Journal of Clinical Neurophysiology最新文献

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Book Review for Current Practice of Clinical Electroencephalography, 5th Edition. 当前临床脑电图实践书评,第5版。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-10 DOI: 10.1097/WNP.0000000000001138
Jong Woo Lee
{"title":"Book Review for Current Practice of Clinical Electroencephalography, 5th Edition.","authors":"Jong Woo Lee","doi":"10.1097/WNP.0000000000001138","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001138","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electrophysiological Signatures of Alpha Coma. 阿尔法昏迷的电生理特征。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-09 DOI: 10.1097/WNP.0000000000001141
Giulio Degano, Francesco Misirocchi, Isotta Rigoni, Peter W Kaplan, Hervé Quintard, Serge Vulliémoz, Karl Schaller, Andreas Kleinschmidt, Margitta Seeck, Pia De Stefano
{"title":"Electrophysiological Signatures of Alpha Coma.","authors":"Giulio Degano, Francesco Misirocchi, Isotta Rigoni, Peter W Kaplan, Hervé Quintard, Serge Vulliémoz, Karl Schaller, Andreas Kleinschmidt, Margitta Seeck, Pia De Stefano","doi":"10.1097/WNP.0000000000001141","DOIUrl":"10.1097/WNP.0000000000001141","url":null,"abstract":"<p><strong>Purpose: </strong>Recent research on quantitative EEG in coma has proposed several metrics correlating with consciousness level. However, the heterogeneous nature of coma can challenge the generalizability of these measures. This study investigates alpha-coma, an electroclinical pattern characterized by a widespread, nonreactive alpha rhythm often linked to poor outcomes. The aim was to quantify the electrophysiological features of alpha-coma and compare them to the alpha rhythm in awake controls, seeking clearer insights into quantitative EEG analysis in comatose states.</p><p><strong>Methods: </strong>Fourteen alpha-coma patients were retrospectively selected from University Hospitals of Geneva and age-matched with 14 healthy control subjects from an open-source dataset. EEG data were preprocessed and analyzed to extract power spectra, spectral decay (aperiodic activity), sample entropy, and functional connectivity.</p><p><strong>Results: </strong>Alpha-coma patients did not differ in alpha power but exhibited significantly higher levels of spectral decay ( p < 0.001), suggesting a convergence toward an inhibitory state. Sample entropy was significantly higher in alpha-coma patients ( p = 0.01), indicating an increase in the cortical complexity in alpha-coma compared with healthy subjects.</p><p><strong>Conclusions: </strong>Alpha-coma shows increased aperiodic activity and EEG complexity, despite similar alpha power and clustering coefficient. The increased aperiodic activity aligns with findings in other comatose patients, including those sedated or with subcortical dysfunction. However, the increased entropy contradicts existing literature, suggesting that alpha-coma may represent a state of widespread cortical dysfunction likely resulting from nonhierarchical, turbulent brain activity. This indicates that the loss of consciousness does not guarantee consistent cortical measures across the whole spectrum of EEG patterns.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of Scalp High-Frequency Oscillation Detection and Characteristics With Disease Activity in Pediatric Epilepsy. 小儿癫痫头皮高频振荡检测及其特征与疾病活动的关系。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2023-10-30 DOI: 10.1097/WNP.0000000000001052
Keisuke Maeda, Nami Hosoda, Junichi Fukumoto, Shun Kawai, Mizuki Hayafuji, Himari Tsuboi, Shiho Fujita, Naohiro Ichino, Keisuke Osakabe, Keiko Sugimoto, Naoko Ishihara
{"title":"Association of Scalp High-Frequency Oscillation Detection and Characteristics With Disease Activity in Pediatric Epilepsy.","authors":"Keisuke Maeda, Nami Hosoda, Junichi Fukumoto, Shun Kawai, Mizuki Hayafuji, Himari Tsuboi, Shiho Fujita, Naohiro Ichino, Keisuke Osakabe, Keiko Sugimoto, Naoko Ishihara","doi":"10.1097/WNP.0000000000001052","DOIUrl":"10.1097/WNP.0000000000001052","url":null,"abstract":"<p><strong>Purpose: </strong>High-frequency oscillation (HFO) in scalp electroencephalography is a promising new noninvasive prognostic epilepsy biomarker, but further data are needed to ascertain the utility of this parameter. The present work investigated the association between epileptic activity and scalp HFO in pediatric patients with various types of epilepsy, using multivariable regression models to correct for possible confounding factors.