Journal of Clinical Neurophysiology最新文献

{"title":"Sleep Deprivation in Healthy Males Increases Muscle Afferents, Impairing Motor Preparation and Reducing Endurance.","authors":"Christophe C S Rault, Quentin Heraud, Solène Ansquer, Stéphanie Ragot, Angela Kostencovska, Arnaud W Thille, Alexandra Stancu, Pierre-Jean Saulnier, Xavier Drouot","doi":"10.1097/WNP.0000000000001134","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001134","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep deprivation (SD) reduces time to task failure during endurance exercises. The aim of our work was to study the effect of acute SD on the endurance of a skeletal hand muscle and to investigate cortical motor drive to muscle and perception of effort.</p><p><strong>Methods: </strong>Origin of the early exhaustion after SD might be insufficient cortical motor drive to muscle or motor inhibition because of excessive perception of effort. The supplementary motor area, the medial part of the premotor cortex, links the motor and sensory cortexes, prepares for voluntary movements, and may play a central role in the pathophysiology of impaired muscle endurance after SD. Supplementary motor area can be noninvasively assessed by electromyogram measuring amplitude of premotor potentials before hand movements. We investigated the effect of SD on muscle endurance in healthy volunteers performing moderate hand exercise by monitoring supplementary motor area activation and muscle afferents. Two sessions were performed, in random order, one after a normal sleep night and the other after a sleepless night.</p><p><strong>Results: </strong>Twenty healthy young men were included in this study. Sleep deprivation reduced time to task failure by 11%. Supplementary motor area activation was altered throughout the task and effort perception was increased.</p><p><strong>Conclusions: </strong>Our results suggest that SD reduces skeletal muscle endurance by increasing the effects of muscle afferents on the supplementary motor area. Sleep alterations frequently reported in chronic diseases might reduce patients' capacity to achieve the low-intensity motor exercises required in everyday life. Our results should lead to the search for sleep disorders in patients with chronic pathology.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729050","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":"Alpha-Delta Ratio for Detection of Cerebral Injury and Stroke in Pediatric Extracorporeal Membrane Oxygenation.","authors":"Arnold J Sansevere, Melissa L DiBacco, Kelly Cavan, Alexander Rotenberg","doi":"10.1097/WNP.0000000000001128","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001128","url":null,"abstract":"<p><strong>Introduction: </strong>To assess the alpha-delta ratio (ADR) as a biomarker for cerebral injury and stroke in pediatric extracorporeal membrane oxygenation (ECMO).</p><p><strong>Methods: </strong>Retrospective study of children aged >44 weeks gestation to 21 years monitored with continuous electroencephalography during ECMO. The interhemispheric ADR difference between the left and right hemisphere was calculated per hour. A t-test was performed comparing the mean interhemispheric difference between controls and patients with cerebral injury at set intervals (i.e., 1, 3, 6, 9, 12, and 24 hours) from the start of continuous electroencephalography. Injury was established if confirmed by imaging on the same day as ECMO cannulation and acquired if confirmed the day after ECMO or later. Analysis of variance was performed to compare the mean interhemispheric difference in the ADR among control patients to those with early-acquired and late-acquired injury at 24 hours.</p><p><strong>Results: </strong>We included 49 patients with a median age of 3.4 years (interquartile range [1-10.4]), 47% (23/49) were male, and 73% (36/49) had cardiac arrest. Cerebrovascular injury was detected in 45% (22/49), with focal stroke in 82% (18/22). A significant difference was seen between control patients compared with cerebrovascular injury after 6 hours of continuous electroencephalography (0.016 vs. 0.042) (mean interhemispheric ADR difference) (P = 0.03). Analysis of variance of control patients to early- and late-acquired injury at 24 hours showed a significant difference (P = 0.03).</p><p><strong>Conclusions: </strong>The ADR is a reliable metric to detect in-ECMO cerebral injury and stroke. Further study is needed to automate and assess this metric for real-time detection of stroke in ECMO.