Clinical Neurophysiology Practice最新文献

{"title":"Stimulation selectivity in transcranial motor evoked potentials for monitoring during surgery for supratentorial lesions","authors":"Tammam Abboud ,&nbsp;Jan-Bernd Wemhoff ,&nbsp;Fares Komboz ,&nbsp;Angelina Nazarenus ,&nbsp;Tatiana Chacon ,&nbsp;Dorothee Mielke ,&nbsp;Veit Rohde","doi":"10.1016/j.cnp.2026.01.006","DOIUrl":"10.1016/j.cnp.2026.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the most selective electrode configuration for monitoring of transcranial motor evoked potentials (TcMEP) during supratentorial tumor surgery and determine the stimulation threshold at which bilateral corticospinal tract (CST) activation occurs at deeper white matter levels.</div></div><div><h3>Methods</h3><div>Fifty-six patients undergoing resection of supratentorial tumors without preoperative motor deficits were prospectively included. TcMEPs were elicited under general anesthesia using three electrode configurations: C1 ↔ C2, C3 ↔ C4, and C3/4 → Cz. Motor thresholds (MT) were recorded bilaterally from the abductor pollicis brevis (APB), and the selectivity ratio (ipsilateral/contralateral MT) was calculated. Electrode combinations were compared using paired t-tests. Linear regression assessed the influence of age, sex, height, and weight.</div></div><div><h3>Results</h3><div>The C3/4 → Cz montage demonstrated the highest selectivity ratio (median 248%, range: 140–364%), significantly greater than C1 ↔ C2 and C3 ↔ C4 (p &lt; 0.001). Bilateral CST activation with C3/4 → Cz began at 140% of the contralateral MT. Age correlated with lower MTs; sex, height, and weight had no significant effect.</div></div><div><h3>Conclusions</h3><div>C3/4 → Cz is the most selective configuration for eliciting contralateral TcMEP and requires higher stimulation intensity before activating bilateral CST fibers at deeper levels.</div></div><div><h3>Significance</h3><div>This study supports using C3/4 → Cz to optimize TcMEP selectivity and reduce the risk of false-negative monitoring due to deep white matter stimulation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 86-92"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A movie in the operating theater: Guided story narration as a pragmatic language screening tool during awake craniotomy","authors":"Nishanth Sampath ,&nbsp;Sunil Kapilavayi Raghavendra ,&nbsp;Vishwaraj Ratha ,&nbsp;Gomathi Sivakumar ,&nbsp;Vijay Sankaran ,&nbsp;Suresh Bapu K.R.","doi":"10.1016/j.cnp.2026.01.002","DOIUrl":"10.1016/j.cnp.2026.01.002","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 36-37"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating paediatric normative values for nerve studies using clustering techniques","authors":"G.K. Cooray ,&nbsp;D. Motan ,&nbsp;K. Howse ,&nbsp;L. Nastasi ,&nbsp;J. Deeb","doi":"10.1016/j.cnp.2026.02.006","DOIUrl":"10.1016/j.cnp.2026.02.006","url":null,"abstract":"<div><h3>Objective:</h3><div>To estimate normative values from mixed clinical paediatric electroneurography data using an unsupervised clustering approach.</div></div><div><h3>Methods:</h3><div>Electroneurography studies from paediatric patients (2009–2024) were analysed for common motor and sensory nerves. Motor parameters included distal motor latency, CMAP amplitude, duration, area, and conduction velocity; sensory parameters included SNAP amplitude and conduction velocity. Data were grouped into age windows, and within each, t-distributed stochastic neighbour embedding (t-SNE) was applied to identify the normative distribution. The mean, 5th, and 95th centiles were derived and modelled using exponential fits.</div></div><div><h3>Results:</h3><div>Normative values were estimated for ages 0–18 years. Motor amplitudes increased with age, and conduction velocities rose rapidly until 3–4 years before plateauing. Distal motor latency showed a brief early dip followed by an increase. Sensory amplitudes peaked between 1 and 8 years, while sensory conduction velocities increased sharply in the first year, then gradually declined.</div></div><div><h3>Conclusion:</h3><div>Unsupervised clustering can derive normative paediatric electroneurography values from heterogeneous clinical data, yielding trends consistent with published references.</div></div><div><h3>Significance:</h3><div>This data-driven approach is practical, generalisable, and enables identification of likely healthy individuals using multivariate electrophysiological parameters.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 187-194"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor re: “Stimulation selectivity in transcranial motor evoked potentials for monitoring during surgery for supratentorial lesions”","authors":"Justin W. Silverstein ,&nbsp;Otakhon Matchanov ,&nbsp;Jung Park ,&nbsp;Daniel G. Eichberg ,&nbsp;Jason A. Ellis ,&nbsp;Randy S. D’Amico","doi":"10.1016/j.cnp.2026.03.004","DOIUrl":"10.1016/j.cnp.2026.03.004","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 216-217"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147537693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency-dependent effects of primary hand motor cortex stimulation on volitional finger movement","authors":"Léon Taquet ,&nbsp;Brian J. Conway ,&nbsp;Timothy F. Boerger ,&nbsp;Kaitlin Goetschel ,&nbsp;Sarah C. Young ,&nbsp;Nada E. Botros ,&nbsp;Manoj Raghavan ,&nbsp;Brian D. Schmit ,&nbsp;Max O. Krucoff","doi":"10.1016/j.cnp.2026.03.001","DOIUrl":"10.1016/j.cnp.2026.