Clinical Neurophysiology最新文献

{"title":"EEG-based stratification in Alzheimer’s disease: Cognitive progression, pathological marker associations, and therapeutic interventions","authors":"Zian Pei ,&nbsp;Lin Zhu ,&nbsp;Huixia Ren ,&nbsp;Yumei Liu ,&nbsp;Xue Shi ,&nbsp;Yun Lin ,&nbsp;Jing Wang ,&nbsp;Pan Li ,&nbsp;Pan Wang ,&nbsp;Yong Ji ,&nbsp;Yuying Zhou ,&nbsp;Xiaoying Tang ,&nbsp;Xin Jiang ,&nbsp;Xiaoguang Tong ,&nbsp;Yi Guo","doi":"10.1016/j.clinph.2025.2111440","DOIUrl":"10.1016/j.clinph.2025.2111440","url":null,"abstract":"<div><h3>Objective</h3><div>Clinical cognitive and pathological marker stratification systems have evolved separately, causing mismatches that limit their clinical use. This study retrospectively validated the link between EEG and clinical symptoms, pathological markers, and the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS).</div></div><div><h3>Methods</h3><div>This multicenter study involved 308 Alzheimer’s patients (AD), 176 with Parkinson’s (PD), and 181 normal controls. Resting-state EEG were analyzed to identify four oscillation modes. An EEG-based cognitive risk system was created and validated, also evaluating its effect on rTMS therapy effectiveness.</div></div><div><h3>Results</h3><div>EEG oscillation changes correlated with cognitive decline, revealing distinct brain network disruptions in AD and PD. These oscillation changes were associated with AD biomarkers, particularly tau hyperphosphorylation. Multicenter validation showed an 83% concordance with the Clinical Dementia Rating Scale, and EEG stratification enhanced rTMS therapeutic efficacy.</div></div><div><h3>Conclusions</h3><div>This study showed that EEG-based stratification can assess cognitive function, track disease progression, identify key intervention periods, and improve patient selection for better treatment outcomes in clinical settings.</div></div><div><h3>Significance</h3><div>This study demonstrates that EEG can connect disease processes to clinical symptoms at a molecular level, offering a unified framework for improved dementia management. This method allows for dynamic monitoring and precise neuromodulation, enhancing personalized care for neurodegenerative diseases.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111440"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616621","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":"Identifying the epileptogenic zone by 18F-FDG PET/MRI in drug-resistant epilepsy with focal cortical dysplasia type IIIa","authors":"Lingling Zhang ,&nbsp;Hailing Zhou ,&nbsp;Yongjin Tang ,&nbsp;Jiefeng Gan ,&nbsp;Xiangshu Hu ,&nbsp;Hainan Li ,&nbsp;Xueying Ling ,&nbsp;Qiang Guo ,&nbsp;Hao Xu","doi":"10.1016/j.clinph.2025.2111412","DOIUrl":"10.1016/j.clinph.2025.2111412","url":null,"abstract":"<div><h3>Objective</h3><div>Focal cortical dysplasia (FCD) type IIIa, distinct from isolated FCD in drug-resistant epilepsy, is typically confirmed via postoperative histopathology. This study aimed to evaluate the diagnostic utility of preoperative noninvasive ¹⁸F-fludeoxyglucose (FDG) PET/MRI co-registration in localizing the epileptogenic zone (EZ) in FCD type IIIa.</div></div><div><h3>Methods</h3><div>We performed a retrospective study that included 60 patients with FCD type IIIa who underwent resection for drug-resistant epilepsy. The sensitivity of each modality for localizing the EZ was calculated, with invasive stereoelectroencephalography (SEEG) as a reference. Diagnostic accuracy and value of each modality were further assessed with respect to SEEG and postoperative outcomes for all patients and MRI negative/doubtful patients.</div></div><div><h3>Results</h3><div>We analyzed the diagnostic value of the different non-invasive diagnostic techniques with respect to concordance with SEEG findings and postsurgical seizure outcomes. For all included patients, ¹⁸F-FDG PET/MRI showed the highest sensitivity (75.7 %) for localizing the EZ across all modalities. We also found that ¹⁸F-FDG PET/MRI demonstrated the best accuracy and diagnostic value for localizing the EZ (60.0 %). Among MRI-doubtful/negative patients, ¹⁸F-FDG PET/MRI not only showed the highest sensitivity (79.3 %) but also achieved most promising accuracy and diagnostic value for identifying the EZ (61.7 % accuracy) across all modalities.