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710191","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":"Asymmetry of Directed Brain Connectivity at Birth in Low-Risk Full-Term Newborns.","authors":"Venkata C Chirumamilla, Sarah B Mulkey, Tayyba Anwar, Robin Baker, G Larry Maxwell, Josepheen De Asis-Cruz, Kushal Kapse, Catherine Limperopoulos, Adre du Plessis, R B Govindan","doi":"10.1097/WNP.0000000000001131","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001131","url":null,"abstract":"<p><strong>Purpose: </strong>Functional connectivity hubs were previously identified at the source level in low-risk full-term newborns by high-density electroencephalography (HD-EEG). However, the directionality of information flow among hubs remains unclear. The aim of this study was to study the directionality of information flow among source level hubs in low-risk full-term newborns using HD-EEG.</p><p><strong>Methods: </strong>A retrospective analysis of HD-EEG collected from a prospective study. Subjects included 112 low-risk full-term (37-41 weeks' gestation) newborns born in a large delivery center and studied within 72 hours of life by HD-EEG. The directionality of information flow between hubs at the source level was quantified using the partial directed coherence in the delta frequency band. Descriptive statistics were used to identify the maximum and minimum information flow. Differences in information flow between cerebral hemispheres were assessed using Student t-test.</p><p><strong>Results: </strong>There was higher information flow from the left hemisphere to the right hemisphere hubs (p < 0.05, t-statistic = 2). The brainstem had the highest information inflow and lowest outflow among all the hubs. The left putamen received the lowest information, and the right pallidum had the highest information outflow to other hubs.</p><p><strong>Conclusions: </strong>In low-risk full-term newborns, there is a significant information flow asymmetry already present, with left hemisphere dominance at birth. The relationship between these findings and the more prevalent left hemisphere dominance observed in full-term newborns, particularly in relation to language, warrants further study.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621264","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 Role of High-Resolution Ultrasound in the Diagnosis of Nerve Trauma New Perspective: A Preliminary Systematic Review and Meta-Analysis of the Recent Evidence.","authors":"Aya Moustafa Aboutaleb, Ezzeldin Abouelatta, Talal Salem, Abdelbaki Idriss Ibrahim, Aya Sayed Serour, Nagham Bushara Abbas, Rana Ahmed Youssef, Osama Omar Ballut, Reda Ibrahim Shehta, Merna Wagih Awad, Khaled Walid Hassan, Hasnaa Ali Hassan Abdelrhem, Mona Ali, Mostafa Badr, Shady Sherif Mohamed Aref, Mohamed Abdelmohsen Bedewi, Khaled Ashraf Mohamed, Hubertus Axer, Ramy Abdelnaby","doi":"10.1097/WNP.0000000000001126","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001126","url":null,"abstract":"<p><strong>Summary: </strong>Precise localization of peripheral nerve injuries and evaluation of their prognosis based on clinical and electrodiagnostic examinations are particularly challenging in the acute phase. High-resolution ultrasound (HRUS) may offer a viable and cost-effective imaging option for assessing the morphology of nerve injuries. Consequently, a systematic review and meta-analysis of studies on the use of ultrasound for diagnosing traumatic nerve injuries were conducted. A total of 15 studies were included, reporting the most recent findings on using HRUS in the diagnosis of traumatic nerve injury. These studies assessed the diagnostic test accuracy of ultrasound for the detection of traumatic nerve injury in 272 participants, with the cross-sectional area at the site of traumatic nerve injury also reported in 1,249 participants. The pooled sensitivity and specificity of the included studies were 92% confidence interval (CI) (0.89-0.95) and 86% CI (0.82-0.89), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 13.76 CI (1.41-134.34), 0.08 CI (0.03-0.18), and 286.23 CI (21.22-3,860.40), respectively. In the summary of the receiver operating characteristic curve, the area under the curve was 0.986, and the Q* index was 0.949. Based on the current literature, HRUS has shown promising results in addition to its availability and feasibility. HRUS can serve as a valuable complement to clinical and electrodiagnostic examinations for diagnosing traumatic peripheral nerve injuries. Further research is recommended to better understand the ultrasound characteristics of these injuries.