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>We conducted a prospective study in human patients undergoing awake craniotomies to examine whether the effects of cortical stimulation in hand primary motor cortex (M1) can be (1) frequency dependent and (2) inhibitory.</div></div><div><h3>Methods</h3><div>In 11 participants undergoing clinically indicated awake craniotomies, we delivered bursts of 1–333 Hz stimulation during a finger-flexion task. Synchronized electrocorticography (ECoG), finger joint kinematics, electromyography (EMG), and video were recorded.</div></div><div><h3>Results</h3><div>Inability to flex the index finger during subthreshold stimulation was noted in 3 participants at frequencies &gt;250 Hz when the electrodes were in locations that induced extension of the forefinger at higher amplitudes. Other than these trials, all stimulation events either induced muscle contractions or had no measurable effect.</div></div><div><h3>Conclusion</h3><div>Data presented here represent the first evidence of (1) movement inhibition of the human hand caused by electrical stimulation of M1, as well as (2) the frequency-dependence of net downstream effects of hand M1 stimulation during task. Our findings support the hypothesis that the mechanism of movement inhibition may be activation of indirect, net-inhibitory mechanisms, as opposed to direct inhibition of the stimulated motor neurons.</div></div><div><h3>Significance</h3><div>There is growing interest in using continuous electrical stimulation of the brain to remap anatomical-functional relationships away from invasive lesions. Achieving this type of neuroplasticity requires a better understanding of the direct and indirect effects of cortical stimulation. Here we demonstrate the frequency-dependent effects of cortical M1 stimulation on volitional finger movement.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 252-261"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-montage visualization of interictal epileptic events in high-density intraoperative electrocorticography","authors":"Jiaojiao Guo ,&nbsp;Ziyi Wang ,&nbsp;Nicole van Klink ,&nbsp;Eline Schaft ,&nbsp;Dongqing Sun ,&nbsp;Sandra van der Salm ,&nbsp;Maryse van ’t Klooster ,&nbsp;Maeike Zijlmans","doi":"10.1016/j.cnp.2025.12.006","DOIUrl":"10.1016/j.cnp.2025.12.006","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 13-15"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra long-term EEG monitoring for developmental and epileptic encephalopathies: protocol for a prospective study using subscalp EEG","authors":"Leonardo Affronte ,&nbsp;Stefania Maffei ,&nbsp;Mara Malerba ,&nbsp;Giada Giovannini ,&nbsp;Paolo Manganotti ,&nbsp;Antonietta Coppola ,&nbsp;Leonilda Bilo ,&nbsp;Anna Elisabetta Vaudano ,&nbsp;Marina Trivisano ,&nbsp;Nicola Specchio ,&nbsp;Stefano Meletti","doi":"10.1016/j.cnp.2025.12.005","DOIUrl":"10.1016/j.cnp.2025.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>Poor documentation of seizures can be a major challenge in epilepsy. Objective seizure counting with mobile devices might improve this challenge and the patient management. We investigate whether ultra long-term subcutaneous EEG improves seizure documentation and disease monitoring in adults and adolescents with developmental and epileptic encephalopathies (DEEs).</div></div><div><h3>Methods</h3><div>Ultra long-term subcutaneous EEG Monitoring In Rare Epilepsies and DEE (EMIRE) is a multi-centre prospective interventional study with an expected duration of 6 months. 33 Adolescents and adult participants will be implanted with 24/7 EEG SubQ and collect 2-channel EEG data up to 6 months. Data will be reviewed by experts on a weekly basis and a summary sent to the treating clinician.</div></div><div><h3>Results</h3><div>(1) safety and tolerability of subcutaneous EEG in this special patient population; (2) seizure detection sensitivity and specificity with respect to patients’ seizure-diaries and ‘ground truth’; (3) whether and how home monitoring can affect the clinical management of the patients.</div></div><div><h3>Conclusions</h3><div>This project will investigate home and remote patient monitoring systems, offering an accuracy that is unthinkable today.</div></div><div><h3>Significance</h3><div>This trial of home monitoring is intended to be of clinical utility to the patient by allowing objective assessment of therapeutic interventions and their effectiveness.</div><div>Plain language summary.</div><div>We present a clinical trial protocol for a prospective cohort study in people with severe epilepsies across Italy. The study aims to assess whether an EEG implant placed under the skin (1) is more accurate than patient-reported seizure diary, (2) is feasible and acceptable to patients and clinicians, (3) affect the clinical management of the patients, (4) reduces the impact of epilepsy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 16-23"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACF-SAP: A machine learning framework for predicting obstructive sleep apnea severity using anthropometric and clinical features","authors":"Abduladhim Ashtaiwi ,&nbsp;Mohamed Eltwayeb","doi":"10.1016/j.cnp.2025.12.001","DOIUrl":"10.1016/j.cnp.2025.12.001","url":null,"abstract":"<div><h3>Objective:</h3><div>This study aims to develop and evaluate ACF-SAP, a machine learning (ML) framework for predicting obstructive sleep apnea (OSA) severity using non-invasive, routinely collected clinical features.