Journal of Clinical Neurophysiology最新文献

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Collodion Versus Tensive-Quality and Cost Comparison in 48-hour Ambulatory EEG Studies. 胶凝与张力- 48小时动态脑电图研究的质量和成本比较。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-05-08 DOI: 10.1097/WNP.0000000000001262
Tomi Ashaye, Sedalia Cole, Danielle Pierce, Magdalena Warzecha, Jesus Natividad Sarol, Fatima Ahmed
{"title":"Collodion Versus Tensive-Quality and Cost Comparison in 48-hour Ambulatory EEG Studies.","authors":"Tomi Ashaye, Sedalia Cole, Danielle Pierce, Magdalena Warzecha, Jesus Natividad Sarol, Fatima Ahmed","doi":"10.1097/WNP.0000000000001262","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001262","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether there is a difference in electrode impedances in 48-hour in-home ambulatory EEGs (AEEG) when using collodion versus Tensive for electrode application. In addition, to compare the costs of using the two adhesive agents.</p><p><strong>Methods: </strong>This retrospective review analyzed 252 intermittently monitored 48-hour ambulatory EEG studies conducted in adult patients. In total, 126 studies were conducted using collodion and 126 using Tensive for electrode application. Each group was composed of an equal number of male and female. Electrode impedances were checked and documented at least every 4 hours, more frequently if artifact was noticed by the registered EEG technologist (R.EEG T.) during intermittent monitoring. The number of electrodes in which impedance exceeded 10 kOhms anytime during the 48-hour study was assessed. In addition, the per-patient cost of collodion and its required ancillary supplies was compared with that of Tensive.</p><p><strong>Results: </strong>The incidence of impedances greater than 10 kOhms in 48-hour ambulatory EEGs was similar for the collodion and Tensive groups. It was 42.1% for collodion and 45.2% for Tensive. The difference between the two adhesives was not statistically significant (P = 0.6114). There was a 73% cost reduction per patient when using Tensive compared with collodion.</p><p><strong>Conclusions: </strong>There is no significant difference in the maintenance of proper electrode impedance in 48-hour ambulatory EEGs when using collodion or Tensive for electrode application. There is a 73% cost reduction per patient when using Tensive.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Electrical Source Imaging in Stereoelectroencephalography: A Proof-of-Concept Study. 立体脑电图中的电源成像:概念验证研究。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-05-05 DOI: 10.1097/WNP.0000000000001257
Luca Bosisio, Matteo Cataldi, Domenico Tortora, Alessandro Consales, Giulia Nobile, Ezequiel Mikulan, Valentina Marazzotta, Lino Nobili, Stefano Francione
{"title":"Electrical Source Imaging in Stereoelectroencephalography: A Proof-of-Concept Study.","authors":"Luca Bosisio, Matteo Cataldi, Domenico Tortora, Alessandro Consales, Giulia Nobile, Ezequiel Mikulan, Valentina Marazzotta, Lino Nobili, Stefano Francione","doi":"10.1097/WNP.0000000000001257","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001257","url":null,"abstract":"<p><strong>Purpose: </strong>Electrical source imaging (ESI) estimates the intracerebral generators of EEG signals. Although traditionally applied to scalp EEG sensors, recent studies suggested its potential applicability to intracerebral recordings. We systematically evaluated the localization accuracy of ESI applied to SEEG data rather than scalp EEG.</p><p><strong>Methods: </strong>We compared three different inverse solution methods (standardized low-resolution electromagnetic tomography [sLORETA], minimum norm estimate, and dynamic statistical parametric mapping) in localizing the stimulation artifact in 12 subjects undergoing SEEG. Localization accuracy was defined as the Euclidean distance between the stimulation site and the peak of the estimated source.</p><p><strong>Results: </strong>Standardized low-resolution electromagnetic tomography showed the highest accuracy. For single stimuli, the mean localization error was 11.65 mm, improving to 9.28 mm when averaging 10 stimuli. Subcentimeter accuracy was achieved in 77.5% of averaged trials. Although localization based on the maximum amplitude artifact increased linearly with the distance from the nearest SEEG contact, sLORETA maintained higher accuracy, typically within ∼1 cm. The weak association between sLORETA error and sensor distance disappeared when excluding stimulations at the outermost boundaries of the explored region.</p><p><strong>Conclusions: </strong>These results support the application of ESI to SEEG data for accurate source localization. Among tested methods, sLORETA was the most effective and may improve spatial interpretability in challenging epilepsy cases, including those with suboptimal spatial sampling.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Understanding of Rapid Ictal Blinking: Definition Criteria, Prevalence, and Localizing Value. 快速闪烁的理解:定义标准、流行程度和定位价值。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-13 DOI: 10.1097/WNP.0000000000001248
