Clinical Neurophysiology最新文献_第2页

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-19 DOI: 10.1016/j.clinph.2025.2110811

Lino Nobili , Steve Alex Gibbs , Gaia Burlando , Gaia Patrone , Giuseppe De Venuto , Sheng H. Wang , Gabriele Arnulfo , Michele Terzaghi , Stefano Francione , Ivana Sartori

{"title":"Sleep-related epilepsy through the lens of stereo-EEG: Clinical and research update","authors":"Lino Nobili , Steve Alex Gibbs , Gaia Burlando , Gaia Patrone , Giuseppe De Venuto , Sheng H. Wang , Gabriele Arnulfo , Michele Terzaghi , Stefano Francione , Ivana Sartori","doi":"10.1016/j.clinph.2025.2110811","DOIUrl":"10.1016/j.clinph.2025.2110811","url":null,"abstract":"<div><div>The complex interactions between sleep and epilepsy have drawn increasing attention, and stereo-electroencephalography (SEEG) has become a pivotal tool for investigating their underlying pathophysiological mechanisms. This review highlights key contributions from SEEG studies over the past two decades, with a focus on Sleep-Related Hypermotor Epilepsy (SHE). Considered a disorder of frontal lobe origin, SHE is now recognized as a network-based epilepsy with a broader involvement of cortical regions. Sleep instability in Non-Rapid Eye Movement (NREM) sleep, indexed by the cyclic alternating pattern (CAP), and increased bistability, emerge as critical facilitators of epileptiform discharges. In contrast, rapid eye movement (REM) sleep, particularly its phasic substate, exerts a strong suppressive effect on epileptic activity. SEEG has been instrumental in characterizing these mechanisms and identifying novel biomarkers, including cross-frequency coupling and network-level measures of cortical instability. These findings have implications not only for diagnosis and surgical targeting but also for the development of neuromodulatory and state-based therapeutic approaches. Looking forward, the integration of SEEG with advanced computational tools offers new avenues for real-time brain-state mapping and seizure risk stratification. By bridging clinical neurophysiology with systems neuroscience, SEEG provides a unique platform for advancing the understanding of epilepsy within the dynamic context of sleep.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"177 ","pages":"Article 2110811"},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523850","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}

引用次数: 0

Activation site estimation using induced current simulation and motor evoked potential latency in transcranial magnetic stimulation 经颅磁刺激中感应电流模拟和运动诱发电位潜伏期的激活位点估计

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-18 DOI: 10.1016/j.clinph.2025.2110801

Takumi Tanabe , Akimasa Hirata , Keita Iijima , Sachiko Kodera , Masaki Fukunaga , Yoshikazu Ugawa , Ilkka Laakso

{"title":"Activation site estimation using induced current simulation and motor evoked potential latency in transcranial magnetic stimulation","authors":"Takumi Tanabe , Akimasa Hirata , Keita Iijima , Sachiko Kodera , Masaki Fukunaga , Yoshikazu Ugawa , Ilkka Laakso","doi":"10.1016/j.clinph.2025.2110801","DOIUrl":"10.1016/j.clinph.2025.2110801","url":null,"abstract":"<div><h3>Objective</h3><div>The exact part of the motor cortex activated by transcranial magnetic stimulation (TMS) remains debatable. This study investigates the electric field (EF) distribution induced by TMS coils in personalized head models, focusing on group-level evaluation considering motor-evoked potential (MEP) latency differences.</div></div><div><h3>Methods</h3><div>Thirteen healthy right-handed men (mean age 22.9 ± 1.04 years) participated in this study. Two TMS coils, Figure-of-8 (Fo8) and a double cone (DC), were employed to deliver single pulses at various coil positions. MEPs were recorded from the first dorsal interosseous muscle. The EF distribution was computed in personalized head models using finite-difference methods and mapped to the standard brain space.</div></div><div><h3>Results</h3><div>MEP latencies differed significantly between Fo8 and DC coils in seven participants but were similar in six. Group-level EF analysis revealed distinct activation patterns, with the highest EF strength in the crowns of the gyri. In cases with minimal MEP latency differences, EF–motor threshold correlation highlighted activation in the anterior wall of the central sulcus, consistent with fMRI studies.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the variability in EF distribution across participants and coils, offering novel insights into the relationship between the EF and MEP latencies.</div></div><div><h3>Significance</h3><div>EF computation considering MEP latency differences may enable high-resolution imaging of the activation sites.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"177 ","pages":"Article 2110801"},"PeriodicalIF":3.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335715","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}

