Journal of Clinical Neurophysiology最新文献

{"title":"History of Clinical Neurophysiology in Mexico.","authors":"Oscar Eduardo Bernal López, Daniel San Juan, Bruno Estañol Vidal, Miguel Ángel Collado-Corona","doi":"10.1097/WNP.0000000000001159","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001159","url":null,"abstract":"<p><strong>Summary: </strong>In the 18th century, Luigi Galvani proposed the hypothesis of animal electricity, which is produced by the brain and distributed through the nerves to the muscles. This was the cornerstone of what is known today as the modern study of nerve function, earning him the title of the Father of Clinical Neurophysiology. The 19th century was subsequently marked by two major figures: Santiago Ramón y Cajal (Neuron Theory) and Hans Berger, known for describing cerebral electrical activity and recording the first electroencephalograms. In Mexico, Clinical Neurophysiology emerged in the late 19th century and consolidated itself in the first half of the 20th century. In the year of 1938, Dr. Clemente Robles and Teodoro Flores Covarrubias built the first electroencephalograph, marking the beginning of the era of Clinical Neurophysiology. Initially, this diagnostic tool was primarily applied to psychiatric patients, as there was no clear separation between psychiatry and neurology and patients were treated jointly at the largest psychiatric center of that time, \"La Castañeda.\" In 1968, the Mexican Society of Electroencephalography A.C. was founded and later changed its name to the Mexican Society of Clinical Neurophysiology A.C. Simultaneously, its members achieved universal recognition of the medical specialty, which has become established in clinical practice and has shown progressive academic and scientific growth in Mexico.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657371","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":"Early Electrodiagnostic Study in Guillain-Barré Syndrome Requires a Second One for Accurate Electrodiagnosis.","authors":"Volkan Tasdemir, Nermin G Sirin, Ali E Oge","doi":"10.1097/WNP.0000000000001154","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001154","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597112","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":"Using Quantitative EEG to Stratify Epilepsy Risk After Neonatal Encephalopathy: A Comparison of Automatically Extracted Features.","authors":"Natalie Fulton, Réjean M Guerriero, Maire Keene, Rebekah L Landre, Stuart R Tomko, Zachary A Vesoulis, John M Zempel, ShiNung Ching, Jennifer C Keene","doi":"10.1097/WNP.0000000000001156","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001156","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal encephalopathy (NE) is a commonly encountered, highly morbid condition with a pressing need for accurate epilepsy prognostication. We evaluated the use of automated EEG for prediction of early life epilepsy after NE treated with therapeutic hypothermia (TH).</p><p><strong>Methods: </strong>We conducted retrospective analysis of neonates with moderate-to-severe NE who underwent TH at a single center. The first 24 hours of EEG data underwent automated artifact removal and quantitative EEG (qEEG) analysis with subsequent evaluation of qEEG feature accuracy at the 1st and 20th hour for epilepsy risk stratification.</p><p><strong>Results: </strong>Of 144 neonates with NE, 67 completed at least 1 year of follow-up with a neurologist and were included. Twenty-three percent had seizures (N = 18) in the NICU and 9% developed epilepsy (N = 6). We found multiple automatically extracted qEEG features were predictive of epilepsy as early as the first hour of life, with improved risk stratification during the first day of life. In the 20th hour EEG, absolute spectral power best stratified epilepsy risk, with area under the curve ranging from 76% to 83% across spectral frequencies, followed by range EEG features including width, SD, upper and lower margin, and median. Clinical examination did not significantly predict epilepsy development.</p><p><strong>Conclusions and significance: </strong>Quantitative EEG features significantly predicted early life epilepsy after NE. Automatically extracted qEEG may represent a practical tool for improving risk stratification for post-NE epilepsy development. Future work is needed to validate using automated EEG for prediction of epilepsy in a larger cohort.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585900","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 Effect of Playing Career on Chronic Neurophysiologic Changes in Retired Male Football Players: An Exploratory Study Using Transcranial Magnetic Stimulation.","authors":"Alan J Pearce, Jamie Tallent, Ashlyn K Frazer, Billymo Rist, Dawson J Kidgell","doi":"10.1097/WNP.0000000000001155","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001155","url":null,"abstract":"<p><strong>Purpose: </strong>Repetitive head impact exposure, from contact and collision sports, are increasingly being attributed to increased risk of neurodegenerative disease in aging athletes. This exploratory study investigated the association of playing career in retired professional contact sport athletes with cortical neurophysiology via transcranial magnetic stimulation (TMS).