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621421","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":"EEG Infrastructure Within the Veterans Administration: A Survey.","authors":"Alisa Lu, Krishna Chandra, Dmitri Kovalev, Edward N Savarese, Kamakshi Patel, David C McCarthy, Stephan Eisenschenk, Zulfi Haneef","doi":"10.1097/WNP.0000000000001132","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001132","url":null,"abstract":"<p><strong>Purpose: </strong>EEG is a vital tool in the diagnosis and management of neurologic conditions prevalent among veterans such as seizures, epilepsy, and brain injuries. This cross-sectional study aimed to assess the state of EEG infrastructure within the Veterans Administration (VA), focusing on availability, utilization, and the potential avenues to addressing gaps in infrastructure.</p><p><strong>Methods: </strong>This survey was distributed to 123 VA hospitals using the Research Electronic Data Capture (REDCap) platform, gathering data on EEG equipment, staffing, and service provision from June to December 2023.</p><p><strong>Results: </strong>Of the 123 VA hospitals surveyed, 70 responded (56.9% response rate). Most respondents (88.6%) reported having EEG services, although only 38.7% offering continuous EEG (cEEG). Respondents reported having less EEG technologists, machines, and faculty readers than what they thought would be ideal. Significant correlations were found between the availability of resources (e.g., number of EEG machines) and service capabilities, including remote access and cEEG. The use of alternative EEG technologies such as rapid or quantitative EEG varied greatly. Interest in participating in the VA Tele-EEG program was reported by 59.4% of respondents.</p><p><strong>Conclusions: </strong>There is large variability in EEG infrastructure across the VA. Tele-EEG has the potential to maintain continuity of operations through challenges affecting staffing and to improve EEG service access, especially in resource-limited settings. Expanding access to quantitative, rapid, and tele-EEG services may enhance patient management and may be a potential avenue to explore as the VA continues to invest in and grow its capacity for treating neurologic conditions.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621266","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":"Analysis of Intraoperative Visual Evoked Potentials for Inclusion of Unstable Electroretinograms.","authors":"Eva Cochard, Nadia Bérard, Karl Schaller, Colette Boëx","doi":"10.1097/WNP.0000000000001129","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001129","url":null,"abstract":"<p><strong>Purpose: </strong>The objectives of the study were to evaluate the validity of intraoperative flash visual evoked potentials (VEPs) when electroretinograms (ERGs) were unstable, to compare white versus red light-emitting diodes, and to assess the impact of luminance on ERG variability.</p><p><strong>Methods: </strong>Thirty patients were included (Inomed system; pre- and postoperative visual fields). Possible changes in visual fields were assessed with mean defects in perimetry. The receiver operating characteristic (ROC) curves of normalized VEPs and of normalized and corrected VEPs with ERGs were compared.</p><p><strong>Results: </strong>Thirty-two eyes could be analyzed in 20 patients (mainly gliomas and meningiomas): 2 had a severe defect in their visual field, and 6 had a mild defect. The receiver operating characteristic curve indicated (1) normalized and corrected VEPs with ERGs were more reliable than normalized VEPs only (P < 0.03) and (2) an alarm threshold of 80% of normalized and corrected VEPs. No significant difference in variability of ERGs was found with white or red light-emitting diodes with this system. Increased luminance improved stability of ERGs (P < 0.05).</p><p><strong>Conclusions: </strong>Normalization and correction of VEPs with ERGs improved the validity of VEPs and indicated a 20% decrease as alarm criterion. This normalization and correction with peripheral excitation could be generalized to improve the reliability of neuromonitoring.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604956","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":"Effect of Sevoflurane Anesthesia on Intraoperative Spikes, High-Frequency Oscillations, and Phase-Amplitude Coupling in MRI-Normal Hippocampus.","authors":"Riju Dahal, Kentaro Tamura, Dong-Sheng Pan, Ryota Sasaki, Yasuhiro Takeshima, Ryosuke Matsuda, Shuichi Yamada, Fumihiko Nishimura, Ichiro Nakagawa, Young-Soo Park, Hironobu Hayashi, Masahiko Kawaguchi, Hiroyuki Nakase","doi":"10.1097/WNP.0000000000001031","DOIUrl":"10.1097/WNP.0000000000001031","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the effect of sevoflurane anesthesia on spikes, high-frequency oscillations (HFOs), and phase-amplitude coupling using a modulation index in MRI-normal hippocampus, with the aim of evaluating the utility of intraoperative electrocorticography in identifying the epileptogenic hippocampus during sevoflurane administration.