Journal of Clinical Neurophysiology最新文献

{"title":"Response to the Letter to the Editor \"The Intracranial Source of Cortico-Cortical Evoked Potentials\" by Odile Feys and Fabrice Bartolomei.","authors":"Benjamin C Cox, Rachel J Smith, Ismail Mohamed, Jenna V Donohue, Mahtab Rostamihosseinkhani, Jerzy P Szaflarski, Rebekah J Chatfield","doi":"10.1097/WNP.0000000000001174","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001174","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215993","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}

{"title":"Introducing the Concept of Error Vectors to Improve Source Localization Results of Epileptic Discharges.","authors":"Kanjana Unnwongse, Carsten H Wolters, Tim Wehner, Lia Theophilo Krüger, Stefan Rampp, Jörg Wellmer","doi":"10.1097/WNP.0000000000001170","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001170","url":null,"abstract":"<p><strong>Purpose: </strong>To improve EEG source localization results of interictal epileptic discharges (IED) by applying postprocessing step to electrical source imaging (ESI).</p><p><strong>Methods: </strong>Localization error of ESI was evaluated in comparison to known sources of stimulation potentials (ESP) by recording simultaneous stereo-EEG/scalp EEG. Error vectors were defined as the offset of the ESI-dipole of ESP to the stereo-EEG contacts used for stimulation. The inverted error vector was applied to the ESI-dipole of IED (IED-dipole).</p><p><strong>Results: </strong>Seven IED clusters were evaluated. Corrected IED-dipoles were located closer to IED-onset contacts on stereo-EEG than uncorrected IED-dipoles (median [IQR]: 7.8 [2.5] versus 18.7 [10.7] mm, P = 0.02). Anatomically, for high skull conductivities, all corrected IED-dipoles were located in cortical structures or adjacent to epileptogenic lesion, whereas uncorrected IED-dipoles were located in white matter or CSF (P = 0.02). Physiologically, cortical extent of IED generators estimated from corrected IED-dipoles was 16.5 cm2 (IQR = 10.4 cm2) and 7.4 cm2 (range 5.8-9.2 cm2) in the group of anterior temporal IED and prefrontal IED, respectively; the former was concordant with the extent estimated by subdural electrodes. In addition, the relationship of stereo-EEG IED amplitude (a) drop with increasing distance (d) from corrected IED-dipole could be modeled as a negative power equation a(d)∝1/db (R2 = 0.87, P < 0.01), with b ranging from 0.79 to 2.3, median: 1.57, consistent with a simulation model of the sensitivity of intracerebral electrode.</p><p><strong>Conclusions: </strong>Application of inverted error vector reduces localization error and shifts IED-dipole to an anatomically and physiologically plausible location.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159121","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}

{"title":"The Intracranial Source of Cortico-Cortical Evoked Potentials.","authors":"Odile Feys, Fabrice Bartolomei","doi":"10.1097/WNP.0000000000001173","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001173","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182080","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}

{"title":"Sonographic Muscle Thickness Assessment Correlates With Disease Burden and Progression in Charcot-Marie-Tooth 1A Disease.","authors":"Bar Ravid, David Krivitski, Elisheva Nechushtan, Alon Abraham","doi":"10.1097/WNP.0000000000001172","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001172","url":null,"abstract":"<p><strong>Purpose: </strong>Charcot-Marie-Tooth disease (CMT), the most common form of hereditary neuropathy causes varying disability. Valid and accessible tools are needed for clinical and research evaluation. Previous studies have shown sonographic muscle thickness correlates with clinical and electrophysiological findings in many neuromuscular disorders. This study examines the correlation between muscle thickness in CMT1A patients with disease progression and clinical parameters, including the CMT neuropathy scale.</p><p><strong>Methods: </strong>Prospective study evaluating CMT1A patients between January and December 2023 at the neuromuscular unit in Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Patients underwent comprehensive clinical evaluation including the CMT neuropathy scale, and quantitative sonographic evaluation of muscle thickness in eight limb muscles.</p><p><strong>Results: </strong>Eight CMT1A patients were examined, five on two occasions. Sum muscle thickness measured by ultrasound strongly correlated with most clinical parameters, including the CMT neuropathy scale. However, disease progression showed strong correlation with CMT neuropathy scale only.</p><p><strong>Conclusions: </strong>In CMT1A patients, standardized quantitative sonographic muscle thickness assessment is a valid and promising tool for evaluating disease burden and, to a lesser extent, progression, showing strong correlations with key clinical parameters. Consistent with prior studies of other neuromuscular disorders.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150551","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}

