Clinical Neurophysiology最新文献

{"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}

{"title":"Modulation of brain complexity in schizophrenia patients with auditory verbal hallucinations by low-frequency rTMS stimulation","authors":"Yuanjun Xie ,&nbsp;Yijun Li ,&nbsp;Muzhen Guan ,&nbsp;Tian Zhang ,&nbsp;Chaozong Ma ,&nbsp;Zhongheng Wang ,&nbsp;Zhujing Ma ,&nbsp;Peng Fang ,&nbsp;Huaning Wang ,&nbsp;Chenxi Li","doi":"10.1016/j.clinph.2025.2110752","DOIUrl":"10.1016/j.clinph.2025.2110752","url":null,"abstract":"<div><h3>Background</h3><div>Entropy is a critical measure for assessing the complexity and irregularity of brain signals. Understanding how brain entropy can be influenced by non-invasive neurostimulation in psychiatric patients remains a clinically relevant issue.</div></div><div><h3>Objective</h3><div>This study aims to explore whether low-frequency repetitive transcranial magnetic stimulation (rTMS) can modulate brain entropy in schizophrenia patient with auditory verbal hallucinations (AVH).</div></div><div><h3>Methods</h3><div>A case-control design was employed in this study. Low-frequency (1 Hz) rTMS targeting at left temporoparietal junction was administered to schizophrenia patients with AVH. Brain entropy (sample entropy) was calculated from resting-state functional magnetic resonance imaging (fMRI) data. Comparisons of sample entropy were made between the schizophrenia patients and healthy controls, as well as within the patient group pre- and post-rTMS.</div></div><div><h3>Results</h3><div>Following rTMS treatment, patients showed a reduction in clinical symptoms, including positive symptoms and AVH. Neurocognitive improvements were also observed in domains such as verbal and visual memory. Furthermore, patients exhibited increased sample entropy in regions including the prefrontal cortices and temporal lobes compared to healthy controls. However, this elevated entropy was reduced post-rTMS, particularly in areas associated with AVH. The language network and default model network, initially showing high mean sample entropy, demonstrated a significant decrease after rTMS treatment. These changes in brain entropy were correlated with clinical improvements.</div></div><div><h3>Conclusion</h3><div>This modulation of neural activity complexity induced by the low-frequency rTMS may underlie the observed clinical and cognitive improvement in schizophrenia.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110752"},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125211","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":"Dynamic functional connectivity is modulated by the amount of p-Tau231 in blood in cognitively intact participants","authors":"Martín Carrasco-Gómez ,&nbsp;Alejandra García-Colomo ,&nbsp;Alberto Nebreda ,&nbsp;Ricardo Bruña ,&nbsp;Andrés Santos ,&nbsp;Fernando Maestú","doi":"10.1016/j.clinph.2025.2110751","DOIUrl":"10.1016/j.clinph.2025.2110751","url":null,"abstract":"<div><h3>Introduction</h3><div>Electrophysiology and plasma biomarkers are early and non-invasive candidates for Alzheimer’s disease detection. The purpose of this paper is to evaluate changes in dynamic functional connectivity measured with magnetoencephalography, associated with the plasma pathology marker p-tau231 in unimpaired adults.</div></div><div><h3>Methods</h3><div>73 individuals were included. Static and dynamic functional connectivity were calculated using leakage corrected amplitude envelope correlation. Each source’s strength entropy across trials was calculated. A data-driven statistical analysis was performed to find the association between functional connectivity and plasma p-tau231 levels. Regression models were used to assess the influence of other variables over the clusters’ connectivity.</div></div><div><h3>Results</h3><div>Frontotemporal dynamic connectivity positively associated with p-tau231 levels. Linear regression models identified pathological, functional and structural factors that influence dynamic functional connectivity.</div></div><div><h3>Conclusions</h3><div>Changes associated to AD pathology can be observed very early on using dFC, which might be more sensitive to subtle alterations than sFC. Furthermore, this early increase in dFC appears to have a pathological nature given its relationship with other plasma, functional and structural measures.</div></div><div><h3>Significance</h3><div>These results expand previous literature on dynamic functional connectivity in healthy individuals at risk of AD, highlighting its usefulness as an early, non-invasive and more sensitive biomarker.