</p><p><strong>Methods: </strong>The authors analyzed 97 subjects who were divided into groups with active epilepsy (within 1 year of seizure), seizure-free epilepsy (>1 year without seizure), and nonepilepsy. Regarding the frequency of seizure occurrence as an indicator of epileptic activity, we categorized subjects into four groups (Daily/Weekly, Monthly, Yearly, and Rarely).</p><p><strong>Results: </strong>Multiple linear regression analysis showed that the scalp HFO detection rate was significantly higher in patients with active epilepsy than in those with nonepilepsy (β [95% confidence interval] = 2.77 [1.79-4.29]; P < 0.001). The association between scalp HFO detection rate and frequency of seizure occurrence was highest in the Daily/Weekly group (β [95% confidence interval] = 3.38 [1.57-7.27]; P = 0.002), followed by Monthly and Yearly groups (β [95% confidence interval] = 2.42 [1.02-5.73]; P = 0.046 and 0.36 [0.16-0.83]; P = 0.017). In addition, HFO duration, number of peaks, and number of channels detected were significantly higher in patients with active epilepsy.</p><p><strong>Conclusions: </strong>Pediatric patients with active epilepsy and high frequency of seizure occurrence exhibited a higher scalp HFO detection rate. These results may help to establish HFO detectable by noninvasive scalp electroencephalography as a biomarker of active epilepsy in pediatric patients.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"28-35"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lateralized Rhythmic Delta Activity and Lateralized Periodic Discharges in Critically Ill Pediatric Patients. 重症儿科患者的侧向节律德尔塔活动和侧向周期性放电
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2024-01-09 DOI: 10.1097/WNP.0000000000001064
Siddharth Gupta, Eva K Ritzl, Khalil S Husari
{"title":"Lateralized Rhythmic Delta Activity and Lateralized Periodic Discharges in Critically Ill Pediatric Patients.","authors":"Siddharth Gupta, Eva K Ritzl, Khalil S Husari","doi":"10.1097/WNP.0000000000001064","DOIUrl":"10.1097/WNP.0000000000001064","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and electrographic characteristics of critically ill pediatric patients with lateralized rhythmic delta activity (LRDA) and compare them with patients with lateralized periodic discharges (LPDs).</p><p><strong>Methods: </strong>This was a retrospective study examining consecutive critically ill pediatric patients (1 month-18 years) with LRDA or LPDs monitored on continuous electroencephalography. Clinical, radiologic, and electrographic characteristics; disease severity; and acute sequelae were compared between the two groups.</p><p><strong>Results: </strong>Of 668 pediatric patients monitored on continuous electroencephalography during the study period, 12 (1.79%) patients had LRDA and 15 (2.24%) had LPDs. The underlying etiologies were heterogeneous with no difference in the acuity of brain MRI changes between both groups. Lateralized rhythmic delta activity and LPDs were concordant with the side of MRI abnormality in most patients [85.7% (LRDA) and 83.3% (LPD)]. There was no difference in the measures of disease severity between both groups. Seizures were frequent in both groups (42% in the LRDA group and 73% in the LPD group). Patients in the LPD group had a trend toward requiring a greater number of antiseizure medications for seizure control (median of 4 vs. 2 in the LRDA group, p = 0.09), particularly those patients with LPDs qualifying as ictal-interictal continuum compared with those without ictal-interictal continuum ( p = 0.02).</p><p><strong>Conclusions: </strong>Lateralized rhythmic delta activity and LPDs are uncommon EEG findings in the pediatric population. Seizures occur commonly in patients with these patterns. Seizures in patients with LPDs, especially those qualifying as ictal-interictal continuum, showed a trend toward being more refractory. Larger studies are needed in the future to further evaluate these findings.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"44-50"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Comparison of Automatically Extracted Quantitative EEG Features for Seizure Risk Stratification in Neonatal Encephalopathy. 自动提取定量脑电图特征用于新生儿脑病发作风险分层的比较。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2024-06-10 DOI: 10.1097/WNP.0000000000001067
Jennifer C Keene, Maren E Loe, Talie Fulton, Maire Keene, Michael J Morrissey, Stuart R Tomko, Zachary A Vesoulis, John M Zempel, ShiNung Ching, Réjean M Guerriero