引用次数: 0

No one is too young to show high frequency oscillations on scalp EEG. 没有人会因为太年轻而在头皮脑电图上显示出高频振荡。

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-16 DOI: 10.1016/j.clinph.2025.2110795

Lotte Noorlag, Ella M R Fonteyn, Maeike Zijlmans

引用次数: 0

Heart rate variability-based detection of epileptic seizures: Machine learning analysis and characterization of discriminant metrics 基于心率变异性的癫痫发作检测：判别度量的机器学习分析和表征

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-16 DOI: 10.1016/j.clinph.2025.2110793

Carole Nouboue , Eva Diab , William Gacquer , Philippe Derambure , Bertille Perin , Simone Chen , Mélodie Mercier-Bryczman , Julien DE Jonckheere , William Szurhaj

{"title":"Heart rate variability-based detection of epileptic seizures: Machine learning analysis and characterization of discriminant metrics","authors":"Carole Nouboue , Eva Diab , William Gacquer , Philippe Derambure , Bertille Perin , Simone Chen , Mélodie Mercier-Bryczman , Julien DE Jonckheere , William Szurhaj","doi":"10.1016/j.clinph.2025.2110793","DOIUrl":"10.1016/j.clinph.2025.2110793","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to determine the most suitable cardiac metrics and machine learning algorithms (MLa) for an electrocardiography-based seizure detection device.</div></div><div><h3>Methods</h3><div>In a multicenter, prospective study of adult inpatients, with limited physical activity, 24-hour video-electroencephalogram recordings including ≥ 1 seizure were analyzed. Heart Rate (HR) and Heart Rate Variability (HRV) metrics were calculated continuously from the corresponding electrocardiogram. HR and HRV time series were segmented into 5-min epochs. MLa were used to classify the epochs as containing seizures or not for the whole dataset; then for convulsive and nonconvulsive seizures only, without focusing on individual results. The sensitivity, specificity and False Alarm Rate (FAR) were calculated.</div></div><div><h3>Results</h3><div>We included 129 patients and 313 seizures (255 nonconvulsive). The most discriminant metrics were the signal quality, maximum cardiac sympathetic index, maximum heart rate, and minimum high frequency variability index. The sensitivity, specificity and FAR were respectively 94%, 89% and 0.6 for convulsive seizures (extremely randomized trees), and 83%, 82% and 1.13 for nonconvulsive seizures (random forest).</div></div><div><h3>Conclusions</h3><div>In the largest unselected patient cohort study of this topic to date, seizure detection with ML analyses of cardiac metrics provides good results – even for nonconvulsive seizures.</div></div><div><h3>Significance</h3><div>The high FAR suggests to combine HR and HRV analysis with other metrics to increase specificity.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"177 ","pages":"Article 2110793"},"PeriodicalIF":3.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366492","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}

引用次数: 0

Agent-guided AI-powered interpretation and reporting of nerve conduction studies and EMG (INSPIRE) 智能体引导的人工智能神经传导研究和肌电图的解释和报告（INSPIRE）

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-15 DOI: 10.1016/j.clinph.2025.2110792