</p><p><strong>Methods: </strong>This study used a cross-correlation design without a control group. Male athletes between the ages of 28 and 68 years (n = 113; mean age [SD] 48.8 [9.7]) who had been retired from professional sport for a minimum of 5 years were recruited. Cortical excitability was measured using single pulse TMS for motor evoked potentials and paired pulse for short-interval intracortical inhibition and long-interval intracortical inhibition. Associations were assessed between TMS measures and concussion history, clinical symptom scores, total career length (including junior to complete retirement), and professional career length (elite competition only).</p><p><strong>Results: </strong>Correlations showed significant associations between motor evoked potentials and clinical symptom reporting (rho: -0.21 to -0.38; P < 0.01) and motor evoked potentials and short-interval intracortical inhibition with total career length (rho: 0.26 to -0.33; P < 0.01). No significant correlations were observed between single and paired-pulse TMS and professional career length (rho: 0.16 to -0.15), nor the number of concussions (rho: 0.17 to -0.17).</p><p><strong>Conclusions: </strong>This exploratory study is the first to report pathophysiologic outcomes in a cohort of retired professional athletes associated with total career exposure, rather than professional career exposure or concussion history. Without a control group comparison and cross-correlational design, these preliminary results should be viewed with caution; however, TMS assessment could be considered a viable biomarker in future studies of retired athletes classified with traumatic encephalopathy syndrome.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567241","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":"A Quantitative Electroencephalographic Index for Stroke Detection in Adults.","authors":"Mauro Caffarelli, Roxanne Simmons, Illya Tolokh, Vishnu Karukonda, Elan L Guterman, Wade Smith, Christine K Fox, M Brandon Westover, Edilberto Amorim","doi":"10.1097/WNP.0000000000001151","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001151","url":null,"abstract":"<p><strong>Purpose: </strong>Electroencephalography (EEG) remains underutilized for stroke characterization. We sought to assess the performance of the EEG Correlate Of Injury to the Nervous system (COIN) index, a quantitative metric designed for stroke recognition in children, in discriminating large from small ischemic strokes in adults.</p><p><strong>Methods: </strong>Retrospective, single-center cohort of adults with acute (within 7 days) ischemic stroke who underwent at least 8 hours of continuous EEG monitoring in hospital. Stroke size was categorized as large or small based on a threshold of 100 mL using the ABC/2 approach. EEG data were processed on MATLAB. COIN was independently calculated from consecutive 4-second EEG epochs. Student t-test and logistic regression were used to assess COIN performance in stroke size discrimination across the entire recording; random forest classification was used to determine COIN performance in limited EEG time windows ranging from 5 to 30 minutes in duration.</p><p><strong>Results: </strong>Thirty-five patients with mean age 67 (SD ± 17) years were analyzed with mean 4.5 ± 1.3 hours of clean EEG per patient. Ten patients had large stroke and 25 had small stroke. Participants with large strokes had larger COIN values than those with small strokes (-53 vs. -16, P = 0.0001). Logistic regression for stroke size classification model showed accuracy 83% ± 8%, sensitivity 70%±15%, specificity 88%±8%, and area under the receiver operator curve 0.75±0.10. Random Forest Classification performance was similar using 5 or 30 minutes of EEG data with accuracy 81% to 82%, specificity 91% to 92%, and sensitivity 55% to 58%, respectively.</p><p><strong>Conclusions: </strong>COIN differentiated large from small acute ischemic strokes in this single-center cohort. Prospective evaluation in larger multicenter data sets is necessary to determine COIN utility as an aid for bedside detection of large ischemic strokes in contexts where neuroimaging cannot be easily obtained or when neurologic examination is limited by sedation or neuromuscular blockade.