{"title":"A Comparison of Automatically Extracted Quantitative EEG Features for Seizure Risk Stratification in Neonatal Encephalopathy.","authors":"Jennifer C Keene, Maren E Loe, Talie Fulton, Maire Keene, Michael J Morrissey, Stuart R Tomko, Zachary A Vesoulis, John M Zempel, ShiNung Ching, Réjean M Guerriero","doi":"10.1097/WNP.0000000000001067","DOIUrl":"10.1097/WNP.0000000000001067","url":null,"abstract":"<p><strong>Purpose: </strong>Seizures occur in up to 40% of neonates with neonatal encephalopathy. Earlier identification of seizures leads to more successful seizure treatment, but is often delayed because of limited availability of continuous EEG monitoring. Clinical variables poorly stratify seizure risk, and EEG use to stratify seizure risk has previously been limited by need for manual review and artifact exclusion. The goal of this study is to compare the utility of automatically extracted quantitative EEG (qEEG) features for seizure risk stratification.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of neonates with moderate-to-severe neonatal encephalopathy who underwent therapeutic hypothermia at a single center. The first 24 hours of EEG underwent automated artifact removal and qEEG analysis, comparing qEEG features for seizure risk stratification.</p><p><strong>Results: </strong>The study included 150 neonates and compared the 36 (23%) with seizures with those without. Absolute spectral power best stratified seizure risk with area under the curve ranging from 63% to 71%, followed by range EEG lower and upper margin, median and SD of the range EEG lower margin. No features were significantly more predictive in the hour before seizure onset. Clinical examination was not associated with seizure risk.</p><p><strong>Conclusions: </strong>Automatically extracted qEEG features were more predictive than clinical examination in stratifying neonatal seizure risk during therapeutic hypothermia. qEEG represents a potential practical bedside tool to individualize intensity and duration of EEG monitoring and decrease time to seizure recognition. Future work is needed to refine and combine qEEG features to improve risk stratification.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"57-63"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300781","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}
引用次数: 0
The Electrographic Effects of Ketamine on Patients With Refractory Status Epilepticus After Cardiac Arrest: A Single-Center Retrospective Cohort. 氯胺酮对心脏骤停后难治性癫痫状态患者的电图效应:单中心回顾性队列。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2024-01-09 DOI: 10.1097/WNP.0000000000001065
Kurt Qing, Ayham Alkhachroum, Jan Claassen, Peter Forgacs, Nicholas Schiff
{"title":"The Electrographic Effects of Ketamine on Patients With Refractory Status Epilepticus After Cardiac Arrest: A Single-Center Retrospective Cohort.","authors":"Kurt Qing, Ayham Alkhachroum, Jan Claassen, Peter Forgacs, Nicholas Schiff","doi":"10.1097/WNP.0000000000001065","DOIUrl":"10.1097/WNP.0000000000001065","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of ketamine on patients with refractory status epilepticus after cardiac arrest.</p><p><strong>Methods: </strong>In this retrospective cohort, selected EEG segments from patients after cardiac arrest were classified into different EEG patterns (based on background continuity and burden of epileptiform discharges) and spectral profiles (based on the presence of frequency components). For patients who received ketamine, EEG data were compared before, during, and after ketamine infusion; for the no-ketamine group, EEG data were compared at three separated time points during recording. Ketamine usage was determined by clinical providers. Electrographic improvement in epileptiform activity was scored, and the odds ratio was calculated using the Fisher exact test. Functional outcome measures at time of discharge were also examined.</p><p><strong>Results: </strong>Of a total of 38 patients with postcardiac arrest refractory status epilepticus, 13 received ketamine and 25 did not. All patients were on ≥2 antiseizure medications including at least one sedative infusion (midazolam). For the ketamine group, eight patients had electrographic improvement, compared with only two patients in the no-ketamine group, with an odds ratio of 7.19 (95% confidence interval 1.16-44.65, P value of 0.0341) for ketamine versus no ketamine. Most of the patients who received ketamine had myoclonic status epilepticus, and overall neurologic outcomes were poor with no patients having a favorable outcome.</p><p><strong>Conclusions: </strong>For postarrest refractory status epilepticus, ketamine use was associated with electrographic improvement, but with the available data, it is unclear whether ketamine use or EEG improvement can be linked to better functional recovery.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"36-43"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403034","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}
