Clinical Neurophysiology最新文献

{"title":"Reduced alpha-band phase coherence and cortical complexity in fibromyalgia: A tms-eeg exploratory study","authors":"Anne Jakobsen ,&nbsp;Enrico De Martino ,&nbsp;Bruno A.N. Couto ,&nbsp;Margit M. Bach ,&nbsp;Stian Ingemann-Molden ,&nbsp;Thorvaldur S. Palsson ,&nbsp;Jakob Udby Blicher ,&nbsp;Adenauer G. Casali ,&nbsp;Thomas Graven-Nielsen ,&nbsp;Daniel Ciampi de Andrade","doi":"10.1016/j.clinph.2026.2111711","DOIUrl":"10.1016/j.clinph.2026.2111711","url":null,"abstract":"<div><h3>Objectives</h3><div>Cortico-spinal excitability of the primary motor cortex (M1) is reduced in fibromyalgia, and repetitive transcranial magnetic stimulation (TMS) targeting M1 normalizes these changes and relieves symptoms. TMS combined with electroencephalography (TMS-EEG) allows the measurement of M1 excitability and its connectivity to other regions, which may help clarify neurophysiological abnormalities in fibromyalgia. We assessed cortical excitability, oscillatory activity, and complexity in individuals with fibromyalgia compared to pain-free healthy controls.</div></div><div><h3>Methods</h3><div>Global- and local-mean field power, peak-to-peak amplitude, event-related spectral perturbation, intertrial coherence (ITC), natural frequency, and perturbational complexity index (PCIst) of the EEG response after left-M1 TMS were compared between groups (n = 18 fibromyalgia; n = 15 controls). Pain intensity, interference, current therapy, mood, and quality of life were assessed in individuals with fibromyalgia.</div></div><div><h3>Results</h3><div>Compared with controls, individuals with fibromyalgia showed a reduction in the alpha-band ITC in middle- (p = 0.044) and right-parieto-occipital areas (p = 0.040). Middle-parieto-occipital ITC negatively correlated with reported pain relief (rho = -0.552, p = 0.019). The PCIst was lower in fibromyalgia compared with controls (p = 0.009) and correlated with higher pain interference in general activity (rho = -0.486, p = 0.042).</div></div><div><h3>Conclusion</h3><div>Individuals with fibromyalgia have abnormal cortical connectivity compared with asymptomatic controls.</div></div><div><h3>Significance</h3><div>TMS-EEG may provide insights on brain connectivity relevant for prognostication and therapy in fibromyalgia.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"185 ","pages":"Article 2111711"},"PeriodicalIF":3.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347334","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":"IFCN position statement: use of artificial intelligence in clinical neurophysiology.","authors":"Aatif M Husain, Sandor Beniczky, Meriem Bensalem-Owen, Jeremy Bland, Benjamin H Brinkman, Ritsuko Hanajima, Michal Holub, Lara Jehi, Sanjeev Nandedkar, Nortina Shahrizaila, Hatice Tankisi, Martijn R Tannemaat, M Brandon Westover, Walter Paulus","doi":"10.1016/j.clinph.2026.2111893","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111893","url":null,"abstract":"<p><p>In recent years, artificial intelligence (AI) has made significant strides, gaining traction across various domains, including clinical medicine. The integration of AI as a decision-support tool introduces complexities, particularly in ensuring patient safety and upholding clinical accountability. This is especially pertinent in clinical neurophysiology (CNP), where AI shows promise in enhancing the interpretation of neurophysiologic data from modalities such as electroencephalography, electromyography, and others. Recognizing the potential and inherent challenges of AI integration, the International Federation of Clinical Neurophysiology (IFCN) has set forth guidelines to steer the responsible development, evaluation, and application of AI technologies in CNP. The IFCN's core position on AI in CNP emphasizes improving healthcare outcomes, prioritizing patient-centered care, maintaining transparency in AI-generated interpretations, and supporting, rather than replacing, clinical expertise. As AI technology evolves, the IFCN stresses that models implemented in clinical practice, especially when lacking supervision by experts must meet stringent standards for accuracy, safety, and quality control, and that AI cannot substitute expert care without adequate oversight. The successful integration of AI in CNP hinges on dataset diversity, transparent and ethical training practices, and balancing model complexity with real-world validation. Continuous performance monitoring and clinician feedback are vital to maintaining AI system reliability over time. The IFCN envisions a future where AI ethically enhances CNP practice through multidisciplinary collaboration, focusing on patient safety, clinical integrity, and scientific rigor. Properly implemented, AI can revolutionize CNP by offering real-time decision support, personalized interventions, and remote monitoring, thus advancing the quality of care in CNP.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111893"},"PeriodicalIF":3.