Clinical Neurophysiology Practice最新文献

{"title":"Eye-opening in brain death: A case report and review of the literature","authors":"Martina Focardi ,&nbsp;Barbara Gualco ,&nbsp;Maenia Scarpino ,&nbsp;Manuela Bonizzoli ,&nbsp;Beatrice Defraia ,&nbsp;Riccardo Carrai ,&nbsp;Giovanni Lanzo ,&nbsp;Silvia Raddi ,&nbsp;Ilenia Bianchi ,&nbsp;Antonello Grippo","doi":"10.1016/j.cnp.2022.03.006","DOIUrl":"10.1016/j.cnp.2022.03.006","url":null,"abstract":"<div><h3>Background</h3><p>According to Italian law, brain death is diagnosed when the patient is in a coma, showing the absence of respiratory drive under specific clinical conditions, and without any brain stem reflexes. On the other hand, presence of spinal reflexes, when correctly identified, does not hamper the diagnosis.</p></div><div><h3>Case report</h3><p>We present a case of eyelid elevation two seconds after thoracic pain stimulation in a patient who otherwise fulfilled all clinical and instrumental brain-death criteria due to a residual preserved function of the superior cervical ganglion.</p></div><div><h3>Conclusion</h3><p>Although the observed reflex is to be considered extracerebral, and therefore it should not hamper the diagnosis of BD, the authors propose implementing cerebral flow evaluation, considered “prudential”, as a preliminary assessment before determining BD.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 139-142"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X22000191/pdfft?md5=0c5d0b2a34c43a369e58b0bc15fcbee5&pid=1-s2.0-S2467981X22000191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48300984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sural-sparing pattern: A study against electrodiagnostic subtypes of Guillain–Barre syndrome","authors":"Nath Pasutharnchat ,&nbsp;Varis Ratanasirisawad ,&nbsp;Manasawan Santananukarn ,&nbsp;Chamaiporn Taychargumpoo ,&nbsp;Jakkrit Amornvit ,&nbsp;Chaipat Chunharas","doi":"10.1016/j.cnp.2022.09.001","DOIUrl":"10.1016/j.cnp.2022.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>To study sural-sparing pattern in Guillain<strong>–</strong>Barre syndrome (GBS) and compare it among GBS’s electrodiagnostic subtypes, classified by two recent criteria.</p></div><div><h3>Methods</h3><p>This study retrospectively reviewed clinical data and electrodiagnostic studies (EDXs) of 88 GBS patients diagnosed in a tertiary care hospital (2010–2019).</p></div><div><h3>Results</h3><p>Overall, 79/88 (89.8%) and 36/45 (80%) patients had bilateral sensory nerve conduction studies (NCS) in the first EDX and follow-up EDX, respectively. Sural-sparing occurred in all subtypes (50% overall occurrence rate), most commonly in demyelination. There was no statistically significant difference in sural-sparing occurrence rates between demyelinating and axonal GBS; however, sural-sparing in axonal GBS tended to show a lower number of abnormal upper-limb sensory nerve action potentials (SNAPs) than demyelinating GBS. Shifting between sural-sparing and no sural-sparing occurred in approximately-one-fourth of patients receiving serial studies. Follow-up EDX additionally discovered 20% of all sural-sparing. Unilateral EDX could have omitted up to 30% of sural-sparing.</p></div><div><h3>Conclusions</h3><p>Sural-sparing is less obviously manifested in axonal than demyelinating GBS, with respect to the number of affected upper-limb SNAPs. Extended sensory NCS is worth in detecting sural-sparing as a supportive electrodiagnostic GBS feature.</p></div><div><h3>Significance</h3><p>This report showed one different character of sural-sparing (number of affected upper-limb SNAPs) between demyelinating and axonal GBS.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 266-272"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/70/main.PMC9557237.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33515761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgement to Reviewers","authors":"","doi":"10.1016/j.cnp.2022.10.003","DOIUrl":"https://doi.org/10.1016/j.cnp.2022.10.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 388-389"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X22000415/pdfft?md5=6f695845e988c879ac96f6a7f0d4f759&pid=1-s2.0-S2467981X22000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92032439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards more reliable TMS studies – How fast can we probe cortical excitability?","authors":"Maria Nazarova ,&nbsp;Anastasia Asmolova","doi":"10.1016/j.cnp.2021.11.004","DOIUrl":"10.1016/j.cnp.2021.11.004","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 21-22"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/b4/main.PMC8752992.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39940059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tradução e Adaptação para a Língua Portuguesa – Brasil do Glossário Revisado dos Termos Mais Comumente Usados por Eletroencefalografistas Clínicos e Proposta Atualizada do Formato do Laudo de EEG (IFCN Revisão 2017)","authors":"Ana Paula Gonçalves ,&nbsp;Carlos Eduardo Silvado ,&nbsp;Isabella D'Andrea Meira ,&nbsp;José Augusto Bragatti ,&nbsp;Luís Otávio Caboclo ,&nbsp;Mirian Bittar Guaranha ,&nbsp;Priscila Oliveira da Conceição ,&nbsp;Pedro Alessandro Leite de Oliveira ,&nbsp;Taíssa Ferrari Marinho","doi":"10.1016/j.cnp.2021.12.003","DOIUrl":"10.1016/j.cnp.2021.12.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 78-95"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/0e/main.PMC8933678.