</div></div><div><h3>Methods:</h3><div>The proposed approach leverages common anthropometric and clinical variables, including sex, body mass index (BMI), height, weight, neck circumference, and nocturia. The methodology integrates machine-learning–based feature selection to identify the most informative predictors, followed by unsupervised clustering to generate data-driven sleep severity labels. These labeled data are then used to train and evaluate the ACF-SAP framework.</div></div><div><h3>Results:</h3><div>ACF-SAP, implemented with ensemble classifiers, achieved a classification accuracy of 0.84, with strong F1-scores and balanced sensitivity across OSA severity levels.</div></div><div><h3>Conclusions:</h3><div>The ACF-SAP model supports early identification of patients at high risk for OSA and may serve as a first-line screening tool to prioritize referrals for polysomnography (PSG).</div></div><div><h3>Significance:</h3><div>This work presents a scalable, low-cost screening framework that can improve triage efficiency and facilitate timely diagnosis, particularly in resource-constrained healthcare environments.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 45-53"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lightweight deep convolutional neural network for detecting artifacts in continuous EEG signals","authors":"Evans Nyanney ,&nbsp;Parthasarathy D. Thirumala ,&nbsp;Shyam Visweswaran ,&nbsp;Zhaohui Geng","doi":"10.1016/j.cnp.2026.03.005","DOIUrl":"10.1016/j.cnp.2026.03.005","url":null,"abstract":"<div><h3>Objective:</h3><div>To Develop and validate artifact-specific lightweight convolutional neural networks (CNNs) for automated detection of eye movement, muscle-related, and non-physiological artifacts in clinical EEG, and determine the optimal temporal window for each class (category of artifact type).</div></div><div><h3>Methods:</h3><div>Three binary CNN detectors were trained on the Temple University Hospital EEG artifact corpus with patient-level 60/20/20 splits. Signals were standardized to 250 Hz and a 22-channel bipolar montage. Non-overlapping segments of 1–30 s were evaluated. Operating points were fixed by Youden’s <span><math><mi>J</mi></math></span> on validation and applied unchanged to the test set. Rule-based clinical comparators were implemented for each class.</div></div><div><h3>Results:</h3><div>CNNs outperformed rule-based baselines. Optimal windows differed by artifact type: 20 s for eye movements (ROC AUC 0.975; F1 0.905), 5 s for muscle (accuracy 93.2%, specificity 96.0%, F1 0.855), and 1 s for non-physiological artifacts (F1 0.774; specificity 98.2%).</div></div><div><h3>Conclusion:</h3><div>Lightweight artifact-specific CNNs with class-tailored windows provide reliable EEG artifact detection and exceed rule-based performance at fixed operating points.</div></div><div><h3>Significance:</h3><div>The work offers practical guidance on per-class windowing (20 s eye, 5 s muscle, 1 s non-physiological) and transparent threshold selection for clinically oriented EEG quality control.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 208-215"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translational prospectives for deep brain stimulation and low-intensity focused ultrasound neuromodulation: IFCN Handbook chapter","authors":"Wolf-Julian Neumann ,&nbsp;Ghazaleh Darmani","doi":"10.1016/j.cnp.2026.03.008","DOIUrl":"10.1016/j.cnp.2026.03.008","url":null,"abstract":"<div><div>The translation of experimental brain stimulation procedures to clinical practice remains a significant challenge. In the present book chapter we review emergent innovations that have recently surfaced or are imminent to make the leap, improving the treatment of patients with brain disorders. We focus on two domains of accelerated innovative potential in both invasive and non-invasive brain stimulation domains. First, current advances in deep brain stimulation (DBS) methodology are introduced. DBS is an established treatment for neurological disorders such as Parkinson’s disease, essential tremor and dystonia. Emerging technological advances focusing on when and how to stimulate allow for an extension and refinement of DBS promising scientific and clinical breakthroughs. We reflect on the unprecedented opportunities that MRI-based connectomics and neurophysiology based closed-loop DBS provide for patients with movement disorders, epilepsy and neuropsychiatric diseases. Next, we explore low-intensity focused transcranial ultrasound stimulation (TUS) as an emergent non-invasive neuromodulation technique. Unlike electrical or magnetic methods, TUS combines millimeter spatial precision with the ability to reach deep brain targets, making it the closest non-invasive analogue to DBS. We summarize its candidate mechanisms of action, highlight advances in transducer hardware and skull aberration-correction strategies, and review early clinical studies across movement disorders, epilepsy, pain, and psychiatric indications. Together, these developments illustrate how TUS is progressing from proof-of-concept experiments toward biomarker-guided therapeutic protocols. In conclusion, this chapter provides an outlook on the future of invasive and non-invasive techniques, emphasizing the need for continued research and innovation to overcome challenges in translating experimental successes into effective clinical therapies.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 294-307"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}