引用次数: 0
Electrocorticographic Patterns in Frontal Epilepsy and Long-Term Outcomes: Retraction. 额叶癫痫的皮层电图模式与长期疗效撤回。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2024-08-28 DOI: 10.1097/WNP.0000000000001115
{"title":"Electrocorticographic Patterns in Frontal Epilepsy and Long-Term Outcomes: Retraction.","authors":"","doi":"10.1097/WNP.0000000000001115","DOIUrl":"10.1097/WNP.0000000000001115","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"94"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcranial Magnetic Stimulation in the Diagnosis of Compressive Myelopathy at the Thoracolumbar Junction. 经颅磁刺激在胸腰椎交界处压迫性脊髓病诊断中的应用。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2024-01-09 DOI: 10.1097/WNP.0000000000001063
Kazuhiro Fujimoto, Masahiro Funaba, Hidenori Suzuki, Norihiro Nishida, Hiroaki Ikeda, Yusuke Ichihara, Yasuaki Imajo, Takashi Sakai
{"title":"Transcranial Magnetic Stimulation in the Diagnosis of Compressive Myelopathy at the Thoracolumbar Junction.","authors":"Kazuhiro Fujimoto, Masahiro Funaba, Hidenori Suzuki, Norihiro Nishida, Hiroaki Ikeda, Yusuke Ichihara, Yasuaki Imajo, Takashi Sakai","doi":"10.1097/WNP.0000000000001063","DOIUrl":"10.1097/WNP.0000000000001063","url":null,"abstract":"<p><strong>Purpose: </strong>The disc level in the thoracolumbar junction at which measurement of the central motor conduction time in the lower limbs (CMCT-LL) is useful for a diagnosis remains unclear. Therefore, this study investigated the spinal vertebral level at which compressive myelopathy due to ossification of the ligamentum flavum in the thoracolumbar junction is detectable using CMCT-LL.</p><p><strong>Methods: </strong>We preoperatively measured CMCT-LL in 57 patients (42 men, 15 women; aged 35-85 years) with a single ossification of the ligamentum flavum from the T10-11 to T12-L1 disc levels and in 53 healthy controls. Motor evoked potentials after transcranial magnetic stimulation, compound muscle action potentials, and F waves were recorded from the abductor hallucis. Central motor conduction time in the lower limbs was calculated as follows: Motor evoked potential latency - (compound muscle action potential latency + F latency - 1)/2 (ms). Central motor conduction time in the lower limbs was compared between patients and controls.</p><p><strong>Results: </strong>Compressive lesions were located at the T10 to 11 level in 27 patients, the T11 to 12 level in 28, and the T12-L1 level in 2. Central motor conduction time values in the lower limbs at the T10 to 11 level (19.9 ± 4.7 ms) and T11 to 12 level (18.1 ± 3.4 ms) were significantly longer than control values (11.8 ± 1.1 ms; P < 0.01). Central motor conduction time in the lower limbs was not calculated at the T12-L1 level because motor evoked potentials were not recorded in any patient.</p><p><strong>Conclusions: </strong>We confirmed that CMCT-LL was significantly longer in patients with ossification of the ligamentum flavum at the T10 to 11 and T11 to 12 levels because the S2 segment of the spinal cord is caudal at the T12 vertebral body level. Therefore, CMCT-LL is useful for diagnosing thoracolumbar junction disorders proximal to the T12 vertebral body level.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"51-56"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The American Clinical Neurophysiology Society Guideline on Indications for Continuous Electroencephalography Monitoring in Neonates. 美国临床神经生理学会关于新生儿连续脑电图监测适应症的指南。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI: 10.1097/WNP.0000000000001120
Courtney J Wusthoff, Adam L Numis, Ronit M Pressler, Catherine J Chu, Shavonne Massey, Robert R Clancy, Sylvie Nguyen, Cecil D Hahn, Mark S Scher, Betsy Pilon, Donald T King, Hong-Nei Wong, Tammy N Tsuchida, James J Riviello, Renée A Shellhaas
{"title":"The American Clinical Neurophysiology Society Guideline on Indications for Continuous Electroencephalography Monitoring in Neonates.","authors":"Courtney J Wusthoff, Adam L Numis, Ronit M Pressler, Catherine J Chu, Shavonne Massey, Robert R Clancy, Sylvie Nguyen, Cecil D Hahn, Mark S Scher, Betsy Pilon, Donald T King, Hong-Nei Wong, Tammy N Tsuchida, James J Riviello, Renée A Shellhaas","doi":"10.1097/WNP.0000000000001120","DOIUrl":"10.1097/WNP.0000000000001120","url":null,"abstract":"<p><strong>Purpose: </strong>Continuous EEG (cEEG) monitoring is increasingly used in the management of neonates with seizures. There remains debate on what clinically relevant information can be gained from cEEG in neonates with suspected seizures, at high risk for seizures, or with definite seizures, as well as the use of cEEG for prognosis in a variety of conditions. In this guideline, we address these questions using American Clinical Neurophysiology Society structured methodology for clinical guideline development.