</div></div><div><h3>Significance</h3><div>¹⁸F-FDG PET/MRI coregistration appears to be overwhelmingly rewarding in affording localization of EZ for patients with FCD type IIIa. This technique is potentially valuable as a noninvasive method to identify the EZ in patients with drug-resistant epilepsy due to FCD type IIIa, especially for MRI-negative/doubtful patients.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111412"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511930","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":"Deriving reference limits from historical data – A comparison of four novel methods","authors":"Tomasz Szymon Szczepanski ,&nbsp;Petter Moe Omland ,&nbsp;Øystein Dunker ,&nbsp;Trond Sand ,&nbsp;Martijn Tannemaat ,&nbsp;Robert Reijntjes ,&nbsp;Anis Yazidi ,&nbsp;Kerstin Bach ,&nbsp;John Anker Zwart ,&nbsp;Joe Jabre ,&nbsp;Kristian Bernhard Nilsen","doi":"10.1016/j.clinph.2025.2111451","DOIUrl":"10.1016/j.clinph.2025.2111451","url":null,"abstract":"<div><h3>Objective</h3><div>To compare four novel methods – extrapolated norms (E-norms), extrapolated reference values (E-Ref), multivariable extrapolated reference values (MeRef) and mixture model clustering (MMC) – for obtaining reference limits for nerve conduction studies (NCS) from historical data containing both normal and abnormal studies.</div></div><div><h3>Methods</h3><div>Reference limits for 29 commonly clinically used NCS measurements were calculated from a historical database containing measurements from 24<!--> <!-->618 patients using E-norms, E-ref, MeRef and MMC. The resulting reference limits were compared to reference limits for NCS calculated from 680 healthy subjects using Youden’s J statistics.</div></div><div><h3>Results</h3><div>Except for distal latencies, E-norms produced reference limits with the highest Youden’s J statistics with higher sensitivity, but lower specificity. E-Ref, MeRef and MMC produced reference limits with high specificity, but lower sensitivity than E-norms.</div></div><div><h3>Conclusions</h3><div>There are substantial differences in the performance of E-norms, E-Ref, MeRef and MMC. A dynamic approach, where the methods used are changed based on the type of NCS measurement and the amount of historical data available, may yield the highest accuracy.</div></div><div><h3>Significance</h3><div>When combining the different novel methods, it is possible to create clinically useful reference limits using historical data.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111451"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616692","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":"“Fascicular twitch” on muscle ultrasonography in neuromuscular disorders: quantitative video-image analysis","authors":"Shun Matoba ,&nbsp;Kenji Sekiguchi ,&nbsp;Yoshikatsu Noda ,&nbsp;Ryosuke Sugisawa ,&nbsp;Hirotomo Suehiro ,&nbsp;Katsuya Nishida ,&nbsp;Riki Matsumoto","doi":"10.1016/j.clinph.2025.2111447","DOIUrl":"10.1016/j.clinph.2025.2111447","url":null,"abstract":"<div><h3>Objective</h3><div>In contrast to needle electromyography, the diagnostic performance of muscle ultrasound (MUS) for differentiating neurogenic from myopathic disorders remains unclear. We examined the clinical utility of “fascicular twitch,” a visible movement of muscle bundles during isometric contraction, and evaluated its ability to differentiate neurogenic from myopathic changes.</div></div><div><h3>Methods</h3><div>We quantified fascicular twitches on MUS during isometric contraction as normalized twitch pixels (nTP) using an original image analysis method based on background subtraction. We analyzed echogenicity and nTP values in the biceps brachii muscle of 89 patients with neuromuscular disorders and 42 controls.</div></div><div><h3>Results</h3><div>The neurogenic group demonstrated substantially higher nTP values than the myopathic group and controls, achieving a sensitivity of 90.5% and specificity of 88.1% at an nTP cutoff of 0.04. Although echogenicity distinguished patients with neuromuscular disorders from controls, it failed to discriminate between the neurogenic and myopathic groups.