Journal of Clinical Neurophysiology最新文献

Reply to "Refining the Interpretation of Bulbocavernosus Reflex Monitoring in Tethered Cord Surgery: Limitations, Potentials, and Contextual Value". 回复“完善对脊髓栓系手术中球海绵体反射监测的解释：局限性、潜力和背景价值”。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-25 DOI: 10.1097/WNP.0000000000001198

Giovanna Squintani, Andrea Rasera, Francesco Sala

引用次数: 0

The Impact of Transcranial Direct Current Stimulation on Drug-Resistant Temporal Lobe Epilepsy. 经颅直流电刺激对耐药颞叶癫痫的影响。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-25 DOI: 10.1097/WNP.0000000000001201

Omar El-Nakah, Ann Ali AbdelKader, Nirmeen A Kishk, Radwa Mahmoud Azmy, Mohamed Khaled Al Menabbawy, Hagar Hassan Mourad, Eman El-Zamarany

{"title":"The Impact of Transcranial Direct Current Stimulation on Drug-Resistant Temporal Lobe Epilepsy.","authors":"Omar El-Nakah, Ann Ali AbdelKader, Nirmeen A Kishk, Radwa Mahmoud Azmy, Mohamed Khaled Al Menabbawy, Hagar Hassan Mourad, Eman El-Zamarany","doi":"10.1097/WNP.0000000000001201","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001201","url":null,"abstract":"Purpose: Cathodal transcranial direct current stimulation (c-tDCS), a noninvasive neuromodulation technique, is effective in reducing cortical excitability in patients with drug-resistant epilepsy.This study aimed to examine the impact of c-tDCS on seizure frequency, Liverpool Seizure Severity Scale, and electroencephalography in patients with drug-resistant temporal lobe epilepsy.Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted on 30 patients with temporal lobe drug-resistant epilepsy. The patients were randomized into two groups. Group A received a once-daily split session (20 minutes stimulation-20 minutes break-20 minutes stimulation) on five consecutive days of 1 mA c-tDCS over the side of most frequent interictal epileptiform discharges or the area of suspected ictal onset. Group B underwent the sham sessions.Results: A statistically significant reduction in seizure frequency, Liverpool Seizure Severity Scale, and epileptiform discharges on the EEG record was detected in the c-tDCS group after one month of the five daily sessions.Conclusions: In patients with temporal lobe drug-resistant epilepsy, c-tDCS improved seizure control by lowering seizure frequency, severity, and epileptiform discharges in the EEG for up to one month after the sessions.Significance: This confirmatory study is consistent with several previous studies showing the efficacy of c-tDCS in reducing seizure frequency in patients with temporal lobe drug-resistant epilepsy.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707658","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

Response to: Usefulness of the H-Reflex for Intraoperative Monitoring of Thoracoabdominal Aneurysms. 对h反射在胸腹动脉瘤术中监测中的作用的回应。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-25 DOI: 10.1097/WNP.0000000000001200

Guillermo Martín-Palomeque, Jaime R López

引用次数: 0

Refining the Interpretation of Bulbocavernosus Reflex Monitoring in Tethered Cord Surgery: Limitations, Potentials, and Contextual Value. 完善脊髓系扎手术中球海绵体反射监测的解释：局限性、潜力和背景价值。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-23 DOI: 10.1097/WNP.0000000000001197

Jongsuk Choi

引用次数: 0

H-reflex Monitoring During Thoracoabdominal Aneurysm Surgery: Optimizing Clinical Application. 胸腹动脉瘤手术中h反射监测：优化临床应用。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-21 DOI: 10.1097/WNP.0000000000001199

Jongsuk Choi, Kieob Kim

引用次数: 0

Biomarkers for Epilepsy Deep Brain Stimulation. 癫痫深部脑刺激的生物标志物。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-17 DOI: 10.1097/WNP.0000000000001189

Gloria Ortiz-Guerrero, Nicholas M Gregg

引用次数: 0

Responsive Neurostimulation for Treatment of Drug-Resistant Epilepsy in a Child With Dravet Syndrome. 反应性神经刺激治疗儿童Dravet综合征耐药癫痫。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-14 DOI: 10.1097/WNP.0000000000001190