{"title":"Long-Term Adherence to a Subcutaneous Two-Channel EEG System in Patients With Focal Epilepsy.","authors":"Nicolas Zabler, Yulia Novitskaya, René Sprünken, Martin Hirsch, Matthias Dümpelmann, Andreas Schulze-Bonhage","doi":"10.1097/WNP.0000000000001169","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001169","url":null,"abstract":"<p><strong>Purpose: </strong>Outpatient seizure monitoring is crucial for optimizing treatment strategies in epilepsy; however, traditional approaches such as seizure diaries and wearables have limitations in accuracy and practicality. This study evaluated the adherence and utility of an implanted subcutaneous EEG monitoring system in patients with focal temporal lobe epilepsy.</p><p><strong>Methods: </strong>At a tertiary epilepsy center, patients with focal epilepsy received a subcutaneous two-channel EEG system for ultra-long-term monitoring. The system includes a subcutaneously implanted electrode for data recording and a behind-the-ear companion device for the power supply and data transmission. Patient adherence to the device was evaluated using generalized estimating equations, considering sex, daytime/nighttime periods, age, and temporal course of measurements. The correlations between adherence and electrographic or diary-recorded seizures were also assessed.</p><p><strong>Results: </strong>Fifteen adult patients (mean age: 45.6 years, 6 females) were monitored for an average of 200.6 days, with 416 electrographic seizures confirmed in 13 patients. The median adherence was 89.3% (interquartile range, [75.6%, 93.4%]), with females showing significantly higher adherence than males (β, -1.1600; P = 0.049). Seizure diary reporting sensitivity and precision were 20.8% and 56.4%, respectively, compared with confirmed electrographic seizures. Adherence correlated positively with confirmed electrographic seizures (r, 0.40; P, 0.004), but not with diary reports (r, -0.22; P, 0.13).</p><p><strong>Conclusions: </strong>Patients using the subcutaneous EEG system demonstrated high adherence and reliable seizure monitoring, suggesting that it could serve as a valuable tool for managing focal epilepsy in clinical practice.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110407","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}

{"title":"Quantitative Electroencephalography Biomarkers in Patients With Anti-N-methyl-D-aspartate Receptor Encephalitis: A Case-Control Study.","authors":"César Alejandro David Cancino, Carlos Trenado, Peter W Kaplan, Felipe Alberto Gómez Ávila, María Del Carmen Fernández González-Aragón, Álvaro José Moreno Avellán, Carlos Alberto Soto Rincón, Gerardo Arturo Quiñones Pesqueira, Daniel San-Juan","doi":"10.1097/WNP.0000000000001124","DOIUrl":"10.1097/WNP.0000000000001124","url":null,"abstract":"<p><strong>Purpose: </strong>Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune reaction involving Immunoglobulin G antibodies against GluN1 subunit of NMDAR. Absence of biomarkers for early diagnosis and prognosis poses a challenge. Several small case-control studies have emphasized the prospect of quantitative EEG measurements. This study aimed to analyze and identify novel scalp quantitative EEG biomarkers and their implications on outcome of NMDRA encephalitis compared with a control group.</p><p><strong>Methods: </strong>Retrospective (2012-2021) case-control study of patients with NMDRA encephalitis and with acute/subacute encephalitis from other causes. Clinical variables and outcomes were assessed with modified Rankin Scale at admission, discharge, and follow-up. All patients underwent extensive diagnostic workup, including scalp EEG within 72 hours of admission. Quantitative EEG was calculated for Renyi, Tsalis entropy, Hjorth complexity, mean energy, and spectral power of the following frequency bands and ratios: delta (0.5-4 Hz), theta (5-8 Hz), alpha (9-14 Hz), beta (15-30 Hz), gamma (31-45 Hz), gamma-beta, beta/alpha, beta/theta, and beta/delta. Descriptive statistics, power frequency bands, complexity measures, and Wilcoxon rank sum test were used.</p><p><strong>Results: </strong>Patients with anti-NMDAR encephalitis had significantly higher delta frequency peak power, higher beta/alpha and gamma/beta frequency ratios, lower alpha and beta peak power, and lower beta/delta frequency ratio than the control group. In patients with anti-NMDAR encephalitis, higher delta and alpha peak power had the worst clinical outcome, at discharge and follow-up, and patients with higher gamma peak power had better outcomes.</p><p><strong>Conclusions: </strong>Quantitative EEG is a valuable tool to differentiate anti-NMDAR encephalitis from other inflammatory encephalitis and predict outcomes in patients with anti-NMDAR encephalitis.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"314-322"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894847","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}