</div></div><div><h3>Conclusions</h3><div>Quantification of fascicular twitch via nTP effectively differentiates neurogenic from myopathic disorders, thereby demonstrating that MUS is a valuable, noninvasive diagnostic method for assessing neuromuscular diseases.</div></div><div><h3>Significance</h3><div>This study introduces fascicular twitch quantification as a novel ultrasound biomarker that uniquely discriminates neurogenic from myopathic pathology, offering a high‑performance, noninvasive approach to neuromuscular diagnosis.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111447"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616691","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 precision medicine in non-invasive brain stimulation for chronic pain","authors":"Elisa Mantovani,&nbsp;Federico Ranieri,&nbsp;Stefano Tamburin","doi":"10.1016/j.clinph.2025.2111435","DOIUrl":"10.1016/j.clinph.2025.2111435","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111435"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518420","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 muscle ultrasound and ultrasound-guided needle electromyography in quadrilateral space syndrome","authors":"Cameron S. Smock ,&nbsp;Jessica N. Buttinger ,&nbsp;Marianne T. Luetmer ,&nbsp;Amy S. Beacom ,&nbsp;Joaquin Sanchez-Sotelo ,&nbsp;James B. Meiling","doi":"10.1016/j.clinph.2025.2111470","DOIUrl":"10.1016/j.clinph.2025.2111470","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111470"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700002","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":"Clinical and methodological advances in EEG-fMRI for epilepsy: a focused review","authors":"Thaera Arafat ,&nbsp;Zhengchen Cai ,&nbsp;Jean Gotman","doi":"10.1016/j.clinph.2025.2111460","DOIUrl":"10.1016/j.clinph.2025.2111460","url":null,"abstract":"<div><div>Simultaneous EEG-fMRI is a unique, noninvasive neuroimaging technique that enables high spatial resolution mapping of metabolic changes linked to EEG epileptic discharges in focal and generalized epilepsy, reflected through fMRI signals. It is increasingly recognized as a valuable tool in the presurgical evaluation of drug-resistant epilepsy, supporting the localization of epileptogenic zones, guiding electrode implantation, and informing surgical strategies and outcome prediction, while also revealing important insights into the networks involved in epileptic activity.</div><div>Advances in artifact removal, automated spike detection, and statistical modeling have improved EEG-fMRI’s data quality and clinical utility. It is particularly valuable in diagnostically challenging cases where standard EEG is not localizing, or MRI findings are negative. However, its routine clinical adoption is limited by the complexity of the procedure, the lack of standardized protocols, interpretation criteria, and broader validation across diverse epilepsy populations.</div><div>This review highlights EEG-fMRI’s evolving role in localizing epileptic discharges, emphasizing both methodological and clinical aspects. It covers the process from data acquisition through analysis to statistical interpretation and decision-making, with its application in distinguishing generalized from widespread activity, assessing thalamic involvement in focal epilepsy, evaluating status epilepticus, mapping blood oxygen–level dependent responses in relation to structural lesions, and supporting presurgical planning in complex cases, demonstrating its potential to improve diagnostic precision and treatment outcomes.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111460"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682020","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":"Multiple, not just Beta–Gamma, phase-amplitude couplings are associated with Parkinson’s disease and related intervention effects","authors":"Alireza Kazemi ,&nbsp;Salar Nouri ,&nbsp;Maryam S. Mirian ,&nbsp;Soojin Lee ,&nbsp;Martin J. McKeown","doi":"10.1016/j.clinph.2025.2111425","DOIUrl":"10.1016/j.clinph.2025.2111425","url":null,"abstract":"<div><h3>Objective</h3><div>1) To evaluate the importance of various EEG Phase Amplitude Couplings (PACs) in predicting motor vigor (MV) in Parkinson’s Disease (PD). 