Saeideh Salehizadeh, Suraj Thyagaraj, Neel Fotedar, Naiara Garcia-Losarcos, Hans Lüders
{"title":"Understanding of Rapid Ictal Blinking: Definition Criteria, Prevalence, and Localizing Value.","authors":"Saeideh Salehizadeh, Suraj Thyagaraj, Neel Fotedar, Naiara Garcia-Losarcos, Hans Lüders","doi":"10.1097/WNP.0000000000001248","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001248","url":null,"abstract":"<p><strong>Purpose: </strong>Ictal blinking is an undefined phenomenon of involuntary bilateral blinks during a seizure, at a higher frequency than baseline blinking that is not associated with other facial motor manifestations. In most reports, the epileptogenic zone has been identified in the occipital regions. The purpose of this study is to characterize ictal blinking and assess its potential localizing value.</p><p><strong>Method: </strong>EEG and EOG data from 45 patients with seizures from temporal, occipito-parietal, and fronto-central regions (15 per group) were analyzed. Blinks were quantified in 15-second epochs during ictal and baseline phases. Baseline duration matched the ictal phase or extended to 150 seconds. RIB is defined as the blinking rate at least 50% greater than the average baseline blinking during any ictal window. The ictal blinking rate ratio (BRR) was also calculated for each group, defined as the ratio of maximum ictal blinks to average baseline blinks. Ictal blink suppression (BS) was defined as no blinks in the first 30 seconds of a seizure.</p><p><strong>Results: </strong>The average blinking frequency during the baseline period was four blinks every 15-second page. The average ictal blinks for patients who met the criteria for RIB were seven per 15-second page. RIB occurs most frequently in temporal epilepsy (73%) and less commonly in frontal epilepsy (47%). Ictal BRR is highest (5.6) in occipital epilepsy. Ictal BS occurred in 22% of cohort.</p><p><strong>Conclusions: </strong>RIB is a frequent ictal phenomenon without significant localizing value. Ictal BRR was significantly higher for patients with occipital seizures. Based on the findings, a practical definition for RIB was proposed: seven or more blinks in any 15-second epoch during seizure.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Generalized Periodic Discharges: Nonconvulsive Status Epilepticus or Diffuse Encephalopathy-A Case Comparison. 广泛性周期性放电:非惊厥性癫痫持续状态或弥漫性脑病1例比较。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-02 DOI: 10.1097/WNP.0000000000001256
Chanawee Hirunpattarasilp, Joshua Edmondson, Daniel Wood, Guadalupe Fernandez-BacaVaca, Neel Fotedar
{"title":"Generalized Periodic Discharges: Nonconvulsive Status Epilepticus or Diffuse Encephalopathy-A Case Comparison.","authors":"Chanawee Hirunpattarasilp, Joshua Edmondson, Daniel Wood, Guadalupe Fernandez-BacaVaca, Neel Fotedar","doi":"10.1097/WNP.0000000000001256","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001256","url":null,"abstract":"<p><strong>Summary: </strong>Nonconvulsive status epilepticus (NCSE) refers to persistent epileptiform discharges on EEG meeting the Salzburg criteria. Nonconvulsive status epilepticus with coma mostly occurs in critically ill patients without preceding convulsions and without a history of chronic epilepsy, where the EEG typically shows generalized periodic discharges (GPDs). Nonconvulsive status epilepticus without coma is typically described in patients with chronic epilepsy and is associated with a different alteration of consciousness where patients are awake with eyes open, retained posture, however unresponsive with amnesia (known as dialepsis). The GPDs in NCSE with coma could represent an epiphenomenon and the coma might not be a direct result of the GPDs. In contrast, the dialeptic state in NCSE without coma is a true manifestation of the epileptiform discharges, hence warranting treatment with antiseizure medications. In this report, a case of NCSE with coma is described caused by ceftriaxone-induced neurotoxicity and its electroclinical characteristics are compared with a case of NCSE without coma in a patient with chronic focal epilepsy.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Safety and Feasibility of Transcranial Motor-Evoked Potentials During Intraoperative Neurophysiologic Monitoring in Patients With Deep Brain Stimulators. 经颅运动诱发电位在深部脑刺激器患者术中神经生理监测中的安全性和可行性。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-02 DOI: 10.1097/WNP.0000000000001249