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573106","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":"Journal of Clinical Neurophysiology is Going Digital.","authors":"Douglas R Nordli, Stephan Schuele","doi":"10.1097/WNP.0000000000001145","DOIUrl":"10.1097/WNP.0000000000001145","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"189"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028927","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":"Visual Electroencephalography Assessment in the Diagnosis and Prognosis of Cognitive Disorders.","authors":"Daan M Michels, Sjoerd van Marum, Samuel Arends, D L J Tavy, Paul W Wirtz, Bas S F T M de Bruijn","doi":"10.1097/WNP.0000000000001107","DOIUrl":"10.1097/WNP.0000000000001107","url":null,"abstract":"<p><strong>Purpose: </strong>Electroencephalography (EEG) is a noninvasive diagnostic tool that can be of diagnostic value in patients with cognitive disorders. In recent years, increasing emphasis has been on quantitative EEG analysis, which is not easily accessible in clinical practice. The aim of this study was to assess the diagnostic and prognostic value of visual EEG assessment to distinguish different causes of cognitive disorders.</p><p><strong>Methods: </strong>Patients with cognitive disorders from a specialized memory clinic cohort underwent routine workup including EEG, neuropsychological testing and brain imaging. Electroencephalography parameters including posterior dominant rhythm, background activity, and response to photic stimulation (intermittent photic stimulation) were visually scored. Final diagnosis was made by an expert panel.</p><p><strong>Results: </strong>A total of 501 patients were included and underwent full diagnostic workup. One hundred eighty-three patients had dementia (111 Alzheimer disease, 30 vascular dementia, 15 frontotemporal dementia, and 9 dementia with Lewy bodies), 66 patients were classified as mild cognitive impairment, and in 176, no neurologic diagnosis was made. Electroencephalography was abnormal in 60% to 90% of patients with mild cognitive impairment and dementia, most profoundly in dementia with Lewy bodies and Alzheimer disease, while frontotemporal dementia had normal EEG relatively often. Only 30% of those without neurologic diagnosis had EEG abnormalities, mainly a diminished intermittent photic stimulation response. Odds ratio of conversion to dementia was 6.1 [1.5-24.7] for patients with mild cognitive impairment with abnormal background activity, compared with those with normal EEG.</p><p><strong>Conclusions: </strong>Visual EEG assessment has diagnostic and prognostic value in clinical practice to distinguish patients with memory complaints without underlying neurologic disorder from patients with mild cognitive impairment or dementia.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"243-250"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759065","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}

{"title":"American Clinical Neurophysiology Society Technical Standards for Electrical Stimulation With Intracranial Electrodes for Functional Brain Mapping and Seizure Induction.","authors":"Ravindra Arya, Fiona M Baumer, Patrick Chauvel, Birgit Frauscher, Prasanna Jayakar, Ammar Kheder, Bradley Lega, Ronald P Lesser, Kai J Miller, Marc R Nuwer, Nigel P Pedersen, Anthony L Ritaccio, David S Sabsevitz, Saurabh R Sinha, Elson L So, William O Tatum, Jessica W Templer, Stephan U Schuele","doi":"10.1097/WNP.0000000000001149","DOIUrl":"10.1097/WNP.0000000000001149","url":null,"abstract":"<p><strong>Purpose: </strong>These American Clinical Neurophysiology Society technical standards suggest best practices for electrical stimulation mapping (ESM) with subdural and stereotactic depth electrodes for seizure induction and mapping of brain function.</p><p><strong>Methods: </strong>A working group was convened from American Clinical Neurophysiology Society membership with expertise in ESM. PubMed searches were performed to identify pertinent peer-reviewed literature. Recurrent meetings reviewed progress, built consensus by discussion, and developed evidence-based recommendations to the extent possible.</p><p><strong>Recommendations: </strong>Stimulators used for ESM should have sufficient dynamic range, ability to interrupt a stimulus train, and ictal disrupt mechanism(s). Charge density should be calculated for the specific electrodes and ESM settings, the maximum safe limits being 52 to 57 μC/cm 2 /phase for subdural electrodes and not established for stereotactic depth electrodes. Subdural ESM for functional mapping is typically performed at 50-Hz pulse frequency, 200- to 300-µs pulse width, 2- to 8-s train duration, and 1- to 20-mA current strength. Stereo ESM is commonly performed using 2 different pulse frequencies: 1 Hz (300-500 µs pulse width, train duration up to 30 s, and often a constant current of 3-5 mA), and 50 Hz (100-500 µs pulse width, train duration 2-8 s, and 0.5-10 mA current intensity).</p><p><strong>Conclusions: </strong>This guideline provides technical standards for the performance of ESM, which will likely evolve over time with advances in technology and additional evidence (also see Graphical Abstract).