Neurophysiologie Clinique/Clinical Neurophysiology最新文献

{"title":"Clarifying the diagnostic utility of decrement patterns in MuSK- and AChR-positive myasthenia gravis","authors":"Parth Aphale, Himanshu Shekhar, Shashank Dokania","doi":"10.1016/j.neucli.2025.103113","DOIUrl":"10.1016/j.neucli.2025.103113","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103113"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of electrodiagnostic parameters for assessing initial severity in Bell’s Palsy: A retrospective study of 3219 patients","authors":"Ah-hyeon Kim ,&nbsp;Ga Yang Shim ,&nbsp;Yunsoo Soh ,&nbsp;Myung Chul Yoo","doi":"10.1016/j.neucli.2025.103120","DOIUrl":"10.1016/j.neucli.2025.103120","url":null,"abstract":"<div><h3>Introduction</h3><div>The House-Brackmann grading system exhibits inherent subjectivity despite widespread clinical adoption. Although electrophysiological assessments provide objective neurophysiological data, their correlation with initial clinical severity remains inadequately characterized in large-scale cohorts with standardized methodologies. This study aimed to evaluate the diagnostic utility of electrodiagnostic parameters in determining initial severity among Bell's palsy patients.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 3219 patients with unilateral Bell's palsy who underwent electrodiagnostic testing within 14 days of symptom onset. Patients were stratified using House-Brackmann (H-B) grades into mild (2–3) and moderate-to-severe (4–6) groups. Five electrophysiological parameters were evaluated: electroneurography degeneration index (ENoG DI), motor unit action potential (MUAP) interference patterns, compound muscle action potential latency, blink reflex, and abnormal spontaneous activity. Associations were analyzed using logistic regression and ROC analyses.</div></div><div><h3>Results</h3><div>ENoG DI and MUAP interference patterns in orbicularis oculi showed strongest association with initial H-B grade (area under curve = 0.75). Patients with moderate-to-severe paralysis (H-B grades 4–6) had significantly higher prevalence of severe axonal degeneration (ENoG DI ≥ 90 %) compared to mild paralysis (34.9 % vs. 8.3 %, <em>p</em> &lt; 0.0001). MUAP interference grades ≤3 were strongly associated with increased severity.</div></div><div><h3>Conclusion</h3><div>ENoG DI and MUAP interference patterns serve as reliable early electrophysiological indicators of facial paralysis severity, providing objective markers for patient stratification. These findings establish standardized electrodiagnostic criteria for severity assessment, enabling evidence-based early rehabilitation decisions in Bell's palsy management.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103120"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459297","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":"Decrement patterns analysis in neuromuscular junction disorders facilitates the early recognition of MuSK-myasthenia gravis","authors":"Antoine Pegat ,&nbsp;Antoine Gavoille ,&nbsp;Nicolas Rodriguez ,&nbsp;Florent Cluse ,&nbsp;Martin Moussy ,&nbsp;Etienne Fortanier ,&nbsp;Françoise Bouhour","doi":"10.1016/j.neucli.2025.103117","DOIUrl":"10.1016/j.neucli.2025.103117","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103117"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362034","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":"Reconsidering the electrophysiological signature of myasthenia gravis","authors":"Yann Péréon","doi":"10.1016/j.neucli.2025.103118","DOIUrl":"10.1016/j.neucli.2025.103118","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103118"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401328","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":"Central eye movement abnormalities in patients with SMA types II and III","authors":"Bade Güleç ,&nbsp;Melda Acar ,&nbsp;Yeşim Oruç ,&nbsp;Ceren Aliş ,&nbsp;Melih Tütüncü ,&nbsp;Ayşegül Gündüz ,&nbsp;Eyyüp Kara ,&nbsp;Rişvan Deniz ,&nbsp;Ahmet Özdoğan ,&nbsp;Feray Karaali Savrun ,&nbsp;Nurten Uzun Adatepe ,&nbsp;Ahmet Ataş","doi":"10.1016/j.neucli.2025.103112","DOIUrl":"10.1016/j.neucli.2025.103112","url":null,"abstract":"<div><h3>Aims</h3><div>Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder characterized by progressive motor neuron degeneration, leading to symmetrical proximal weakness, bulbar dysfunction, and respiratory involvement. Although extraocular muscles (EOMs) are typically spared, there are conflicting reports regarding oculomotor abnormalities in SMA. This study aimed comprehensively to assess eye movement function in patients with SMA types II and III using videonystagmography (VNG).</div></div><div><h3>Methods</h3><div>We included 18 SMA patients and 21 healthy subjects of similar ages and sexes. All participants underwent an otoscopic/audiological examination before the VNG recording. In VNG testing, we analyzed and compared optokinetic nystagmus (OKN), saccade parameters, and smooth pursuit movement (SPM) gain.