</p><p><strong>Methods: </strong>Eleven patients with intractable temporal lobe epilepsy with a normal hippocampus on MRI underwent extra-operative electrocorticography evaluation. Patients were assigned to the Ictal (+) or Ictal (-) group depending on whether the parahippocampal gyrus was included in the seizure onset zone. Intraoperative electrocorticography was performed under 0.5 and 1.5 minimum alveolar concentration of sevoflurane. The rates of spikes, ripples, fast ripples (FRs), ripples on spikes, FRs on spikes, and MI HFO(3-4 Hz) were evaluated.</p><p><strong>Results: </strong>During the intraoperative electrocorticography procedure, sevoflurane administration was found to significantly increase the rate of spikes, ripples on spikes, fast ripples on spikes, and MI HFO(3-4 Hz) in the Ictal (+) group ( P < 0.01). By contrast, the Ictal (-) group exhibited a paradoxical increase in the rate of ripples and fast ripple ( P < 0.05).</p><p><strong>Conclusions: </strong>Our findings indicate that the administration of sevoflurane during intraoperative electrocorticography in patients with MRI-normal hippocampus can lead to a dose-dependent enhancement of epileptic biomarkers (spikes, ripples on spikes, fast ripples on spikes, and MI (HFO 3-4) ) in the epileptogenic hippocampus, while paradoxically increasing the rate of ripples and fast ripple in the nonepileptogenic hippocampus. These results have significant implications for the identification of the MRI-normal hippocampus that requires surgical intervention and preservation of the nonepileptogenic hippocampus.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"589-596"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482165","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 Intermittent Photic Stimulation Among Adult Patients in a Tertiary Referral Epilepsy Center: A Retrospective Study.","authors":"Bernhard J Steinhoff, Tassanai Intravooth, Jitender Gupta, Viviane Bernedo-Paredes, Patricia Mahn, Jakob Stockinger, Peter Martin, Anke M Staack","doi":"10.1097/WNP.0000000000001040","DOIUrl":"10.1097/WNP.0000000000001040","url":null,"abstract":"<p><strong>Purpose: </strong>Photosensitivity is a phenomenon that may be elicited by standardized intermittent photic stimulation during EEG recording and is detected more frequently in children and adolescents. Nevertheless, at our Epilepsy Center, we routinely assess photosensitivity in all newly referred adult patients. In this investigation, we sought to address the diagnostic yield under the prerequisites described.</p><p><strong>Methods: </strong>We reanalyzed all routine EEG recordings among referrals to the department of adults during the first six months of 2019, including a simultaneous video that is always coregistered in our center. The prevalence of abnormal findings during photic stimulation was assessed.</p><p><strong>Results: </strong>Intermittent photic stimulation was performed on 344 patients. Photoparoxysmal response were detected in five subjects (1.5%). All patients were female. Four patients were diagnosed with idiopathic generalized epilepsy, and one with Doose syndrome. Photomyogenic responses were recorded in 1.1% and only in patients with psychogenic nonepileptic seizures. In two subjects with psychogenic nonepileptic seizures, the typical seizure was provoked by intermittent photic stimulation (8.7% of all subjects with psychogenic nonepileptic seizures in this cohort). Photoparoxysmal response was not detected in any subject with focal epilepsy, syncope, or other nonepileptic paroxysmal events. In every case of photoparoxysmal responses, increased photosensitivity had already been reported before recording.</p><p><strong>Conclusions: </strong>In our study, photoparoxysmal responses was a rare phenomenon among adults with a preponderance of females and idiopathic generalized epilepsies. Intermittent photic stimulation may be helpful in provoking typical psychogenic nonepileptic seizures and thus abbreviate the diagnostic process. Provided a careful history, routine intermittent photic stimulation in adults with epilepsy does not appear to be mandatory.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"625-629"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134192","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":"Association of Complex Repetitive Discharges With Chronicity and Clinical Symptoms in Radiculopathies.","authors":"Michael P Skolka, Reece M Hass, Devon I Rubin, Ruple S Laughlin","doi":"10.1097/WNP.0000000000001036","DOIUrl":"10.1097/WNP.0000000000001036","url":null,"abstract":"<p><strong>Purpose: </strong>Complex repetitive discharges (CRDs) are incompletely understood needle electromyography (EMG) waveforms seen in both myopathic and neurogenic disorders including radiculopathies. This study aimed to clarify the significance of CRDs in patients with radiculopathies.