</p><p><strong>Methods: </strong>A working group was formed from American Clinical Neurophysiology Society membership with expertise in neonatal cEEG and a set of priority questions developed. We performed literature searches in PubMed and EMBASE to identify relevant studies. Evidence tables were compiled from extracted data and quality assessments performed. A modification of the GRADE process was used to evaluate the body of evidence and draft recommendations.</p><p><strong>Results: </strong>Our working group identified six priority questions to evaluate the accuracy of cEEG for neonatal seizure diagnosis and the formulation of prognosis. An initial literature search yielded 18,167 results, which were distilled to a set of 217 articles. Overall, the quality of evidence for most priority questions was rated as very low and we provided conditional recommendations based on published literature and expert consensus. For each priority question, we also considered the benefits and harms of cEEG, with relative harms considered to be far less than the potential benefits across recommendations.</p><p><strong>Conclusions: </strong>We present evidence-based clinical guidelines regarding indications for cEEG monitoring in neonates. Considering resource utilization and feasibility, when cEEG monitoring results have a likelihood of altering clinical decision making, the authors felt the resource investment was justifiable.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":"42 1","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlation Between Quantitative Background Suppression on EEG and Serum NSE in Patients With Hypoxic-ischemic Encephalopathy. 缺氧缺血性脑病患者脑电图定量背景抑制与血清NSE的相关性。
IF 2.3 4区 医学
Journal of Clinical Neurophysiology Pub Date : 2025-01-01 Epub Date: 2023-09-25 DOI: 10.1097/WNP.0000000000001042
Dong Ah Lee, Gyeong Mo Sohn, Byung Joon Kim, Byung Chul Yoo, Jae Hyeok Lee, Hyun Ju Choi, Sung Eun Kim
{"title":"Correlation Between Quantitative Background Suppression on EEG and Serum NSE in Patients With Hypoxic-ischemic Encephalopathy.","authors":"Dong Ah Lee, Gyeong Mo Sohn, Byung Joon Kim, Byung Chul Yoo, Jae Hyeok Lee, Hyun Ju Choi, Sung Eun Kim","doi":"10.1097/WNP.0000000000001042","DOIUrl":"10.1097/WNP.0000000000001042","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the correlation between quantitative background activities on electroencephalography (EEG) and serum neuron specific enolase (NSE) in patients with hypoxic-ischemic encephalopathy as well as a diagnostic value of prognostication.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled patients with return of spontaneous circulation after cardiac arrest from March 2010 to March 2020. The inclusion criteria were (1) older than the age of 16 years and (2) patients who had both EEG and NSE. The median time for EEG and NSE were 3 days (interquartile range 2-5 days) and 3 days (interquartile range 2-4 days), respectively. The quantification of background activity was conducted with the suppression ratio (SR). We used a machine learning (eXtreme Gradient Boosting algorithm) to evaluate whether the SR could improve the accuracy of prognostication.</p><p><strong>Results: </strong>We enrolled 151 patients. The receiver operating characteristic analysis revealed a cut-off value of serum NSE and the SR for poor outcome, serum NSE (>31.9 μg/L, area under curve [AUC] = 0.88), and the SR (>21.5%, AUC = 0.75 in the right hemisphere, >34.4%, AUC = 0.76 in the left hemisphere). There was a significant positive correlation between the severity of SR and the level of NSE ( ρ = 0.57, p < 0.0001 for the right hemisphere, ρ = 0.58, p < 0.0001 for the left hemisphere). The SR showed an excellent diagnostic value for predicting poor outcome (93% specificity, 60% sensitivity in the right hemisphere and 93% specificity, 58% sensitivity in the left hemisphere). With machine learning analysis, there was an increment in distinguishing the neurological outcome by adding SR on clinical factors.</p><p><strong>Conclusions: </strong>The SR showed a positive correlation with the level of serum NSE. The diagnostic value of the SR for predicting poor outcome was excellent, suggesting that it can be a possible biomarker for neuroprognostication in patients with hypoxic-ischemic encephalopathy.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"12-19"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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