2) To determine the effects of dopaminergic medication and non-invasive galvanic vestibular stimulation (GVS) on MV-related PACs.</div></div><div><h3>Methods</h3><div>EEG data from 18 PD patients in comparison to 20 HC controls, executing a simple overlearned handgrip task was used, to identify PD-specific alterations. A deep learning model, PACNET, based on the VGG-16 architecture, was used to predict MV from a visual representation of different PACs.</div></div><div><h3>Results</h3><div>Delta-Beta, Theta-, Alpha-, and Beta-Gamma PACs were important for MV prediction. In PD subjects, GVS affected Delta-Beta, and Theta-, Beta- Gamma PAC’s role in MV prediction in a stimulation-specific manner. Delta-Beta and Theta-Gamma PACs were more relevant for PD patients’ MV prediction after L-dopa medication.</div></div><div><h3>Conclusions</h3><div>Multiple PACs are important for MV in Parkinson’s disease. Therapeutic interventions affect PAC/MV associations.</div></div><div><h3>Significance</h3><div>Multiple PACs, not just Beta–Gamma, are important for MV in PD and may serve as targets for neuromodulation strategies. A combined assessment of PACs could be a valuable biomarker for both disease evaluation and therapeutic effects in PD.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111425"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616622","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":"Feasibility and prognostic utility of laryngeal adductor reflex monitoring in anterior cervical spine surgery","authors":"Jongsuk Choi ,&nbsp;Ki Eob Kim ,&nbsp;Min Jun Song ,&nbsp;Joo Hyeong Lee ,&nbsp;Byung Hoon Yoon ,&nbsp;Kyung Seok Park","doi":"10.1016/j.clinph.2025.2111430","DOIUrl":"10.1016/j.clinph.2025.2111430","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility and clinical relevance of intraoperative laryngeal adductor reflex (LAR) monitoring for detecting recurrent laryngeal nerve (RLN) dysfunction during anterior cervical discectomy and fusion (ACDF).</div></div><div><h3>Methods</h3><div>LAR monitoring was performed in 104 patients undergoing ACDF using an electromyographic endotracheal tube. R1 amplitudes were recorded, and significant reductions were classified as transient or permanent. Swallowing and voice outcomes were assessed on postoperative day 7 (POD7), and at 3 and 6 months (POM3, POM6). Receiver operating characteristic (ROC) analysis was used to identify amplitude-reduction thresholds associated with RLN dysfunction.</div></div><div><h3>Results</h3><div>LAR signals were successfully obtained in 89.4 % of patients. Transient amplitude reductions occurred in 55 patients and were associated with short-term symptoms at POD7 (sensitivity 100 %, specificity 46.6 %, area under the curve [AUC] = 0.88), which resolved by POM6. Permanent reductions (n = 4) corresponded to persistent RLN dysfunction, with 100 % specificity and positive predictive value. Sensitivity increased over time, reaching 100 % at POM6. Post hoc ROC analysis identified an 81 % amplitude-reduction threshold that accurately predicted persistent RLN dysfunction at final follow-up (AUC = 1.000).</div></div><div><h3>Conclusions</h3><div>Intraoperative LAR monitoring was feasible and demonstrated strong predictive value for RLN dysfunction during ACDF.</div></div><div><h3>Significance</h3><div>LAR monitoring may enhance intraoperative neurophysiological monitoring by enabling real-time assessment of vagus nerve function in cervical spine surgery.</div></div>","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"182 ","pages":"Article 2111430"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616619","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":"Machine learning predicts cognitive outcome from preterm infants’ EEG","authors":"Tom A. Campbell","doi":"10.1016/j.clinph.2025.2111433","DOIUrl":"10.1016/j.clinph.2025.2111433","url":null,"abstract":"","PeriodicalId":10671,"journal":{"name":"Clinical Neurophysiology","volume":"181 ","pages":"Article 2111433"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518385","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}