Journal of Clinical Neurophysiology最新文献

{"title":"Electrographic Seizure Characteristics and Electrographic Status Epilepticus Prediction.","authors":"France W Fung, Darshana S Parikh, Maureen Donnelly, Rui Xiao, Alexis A Topjian, Nicholas S Abend","doi":"10.1097/WNP.0000000000001068","DOIUrl":"10.1097/WNP.0000000000001068","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to characterize electrographic seizures (ES) and electrographic status epilepticus (ESE) and determine whether a model predicting ESE exclusively could effectively guide continuous EEG monitoring (CEEG) utilization in critically ill children.</p><p><strong>Methods: </strong>This was a prospective observational study of consecutive critically ill children with encephalopathy who underwent CEEG. We used descriptive statistics to characterize ES and ESE, and we developed a model for ESE prediction.</p><p><strong>Results: </strong>ES occurred in 25% of 1,399 subjects. Among subjects with ES, 23% had ESE, including 37% with continuous seizures lasting >30 minutes and 63% with recurrent seizures totaling 30 minutes within a 1-hour epoch. The median onset of ES and ESE occurred 1.8 and 0.18 hours after CEEG initiation, respectively. The optimal model for ESE prediction yielded an area under the receiver operating characteristic curves of 0.81. A cutoff selected to emphasize sensitivity (91%) yielded specificity of 56%. Given the 6% ESE incidence, positive predictive value was 11% and negative predictive value was 99%. If the model were applied to our cohort, then 53% of patients would not undergo CEEG and 8% of patients experiencing ESE would not be identified.</p><p><strong>Conclusions: </strong>ESE was common, but most patients with ESE had recurrent brief seizures rather than long individual seizures. A model predicting ESE might only slightly improve CEEG utilization over models aiming to identify patients at risk for ES but would fail to identify some patients with ESE. Models identifying ES might be more advantageous for preventing ES from evolving into ESE.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"64-72"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403122","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":"Book Review for Aminoff's Diagnosis of Neuromuscular Disorders, 4th Edition.","authors":"Ruple S Laughlin","doi":"10.1097/WNP.0000000000001125","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001125","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":"42 1","pages":"92-93"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927305","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 Between Magnetoencephalography-Localized Epileptogenic Zone, Surgical Resection Volume, and Postsurgical Seizure Outcome.","authors":"Vahe Poghosyan, Hanin Algethami, Ashwaq Alshahrani, Safiyyah Asiri, Mubarak M Aldosari","doi":"10.1097/WNP.0000000000001069","DOIUrl":"10.1097/WNP.0000000000001069","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical resection of magnetoencephalography (MEG) dipole clusters, reconstructed from interictal epileptiform discharges, is associated with favorable seizure outcomes. However, the relation of MEG cluster resection to the surgical resection volume is not known nor is it clear whether this association is direct and causal, or it may be mediated by the resection volume or other predictive factors. This study aims to clarify these open questions and assess the diagnostic accuracy of MEG in our center.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 68 patients with drug-resistant epilepsy who underwent MEG followed by resective epilepsy surgery and had at least 12 months of postsurgical follow-up.</p><p><strong>Results: </strong>Good seizure outcomes were associated with monofocal localization (χ 2 = 6.94, P = 0.001; diagnostic odds ratio = 10.2) and complete resection of MEG clusters (χ 2 = 22.1, P < 0.001; diagnostic odds ratio = 42.5). Resection volumes in patients with and without removal of MEG clusters were not significantly different ( t = 0.18, P = 0.86; removed: M = 20,118 mm 3 , SD = 10,257; not removed: M = 19,566 mm 3 , SD = 10,703). Logistic regression showed that removal of MEG clusters predicts seizure-free outcome independent of the resection volume and other prognostic factors ( P < 0.001).</p><p><strong>Conclusions: </strong>Complete resection of MEG clusters leads to favorable seizure outcomes without affecting the volume of surgical resection and independent of other prognostic factors. MEG can localize the epileptogenic zone with high accuracy. MEG interictal epileptiform discharges mapping should be used whenever feasible to improve postsurgical seizure outcomes.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"73-80"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403120","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":"Real-World Continuous EEG Utilization and Outcomes in Hospitalized Patients With Acute Cerebrovascular Diseases.","authors":"Rajesh Amerineni, Haoqi Sun, Marta Bento Fernandes, M Brandon Westover, Lidia Moura, Elisabetta Patorno, John Hsu, Sahar F Zafar","doi":"10.1097/WNP.0000000000001043","DOIUrl":"10.1097/WNP.0000000000001043","url":null,"abstract":"<p><strong>Purpose: </strong>Continuous electroencephalography (cEEG) is recommended for hospitalized patients with cerebrovascular diseases and suspected seizures or unexplained neurologic decline. We sought to (1) identify areas of practice variation in cEEG utilization, (2) determine predictors of cEEG utilization, (3) evaluate whether cEEG utilization is associated with outcomes in patients with cerebrovascular diseases.