</div></div><div><h3>Results</h3><div>There were no statistical differences between the OKN gain and saccade velocity between groups. There was a lower percentage of saccade accuracy in the SMA group than in the control group (<em>p</em> = 0.017). SPM gain was lower in the SMA group than in the control group (<em>p</em> &lt; 0.0001). The correlation analyses revealed a positive correlation between age and saccade latency (<em>r</em> = 0.613, <em>p</em> &lt; 0.0001) and a negative correlation between age and SPM gain (<em>r</em> = -0.487, <em>p</em> = 0.003).</div></div><div><h3>Discussion</h3><div>In this study, we performed a comprehensive evaluation of eye movement function with VNG in patients with SMA. Our findings indicate that while extraocular muscles remain unaffected in SMA, subtle central oculomotor control abnormalities—likely involving supranuclear and/or cerebellar pathways—may accompany the disease and can be quantitatively detected using VNG.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103112"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302554","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 placebo effect of tDCS on motor performance: A call for domain-specific methodological considerations","authors":"Everton Borges da Silva ,&nbsp;Mércia Jaynne Leandro de Melo ,&nbsp;Matheus Alves Mendonça ,&nbsp;Daniel de Medeiros Leiros ,&nbsp;Ehsan Amiri ,&nbsp;Daniel Gomes da Silva Machado","doi":"10.1016/j.neucli.2025.103108","DOIUrl":"10.1016/j.neucli.2025.103108","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103108"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154441","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 novel technique to differentiate positional loss of motor function of the spinal cord from failure to obtain baseline transcranial motor evoked potential (TcMEP) in patients with pre-operative motor deficit","authors":"Uditi Gupta ,&nbsp;Heena Parihar ,&nbsp;Ashok Kumar Jaryal ,&nbsp;Megha Bir ,&nbsp;Bhavuk Garg ,&nbsp;Parin Lalwani","doi":"10.1016/j.neucli.2025.103107","DOIUrl":"10.1016/j.neucli.2025.103107","url":null,"abstract":"","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103107"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213313","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":"Investigation of predictors of pain relief with high-frequency repetitive motor cortex transcranial magnetic stimulation among people with fibromyalgia","authors":"Catarina Couras Lins ,&nbsp;Alessandra S. Fonseca ,&nbsp;Pedro Nascimento Martins ,&nbsp;Julio Cesar Barbour Oliveira ,&nbsp;Ana Mércia Fernandes ,&nbsp;Abrahão Fontes Baptista ,&nbsp;Gabriel T. Kubota ,&nbsp;Valquíria Aparecida da Silva ,&nbsp;Manoel Jacobsen Teixeira ,&nbsp;Daniel Ciampi de Andrade","doi":"10.1016/j.neucli.2025.103109","DOIUrl":"10.1016/j.neucli.2025.103109","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify baseline predictors of clinical response to the primary motor cortex high-frequency repetitive transcranial magnetic stimulation (M1 HF-rTMS) in patients with fibromyalgia.</div></div><div><h3>Materials and methods</h3><div>We performed a secondary analysis of 32 women with fibromyalgia from a randomized, double-blind, sham-controlled international multicenter trial registered at clinicaltrials.gov (NCT03658694). Enrolled participants received active or HF-rTMS-over the primary motor cortex (M1). Baseline demographic data, psychological assessments (Hospital Anxiety and Depression Scale, Brief Pain Inventory, Fibromyalgia Impact Questionnaire, Toronto Alexithymia Scale, and Interoception Questionnaire), psychophysical measures (Conditioned Pain Modulation), and structural brain MRI variables were collected and analyzed. Responders were defined as patients who achieved <em>a</em> ≥ 50 % reduction in pain on a numerical rating scale eight weeks after treatment. Associations between baseline variables and response were analyzed using Wilcoxon Rank Sum tests, chi-square tests, and logistic regression where appropriate.</div></div><div><h3>Results</h3><div>At the end of the treatment period, 15 out of 32 participants (47 %) in the active M1 HF-rTMS group and 7 out of 30 (23 %) in the sham group achieved ≥50 % reduction in pain. None of the baseline demographic, clinical, psychological, psychophysical, or neuroimaging variables evaluated were significantly associated with clinical response to M1 HF-rTMS. Although M1 HF-rTMS induced significant antinociceptive effects measured by psychophysical assessments (heat pain threshold), these effects did not predict clinical outcomes.</div></div><div><h3>Conclusions</h3><div>No clear baseline predictors of response to M1 HF-rTMS were identified in patients with fibromyalgia, emphasizing the heterogeneity and complexity of the disorder. Further research incorporating larger samples and additional biomarkers is necessary to establish individualized prediction strategies for M1 HF-rTMS therapy in fibromyalgia.