Journal of Clinical Neurophysiology最新文献

{"title":"Low-Frequency Repetitive Nerve Stimulation in Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome.","authors":"Qingyun Ding, Shuang Wu, Youfang Hu, Yimin Wu, Ying Tan, Liying Cui, Yuzhou Guan","doi":"10.1097/WNP.0000000000001273","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001273","url":null,"abstract":"<p><strong>Objective: </strong>Lambert-Eaton myasthenic syndrome (LEMS) and myasthenia gravis (MG) exhibit distinct decrement patterns in low-frequency repetitive nerve stimulation. While a delayed nadir in LEMS is well-documented, we identified additional unique patterns. This study systematically compared low-frequency repetitive nerve stimulation features between the two conditions using prolonged protocols.</p><p><strong>Methods: </strong>We retrospectively analyzed 20 patients with LEMS (March 2019-August 2025) and 34 age-matched patients with MG (April 2023-August 2025). All subjects underwent low-frequency repetitive nerve stimulation (3 Hz, 5 Hz; 25 stimuli per train) on the abductor digiti minimi and trapezius muscles. Key parameters included compound muscle action potential nadir position and postnadir amplitude recovery.</p><p><strong>Results: </strong>As previously reported, patients with LEMS had significantly lower baseline compound muscle action potential amplitudes than patients with MG. In MG, 90.9% of tested muscles showed a compound muscle action potential nadir at the 4th or 5th response. By contrast, 65.5% of LEMS muscles exhibited a delayed nadir between the 7th and 10th responses. Notably, 24.1% of LEMS muscles displayed a nadir at waves 4 to 5 followed by substantial amplitude recovery. In this subgroup, the amplitude difference between the nadir and the 10th or 25th response showed high sensitivity and specificity in differentiating LEMS from MG. Furthermore, 10.3% of LEMS muscles exhibited direct facilitation, characterized by an amplitude increase without an initial decrement.</p><p><strong>Conclusions: </strong>In addition to the previously reported delayed decrement, we identified two additional abnormal low-frequency repetitive nerve stimulation patterns in LEMS: early decrement with postnadir recovery and direct facilitation. These three LEMS-specific patterns differ from those observed in MG and may aid in the differential diagnosis of MG and LEMS.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217199","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":"Interpreting Motor Evoked Potential and D-wave Changes During Intramedullary Spinal Cord Tumor Surgery.","authors":"Jongsuk Choi","doi":"10.1097/WNP.0000000000001274","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001274","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163284","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":"Scalp EEG Signals: Generators and Dipoles.","authors":"Sándor Beniczky, Michael Scherg","doi":"10.1097/WNP.0000000000001226","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001226","url":null,"abstract":"<p><strong>Summary: </strong>Accurate interpretation of scalp electroencephalogram (EEG) signals relies on understanding the biophysical principles underlying their generation. Although traditional EEG analysis often focuses on identifying negative phase reversals, this approach oversimplifies the complex nature of cortical current flow. Electroencephalogram signals are generated by extracellular currents resulting from postsynaptic potentials in pyramidal neurons, forming dipoles aligned along the apical dendrites. The orientation and location of these dipoles, whether radial, tangential, or oblique, depend on the spatial orientation of the active cortical surface. Orientation critically influences the scalp voltage topography. Therefore, the spatial distribution of both positive and negative poles on the scalp provides valuable insight into source localization. This review highlights the importance of including both polarities when interpreting EEG, particularly in distinguishing tangential and oblique from radial sources. It also emphasizes the role of electrode placement, montage selection, and digital filtering. Simultaneous MEG-EEG recordings further validate the physiologic significance of scalp positivities. Through practical examples and voltage maps, the authors advocate for a shift in clinical EEG interpretation, from relying solely on negativity and phase reversals to a more informed, topographic approach. Such an approach enhances diagnostic accuracy and aligns EEG interpretation with a more complete neurophysiologic understanding.