</p><p><strong>Methods: </strong>This cohort study of the Premier Healthcare Database (2014-2020), included hospitalized patients age > 18 years with cerebrovascular diseases (identified by ICD codes). Continuous electroencephalography was identified by International Classification of Diseases (ICD)/Current Procedural Terminology (CPT) codes. Multivariable lasso logistic regression was used to identify predictors of cEEG utilization and in-hospital mortality. Propensity score-matched analysis was performed to determine the relation between cEEG use and mortality.</p><p><strong>Results: </strong>1,179,471 admissions were included; 16,777 (1.4%) underwent cEEG. Total number of cEEGs increased by 364% over 5 years (average 32%/year). On multivariable analysis, top five predictors of cEEG use included seizure diagnosis, hospitals with >500 beds, regions Northeast and South, and anesthetic use. Top predictors of mortality included use of mechanical ventilation, vasopressors, anesthetics, antiseizure medications, and age. Propensity analysis showed that cEEG was associated with lower in-hospital mortality (Average Treatment Effect -0.015 [95% confidence interval -0.028 to -0.003], Odds ratio 0.746 [95% confidence interval, 0.618-0.900]).</p><p><strong>Conclusions: </strong>There has been a national increase in cEEG utilization for hospitalized patients with cerebrovascular diseases, with practice variation. cEEG utilization was associated with lower in-hospital mortality. Larger comparative studies of cEEG-guided treatments are indicated to inform best practices, guide policy changes for increased access, and create guidelines on triaging and transferring patients to centers with cEEG capability.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"20-27"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11058112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482168","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":"Comparison of EEG Signal Characteristics of Subdural and Depth Electrodes.","authors":"Cigdem Isitan Alkawadri, Qi Yan, Ayse Gul Kocuglu Kinal, Dennis D Spencer, Rafeed Alkawadri","doi":"10.1097/WNP.0000000000001139","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001139","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to compare signal characteristics of subdural electrodes (SDE) and depth stereo EEG placed within a 5-mm vicinity in patients with drug-resistant epilepsy. We report how electrode design and placement collectively affect signal content from a shared source between these electrode types.</p><p><strong>Methods: </strong>In subjects undergoing invasive intracranial EEG evaluation at a surgical epilepsy center from 2012 to 2018, stereo EEG and SDE electrode contacts placed within a 5-mm vicinity were identified. Of these, 24 contacts (12 pairs) met our criteria for signal-to-noise ratio and data availability for final analysis. We used Welch method to analyze the correlation of power spectral densities of EEG segments, root mean square of 1-second windows, and fast-Fourier transform to calculate coherence across conventional frequency bands.</p><p><strong>Results: </strong>We observed a median distance of 3.7 mm between the electrode contact pairs. Time-aware analysis highlighted the coherence's strength primarily in the high-gamma band, where the median (r) was 0.889. In addition, the median power ratios between the SDE and stereo EEG signal was 1.99. This ratio decreased from high-gamma to infra-low frequencies, with medians of 2.07 and 0.97, respectively. The power spectral densities for the stereo EEG and SDE electrodes demonstrated a strong correlation, with a median correlation coefficient (r) of 0.99 and an interquartile range from 0.915 to 0.996.</p><p><strong>Conclusions: </strong>Signals captured by standard subdural and depth (intracranial EEG) electrodes within a 5-mm radius exhibit band-specific coherence and are not identical. The association was most pronounced in the high-gamma band, with coherence decreasing with lower frequencies. Our findings underscore the combined effects of electrode size, design, placement, preferred bandwidth, and the nature of the activity source on signal recording. Particularly, SDE employed herein may offer advantages for high-frequency signals, but the impact of electrode size on recordings necessitates careful consideration in context-specific situations.</p><p><strong>Significance: </strong>The findings relate to surgical epilepsy care and may inform the design of brain-computer interface.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949694","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":"Ultra High-Frequency Ultrasound of Median Nerve Fascicles at the Wrist in Amyotrophic Lateral Sclerosis: An Exploratory Study.","authors":"James B Meiling, James B Caress, Michael S Cartwright","doi":"10.1097/WNP.0000000000001136","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001136","url":null,"abstract":"<p><strong>Purpose: </strong>High-frequency ultrasound (HFUS) of muscle and nerve has the potential to be a reliable, responsive, and informative biomarker of disease progression for individuals with amyotrophic lateral sclerosis (ALS). High-frequency ultrasound is not able to visualize median nerve fascicles to the same extent as ultra-high-frequency ultrasound (UHFUS). Evaluating the number and size of fascicles within a nerve may facilitate a better understanding of nerve diseases. This exploratory study aims to image median nerve fascicles at the wrist in individuals with ALS using UHFUS and compare these findings with those from previously observed controls.