Nicholas Meyers, Mark Keroles, Sungho Charles Cho, Rohit Gummi, Scheherazade Le, Leslie Lee, Viet Nguyen, Ankita Tippur, Jaime R López, Felix Chang
{"title":"Safety and Feasibility of Transcranial Motor-Evoked Potentials During Intraoperative Neurophysiologic Monitoring in Patients With Deep Brain Stimulators.","authors":"Nicholas Meyers, Mark Keroles, Sungho Charles Cho, Rohit Gummi, Scheherazade Le, Leslie Lee, Viet Nguyen, Ankita Tippur, Jaime R López, Felix Chang","doi":"10.1097/WNP.0000000000001249","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001249","url":null,"abstract":"<p><strong>Purpose: </strong>Transcranial motor-evoked potentials (TcMEPs) are routinely used for intraoperative neurophysiologic monitoring to assess corticospinal tract integrity. However, data regarding the use of TcMEPs in patients with implanted deep brain stimulator (DBS) devices remain limited. This study aims to evaluate the safety and feasibility of TcMEP monitoring in patients with implanted DBS systems undergoing a variety of surgical procedures.</p><p><strong>Methods: </strong>A retrospective review was conducted using clinical and neurophysiologic data from patients with DBS devices who underwent surgery with TcMEP monitoring at a single institution between 2014 and 2024. Patient demographics, surgical and device information, TcMEP stimulation parameters, and intraoperative neurophysiologic monitoring documentation, as well as intraoperative and postoperative clinical notes were reviewed.</p><p><strong>Results: </strong>Sixteen patients were identified who underwent 19 surgical procedures with TcMEP monitoring. Reliable TcMEP signals were successfully obtained in all patients across a variety of surgical procedures, DBS targets, and stimulation parameters (80-520 V, 147-1,388 mA). No TcMEP-related intraoperative or postoperative complications were identified, and DBS device functionality remained preserved. However, active DBS stimulation during surgery generated electrical artifacts that interfered with other intraoperative neurophysiologic monitoring modalities, including somatosensory evoked potentials and EEG (electroencephalogram).</p><p><strong>Conclusions: </strong>Transcranial motor-evoked potentials monitoring is safe and feasible in patients with implanted DBS devices undergoing a variety of surgical procedures. Standard TcMEP stimulation parameters can be implemented without significant modification. To minimize interference with multimodal intraoperative neurophysiologic monitoring, DBS devices should be turned off during monitoring. Further studies are needed to establish standardized guidelines for TcMEP monitoring in patients with DBS and other intracranial neurostimulation devices.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
A Call for the Inclusion of Standardized Filter Parameters in the ACNS Standardized Critical Care EEG Terminology. 呼吁在ACNS标准化危重监护脑电图术语中纳入标准化滤波参数。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-01 Epub Date: 2025-06-26 DOI: 10.1097/WNP.0000000000001180
Fábio A Nascimento, Lawrence J Hirsch, Peter W Kaplan, Aatif Husain, Donald Schomer, Sándor Beniczky
{"title":"A Call for the Inclusion of Standardized Filter Parameters in the ACNS Standardized Critical Care EEG Terminology.","authors":"Fábio A Nascimento, Lawrence J Hirsch, Peter W Kaplan, Aatif Husain, Donald Schomer, Sándor Beniczky","doi":"10.1097/WNP.0000000000001180","DOIUrl":"10.1097/WNP.0000000000001180","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"366-367"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
24-Hour Video EEG in the Evaluation of the Seizure-Free Patient Before Antiseizure Medication Withdrawal. 24小时视频脑电图在无癫痫患者停药前的评价。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-01 Epub Date: 2025-10-01 DOI: 10.1097/WNP.0000000000001212
Areej Nauman, Ahamed Lazim Vattoth, Gayane Melikyan, Musab Ali, Yaser Othman, Boulenouar Mesraoua, Hasan Al Hail, Soha Roger Dargham, Farhana Khan, Abdulraheem Alrabi, Ziyad Mahfoud, Naim Haddad