Reilly F Philliben, Shanna M Swartwood, Audie C Espinoza

{"title":"Responsive Neurostimulation for Treatment of Drug-Resistant Epilepsy in a Child With Dravet Syndrome.","authors":"Reilly F Philliben, Shanna M Swartwood, Audie C Espinoza","doi":"10.1097/WNP.0000000000001190","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001190","url":null,"abstract":"Summary: Dravet syndrome is an intractable developmental and epileptic encephalopathy caused primarily by SCN1A haploinsufficiency, leading to impaired NaV1.1 sodium channel function and reduced inhibitory signaling. Despite treatment with antiseizure medications, many patients remain drug resistant, necessitating alternative approaches such as neuromodulation. Responsive neurostimulation (RNS), which detects and responds to abnormal brain activity in real time, has shown promise in generalized epilepsy by targeting the thalamus. Thalamic stimulation can disrupt abnormal oscillatory activity, potentially reducing seizure frequency and severity. This report presents a 7-year-old girl with Dravet syndrome in the setting of a pathogenic SCN1A variant and drug-resistant epilepsy, who experienced numerous generalized seizures daily. After extensive testing and multiple antiseizure medication trials, RNS was implanted with bilateral centromedian nucleus of the thalamus depth electrodes. At her most recent clinic visit, she exhibited a 50% to 75% reduction in seizure frequency, with resolution of myoclonic and myoclonic-atonic seizures. Her family reported significant reductions in rescue medication use, seizure duration, and seizure severity after RNS implantation. This case adds to the growing evidence supporting the use and safety of RNS in pediatric patients with drug-resistant generalized epilepsy and is the first reported instance of RNS treatment in a patient with Dravet syndrome. Although the initial results are promising, further research is needed to explore the long-term efficacy, safety, and neurodevelopmental impacts of RNS in this population. This case highlights the importance of continued research and clinical innovation in neuromodulation therapies for Dravet syndrome.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626432","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

Mapping the Effects of Intracranial Electrical Stimulation of the Human Orbitofrontal Cortex. 绘制颅内电刺激对人眶额皮质的影响。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-10 DOI: 10.1097/WNP.0000000000001184

Sofia Pantis, Dian Lyu, Weichen Huang, Abby Kwon, Claire Cheng, Anna Duong, Eileen Ma, Kieran C R Fox, Josef Parvizi

{"title":"Mapping the Effects of Intracranial Electrical Stimulation of the Human Orbitofrontal Cortex.","authors":"Sofia Pantis, Dian Lyu, Weichen Huang, Abby Kwon, Claire Cheng, Anna Duong, Eileen Ma, Kieran C R Fox, Josef Parvizi","doi":"10.1097/WNP.0000000000001184","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001184","url":null,"abstract":"Introduction: Prior findings on direct intracranial electrical stimulation (iES) of the human orbitofrontal cortex (OFC), which includes the orbital and ventromedial prefrontal regions, have been mixed, with several reports lacking replication. We aimed to clarify the effects of iES in the OFC.Methods: We analyzed data from 608 stimulations across 277 OFC site pairs (352 sites total) in 49 patients collected over 17 years of our practice.Results: We found 24.4% of sites as responsive to iES, with subjects reporting visual and olfactory sensations. However, post hoc analysis revealed that these responses largely originated from the stimulation of nearby non-OFC optic and olfactory structures. After applying quality controls, stimulation of only 0.6% of OFC sites (2 sites, 2 patients) produced changes in subjective domain, while 99.4% had no reportable effects. Contrary to earlier studies, we found no evidence of valence lateralization or functional organization within the OFC.Conclusions: Our findings suggest that the electrical perturbation of OFC is largely silent and does not lead to reportable change in the subjective state of the individual.Significance: Orbitofrontal cortex is a higher transmodal cortical area. The variability and limited replicability of reported effects from prior publications and the inconsistencies in the extant literature about OFC stimulations can be attributed to methodological shortcomings.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600615","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

Semiology of Seizures Involving the OFC: A Narrative Review About a Silent Epilepsy. 涉及OFC的癫痫的符号学：关于一例无声癫痫的叙述回顾。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-09 DOI: 10.1097/WNP.0000000000001183