Alon Gorenshtein , Moran Sorka , Mohamed Khateb , Dvir Aran , Shahar Shelly

{"title":"Agent-guided AI-powered interpretation and reporting of nerve conduction studies and EMG (INSPIRE)","authors":"Alon Gorenshtein , Moran Sorka , Mohamed Khateb , Dvir Aran , Shahar Shelly","doi":"10.1016/j.clinph.2025.2110792","DOIUrl":"10.1016/j.clinph.2025.2110792","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to create a tool for electrophysiologist enhancing and standardizing interpretation of neuromuscular electrodiagnostic tests (EDX) using state of the art generative AI technology.</div></div><div><h3>Methods</h3><div>We developed three model frameworks for interpreting and reporting EDX: (1) Base-LLM (large language model), employing one-shot inference; (2) INSPIRE (Agent-Guided AI-Powered Interpretation and Reporting of Nerve Conduction Studies and EMG), a multi-agent AI framework; and (3) INSPIRE-Lite, a cost-efficient version of INSPIRE. INSPIRE uses three agents integrating tools to read reference tables and long-context clinical neuromuscular textbook. Performance was evaluated using the AI-Generated EMG Report Score (AIGERS), a scoring system we developed.</div></div><div><h3>Results</h3><div>INSPIRE achieved an accuracy of 92.2 % for detecting normal versus abnormal tests, significantly outperforming the Base-LLM model, which achieved 62.6 % (p < 0.001). INSPIRE demonstrated significantly higher AIGERS scores overall and across the domains of finding, clinical diagnosis, and semantic concordance (p < 0.001). INSPIRE-Lite scored lower than INSPIRE in finding and clinical diagnosis (p = 0.001 and p = 0.004).</div></div><div><h3>Conclusion</h3><div>Our model integrates variables like patient medical history, current complaints, and EDX findings to manage and interpret EMG. Demonstrating superior performance while addressing hallucinations, data overload, and aiding prioritization and standardization.</div></div><div><h3>Significance</h3><div>This model enables comprehensive analysis by integrating diverse clinical variables, enhancing diagnostic accuracy and efficiency of EDX reports.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"177 ","pages":"Article 2110792"},"PeriodicalIF":3.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322849","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}

引用次数: 0

Trigemino-Vocal Reflex: A potential indicator of brainstem integration. 三叉神经-声音反射：脑干整合的潜在指标。

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-14 DOI: 10.1016/j.clinph.2025.2110796

Jongsuk Choi

引用次数: 0

Utility of neuromuscular ultrasound and comparison of NMUS with electrodiagnostic tests in dominant spinocerebellar ataxia 神经肌肉超声在优势型脊髓小脑共济失调中的应用及NMUS与电诊断试验的比较

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-12 DOI: 10.1016/j.clinph.2025.2110783

Luciana Pelosi , Antonella Antenora , Julian Bauer , Rosa Iodice , Ruth Leadbetter , Fiore Manganelli , Eoin Mulroy , Miriam Rodrigues , Richard Roxburgh

{"title":"Utility of neuromuscular ultrasound and comparison of NMUS with electrodiagnostic tests in dominant spinocerebellar ataxia","authors":"Luciana Pelosi , Antonella Antenora , Julian Bauer , Rosa Iodice , Ruth Leadbetter , Fiore Manganelli , Eoin Mulroy , Miriam Rodrigues , Richard Roxburgh","doi":"10.1016/j.clinph.2025.2110783","DOIUrl":"10.1016/j.clinph.2025.2110783","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate and compare the prevalence of sensory neuronopathy and neuropathy in autosomal dominant spinocerebellar ataxia (SCA) using neuromuscular ultrasound (NMUS) and traditional electrodiagnostic tests (EDX).</div></div><div><h3>Methods</h3><div>We compared NMUS [median and ulnar nerve cross-sectional areas (CSAs)] with EDX [sensory (sural, radial, median, ulnar); motor (median, ulnar, tibial)] findings from previously published and newly recruited patients with SCA (44 in total; SCA1 = 8, SCA2 = 27, SCA3 = 2; SCA6 = 7).</div><div>Sensory neuronopathy was diagnosed by reduced nerve CSA on NMUS and non length-dependent sensory axonal pattern on EDX, and neuropathy by enlarged nerve CSA on NMUS and length-dependent axonal pattern on EDX.</div></div><div><h3>Results</h3><div>Abnormalities were detected significantly more frequently on NMUS than EDX (75 % vs 51 %, p < 0.001), especially sensory neuronopathy (57 % vs 32 %; p < 0.001). Ten of 24 sensory neuronopathies detected by NMUS were missed by EDX. No sensory neuronopathy detected by EDX was missed by NMUS.</div></div><div><h3>Conclusions and significance</h3><div>The prevalence of abnormality, especially sensory neuronopathy, detected in our SCA cohort was significantly higher with NMUS than EDX.</div><div>This has significant implication for clinical practice. Where NMUS resources are available, NMUS can be proposed as the method of choice for the investigation of sensory neuronopathy in SCA.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"176 ","pages":"Article 2110783"},"PeriodicalIF":3.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306765","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}