{"title":"24-Hour Video EEG in the Evaluation of the Seizure-Free Patient Before Antiseizure Medication Withdrawal.","authors":"Areej Nauman, Ahamed Lazim Vattoth, Gayane Melikyan, Musab Ali, Yaser Othman, Boulenouar Mesraoua, Hasan Al Hail, Soha Roger Dargham, Farhana Khan, Abdulraheem Alrabi, Ziyad Mahfoud, Naim Haddad","doi":"10.1097/WNP.0000000000001212","DOIUrl":"10.1097/WNP.0000000000001212","url":null,"abstract":"<p><strong>Purpose: </strong>In patients with epilepsy who achieve seizure freedom, physicians may consider discontinuing antiseizure medications, often using EEG beforehand to guide the decision. This study evaluates the gain in detection of epileptiform discharges (EDs) in 24-hour video EEG (VEEG) monitoring in seizure-free patients.</p><p><strong>Methods: </strong>The authors identified patients with epilepsy who were seizure free on antiseizure medications and had undergone 24-hour VEEG after an unrevealing routine EEG. The authors evaluated the yield and latency of observed EDs in the VEEG study. The authors compared the rate of ED detection during the first 60 minutes versus later in the recording.</p><p><strong>Results: </strong>Of the 27 patients, aged 19 to 51 years, 10 (37%) exhibited EDs on 24-hour VEEG. The latency to the first EDs ranged from 52 to 748 minutes, with a median of 164 minutes. Nine of these 10 patients (90%) had their EDs appear only after the first 60 minutes of recording. In other words, prolonging the EEG beyond 1 hour yielded an additional 33.3% of patients with EDs that a 1-hour recording would have missed. Younger age and presence of EDs on a past EEG were predictive of the presence of EDs on VEEG ( P = 0.040 and P = 0.039 respectively).</p><p><strong>Conclusions: </strong>The results suggest that 24-hour VEEG is more sensitive in detecting EDs than routine EEG in seizure-free patients and thus may be superior in individualized risk assessments for seizure recurrence on potential antiseizure medication discontinuation.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"283-288"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Visualization of Neural Activity in the Upper and Middle Lumbar Spine Using Magnetospinography After Lateral Femoral Cutaneous, Saphenous, and Femoral Nerve Stimulation. 在股外侧皮神经、隐神经和股神经刺激后,利用脊髓磁成像显示上腰椎和中腰椎的神经活动。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-01 Epub Date: 2025-10-16 DOI: 10.1097/WNP.0000000000001219
Hisato Higashikawa, Jun Hashimoto, Yuta Tanaka, Toru Sasaki, Hiroaki Onuma, Satoru Egawa, Yu Matsukura, Takashi Hirai, Yuko Hoshino, Taishi Watanabe, Yuki Miyano, Saeri Kaminaka, Yusuke Yamamoto, Yoshiaki Adachi, Miho Akaza, Shigenori Kawabata, Toshitaka Yoshii
{"title":"Visualization of Neural Activity in the Upper and Middle Lumbar Spine Using Magnetospinography After Lateral Femoral Cutaneous, Saphenous, and Femoral Nerve Stimulation.","authors":"Hisato Higashikawa, Jun Hashimoto, Yuta Tanaka, Toru Sasaki, Hiroaki Onuma, Satoru Egawa, Yu Matsukura, Takashi Hirai, Yuko Hoshino, Taishi Watanabe, Yuki Miyano, Saeri Kaminaka, Yusuke Yamamoto, Yoshiaki Adachi, Miho Akaza, Shigenori Kawabata, Toshitaka Yoshii","doi":"10.1097/WNP.0000000000001219","DOIUrl":"10.1097/WNP.0000000000001219","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetospinography provides a noninvasive and detailed visualization of neural currents. We previously reported that magnetospinography can be used to evaluate neural function in the lower lumbar spine in response to tibial, peroneal, and sciatic nerve stimulation. However, evaluating the neural function of the upper and middle lumbar spine is often difficult due to lower current intensity. We aimed to visualize the neural activity of the upper and middle lumbar spine using new stimulation methods and assess the foraminal current.</p><p><strong>Methods: </strong>Neural magnetic fields in 10 healthy volunteers were recorded after stimulation of the lateral femoral cutaneous nerve, saphenous nerve, femoral nerve, and peroneal nerve. The conduction velocity and current intensity in the spinal canal and intervertebral foramen were calculated and compared for each type of nerve stimulation.</p><p><strong>Results: </strong>Magnetospinography visualized the evoked magnetic fields in the lumbar region after each nerve stimulation method in all volunteers. The current intensity in the upper lumbar spine was significantly greater after femoral nerve stimulation. Magnetospinography revealed that action current flowed mainly along the L2 nerve root after lateral femoral cutaneous nerve stimulation and the L4 nerve root after saphenous nerve stimulation.</p><p><strong>Conclusions: </strong>Using a new stimulation method, magnetospinography enabled the noninvasive visualization of neural currents in the upper and middle lumbar spine. Femoral nerve stimulation is suitable for evaluating the spinal canal of the upper lumbar spine, and lateral femoral cutaneous nerve and saphenous nerve stimulations are suitable for evaluating the upper and middle lumbar intervertebral foramina, respectively.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"332-339"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Relationship Between Obstructive Sleep Apnea and Autonomic Failure. 阻塞性睡眠呼吸暂停与自主神经衰竭的关系。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-01 Epub Date: 2025-10-21 DOI: 10.1097/WNP.0000000000001216