</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"190-200"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408121","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":"Intraoperative Neuromonitoring for the Lower-Extremity Region Using Motor-Evoked Potential With Direct Cortical Stimulation in Brain Tumor Surgeries.","authors":"Tsunenori Takatani, Ryosuke Matsuda, Hironobu Hayashi, Ryosuke Maeoka, Kenta Nakase, Yudai Morisaki, Shohei Yokoyama, Yasuhiro Takeshima, Ichiro Nakagawa, Yasushi Momoyama, Masahiko Kawaguchi","doi":"10.1097/WNP.0000000000001108","DOIUrl":"10.1097/WNP.0000000000001108","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the motor function of the lower extremity (LE), we used direct cortical stimulation motor-evoked potential (D-MEP) monitoring with a single six-contact subdural strip electrode placed in the interhemispheric fissure.</p><p><strong>Methods: </strong>Intraoperative neuromonitoring using D-MEPs in the LE was performed in 18 cases (16 patients) for brain tumor surgery from December 2018 to April 2023 with a follow-up period of at least 3 months. After dural opening, a single six-contact subdural strip electrode was placed inside the interhemispheric fissure. To identify the central sulcus, phase reversal was recorded using somatosensory evoked potentials. Next, direct cortical stimulation was applied to the primary motor cortex. The baseline waveform was defined as a reproducible waveform of 30 µV or higher, and a significant decrease of ≥50% in the amplitude resulted in a warning during surgery.</p><p><strong>Results: </strong>The success rate of central sulcus identification in the LE was 66.7% (12/18 cases). Direct cortical stimulation motor-evoked potential monitoring could record stable contralateral motor-evoked potentials of the tibialis anterior, gastrocnemius, and abductor hallucis in 16 of 18 cases (88.9%). The mean intensity of stimulation for D-MEPs was 20.5 ± 9.9 mA, and the 16 cases showed no significant reduction in amplitude. Seventeen cases showed no deterioration of motor function of the LE at 1 and 3 months postoperatively. In the remaining case with unsuccessful D-MEP, paralysis of the LE worsened at 1 and 3 months postoperatively.</p><p><strong>Conclusions: </strong>The placement of electrodes in the interhemispheric fissure on the primary motor cortex of the LE enabled motor-function monitoring in the LE with D-MEPs, suggesting that D-MEP-based monitoring may be a reliable approach.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"272-278"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874972","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":"Direct (D)-Wave Monitoring Enhancement With Subdural Electrode Placement: A Case Series.","authors":"Harshal A Shah, Adrian Chen, Ross Green, Roee Ber, Randy S D'Amico, Daniel M Sciubba, Sheng-Fu Larry Lo, Justin W Silverstein","doi":"10.1097/WNP.0000000000001100","DOIUrl":"10.1097/WNP.0000000000001100","url":null,"abstract":"<p><strong>Purpose: </strong>Direct-wave (D-wave) neuromonitoring is a direct measure of corticospinal tract integrity that detects potential injury during spinal cord surgery. Epidural placement of electrodes used for D-wave measurements can result in high electrical impedances resulting in substantial signal noise that can compromise signal interpretation. Subdural electrode placement may offer a solution.</p><p><strong>Methods: </strong>Medical records for consecutive patients with epidural and subdural D-wave monitoring were reviewed. Demographic and clinical information including preoperative and postoperative motor strength were recorded. Neuromonitoring charts were reviewed to characterize impedances and signal amplitudes of D-waves recorded epidurally (before durotomy) and subdurally (following durotomy). Nonparametric statistics were used to compare epidural and subdural D-waves.</p><p><strong>Results: </strong>Ten patients (50% women, median age 50.5 years) were analyzed, of which five patients (50%) were functionally independent (modified McCormick grade ≤ II) preoperatively. D-waves were successfully acquired by subdural electrodes in eight cases and by epidural electrodes in three cases. Subdural electrode placement was associated with lower impedance values ( P = 0.011) and a higher baseline D-wave amplitude ( P = 0.007) relative to epidural placement. No association was observed between D-wave obtainability and functional status, and no adverse events relating to subdural electrode placement were encountered.</p><p><strong>Conclusions: </strong>Subdural electrode placement allows successful D-wave acquisition with accurate monitoring, clearer waveforms, and a more optimal signal-to-noise ratio relative to epidural placement. For spinal surgeries where access to the subdural compartment is technically safe and feasible, surgeons should consider subdural placement when monitoring D-waves to optimize clinical interpretation.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"251-256"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446285","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}