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156813","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":"Consistency of Ictal Epileptogenic Foci in Children With Tuberous Sclerosis Complex and Its Clinical Predictors.","authors":"Carmen Stevering, Willem Otte, Frans Leijten, Mireille Bourez, Louis Wagner, Kees Braun, Floor E Jansen","doi":"10.1097/WNP.0000000000001260","DOIUrl":"10.1097/WNP.0000000000001260","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The course of epilepsy in patients with tuberous sclerosis complex (TSC) is highly variable. Consistency of the epileptogenic zone is considered important in presurgical evaluation. The authors aimed to (1) assess consistency of ictal epileptogenic foci over time in patients with TSC, (2) evaluate concordance between interictal epileptiform abnormalities and ictal epileptogenic foci, and (3) identify determinants of ictal consistency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective, observational study included children with definite TSC and epilepsy with ≥2 ictal presurgical EEGs with an interval ≥1 year. In all EEGs, the regional localization of interictal and ictal epileptiform abnormalities was scored based on the EEG reports. All ictal epileptogenic foci were classified with an \"ictal focus consistency score,\" according to one of the following subcategories: \"single focus, consistent,\" \"from unclear localization/diffuse or generalized to unifocal,\" \"≥2 or more foci, each consistent,\" \"≥2 foci of which at least one is consistent,\" \"starting multifocal but at last EEG unifocal,\" and \"multifocal changing otherwise.\" The primary end point was unifocal or multifocal consistency of ictal foci. The secondary end point was concordance between ictal epileptogenic foci and localization of interictal epileptiform abnormalities. The third end point involved an exploratory assessment of potential determinants of ictal consistency, including TSC variant, age at epilepsy onset, epileptic spasms, multiple seizure types, interictal multifocality, and tuber load.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The authors included 45 patients with TSC with a median of 3 (interquartile range 2-4) ictal and 8 (interquartile range 5-10) interictal EEGs per patient. Median time between first and last ictal EEG was 28.4 months (19.0-60.3). Ictal foci were consistent over time in 11 patients (24.4%), of whom 9 had 1 consistent ictal focus. Nine other patients had a single consistent ictal focus on the first EEGs, but developed a second focus at the median age of 67.7 months. Of the 13 patients who later underwent surgery, 3 had a single focus, and only 2 of 13 had consistent ictal EEGs. The same three patients with a single focus over time were part of the seven postoperative seizure-free patients. All six nonseizure-free children had ictal multifocality. Interictal and ictal epileptogenic foci were discordant in 42 of 45 patients (93.3%). Exploratory analyses of potential determinants of ictal consistency suggested a negative association with interictal multifocality (risk ratio 0.32, 95% confidence interval 0.06-0.97, p = 0.04), which was not significant after adjustment for monitoring duration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Ictal epileptogenic foci are consistent in only 25% of the patients with TSC. Interictal epileptogenic foci are often discordant with ictal foci. This instability in the ictal epileptogenic focus might be e","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972701","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":"Predictive Value of Single-Fiber Electromyography for Ocular Myasthenia Gravis in a Low Prevalence Cohort.","authors":"Yorjannys Gomez, Araya Puwanant, James B Caress","doi":"10.1097/WNP.0000000000001267","DOIUrl":"10.1097/WNP.0000000000001267","url":null,"abstract":"<p><strong>Purpose: </strong>Single-fiber electromyography (SFEMG) is a sensitive test to diagnose ocular myasthenia gravis (OMG) when the clinical suspicion is high but the predictive value of the test is also dependent on the prevalence of the condition in the referral population. In a low prevalence population, false positive results can be as common as true positive results. Most of the patients referred for SFEMG at our center do not have symptoms or signs that are strongly suggestive for OMG.</p><p><strong>Methods: </strong>A retrospective chart review was performed of all patients referred to our laboratory for possible OMG for a 1-year period and analyzed the long-term accuracy of SFEMG in a cohort of 33 patients.</p><p><strong>Results: </strong>Eleven of these (33%) were eventually diagnosed with a disease of neuromuscular transmission and SFEMG was abnormal in all of these (100% sensitivity). With the requirement that 3 jitter pairs be abnormal or that mean jitter was elevated, SFEMG was normal in the remaining 22 patients (100% specific).</p><p><strong>Conclusions: </strong>The results confirm that SFEMG is an excellent confirmatory test when clinical suspicion for OMG is high and also demonstrate that when strict criteria are applied, the test accurately excludes OMG in patients with ocular complaints that are not truly suggestive of OMG.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic Normal Values for Ulnar Nerve Cross-Sectional Area.","authors":"Marianne T Luetmer, James B Meiling, Eric J Sorenson, Ruple S Laughlin, Andrea J Boon","doi":"10.1097/WNP.0000000000001265","DOIUrl":"10.1097/WNP.0000000000001265","url":null,"abstract":"<p><strong>Purpose: </strong>Neuromuscular ultrasound, including cross-sectional area measurements, adds diagnostic value to the clinical and electrodiagnosis evaluation of ulnar neuropathy at the elbow. Previously published reference values for ulnar nerve size vary widely. Our objective was to establish age-specific reference values for ulnar nerve cross-sectional area at multiple sites in asymptomatic adults for our laboratory.