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40310675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myoclonus generators in sialidosis","authors":"Felipe Vial ,&nbsp;Patrick McGurrin ,&nbsp;Sanaz Attaripour ,&nbsp;Alesandra d'Azzo ,&nbsp;Cynthia J. Tifft ,&nbsp;Camilo Toro ,&nbsp;Mark Hallett","doi":"10.1016/j.cnp.2022.05.004","DOIUrl":"10.1016/j.cnp.2022.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>Sialidosis is an inborn error of metabolism. There is evidence that the myoclonic movements observed in this disorder have a cortical origin, but this mechanism does not fully explain the bilaterally synchronous myoclonus activity frequently observed in many patients. We present evidence of a subcortical basis for synchronous myoclonic phenomena.</p></div><div><h3>Methods</h3><p>Electromyographic investigations were undertaken in two molecularly and biochemically confirmed patients with sialidosis type-1.</p></div><div><h3>Results</h3><p>The EMG recordings showed clear episodes of bilaterally synchronous myoclonic activity in contralateral homologous muscles. We also observed a high muscular-muscular coherence with near-zero time-lag between these muscles.</p></div><div><h3>Conclusion</h3><p>The absence of coherence phase lag between the right-and-left homologous muscles during synchronous events indicates that a unilateral cortical source cannot fully explain the myoclonic activity. There must exist a subcortical mechanism for bilateral synchronization accounting for this phenomenon.</p></div><div><h3>Significance</h3><p>Understanding this mechanism may illuminate cortical-subcortical relationships in myoclonus.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 169-173"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9253402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of intraoperative neurophysiological monitoring during positioning in pediatric scoliosis correction: A case report","authors":"M. Cavinato ,&nbsp;F. Vittoria ,&nbsp;F. Piccione ,&nbsp;S. Masiero ,&nbsp;M. Carbone","doi":"10.1016/j.cnp.2022.11.001","DOIUrl":"10.1016/j.cnp.2022.11.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Prone position during posterior spine surgery can represent a potentially risky procedure for the nervous system. Infrequent injuries due to prone positioning consist of subtle spinal cord infarction or myelopathy that can be promptly detected by intraoperative neurophysiological monitoring (IONM), if applied in this phase of surgery. Here, we report a case that stresses the value of IONM even in detecting spinal positioning-related neurological complications during kyphoscoliosis correction.</p></div><div><h3>Case presentation</h3><p>A 3-year-old child with a severe thoracic kyphoscoliosis with the angle in the tract T5-T6 underwent an early treatment of scoliosis with growing rods. Before instrumentation or the reduction maneuver, lower limb somatosensory and motor responses disappeared. The patient was repositioned with neck and chest in a more protective position and neuromonitoring signals returned to baseline. The surgery could be completed and the patient had no postoperative neurologic or vascular deficits.</p></div><div><h3>Conclusion</h3><p>Our findings suggest the importance of extending neuromonitoring in the early phases of anesthesia induction and patient positioning during corrective spinal deformity surgery.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 366-371"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/b3/main.PMC9731825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10680989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurology resident EEG training in Europe","authors":"Fábio A. Nascimento ,&nbsp;Jay R. Gavvala ,&nbsp;Hatice Tankisi ,&nbsp;Sándor Beniczky","doi":"10.1016/j.cnp.2022.08.001","DOIUrl":"10.1016/j.cnp.2022.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>To detail current European EEG education practices and compare European and U.S. EEG teaching systems.</p></div><div><h3>Methods</h3><p>A 19-question online survey focused on EEG clinical practices and residency training was emailed to all 47 European Academy of Neurology Societies.</p></div><div><h3>Results</h3><p>Thirty-two (68 %) out of the 47 Societies completed the survey. In half of countries, general neurologists are either among the providers or the only providers who typically read EEGs. The number of weeks devoted to EEG learning required to graduate ranged from none to 26, and it was expected to be continuous in one country. In most countries (n = 17/32), trainees read &gt;40 EEGs per EEG rotation, and the most commonly interpreted studies are routine and prolonged routine EEGs. Rotations involve clinic/outpatient (90 %), epilepsy monitoring unit/inpatient (60 %), or both (50 %). Roughly half of countries do not use objective measures to assess EEG competency. The most reported educational methods are teaching during EEG rotation and yearly didactics, and the most reported education barriers are insufficient didactics and insufficient EEG exposure.</p></div><div><h3>Conclusions</h3><p>We suggest neurology educators in Europe, especially in those countries where EEGs are read by general neurologists, consider ensuring that residency EEG learning is mandatory and establishing objective measures in teaching and evaluating competency.</p></div><div><h3>Significance</h3><p>Similar to the U.S., neurology resident EEG training in Europe is highly variable.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 252-259"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/e8/main.PMC9483746.