</p><p><strong>Methods: </strong>This case-control study randomly identified 100 patients with needle EMG evidence of radiculopathy demonstrating at least one CRD in the electrodiagnostically involved myotome between January 2017 and January 2022. These patients were compared with 100 randomly selected patients with EMG evidence of radiculopathy without CRDs controlled for sex, age at EMG testing, and affected nerve root segment. Patient clinical symptoms, neurologic examination, EMG features, and imaging were analyzed. A paired sample t -test for categorial data and χ 2 test for nonparametric data were used for statistical analysis with significance defined as P < 0.05.</p><p><strong>Results: </strong>Patients with radiculopathies with CRDs had longer disease duration averaging 59 months (range 1-480) compared with patients with radiculopathies without CRDs averaging 26 months (range 1-192, P < 0.01). Clinical symptoms of paresthesias and weakness were both significantly more common in patients with radiculopathies with CRDs than those without CRDs ( P < 0.01 and 0.01, respectively). Needle EMG demonstrated a greater average number of muscles with neurogenic motor unit potentials per radiculopathy in patients with radiculopathies with CRDs compared with those without CRDs. Imaging studies of patients with radiculopathies with CRDs were more likely to reveal evidence of nerve root compression ( P < 0.01).</p><p><strong>Conclusions: </strong>The presence of CRDs in patients with radiculopathies is consistent with clinically more symptomatic radiculopathies and a longer duration of nerve root compromise.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"606-609"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41202404","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":"Comparison of Automated Spike Detection Software in Detecting Epileptiform Abnormalities on Scalp-EEG of Genetic Generalized Epilepsy Patients.","authors":"Mubeen Janmohamed, Duong Nhu, Lubna Shakathreh, Ofer Gonen, Levin Kuhlman, Amanda Gilligan, Chang Wei Tan, Piero Perucca, Terence J O'Brien, Patrick Kwan","doi":"10.1097/WNP.0000000000001039","DOIUrl":"10.1097/WNP.0000000000001039","url":null,"abstract":"<p><strong>Purpose: </strong>Despite availability of commercial EEG software for automated epileptiform detection, validation on real-world EEG datasets is lacking. Performance evaluation of two software packages on a large EEG dataset of patients with genetic generalized epilepsy was performed.</p><p><strong>Methods: </strong>Three epileptologists labelled IEDs manually of EEGs from three centres. All Interictal epileptiform discharge (IED) markings predicted by two commercial software (Encevis 1.11 and Persyst 14) were reviewed individually to assess for suspicious missed markings and were integrated into the reference standard if overlooked during manual annotation during a second phase. Sensitivity, precision, specificity, and F1-score were used to assess the performance of the software packages against the adjusted reference standard.</p><p><strong>Results: </strong>One hundred and twenty-five routine scalp EEG recordings from different subjects were included (total recording time, 310.7 hours). The total epileptiform discharge reference count was 5,907 (including spikes and fragments). Encevis demonstrated a mean sensitivity for detection of IEDs of 0.46 (SD 0.32), mean precision of 0.37 (SD 0.31), and mean F1-score of 0.43 (SD 0.23). Using the default medium setting, the sensitivity of Persyst was 0.67 (SD 0.31), with a precision of 0.49 (SD 0.33) and F1-score of 0.51 (SD 0.25). Mean specificity representing non-IED window identification and classification was 0.973 (SD 0.08) for Encevis and 0.968 (SD 0.07) for Persyst.</p><p><strong>Conclusions: </strong>Automated software shows a high degree of specificity for detection of nonepileptiform background. Sensitivity and precision for IED detection is lower, but may be acceptable for initial screening in the clinical and research setting. Clinical caution and continuous expert human oversight are recommended with all EEG recordings before a diagnostic interpretation is provided based on the output of the software.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"618-624"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482163","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}