</p><p><strong>Methods: </strong>Healthy adult subjects without neuromuscular symptoms or disease were recruited from our tertiary referral electromyogram laboratory and staff. Ulnar nerve cross-sectional area measurements were made in short axis at the wrist, forearm, cubital tunnel, retrocondylar groove, 2 cm proximal to the medial epicondyle, and mid-upper arm with the elbow flexed to 90°. Dynamic neuromuscular ultrasound evaluated for subluxation and dislocation at the medial epicondyle. Results were stratified by age group (younger than 40, 40-60, and older than 60 years) with at least 20 subjects per sex per group, as well as by sex, body mass index, and handedness. The upper limit of normal was established as two standard deviations above the mean.</p><p><strong>Results: </strong>One hundred forty-two subjects (ages 18-84, mean 47.7 years) were included. Cross-sectional area significantly increased with age at all sites except the wrist. Cross-sectional area cut-offs at the retrocondylar groove were 10.0, 10.9, and 11.4 mm 2 , respectively, by age group. Ratios comparing retrocondylar groove and cubital tunnel to arm and forearm were calculated. Thirty-two percent had subluxation or dislocation in at least one limb.</p><p><strong>Conclusions: </strong>Age-specific cross-sectional area cut-offs and ratios may facilitate a more nuanced interpretation and diagnostic value when used in conjunction with clinical and electrodiagnosis evaluation of ulnar neuropathy at the elbow.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874232","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 Motor Unit Number and Size Estimation With Muscle Thickness and Strength in Healthy Young, Middle-Aged, and Older Adults.","authors":"Kaito Igawa, Ryosuke Takeda, Taichi Nishikawa, Marino Karaki, Masahiro Kuniki, Yu-Ichi Noto, Kohei Watanabe","doi":"10.1097/WNP.0000000000001266","DOIUrl":"10.1097/WNP.0000000000001266","url":null,"abstract":"<p><strong>Purpose: </strong>Although age-related declines in muscle mass and strength are believed to result from changes in motor unit number and size, the association of motor unit number and size with muscle mass and strength in healthy individuals remains unclear. We aim to examine the association of motor unit number estimation (MUNE) and motor unit size estimation (MUSE) of abductor pollicis brevis (APB) with muscle thickness of APB and maximal pinch-grip strength among young, middle-aged, and older adults.</p><p><strong>Methods: </strong>Forty-eight young adults (20-39 years; young), 89 middle-aged adults (40-59 years; middle-aged), and 47 older adults (60 years and older; older) participated in this study. MUNE and the mean single motor unit potential as MUSE were calculated using the MScanFit2. Muscle thickness of the APB was measured from ultrasound images. Maximal pinch-grip strength was assessed during maximal voluntary isometric contraction of lateral pinch.</p><p><strong>Results: </strong>MUNE and MUSE were not correlated with muscle thickness in any of the groups. In addition, MUNE was not correlated with maximal pinch-grip strength in either the young or middle-aged group. A significant positive correlation between MUNE and maximal pinch-grip strength was observed in the older group. MUSE was not significantly correlated with maximal pinch-grip strength in any group.</p><p><strong>Conclusions: </strong>MUNE, not MUSE, is associated with maximal pinch-grip strength in older adults, but not in young or middle-aged adults. These findings suggest that MUNE may explain interindividual differences in neuromuscular function among healthy older adults. MUNE could be a useful biomarker for neuromuscular function in older individuals.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874203","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":"Technical Optimization and Clinical Utility of Intraoperative Visual Evoked Potentials During Transsphenoidal Surgery for Pituitary Adenomas.","authors":"Jongsuk Choi, Ki Eob Kim, Min Jun Song, Joo Hyeong Lee, Byung Hoon Yoon","doi":"10.1097/WNP.0000000000001263","DOIUrl":"10.1097/WNP.0000000000001263","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical and technical factors associated with successful intraoperative visual evoked potential (VEP) acquisition during transsphenoidal surgery (TSS) for pituitary adenomas, and to assess the prognostic value of intraoperative VEP changes on postoperative visual outcomes.</p><p><strong>Methods: </strong>A total of 163 patients who underwent primary TSS with intraoperative VEP monitoring between January 2016 and December 2024 were analyzed. Baseline signal acquisition and visual outcomes at 1 month postsurgery were assessed in relation to tumor characteristics, preoperative visual function, stimulation modality (goggle-mounted vs. high-luminance light-emitting diode [LED]), and use of concurrent electroretinography (ERG). Multivariable logistic regression identified independent predictors of successful VEP acquisition.