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103109"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219205","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":"Evaluating the efficacy of rTMS for the management of pain and psychological aspects in non-central nervous system cancer patients: a systematic review","authors":"Jenny Luisi ,&nbsp;Benedetta Capetti ,&nbsp;Lorenzo Conti ,&nbsp;Roberto Grasso ,&nbsp;Gabriella Pravettoni","doi":"10.1016/j.neucli.2025.103110","DOIUrl":"10.1016/j.neucli.2025.103110","url":null,"abstract":"<div><h3>Objectives</h3><div>Non-invasive brain stimulation techniques—particularly repetitive transcranial magnetic stimulation (rTMS) have emerged as promising alternatives to traditional pharmacological treatments for pain management in non-central nervous system cancer patients. By modulating neural circuits involved in pain processing through mechanisms of neuroplasticity, these interventions may also improve cognitive functioning, psychological aspects, and quality of life (QoL). The present systematic review aims to investigate the use of rTMS for cancer-related pain and psychological aspects.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in three electronic scientific databases-PubMed, Scopus, and Embase. Six studies were identified and included, comprising pilot studies, randomized controlled trials, and one randomized clinical trial. PRISMA 2020 guidelines for systematic review were followed.</div></div><div><h3>Results</h3><div>All these studies investigated the use of rTMS to manage pain and psychological aspects such as QoL in patients with different types of oncological conditions, including breast, non-small cell lung, and gynecological cancer, multiple myeloma, and cell glioma. The results suggest a multidimensional improvement in QoL, well-being, and emotional dimension. Notably, a significant reduction in pain intensity was observed following rTMS treatment across all studies.</div></div><div><h3>Conclusion</h3><div>Although limited in number, current studies suggest that rTMS is a promising non-pharmacological intervention for managing cancer-related pain and enhancing psychological well-being. Further high-quality trials are needed to confirm these findings and establish standardized treatment protocols.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103110"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of sural and distal sural nerve responses: Diagnostic role of the amplitude ratio in diabetic polyneuropathy","authors":"Canan Duman İlki ,&nbsp;Ege Çadırcı ,&nbsp;Zerin Özaydın Aksun ,&nbsp;Esra Eraslan Aydemir ,&nbsp;Asena Gökçay Canpolat ,&nbsp;Hüseyin Özden Şener","doi":"10.1016/j.neucli.2025.103114","DOIUrl":"10.1016/j.neucli.2025.103114","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the diagnostic utility of distal sural (DSUR) sensory responses and amplitude ratios compared with conventional proximal sural (PSUR) studies in diabetic polyneuropathy (DPN).</div></div><div><h3>Methods</h3><div>Fifty-eight patients with diabetes and clinical evidence of polyneuropathy (neuropathic symptoms and/or signs, median Neuropathy Impairment Score of the Lower Limbs (NIS-LL) score 6 [IQR 2–8]) and 44 healthy controls underwent bilateral nerve conduction studies of the PSUR and DSUR, and the right radial nerve. Amplitudes, conduction velocities (CV), and amplitude ratios [sural-to-radial amplitude ratio (SRAR), distal sural-to-radial amplitude ratio (DSRAR), and proximal-to-distal sural amplitude ratio (PDSR)] were analysed.</div></div><div><h3>Results</h3><div>PSUR and DSUR amplitudes were significantly lower and conduction velocities slower in patients compared with controls (<em>p</em> &lt; 0.001). DSUR amplitude achieved diagnostic accuracy comparable to PSUR amplitude (AUC 0.762 vs. 0.775), with higher sensitivity (58.5% vs. 41.5 %) and preserved specificity (91 % vs. 93%). SRAR and DSRAR were reduced in patients, but their diagnostic performance was modest (AUC &lt; 0.65). PDSR did not differ significantly between groups (<em>p</em> &gt; 0.05) and was therefore not included in ROC analysis. Amplitude ratios showed weak correlations with diabetes duration, vibration threshold, and NIS-LL.</div></div><div><h3>Conclusion</h3><div>DSUR amplitude is a feasible and reliable parameter that increases sensitivity in the electrophysiological detection of DPN while maintaining high specificity. In contrast, PDSR did not provide significant diagnostic value, suggesting that absolute amplitude measures are more informative than ratio-based indices in routine clinical practice.</div></div>","PeriodicalId":19134,"journal":{"name":"Neurophysiologie Clinique/Clinical Neurophysiology","volume":"55 6","pages":"Article 103114"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258583","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}