</p><p><strong>Methods: </strong>Fifteen individuals with ALS underwent sonographic examination of the median nerves on each upper limb using UHFUS with a 48-MHz linear array transducer. Fascicle count and density in each examined nerve were determined by a single rater. Demographic and sonographic data from 20 previously studied controls were compared.</p><p><strong>Results: </strong>In individuals with ALS, the average fascicle number was 22.4 (SD 5.2) and average fascicle density 1.7 (SD 0.5). There was no significant difference in fascicle counts between individuals with ALS and controls.</p><p><strong>Conclusions: </strong>Fascicular quantification using UHFUS is possible in individuals with ALS. Given the lack of appreciable difference between fascicle counts in individuals with ALS and controls, UHFUS of the median nerve at the wrist may not be a responsive biomarker for ALS disease progression.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894849","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":"Seizure Detection and Lateralization Using Thalamic Deep Brain Stimulator Recordings.","authors":"Gloria Ortiz-Guerrero, Sihyeong Park, Keith Starnes, Brian N Lundstrom, Benjamin H Brinkmann, Jamie J Van Gompel, Gregory A Worrell, Nicholas M Gregg","doi":"10.1097/WNP.0000000000001137","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001137","url":null,"abstract":"<p><strong>Summary: </strong>The lack of reliable seizure detection remains a significant challenge for epilepsy care. A clinical deep brain stimulation (DBS) system provides constrained ambulatory brain recordings; however, limited data exist on the use of DBS recordings for seizure detection and lateralization. We present the case of an 18-year-old patient with drug-resistant focal epilepsy, who had seizure detection and lateralization by DBS recordings. Prior stereotactic-EEG, including a thalamus lead, identified independent left orbitofrontal and mesial temporal onset seizures. Notably, low-frequency thalamic ictal power was significantly elevated relative to baseline awake and sleep states. The patient was subsequently implanted with an anterior nucleus of the thalamus DBS system. Postimplantation, low-frequency power-in-band (5.3-10.3 Hz) recordings were initiated. Nursing staff identified four typical clinical seizures during the inpatient DBS recording period. Thalamic DBS trends contained relative peaks that were coincident with each nurse-reported seizure. Peri-ictal power was uniformly maximal ipsilateral to the seizure network. This case demonstrates the feasibility of seizure detection and lateralization by a thalamic DBS system for some individuals, and suggests DBS sensing parameter selection may be guided by thalamic stereotactic EEG. Further research is necessary to assess the generalizability of DBS seizure detection across individuals and diverse seizure networks.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846886","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":"Improving Electroencephalography Screening via an Online Module for Neurology Trainees: A Multicenter Study.","authors":"Hernan Nicolas Lemus, Camilo Gutierrez, Madeline Fields, Kristine Ziemba, Patrick Landazuri, Vicki Shanker, Daniela Riveros Acosta, Louise McCarthy, Neville Jadeja, Mia Bothwell, Adithya Nagaraja, Gustavo A Patino, Ioannis Karakis, Tracey A Milligan, Steven Tobochnik","doi":"10.1097/WNP.0000000000001135","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001135","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the utility of a 15-minute online module to improve the self-confidence and knowledge of neurology trainees when screening an EEG.</p><p><strong>Methods: </strong>We developed a fast, convenient, and accessible 15-minute online module to teach basic concepts of EEG screening using a five-step approach. To assess the efficacy of the module among neurology trainees, three surveys were developed. The EEG module and surveys were distributed to neurology trainees at multiple institutions in the United States. Associations between continuous variables were evaluated using t-test and ANOVA test.</p><p><strong>Results: </strong>A total of 199 residents from 7 different adult neurology residency programs participated in the study. We obtained a response rate of 38% (76/199) for EEG survey 1 and 25% (49/199) for the demographic survey, among junior and senior residents; 22 senior residents completed EEG survey 2. The online EEG module improved confidence when interpreting an EEG among junior residents (1.67 vs. 2.56, p < 0.0001). Senior residents improved their EEG survey score after completing the online module (53.9 vs. 68.6%, p < 0.001). Most of the trainees would recommend the online module to other trainees (93.9%) and would consider including it in an introductory course (93.9%).</p><p><strong>Conclusions: </strong>A brief and accessible online EEG module was easily implemented as an early introduction to EEG screening for junior neurology trainees and to improve EEG screening skills for senior trainees. These findings clarify specific areas where EEG learning may be optimized and reinforce the importance of implementing innovative curricula that are accessible and efficient for all neurology trainees.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818403","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":"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":"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":"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}