引用次数: 0

Frontal alpha asymmetry in major depression and comorbid anxiety disorder: a five-year follow-up study 重度抑郁症和共病焦虑症的额叶α不对称：一项为期五年的随访研究

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-12 DOI: 10.1016/j.clinph.2025.2110794

Carolin Zsigo , Ellen Greimel , Jürgen Bartling , Gerd Schulte-Körne , Lisa Feldmann

{"title":"Frontal alpha asymmetry in major depression and comorbid anxiety disorder: a five-year follow-up study","authors":"Carolin Zsigo , Ellen Greimel , Jürgen Bartling , Gerd Schulte-Körne , Lisa Feldmann","doi":"10.1016/j.clinph.2025.2110794","DOIUrl":"10.1016/j.clinph.2025.2110794","url":null,"abstract":"<div><h3>Objective</h3><div>Major depression (MD) and anxiety disorders are both associated with higher left compared to right frontal alpha activity (rLFα). The aim of the study was to examine whether young adults with lifetime MD and anxiety disorder differ from healthy controls and whether this pattern remains stable over five years from adolescence into adulthood.</div></div><div><h3>Methods</h3><div>Resting frontal EEG asymmetry of n = 25 young adults with lifetime MD and anxiety (MDAnx) and n = 26 healthy controls (HC) was compared. Moreover, in a subsample of participants, the stability of frontal alpha asymmetry was analyzed from adolescence to young adulthood via intra-class-correlations.</div></div><div><h3>Results</h3><div>Participants with MDAnx displayed significantly more rLFα than HCs. Asymmetry showed fair stability over 5 years in the MDAnx group and poor stability in the HC group, the latter driven by increased relative right frontal alpha activity.</div></div><div><h3>Conclusions</h3><div>Increased rLFα could be a trait marker for comorbid MDAnx. Low stability in the HC group could derive from maturation of cognitive and affective processes, which might be impeded by the presence of lifetime MDAnx.</div></div><div><h3>Significance</h3><div>Results highlight that EEG asymmetry changes from adolescence to adulthood and could be impacted by lifetime MD and anxiety, irrespective of current symptomatology.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"177 ","pages":"Article 2110794"},"PeriodicalIF":3.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366493","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}

引用次数: 0

Ipsilateral motor pathways related to proximal upper limb function in tetraplegia. 四肢瘫痪患者与上肢近端功能相关的同侧运动通路。

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-11 DOI: 10.1016/j.clinph.2025.2110780

M Hussain, S D Foglia, A J Nelson

引用次数: 0

Cerebellar transcranial direct current stimulation in Friedreich ataxia: Anatomy matters. 小脑经颅直流电刺激治疗弗里德赖希共济失调：解剖学问题。

IF 3.7 3区医学

Clinical Neurophysiology Pub Date : 2025-06-10 DOI: 10.1016/j.clinph.2025.2110784

Roderick P P W M Maas, Dennis J L G Schutter

引用次数: 0