{"title":"Diagnostic Value of Bereitschaftspotential in People With Functional Seizures.","authors":"Christoph S Dietze, Dieke van Waart-Houtman, Anne Marthe Meppelink, Mireille Bourez-Swart, Job van der Palen, Maeike Zijlmans, Sandra M A van der Salm","doi":"10.1097/WNP.0000000000001123","DOIUrl":"10.1097/WNP.0000000000001123","url":null,"abstract":"<p><strong>Purpose: </strong>Bereitschaftspotential (BP) or readiness potential in people with functional movement disorders can aid diagnostic workup. We evaluated the diagnostic value of BP as an interictal EEG marker in people with functional seizures (FS).</p><p><strong>Methods: </strong>We recorded and analyzed BP interictal before intended movements in 17 adults with FS and 17 controls with alternative diagnoses. We evaluated the signals for the presence of BP, latency, amplitude, and early versus late BP.</p><p><strong>Results: </strong>Bereitschaftspotential was present in all except one person with FS. We found no significant differences in the latency and amplitude of BP between participants with FS and controls. The early BP showed the most significant variance in amplitude, latency, and presence.</p><p><strong>Conclusions: </strong>We found interictal typical BP values in participants with FS and variable semiology, while earlier research found interictal no BP in functional movement disorders. These findings do not support the use of BP as an interictal diagnostic tool for FS. Differences in early BP and focus on FS with pure motor semiology are starting points for further research evaluating potential interictal markers in people with FS.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"331-335"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365431","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}

{"title":"Is Intraoperative Muscle Motor Evoked Potential Variability due to Fluctuating Lower Motor Neuron Background Excitability?","authors":"Martín J Segura, María E Talarico, Lucas Piantoni, Mariano A Noel, David B MacDonald","doi":"10.1097/WNP.0000000000001118","DOIUrl":"10.1097/WNP.0000000000001118","url":null,"abstract":"<p><strong>Purpose: </strong>This pilot study tests the contribution of fluctuating lower motor neuron excitability to motor evoked potential (MEP) variability.</p><p><strong>Methods: </strong>In six pediatric patients with idiopathic scoliosis and normal neurologic examination, cascades of 30 intraoperative H-reflexes (HRs) and MEPs were evoked in the soleus muscle using constant-current stimulators and recorded through surface electrodes with a 20-second interstimulus interval. First, HRs were obtained with an intensity capable of evoking the maximum response. Subsequently, MEPs were obtained with double trains and an intensity of 700 to 900 mA. Coefficients of variation (CVs) of amplitude and area under the curve from HRs and MEPs were compared using a paired two-tailed Student t test. Coefficients of correlation between the mean CVs of HR and MEP parameters were also assessed.</p><p><strong>Results: </strong>Pooling the results from the six patients, the mean CV of amplitude from the MEP (24.6 ± 3) was significantly higher than that from the HR (3.5 ± 4.4) ( P = 0.000091). The mean CV of the MEP area under the curve (21.8 ± 4.8) was also statistically significantly higher than that from the HR area under the curve (3.4 ± 4.5) ( P = 0.00091). The coefficients of correlation of the mean CV of the HR amplitude and area under the curve compared with the corresponding values of the MEP were low ( r = 0.29) and very low ( r = 0.03), respectively.</p><p><strong>Conclusions: </strong>Our results suggest that fluctuations in lower motor neuron excitability may be less important than previously thought to explain the magnitude of MEP variability. The efficacy of corticospinal volleys to recruit a larger and more stable lower motor neuron population would be critical to obtain reproducible MEPs.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"350-356"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361634","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}