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811966","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":"The Intersegmental Pudendal Reflex: Evidence of human sacral-to-thoracolumbar connectivity for intraoperative monitoring.","authors":"Patricia Colmenarez, Berenice Murià, Maria J Tellez, Sedat Ulkatan","doi":"10.1016/j.clinph.2026.2111889","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111889","url":null,"abstract":"<p><strong>Objective: </strong>To introduce the Intersegmental Pudendal Reflex (IPR) and evaluate its potential as a surrogate functional marker for S2-S4 integrity and for extended suprasegmental levels during Intraoperative Neurophysiological Monitoring (IOM).</p><p><strong>Methods: </strong>Observational retrospective study involving twenty patients undergoing spinal surgery. Pudendal nerve stimulation elicited sacral and suprasacral responses. Reflexive responses were recorded simultaneously in the external anal sphincter (bulbocavernosus reflex, BCR) and the abdominal oblique muscles (IPR).</p><p><strong>Results: </strong>The IPR consists of a short-latency R1 of 31.7 ± 7.5 ms (mean ± standard deviation, milliseconds) and a highly variable long-latency R2 of 124.5 ± 40 ms. The IPR provides additional confirmation of sacral integrity (S2-S4) but, critically, its output to higher segments demonstrates an extensively polysynaptic connection extending cranially to the upper lumbar and lower thoracic spinal cord.</p><p><strong>Conclusions: </strong>The IPR is a reproducible, intersegmental somatic pudendal reflex in anesthetized humans. It enhances standard IOM by confirming sacral integrity along BCR, while simultaneously assessing the functional status of pathways that ascend intersegmental spinal levels.</p><p><strong>Significance: </strong>The IPR enhances standard IOM by confirming sacral integrity and extending monitoring cranially. Its polysynaptic conduction provides a physiological framework to explore the assessment of spinal cord central pattern generators in future clinical studies on micturition, sexual function, and locomotion, a new and critical area of research for IOM.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111889"},"PeriodicalIF":3.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671249","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":"Intraoperative study of afferent and efferent connections in the upper lumbar spinal cord - Part 2: genitoinguinal reflex.","authors":"Denise Lima Medeiros de Melo, Dayanne Rodrigues da Cunha Alves Bento Oliveira, Patrícia Lago Dos Santos Madureira, Fabricio Dutra Ventura, Michele Dominici, Denise Spinola Pinheiro, Mirela V Simon","doi":"10.1016/j.clinph.2026.2111888","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111888","url":null,"abstract":"<p><strong>Objective: </strong>To describe spinal reflex responses mediated by the upper lumbar spinal cord in humans and observed intraoperatively under general anesthesia.</p><p><strong>Methods: </strong>Thirty-one participants undergoing spinal surgery were enrolled. Reflex responses were recorded from the iliopsoas, adductor magnus, and rectus femoris muscles following electrical stimulation of the cutaneous territory innervated by the genitofemoral and ilioinguinal nerves using a multipulse train paradigm.</p><p><strong>Results: </strong>Reflex responses were obtained in the iliopsoas, adductor magnus, and rectus femoris muscles, with distinct recordability rates and neurophysiological characteristics. The most robust and consistently reproducible responses were recorded in the iliopsoas muscle; this response pattern was termed the Genitoinguinal Reflex (GNIR).</p><p><strong>Conclusions: </strong>GNIR components can be reliably elicited in humans under general anesthesia. Stimulation frequently produced proximal thigh movement, which may interfere with surgery and therefore necessitates intermittent application when safe.</p><p><strong>Significance: </strong>The identification of these reflex responses expands current knowledge of human spinal cord circuitry. Moreover, GNIR recording may represent a useful intraoperative neurophysiological technique for monitoring the integrity of the upper lumbar spinal cord, L1-L2 nerve roots, and the genitofemoral, ilioinguinal, and femoral nerves.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111888"},"PeriodicalIF":3.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671231","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":"Microstates to modulation: EEG signatures guiding clinical translation in dementia.","authors":"Yoshihiro Noda","doi":"10.1016/j.clinph.2026.2111876","DOIUrl":"https://doi.org/10.1016/j.clinph.2026.2111876","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2111876"},"PeriodicalIF":3.6,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638162","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":"Experiences of ictal OP-MEG","authors":"Stephanie Mellor ,&nbsp;George C. O’Neill ,&nbsp;Daniel Bush ,&nbsp;Arjun Ramaswamy ,&nbsp;Ryan C. Timms ,&nbsp;David Doig ,&nbsp;Tim M. Tierney ,&nbsp;Meaghan E. Spedden ,&nbsp;Matthew C. Walker ,&nbsp;Gareth R. Barnes ,&nbsp;Umesh Vivekananda","doi":"10.1016/j.clinph.2026.2111504","DOIUrl":"10.1016/j.clinph.2026.2111504","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111504"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084666","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":"Lacosamide modulates alpha-band network hubness: a quantitative EEG study in drug-Naïve focal epilepsy","authors":"Marco Sferruzzi ,&nbsp;Lorenzo Ricci ,&nbsp;Margherita A.G. Matarrese ,&nbsp;Mario Tombini ,&nbsp;Patrizia Pulitano ,&nbsp;Francesca Izzi ,&nbsp;Fabio Placidi ,&nbsp;Biagio Sancetta ,&nbsp;Vincenzo Di Lazzaro ,&nbsp;Giovanni Assenza","doi":"10.1016/j.clinph.2026.2111506","DOIUrl":"10.1016/j.clinph.2026.2111506","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates pharmaco-EEG changes induced by Lacosamide (LCM) in drug-naive people with focal epilepsy (PwE) and explores the association between quantitative EEG (qEEG) and long-term clinical outcome.