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33476061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive brain stimulation and neuroenhancement","authors":"Andrea Antal ,&nbsp;Bruce Luber ,&nbsp;Anna-Katharine Brem ,&nbsp;Marom Bikson ,&nbsp;Andre R. Brunoni ,&nbsp;Roi Cohen Kadosh ,&nbsp;Veljko Dubljević ,&nbsp;Shirley Fecteau ,&nbsp;Florinda Ferreri ,&nbsp;Agnes Flöel ,&nbsp;Mark Hallett ,&nbsp;Roy H. Hamilton ,&nbsp;Christoph S. Herrmann ,&nbsp;Michal Lavidor ,&nbsp;Collen Loo ,&nbsp;Caroline Lustenberger ,&nbsp;Sergio Machado ,&nbsp;Carlo Miniussi ,&nbsp;Vera Moliadze ,&nbsp;Michael A Nitsche ,&nbsp;Walter Paulus","doi":"10.1016/j.cnp.2022.05.002","DOIUrl":"10.1016/j.cnp.2022.05.002","url":null,"abstract":"<div><p>Attempts to enhance human memory and learning ability have a long tradition in science. This topic has recently gained substantial attention because of the increasing percentage of older individuals worldwide and the predicted rise of age-associated cognitive decline in brain functions. Transcranial brain stimulation methods, such as transcranial magnetic (TMS) and transcranial electric (tES) stimulation, have been extensively used in an effort to improve cognitive functions in humans.</p><p>Here we summarize the available data on low-intensity tES for this purpose, in comparison to repetitive TMS and some pharmacological agents, such as caffeine and nicotine. There is no single area in the brain stimulation field in which only positive outcomes have been reported. For self-directed tES devices, how to restrict variability with regard to efficacy is an essential aspect of device design and function. As with any technique, reproducible outcomes depend on the equipment and how well this is matched to the experience and skill of the operator. For self-administered non-invasive brain stimulation, this requires device designs that rigorously incorporate human operator factors. The wide parameter space of non-invasive brain stimulation, including dose (e.g., duration, intensity (current density), number of repetitions), inclusion/exclusion (e.g., subject’s age), and homeostatic effects, administration of tasks before and during stimulation, and, most importantly, placebo or nocebo effects, have to be taken into account. The outcomes of stimulation are expected to depend on these parameters and should be strictly controlled. The consensus among experts is that low-intensity tES is safe as long as tested and accepted protocols (including, for example, dose, inclusion/exclusion) are followed and devices are used which follow established engineering risk-management procedures. Devices and protocols that allow stimulation outside these parameters cannot claim to be “safe” where they are applying stimulation beyond that examined in published studies that also investigated potential side effects.</p><p>Brain stimulation devices marketed for consumer use are distinct from medical devices because they do not make medical claims and are therefore not necessarily subject to the same level of regulation as medical devices (i.e., by government agencies tasked with regulating medical devices). Manufacturers must follow ethical and best practices in marketing tES stimulators, including not misleading users by referencing effects from human trials using devices and protocols not similar to theirs.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 146-165"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40239409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of an electromyography-based similarity index to quantify lower extremity selective voluntary motor control in children with cerebral palsy","authors":"Julia Balzer ,&nbsp;Annina Fahr ,&nbsp;Jeffrey W. Keller ,&nbsp;Marietta L. van der Linden ,&nbsp;Thomas H. Mercer ,&nbsp;Hubertus J.A. van Hedel","doi":"10.1016/j.cnp.2022.03.003","DOIUrl":"10.1016/j.cnp.2022.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To quantify selective voluntary motor control (SVMC) objectively and more precisely, we combined the “Selective Control Assessment of the Lower Extremity” (SCALE) with surface electromyography. The resulting Similarity Index (SI) measures the similarity of muscle activation patterns. This study evaluated the preliminary validity and reliability of this novel SI_SCALE measure in children with cerebral palsy (CP).</p></div><div><h3>Methods</h3><p>We investigated concurrent validity by correlating the SI_SCALE of 24 children with CP (median age 10.6 years) with comparator assessments. For discriminative validity, the patients’ SI_SCALE scores were compared to 31 neurologically intact age-matched peers. Test-retest reliability was quantified using intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values.</p></div><div><h3>Results</h3><p>The SI_SCALE correlated strongly with the SCALE (ρ = 0.90, p &lt; .001) and the Gross Motor Function Classification System (ρ = −0.74, p &lt; .001). SI_SCALE scores were significantly lower in children with CP compared to healthy peers. Test-retest reliability appeared good (for the more and less affected leg, ICC ≥ 0.84, and MDC ≤ 0.17).</p></div><div><h3>Conclusions</h3><p>Validity and reliability of the SI_SCALE leg and total scores lay within clinically acceptable ranges. Further clinimetric analyses should include responsiveness.</p></div><div><h3>Significance</h3><p>A neurophysiology-based assessment could contribute to a more refined assessment of SVMC impairments.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 107-114"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X22000130/pdfft?md5=a0295081ac35e79e6f17e598a648ee56&pid=1-s2.0-S2467981X22000130-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48651883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}