However, there is considerable variability across studies in the FC measures used and in data (pre-)processing methods, leading to difficulties comparing and amalgamating results between studies. Thus, standardisation of EEG (pre-)processing for the measurement and reporting of FC is needed.<!--> <!-->We aimed to assess differences in FC estimates produced by different settings across multiple EEG pre-processing steps, (including re-referencing and epoching) to validate a reliable methodological pipeline for assessing EEG-FC in simulated EEG data.</div></div><div><h3>Methods</h3><div>We simulated EEG-FC data where the ‘ground truth’ of the connections is known and compared estimates of FC from this ground truth data across multiple FC measures and variations in multiple pre-processing steps.</div></div><div><h3>Results</h3><div>Our results indicated that pre-processing steps that included segmenting the data into 40 or more epochs that were 6 s or more in length provided the most accurate estimation of the simulated FC. With regards to the data re-referencing, the Reference Electrode Standardization Technique or the common average re-referencing appeared best when used in conjunction with imaginary coherence and weighted phase lag index metrics. However, the magnitude-squared coherence FC measure performed best with the Current Source Density reference free techniques.</div></div><div><h3>Conclusions &amp; Significance</h3><div>Our paper provides an evidence-base for the influence of referencing, epoch length and number, controls for volume conduction, and different FC metrics on EEG-FC measurement. Using this evidence, we present an initial and promising account of the best performing (pre-)processing choices for robust EEG-FC assessment.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 73-83"},"PeriodicalIF":3.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821290","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":"Estimating sensor-space EEG connectivity PART 2: Identifying optimal artifact reduction techniques for functional connectivity in real data","authors":"Aleksandra Miljevic ,&nbsp;Oscar W. Murphy ,&nbsp;Paul B. Fitzgerald ,&nbsp;Neil W. Bailey","doi":"10.1016/j.clinph.2025.03.042","DOIUrl":"10.1016/j.clinph.2025.03.042","url":null,"abstract":"<div><h3>Objectives</h3><div>Electroencephalography (EEG) can be used to assess functional brain connectivity (FC). However, there is considerable variability in the methods used for FC measurement across different studies, which may contribute to heterogeneity in research outcomes. We aimed to assess how different EEG pre-processing steps impact EEG-FC measurement when applied to real EEG data.</div></div><div><h3>Methods</h3><div>Using the <span><span>BrainClinics.com</span><svg><path></path></svg></span> open-source EEG data repository we investigated how different pre-processing steps impacted the ability to detect age-related differences in alpha band FC and the test–retest reliability of FC measures. The pre-processing steps tested included artifact reduction techniques (Independent Component Analysis (ICA), wavelet-enhanced ICA (wICA), and Multi-channel Wiener Filters (MWF)), different epoch lengths (epochs that were 2 s versus 6 s in length), and different re-referencing montages (the common average reference (CAR) versus current source density (CSD) re-referencing). We also assessed different FC metrics including imaginary coherence (iCOH), real magnitude squared coherence (rMSC), and weighted phase lag index (wPLI) metrics.</div></div><div><h3>Results</h3><div>The best performing pipeline at detecting age-related differences in alpha FC and providing high test–retest reliability included artifact reduction by ICA or wICA, data re-referenced using the CSD method, and FC measured by rMSC.</div></div><div><h3>Conclusion &amp; significance</h3><div>This paper presents evidence for an EEG pre-processing pipeline that provides good detection of meaningful effects and high test–retest reliability for sensor space EEG alpha frequency FC.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 61-72"},"PeriodicalIF":3.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821289","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":"Sawtooth delta of the thalamus: A physiological variant and the intracranial generator of rapid-eye movement sleep sawtooth waves","authors":"Vasileios Kokkinos ,&nbsp;Helweh Hussein ,&nbsp;Joshua Rosenow ,&nbsp;Stephan U. Schuele","doi":"10.1016/j.clinph.2025.03.040","DOIUrl":"10.1016/j.clinph.2025.03.040","url":null,"abstract":"<div><h3>Objective</h3><div>To describe slow wave activity in the thalamic centro-median nucleus (CMN) region during rapid eye-movement (REM) sleep and its relation to the scalp EEG sawtooth waves.</div></div><div><h3>Methods</h3><div>Five (5) patients undergoing stereo-electroencephalography were implanted in the CMN. Sleep was scored using the concurrent scalp EEG, eye-movement artifacts in Fp1, Fp2, F7, and F8, and chin EMG.</div></div><div><h3>Results</h3><div>In the CMN region, blocks of successive delta waves assuming a sawtooth morphology were observed, presenting with high specificity for REM (p_WvsREM &lt; 0.00001; p_NREMvsREM &lt; 0.00001). Sawtooth delta of the thalamus (SDT) presented with discrete high-delta biphasic (∼2.5–4 Hz) and low-delta triphasic (∼1–2.5 Hz) morphologies; the former maximized in CMN space, while the latter in the adjacent ventro-lateral nucleus (VLN). The biphasic SDT’s negative peaks were time-locked to the positive peaks of REM sawtooth waves on scalp (mean lag.</div><div>16.7 ± 5.6 msec). SDT was not specific to tonic or phasic REM (p = 0.179), and was not associated with REM intracranial interictal or ictal activity.</div></div><div><h3>Conclusions</h3><div>SDT is a physiological variant, specific to REM sleep, manifesting with two morphologically distinct subtypes, one of them generating REM sawtooth waves on scalp.</div></div><div><h3>Significance</h3><div>Discriminating between this physiological variant and actual ictal neurophysiological signatures is imperative for efficient therapeutic CMN neurostimulation.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"174 ","pages":"Pages 84-95"},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821287","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}