</div></div><div><h3>Methods</h3><div>We retrospectively identified 28 PwE and 25 healthy controls (HC). PwE were classified as seizure-free (SF) or non-seizure-free (NSF) after two years of LCM. EEGs were acquired before and ∼ 6 months after LCM. Power spectral density (PSD), amplitude-envelope correlation (AEC), and graph-theoretical metrics were compared between PwE and HC. Logistic regression was employed to examine the association between long-term outcomes (two-year seizure freedom) and qEEG metrics, in combination with clinical variables (sex, aetiology, seizure type, baseline EEG).</div></div><div><h3>Results</h3><div>LCM did not significantly modify global-averaged qEEG metrics (p &gt; 0.05). Theta-band PSD was higher in PwE than HC. PwE exhibited higher alpha-band betweenness centrality (BtwC) than HC only before LCM (p = 0.007). Alpha-band BtwC provided the greatest discriminative value for seizure freedom (accuracy = 0.86; area under the curve [AUC] = 0.88).</div></div><div><h3>Conclusions</h3><div>Although no significant differences were observed between pre- and post-LCM conditions, alpha-band BtwC showed a return toward a more physiological state after treatment, suggesting partial network normalization. Combining qEEG with clinical data improved long-term outcome discrimination, with alpha-band BtwC as the most relevant feature.</div></div><div><h3>Significance</h3><div>Graph-theoretical qEEG metrics offer additional insight into LCM’s neurophysiological effects in focal epilepsy.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111506"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001739","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":"Error processing in major depressive disorder: a systematic review and meta-analysis of event-related potential studies","authors":"Kai-Jie Liang ,&nbsp;Chun-Che Hung ,&nbsp;Chia-Wen Ko ,&nbsp;Pin-Chi Lin ,&nbsp;Pei-Ying S Chan ,&nbsp;Chia-Hsiung Cheng","doi":"10.1016/j.clinph.2026.2111503","DOIUrl":"10.1016/j.clinph.2026.2111503","url":null,"abstract":"<div><h3>Objective</h3><div>Alterations in error-related negativity (ERN) and error positivity (Pe)—electrophysiological markers of error processing—have been frequently reported in major depressive disorder (MDD); findings, however, remain inconsistent.</div></div><div><h3>Methods</h3><div>Literature search was performed using Web of Science, MEDLINE/PubMed, and Scopus electronic databases. The effect sizes (Hedges’ g) in the comparisons of ERN (22 studies) and Pe (10 studies) amplitudes between MDD and healthy controls (HC) were employed by a random-effect, inverse-variance weighted model.</div></div><div><h3>Results</h3><div>ERN and Pe amplitudes in MDD patients were generally comparable to those of HC. Nevertheless, moderator analyses revealed specific conditions under which Pe amplitudes were reduced in MDD. Specifically, MDD patients with comorbid conditions showed diminished Pe amplitudes relative to HC (p = 0.001). Moreover, task type moderated Pe responses: studies using the Flanker task reported significantly reduced Pe amplitudes in MDD patients (p = 0.012), a pattern not observed with other paradigms. No significant moderators were identified for ERN amplitudes.</div></div><div><h3>Conclusions</h3><div>Comorbidity and task design, particularly the use of the Flanker task, appear to influence Pe amplitudes in patients with MDD and should be carefully considered in future research.</div></div><div><h3>Significance</h3><div>Our data highlight the importance of methodological factors in interpreting error processing deficits in MDD.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111503"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146001740","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":"Relevance of EEG recording time for juvenile myoclonic epilepsy diagnosis confirmation: a reappraisal","authors":"Guillaume Thévoz ,&nbsp;Davide Bassi ,&nbsp;Andrea O. Rossetti","doi":"10.1016/j.clinph.2026.2111519","DOIUrl":"10.1016/j.clinph.2026.2111519","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111519"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084659","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":"Memories of Mark. Personal reflections by those in IFCN who worked with Mark Hallett","authors":"David Burke ,&nbsp;Robert Chen ,&nbsp;Andrew Eisen ,&nbsp;Marc Nuwer ,&nbsp;Walter Paulus ,&nbsp;Paolo Rossini ,&nbsp;John Rothwell ,&nbsp;Eric Stålberg ,&nbsp;Jonathan Cole","doi":"10.1016/j.clinph.2026.2111590","DOIUrl":"10.1016/j.clinph.2026.2111590","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"184 ","pages":"Article 2111590"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118148","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}