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110751"},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168053","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":"Brain-heart interactions are associated with mortality and acute encephalopathy in ICU patients with severe COVID-19","authors":"Bertrand Hermann ,&nbsp;Sarah Benghanem ,&nbsp;Estelle Pruvost-Robieux ,&nbsp;Tarek Sharshar ,&nbsp;Martine Gavaret ,&nbsp;Alain Cariou ,&nbsp;Jean-Luc Diehl ,&nbsp;Diego Candia-Rivera","doi":"10.1016/j.clinph.2025.2110745","DOIUrl":"10.1016/j.clinph.2025.2110745","url":null,"abstract":"<div><h3>Objective</h3><div>Research in critical care has revealed the significance of autonomic dysfunctions, and more recently of brain–heart interactions, as valuable biomarkers for evaluating patients’ physiological status. These biomarkers provide insights into consciousness levels, severity, and outcomes. This study aims to determine the potential of these biomarkers in predicting the mortality and neurological outcome of severe COVID-19 patients.</div></div><div><h3>Methods</h3><div>We examined severe COVID-19 patients who required mechanical ventilation and observed them both during sedation and after sedation cessation. Standard EEG and ECG recordings were conducted at bedside, from which 5 min of continuous data were analyzed. Using a synthetic data generation model, we evaluated bidirectional brain–heart interactions from EEG power and heartbeat dynamics series.</div></div><div><h3>Results</h3><div>Our findings indicate that brain–heart interactions, especially involving cardiac parasympathetic activity, indicate the degree of patients’ severity. We observed correlations with acute encephalopathy duration (coma and delirium), particularly evident in top-down markers (from brain to heart) while bottom-up signaling (from heart to brain) correlated with ICU mortality. Additionally, we noted stronger modulation of brain–heart interactions in milder patients when comparing sedation versus non-sedation conditions, compared to those in more severe states.</div></div><div><h3>Conclusions</h3><div>Our results imply that autonomic dysfunctions, as measured through brain–heart interactions, can track the pathophysiology of comatose states following SARS-CoV-2 infection.</div></div><div><h3>Significance</h3><div>These findings highlight the potential of brain–heart interactions as an integrated marker for autonomic function in critical care, offering a more accurate assessment of patient severity and outcomes compared to isolated cardiac or brain measures.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110745"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146997","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":"Cerebellar grey matter volume predicts cerebellar tDCS efficacy in individuals with Friedreich ataxia.","authors":"Gilles Naeije, Christian Georgiev, Pierre Cabaraux, Mathieu Bourguignon","doi":"10.1016/j.clinph.2025.2110744","DOIUrl":"https://doi.org/10.1016/j.clinph.2025.2110744","url":null,"abstract":"<p><strong>Objective: </strong>To determine the impact of cerebellar anatomy on ctDCS efficacy in individuals with Friedreich ataxia (FA).</p><p><strong>Methods: </strong>We included 24 FA patients (mean age 31 ± 14 years) and 24 age- and sex-matched healthy controls. Patients underwent a 5-day ctDCS intervention, with cerebellar motor and non-motor symptoms assessed using the Scale for the Assessment and Rating of Ataxia (SARA) and the Cerebellar Cognitive Affective Syndrome Scale (CCAS-S), before and after stimulation. MRI was used to measure cerebellar gray matter volume, superior cerebellar peduncle (SCP) diameter, and skin-to-cerebellum distance. Stepwise linear regression analyses examined predictors of motor and cognitive improvements following ctDCS.</p><p><strong>Results: </strong>FA patients exhibited significantly reduced cerebellar gray matter volume compared to controls (p = 0.024) after intracranial volume correction, skin-to-cerebellum distance did not differ between groups (p = 0.11). Stepwise linear regression analysis disclosed that the anterior cerebellar gray matter volume was a significant predictor of SARA improvement (β = -0.18, p < 0.001) and the posterior cerebellar gray matter volume of CCAS-S improvement (β = -0.13, p 0.023). Neither SCP diameter nor skin-to-cerebellum distance significantly impacted ctDCS efficacy.</p><p><strong>Conclusion: </strong>Cerebellar gray matter volume is associated to ctDCS-induced symptoms improvements in FA.