</p><p><strong>Results: </strong>Visual evoked potentials were successfully obtained in 78.8% of eyes. Higher acquisition rates were observed in patients with tumors <10 mm, intrasellar location, and preserved visual function (all P < 0.05). The high-luminance LED system with ERG significantly improved signal acquisition (89.0 vs. 64.3%, P < 0.001). Among patients monitored with this optimized approach, irreversible intraoperative VEP loss strongly predicted postoperative visual deterioration (70.8 vs. 8.2%, P < 0.001). No such association was observed with the goggle-based system.</p><p><strong>Conclusions: </strong>Technically optimized VEP monitoring using high-luminance stimulation and ERG validation improves signal reliability and prognostic value for visual outcomes in pituitary surgery. Broader adoption may be supported by standardized protocols and careful patient selection.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874244","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":"Collodion Versus Tensive-Quality and Cost Comparison in 48-hour Ambulatory EEG Studies.","authors":"Tomi Ashaye, Sedalia Cole, Danielle Pierce, Magdalena Warzecha, Jesus Natividad Sarol, Fatima Ahmed","doi":"10.1097/WNP.0000000000001262","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001262","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether there is a difference in electrode impedances in 48-hour in-home ambulatory EEGs (AEEG) when using collodion versus Tensive for electrode application. In addition, to compare the costs of using the two adhesive agents.</p><p><strong>Methods: </strong>This retrospective review analyzed 252 intermittently monitored 48-hour ambulatory EEG studies conducted in adult patients. In total, 126 studies were conducted using collodion and 126 using Tensive for electrode application. Each group was composed of an equal number of male and female. Electrode impedances were checked and documented at least every 4 hours, more frequently if artifact was noticed by the registered EEG technologist (R.EEG T.) during intermittent monitoring. The number of electrodes in which impedance exceeded 10 kOhms anytime during the 48-hour study was assessed. In addition, the per-patient cost of collodion and its required ancillary supplies was compared with that of Tensive.</p><p><strong>Results: </strong>The incidence of impedances greater than 10 kOhms in 48-hour ambulatory EEGs was similar for the collodion and Tensive groups. It was 42.1% for collodion and 45.2% for Tensive. The difference between the two adhesives was not statistically significant (P = 0.6114). There was a 73% cost reduction per patient when using Tensive compared with collodion.</p><p><strong>Conclusions: </strong>There is no significant difference in the maintenance of proper electrode impedance in 48-hour ambulatory EEGs when using collodion or Tensive for electrode application. There is a 73% cost reduction per patient when using Tensive.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838410","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":"Electrical Source Imaging in Stereoelectroencephalography: A Proof-of-Concept Study.","authors":"Luca Bosisio, Matteo Cataldi, Domenico Tortora, Alessandro Consales, Giulia Nobile, Ezequiel Mikulan, Valentina Marazzotta, Lino Nobili, Stefano Francione","doi":"10.1097/WNP.0000000000001257","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001257","url":null,"abstract":"<p><strong>Purpose: </strong>Electrical source imaging (ESI) estimates the intracerebral generators of EEG signals. Although traditionally applied to scalp EEG sensors, recent studies suggested its potential applicability to intracerebral recordings. We systematically evaluated the localization accuracy of ESI applied to SEEG data rather than scalp EEG.</p><p><strong>Methods: </strong>We compared three different inverse solution methods (standardized low-resolution electromagnetic tomography [sLORETA], minimum norm estimate, and dynamic statistical parametric mapping) in localizing the stimulation artifact in 12 subjects undergoing SEEG. Localization accuracy was defined as the Euclidean distance between the stimulation site and the peak of the estimated source.</p><p><strong>Results: </strong>Standardized low-resolution electromagnetic tomography showed the highest accuracy. For single stimuli, the mean localization error was 11.65 mm, improving to 9.28 mm when averaging 10 stimuli. Subcentimeter accuracy was achieved in 77.5% of averaged trials. Although localization based on the maximum amplitude artifact increased linearly with the distance from the nearest SEEG contact, sLORETA maintained higher accuracy, typically within ∼1 cm. The weak association between sLORETA error and sensor distance disappeared when excluding stimulations at the outermost boundaries of the explored region.</p><p><strong>Conclusions: </strong>These results support the application of ESI to SEEG data for accurate source localization. Among tested methods, sLORETA was the most effective and may improve spatial interpretability in challenging epilepsy cases, including those with suboptimal spatial sampling.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838584","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}