{"title":"Chronobiological Spatial Clusters of Cortical Regions in the Human Brain.","authors":"Ravindra Arya, Gabrielle T Petito, Jeremy Housekeeper, Jason Buroker, Craig Scholle, Brian Ervin, Clayton Frink, Paul S Horn, Wei Liu, Marc Ruben, David F Smith, Jesse Skoch, Francesco T Mangano, Hansel M Greiner, Katherine D Holland","doi":"10.1097/WNP.0000000000001119","DOIUrl":"10.1097/WNP.0000000000001119","url":null,"abstract":"<p><strong>Purpose: </strong>We demonstrate that different regions of the cerebral cortex have different diurnal rhythms of spontaneously occurring high-frequency oscillations (HFOs).</p><p><strong>Methods: </strong>High-frequency oscillations were assessed with standard-of-care stereotactic electroencephalography in patients with drug-resistant epilepsy. To ensure generalizability of our findings beyond patients with drug-resistant epilepsy, we excluded stereotactic electroencephalography electrode contacts lying within seizure-onset zones, epileptogenic lesions, having frequent epileptiform activity, and excessive artifact. For each patient, we evaluated twenty-four 5-minute stereotactic electroencephalography epochs, sampled hourly throughout the day, and obtained the HFO rate (number of HFOs/minute) in every stereotactic electroencephalography channel. We analyzed diurnal rhythms of the HFO rates with the cosinor model and clustered neuroanatomic parcels in a standard brain space based on similarity of their cosinor parameters. Finally, we compared overlap among resting-state networks, described in the neuroimaging literature, and chronobiological spatial clusters discovered by us.</p><p><strong>Results: </strong>We found five clusters that localized predominantly or exclusively to the left perisylvian, left perirolandic and left temporal, right perisylvian and right parietal, right frontal, and right insular-opercular cortices, respectively. These clusters were characterized by similarity of the HFO rates according to the time of the day. Also, these chronobiological spatial clusters preferentially overlapped with specific resting-state networks, particularly default mode network (clusters 1 and 3), frontoparietal network (cluster 1), visual network (cluster 1), and mesial temporal network (cluster 2).</p><p><strong>Conclusions: </strong>This is probably the first human study to report clusters of cortical regions with similar diurnal rhythms of electrographic activity. Overlap with resting-state networks attests to their functional significance and has implications for understanding cognitive functions and epilepsy-related mortality.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"323-330"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361632","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}

{"title":"Classifying High-Frequency Oscillations by Morphologic Contrast to Background, With Surgical Outcome Correlates.","authors":"Kurt Qing, Erica Von Stein, Lisa Yamada, Adam Fogarty, Paul Nuyujukian","doi":"10.1097/WNP.0000000000001121","DOIUrl":"10.1097/WNP.0000000000001121","url":null,"abstract":"<p><strong>Purpose: </strong>Ictal high-frequency oscillations (HFOs) are a reliable indicator of a seizure onset zone for intracranial EEG recordings. Interictal HFOs often are also observed and may be a useful biomarker to supplement ictal data, but distinguishing pathologic from physiologic HFOs continues to be a challenging task. We present a method of classifying HFOs based on morphologic contrast to the background.</p><p><strong>Methods: </strong>We retrospectively screened 31 consecutive patients who underwent intracranial recordings for epilepsy at Stanford Medical Center during a 2-year period, and 13 patients met the criteria for inclusion. Interictal EEG data were analyzed using an automated event detector followed by morphologic feature extraction and k-means clustering. Instead of only using event features, the algorithm also incorporated features of the background adjacent to the events. High-frequency oscillations with higher morphologic contrast to the background were labeled as pathologic, and \"hotspots\" with the most active pathologic HFOs were identified and compared with clinically determined seizure onset zones.</p><p><strong>Results: </strong>Clustering with contrast features produced groups with better separation and more consistent boundaries. Eleven of the 13 patients proceeded to surgery, and patients whose hotspots matched seizure onset zones had better outcomes, with 4 out of 5 \"match\" patients having no disabling seizures at 1+ year postoperatively (Engel I or International League Against Epilepsy Class 1-2), while all \"mismatch\" patients continued to have disabling seizures (Fisher exact test P -value = 0.015).</p><p><strong>Conclusions: </strong>High-frequency oscillations with higher contrast to background more likely represent paroxysmal bursts of pathologic activity. Patients with HFO hotspots outside of identified seizure onset zones may not respond as well to surgery.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"294-303"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361633","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}