</p><p><strong>Significance: </strong>These findings suggest that cerebellar gray matter volume influences ctDCS responsiveness.</p>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2110744"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119114","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":"Cortical involvement in the initiation of movementscued by moderate, but not loud acoustic stimuli: Evidence for subcortical mediation of the StartReact effect","authors":"Lennart C. Neumann ,&nbsp;Nomah Mahnoor ,&nbsp;Marina Rüfli ,&nbsp;Martina D. Liechti ,&nbsp;Linard Filli","doi":"10.1016/j.clinph.2025.2110743","DOIUrl":"10.1016/j.clinph.2025.2110743","url":null,"abstract":"<div><h3>Objective</h3><div>The reticulospinal tract is critical for motor control, yet its role in human movement regulation remains incompletely understood. The StartReact effect is the primary method to assess reticulospinal motor control, although its neural mechanisms are debated. This study investigated the contribution of the motor cortex to the StartReact effect.</div></div><div><h3>Methods</h3><div>The StartReact paradigm was administered to 22 healthy participants performing wrist extension movements to imperative stimuli (IS) consisting of either loud acoustic stimuli (LAS) or moderate acoustic stimuli (MAS). EMG and high-density EEG assessed muscle and cortical activity.</div></div><div><h3>Results</h3><div>Reaction times were faster following LAS compared to MAS, reflecting the StartReact effect. Whereas movement-related cortical potentials emerged 21 ms before muscle activation following MAS, they appeared only 65 ms after muscle activation in LAS trials. Assessment of contingent negative variation (CNV) and event-related desynchronization (ERD) revealed no significant preparatory motor cortex activity prior to the IS.</div></div><div><h3>Conclusions</h3><div>These findings suggest that while the motor cortex plays a crucial role in mediating MAS-induced movements, it is not critically involved in initiating accelerated movements induced by LAS.</div></div><div><h3>Significance</h3><div>Our results suggest that the StartReact effect is a subcortical phenomenon that primarily assesses reticulospinal motor control.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110743"},"PeriodicalIF":3.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125206","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":"Evaluation of the diagnostic performance of brachial plexus ultrasound in amyotrophic lateral sclerosis","authors":"Hiroki Yamazaki ,&nbsp;Naoko Takamatsu ,&nbsp;Tomoyasu Matsubara ,&nbsp;Miki Tani ,&nbsp;Koji Fukushima ,&nbsp;Takeshi Yoshida ,&nbsp;Yusuke Osaki ,&nbsp;Ryosuke Oki ,&nbsp;Koji Fujita ,&nbsp;Hiroyuki Nodera ,&nbsp;Yuishin Izumi","doi":"10.1016/j.clinph.2025.2110741","DOIUrl":"10.1016/j.clinph.2025.2110741","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the diagnostic performance of brachial plexus cross-sectional area (BP-CSA) measured by nerve ultrasound (NUS) for differentiating amyotrophic lateral sclerosis (ALS) from controls.</div></div><div><h3>Methods</h3><div>A retrospective, cross-sectional study was conducted including patients with ALS and control patients who underwent NUS evaluation of the BP-CSA and the cervical nerve root CSA (C-CSA). Reference values for BP-CSA were built using reference cohort. Receiver operating characteristic curve analysis was performed in independent discovery and validation cohorts to assess the diagnostic performance of BP-CSA.</div></div><div><h3>Results</h3><div>A total of 244 patients (114 ALS and 130 controls) were included. BP-CSA significantly correlated with body weight (coefficient = 0.50, <em>p</em> &lt; 0.001). After adjusting for body weight, BP-CSA values were significantly lower in patients with ALS than controls (<em>p</em> &lt; 0.001). Adjusted BP-CSA showed superior diagnostic performance compared to C-CSA, with area under the curve values of 0.75 (95 % CI: 0.64–0.86) and 0.78 (95 % CI: 0.68–0.88) in the discovery and validation cohorts, respectively.</div></div><div><h3>Conclusions</h3><div>BP-CSA, when adjusted for body weight, shows reliable performance in diagnosing ALS.</div></div><div><h3>Significance</h3><div>This study highlights the clinical value of BP-CSA as a potential ALS diagnostic biomarker and underscores its superiority over cervical nerve root measurements.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110741"},"PeriodicalIF":3.