Alice Despins, Dang K Nguyen, Olivier Aron

{"title":"Semiology of Seizures Involving the OFC: A Narrative Review About a Silent Epilepsy.","authors":"Alice Despins, Dang K Nguyen, Olivier Aron","doi":"10.1097/WNP.0000000000001183","DOIUrl":"10.1097/WNP.0000000000001183","url":null,"abstract":"Summary: The orbitofrontal cortex (OFC) is a highly interconnected region, cytoarchitectonically diverse. Seizures involving the OFC present significant diagnostic challenges because of their variable semiological features, which often overlap with those typically attributed to frontal and temporal epilepsies. Moreover, OFC seizures semiology is shaped by the epileptogenic zone network (EZN), involving either ictal propagation or reconfiguration of functional networks. We systematically reviewed 87 patients presenting seizures involving the OFC to analyze semiological profiles using the latest International League Against Epilepsy classification. We found that seizures with EZN restricted to the OFC displayed sparse semiology, including hyperkinetic behaviors, verbal automatisms, and frequent sleep association, while extended EZN seizures exhibited richer semiological profiles, varying according to EZN distribution. Temporal involvement correlated with more auras, oro-alimentary automatisms, and occurred more often with sleep, while frontal and insular participation involved hyperkinetic behaviors with more mimic and gestural automatisms. Semiological profiles of the OFC-restricted EZN seizures are concordant with propagation patterns that align with the functional connectivity of the OFC: lateral OFC seizures tend to propagate to the lateral and mesial frontal lobe while medial OFC seizures propagated to temporal lobe, either medial or polar. Despite population-level observations, semiological profiles alone seem insufficient for delimitation of extension or distribution of EZN. According to seizure semiology, \"frontal\" like profiles appear more frequent (∼2/3 of patients) while \"temporal\" like profiles were more associated with an extended EZN. These findings underscore the importance of comprehensive presurgical evaluations, to delineate EZN extension and distribution in seizures involving the OFC.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591367","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

Inter-Rater Reliability of EEG-Based Encephalopathy Grading. 基于脑电图的脑病分级的可信度。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-07-02 DOI: 10.1097/WNP.0000000000001185

Ryan A Tesh, Anika Zahoor, Jayme Banks, Kaileigh Gallagher, Christine A Eckhardt, Haoqi Sun, Ioannis Karakis, Roohi Katyal, Jonathan Williams, Chetan Nayak, Aline Herlopian, Marcus C Ng, Adam S Greenblatt, Emma Meyers, Mike Westmeijer, Daniel S Harrison, Wolfgang Ganglberger, Galina Gheihman, Tracey Fan, Aaron F Struck, Irfan S Sheikh, Fábio A Nascimento, M Brandon Westover

{"title":"Inter-Rater Reliability of EEG-Based Encephalopathy Grading.","authors":"Ryan A Tesh, Anika Zahoor, Jayme Banks, Kaileigh Gallagher, Christine A Eckhardt, Haoqi Sun, Ioannis Karakis, Roohi Katyal, Jonathan Williams, Chetan Nayak, Aline Herlopian, Marcus C Ng, Adam S Greenblatt, Emma Meyers, Mike Westmeijer, Daniel S Harrison, Wolfgang Ganglberger, Galina Gheihman, Tracey Fan, Aaron F Struck, Irfan S Sheikh, Fábio A Nascimento, M Brandon Westover","doi":"10.1097/WNP.0000000000001185","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001185","url":null,"abstract":"Purpose: Visual EEG Confusion Assessment Method-Severity (VE-CAM-S) quantifies encephalopathy severity based on electroencephalography features. This study evaluated inter-rater reliability among experts using the VE-CAM-S scale.Methods: Nine experts from six institutions independently reviewed 32 15-second electroencephalography samples in an online test, assessing 29 features (16 in the VE-CAM-S and 13 additional, or \"VE-CAM-S+\"). A consensus of three experts served as the gold standard. Performance was measured by the median Matthews correlation coefficient between expert and gold-standard VE-CAM-S+ scores, along with average sensitivity and specificity. Qualitative analysis identified common feature-recognition errors affecting scores.Results: Experts achieved a median Matthews correlation coefficient of 0.82 [95% CI: 0.74-0.99]. Specificity exceeded 90% for most features except background β (87%) and generalized delta (71%). Sensitivity was ≥65% except for burst suppression with epileptiform activity (61%), extreme delta brush (EDB; 61%), posterior dominant rhythm (50%), background α (59%) and β (42%). Common errors included missing subtle findings, confusing features, and misidentifying extreme delta brush.Conclusions: This pilot study offers some initial support for the reliability of VE-CAM-S+ scoring. The largest errors occurred when experts missed or falsely identified features with higher weight in the VE-CAM-S. Encephalopathy grading through VE-CAM-S may be improved by breaking high-stakes features into smaller parts, creating a \"cheat sheet\" with scored examples, and designing teaching materials.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553629","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