Renata Maria de Carvalho Cremaschi, Fernando Morgadinho Santos Coelho, Sasha Moran, Chun-Yu Lee, Milena Pavlova, Peter Novak
{"title":"Relationship Between Obstructive Sleep Apnea and Autonomic Failure.","authors":"Renata Maria de Carvalho Cremaschi, Fernando Morgadinho Santos Coelho, Sasha Moran, Chun-Yu Lee, Milena Pavlova, Peter Novak","doi":"10.1097/WNP.0000000000001216","DOIUrl":"10.1097/WNP.0000000000001216","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate daytime autonomic dysregulation in patients with obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>This retrospective study was conducted at Brigham and Women's Faulkner Hospital Autonomic Laboratory and evaluated adult patients with a history of orthostatic intolerance and sleep disturbances who completed autonomic testing (deep breathing test, Valsalva maneuver, tilt test) and polysomnography between 2018 and 2024. The Quantitative Scale for Grading of Cardiovascular Autonomic Reflex Tests scoring instrument graded autonomic tests and skin biopsies for the assessment of small fibers. The apnea-hypopnea index was used to assess OSA severity.</p><p><strong>Results: </strong>In total, 138 patients were evaluated in this study. Subjects with OSA (43 with mild and 29 with moderate/severe OSA) were compared with 66 subjects without OSA. Age, body mass index, and the prevalence of hypertension increased with the severity of sleep apnea. At least moderate autonomic failure was identified in 60% of patients without OSA and in 78% of those with OSA. Autonomic failure score was proportional to the severity of OSA (autonomic failure scores: no OSA 4.2 ± 2.54, mild OSA 5.44 ± 3.41, moderate/severe OSA 8.1 ± 4.3, P < 0.001). Small fiber neuropathy was found in 41.8% of patients without OSA and in 70.8% of patients with moderate/severe OSA.</p><p><strong>Conclusions: </strong>Autonomic failure associated with small fiber autonomic neuropathy is common in patients with OSA, and the degree of autonomic failure is proportional to the severity of sleep apnea. Autonomic failure can be an additional risk factor contributing to the cardiovascular complications observed in OSA.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"356-365"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Clinical and Electrophysiologic Features of Ulnar Neuropathy at the Wrist: Analysis of 150 Consecutive Cases. 腕部尺神经病变的临床和电生理特征:附150例病例分析。
IF 1.7 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2026-04-01 Epub Date: 2025-10-03 DOI: 10.1097/WNP.0000000000001211
Federica Ginanneschi, Marianna Curcio, Alessandro Aretini, Mauro Mondelli
{"title":"Clinical and Electrophysiologic Features of Ulnar Neuropathy at the Wrist: Analysis of 150 Consecutive Cases.","authors":"Federica Ginanneschi, Marianna Curcio, Alessandro Aretini, Mauro Mondelli","doi":"10.1097/WNP.0000000000001211","DOIUrl":"10.1097/WNP.0000000000001211","url":null,"abstract":"<p><strong>Purpose: </strong>To report clinical and electrodiagnostic (EDX) findings in ulnar neuropathy at the wrist (UNW).</p><p><strong>Methods: </strong>This is a monocentric study. We collected demographic and clinical data, history, symptom type, neurologic examination findings, EDX results, as well as causes and risk factors of UNW.</p><p><strong>Results: </strong>We enrolled 150 consecutive cases. Based on EDX findings, the most common UNW pattern involved the ulnar nerve at the entrance of Guyon canal, prior to its bifurcation into sensory and motor branches (44% of cases). We identified atypical topographic lesions involving the superficial sensory branch and motor fibers innervating the hypothenar (4.7% of cases) or the interossei muscles (12.8% of cases). The most frequent causes were compressive (20.7%) and traumatic (22%), mainly affecting males, blue-collar workers, and individuals aged ≤60 years. Ganglion was prevalent in females (66.7%). Cases of UNW with unknown etiology were significantly associated with age >60 years, the presence of muscle atrophy, and a history of carpal tunnel syndrome (CTS).</p><p><strong>Conclusions: </strong>Clinical and EDX characteristics of UNW depend on injury site at wrist or hand palm. It is not possible to determine the cause with certainty based solely on the type, although some causes tend to affect specific sites of nerve injury. The coexistence of Guyon canal syndrome and CTS is confirmed to be a fairly frequent finding. The awareness of the ulnar nerve anatomical variations should not lead to the exclusion of UNW if EDX abnormalities do not fall into any of the five classical types according to Wu's classification.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"347-355"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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