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134078","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":"Neuromagnetic responses to multimodal stimuli in Friedreich’s ataxia","authors":"Elisa Visani ,&nbsp;Laura Canafoglia ,&nbsp;Lorenzo Nanetti ,&nbsp;Davide Rossi Sebastiano ,&nbsp;Dunja Duran ,&nbsp;Paola Anversa ,&nbsp;Deborah Bonfoco ,&nbsp;Sara Dotta ,&nbsp;Davide Tabarelli ,&nbsp;Anna Castaldo ,&nbsp;Gloria Marchini ,&nbsp;Alessia Mongelli ,&nbsp;Caterina Mariotti","doi":"10.1016/j.clinph.2025.2110738","DOIUrl":"10.1016/j.clinph.2025.2110738","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores the utility of various evoked fields in elucidating the pathophysiology of Friedreich’s ataxia (FA) and potentially contributing to developing more targeted diagnostic and therapeutic strategies.</div></div><div><h3>Methods</h3><div>Thirty-seven patients with FA aged 27.6 ± 7.4 years and a control group of 17 healthy subjects were enrolled in the study. The neuromagnetic response to auditory, tactile, visual, somatosensory, auditory and tactile oddball stimulation were acquired. For all the components of interest, latency and amplitude were measured and correlated with clinical data.</div></div><div><h3>Results</h3><div>Neuromagnetic responses were identifiable in more than 90% of cases. A significant response delay was observed in all tested modalities (auditory, somatosensory, tactile and visual responses). P300 responses were comparable in patients and healthy subjects. Latencies of visual and auditory responses correlated with SARA scores. Moreover, latencies of auditory responses correlated with disease onset age, whereas latencies of visual responses correlated with disease severity.</div></div><div><h3>Conclusions</h3><div>Auditory and visual responses correlated with the severity of the disease, whereas alterations in somatosensory responses represent an intrinsic characteristic of the disease.</div></div><div><h3>Significance</h3><div>In FA the study of evoked visual fields could provide a possible biomarker of disease progression and treatment efficacy.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110738"},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098596","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":"Stimulate to probe, stimulate to modulate: Single-pulse brain stimulation to titrate neuromodulation.","authors":"Simone Russo, Mario Rosanova","doi":"10.1016/j.clinph.2025.2110737","DOIUrl":"https://doi.org/10.1016/j.clinph.2025.2110737","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":" ","pages":"2110737"},"PeriodicalIF":3.7,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141573","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":"Introducing the Trigemino-Vocal Reflex: New insights to assess brainstem connectivity under general anesthesia","authors":"Javier Urriza ,&nbsp;Isabel Fernandez-Conejero ,&nbsp;Kathleen Seidel ,&nbsp;Sedat Ulkatan","doi":"10.1016/j.clinph.2025.2110739","DOIUrl":"10.1016/j.clinph.2025.2110739","url":null,"abstract":"<div><h3>Objective</h3><div>This descriptive study aims to provide evidence of a newly described reflex, the Trigemino-Vocal Reflex (TVcR). It confirms the functional connectivity between trigeminal and vagal systems in humans under anesthesia.</div></div><div><h3>Methods</h3><div>We stimulated the mental branch of the trigeminal nerve at the mandibular foramen in 47 patients undergoing different surgeries and recorded vocal cord muscle responses. Stimulation consisted of either a single electrical pulse or a train of 2–4 pulses, based on anesthesia depth. The recording was made by using an adhesive tube electrode.</div></div><div><h3>Results</h3><div>A bilateral response was observed in 41 patients, while 2 showed only a unilateral response. All 43 exhibited an early potential (R1) with a latency of about 30 ms, and 24 also displayed a late potential (R2) with a latency of<!--> <!-->around 65 ms.</div></div><div><h3>Conclusions</h3><div>We demonstrate the potential to record the newly described TVcR, recording vagal motor responses in the vocal cords following stimulation of the trigeminal nerve at the mandibular foramen in anesthetized patients.</div></div><div><h3>Significance</h3><div>We introduce a newly described reflex that may be valuable in intraoperative neurophysiological monitoring and could enhance our understanding of brainstem physiology.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"175 ","pages":"Article 2110739"},"PeriodicalIF":3.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941463","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}