Clinical Neurophysiology Practice最新文献_第2页

The role of EEG in the emergency department: Its contribution to the patient’s diagnostic–therapeutic pathway. The EMINENCE study 脑电图在急诊科的作用：它对病人的诊断-治疗途径的贡献。隆起研究

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.010

Scarpino Maenia , Verna Maria Teresa , Grippo Antonello , Lolli Francesco , Piccardi Benedetta , Nazerian Peiman , Nencini Patrizia , Boccardi Cristina , Nencioni Andrea

{"title":"The role of EEG in the emergency department: Its contribution to the patient’s diagnostic–therapeutic pathway. The EMINENCE study","authors":"Scarpino Maenia , Verna Maria Teresa , Grippo Antonello , Lolli Francesco , Piccardi Benedetta , Nazerian Peiman , Nencini Patrizia , Boccardi Cristina , Nencioni Andrea","doi":"10.1016/j.cnp.2025.02.010","DOIUrl":"10.1016/j.cnp.2025.02.010","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the utility of the emergency electroencephalogram(emEEG) in the diagnostic work-up of patients admitted to the Emergency Department(ED).</div></div><div><h3>Methods</h3><div>Data from consecutive patients admitted to the ED during a 1-year period. We evaluated the usefulness of emEEGs based on the subsequent patient clinical management.</div></div><div><h3>Results</h3><div>1125 emEEGs from 1018 patients were analyzed. The overall usefulness of an emEEG was 86.7%, mainly influenced by its contribution to diagnosis(75.0%), often excluding initial working diagnosis(50.0%), and to patient management(78.0%). EmEEGs showed their best overall usefulness in Status Epilepticus(SE) and altered level of consciousness both in contributing to the final diagnosis and in patient management and therapeutic pathway. In speech and cognitive/behavioural disorders, emEEGs contributed to the diagnosis(80.6% and 79.8%, respectively), often excluding the initial suspicion of seizures/SE. Normal emEEGs contributed to diagnosis(79.0%), patient management(87.0%) and discharge to home(82.0%).</div></div><div><h3>Conclusions</h3><div>In ED, attending physicians have to make quick decisions about the diagnostic–therapeutic management of patients, and also the ruling out of the initial diagnosis and safely discharging the patient to home are also important goals.</div></div><div><h3>Significance</h3><div>This study provides valuable guidance to ED clinicians in selecting patients for an emEEG and evaluates its contribution to their diagnostic–therapeutic management.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 70-77"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580355","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}

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Corrigendum to “Neurophysiological monitoring during anterior cervical discectomy and fusion for ossification of the posterior longitudinal ligament” [Clin. Neurophysiol. Pract. 6 (2021) 56–62] “颈椎前路椎间盘切除术和融合治疗后纵韧带骨化的神经生理监测”的勘误[临床。Neurophysiol。惯例6 (2021)56-62]

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.001

Jee-Eun Kim , Jun-Soon Kim , Sejin Yang , Jongsuk Choi , Seung-Jae Hyun , Ki-Jeong Kim , Kyung Seok Park

引用次数: 0

Cortical evoked responses to evaluate the effect of spinal cord stimulation on the pain pathways 皮质诱发反应评价脊髓刺激对疼痛通路的影响

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.04.003

Laurien J. Reinders, Cecile C. de Vos

{"title":"Cortical evoked responses to evaluate the effect of spinal cord stimulation on the pain pathways","authors":"Laurien J. Reinders, Cecile C. de Vos","doi":"10.1016/j.cnp.2025.04.003","DOIUrl":"10.1016/j.cnp.2025.04.003","url":null,"abstract":"<div><h3>Objectives</h3><div>The mechanisms of spinal cord stimulation (SCS) are insufficiently understood. Conditioned pain modulation (CPM) measures how a painful stimulus is affected by a second painful stimulus. We investigated whether cortical evoked response can be used to evaluate CPM in a patient treated with burst, tonic and sham SCS.</div></div><div><h3>Methods</h3><div>A 40-year-old patient underwent 3 magnetoencephalography sessions (burst, tonic, sham SCS) with 1-week intervals. Painful electrical stimuli were applied to the tibial nerve before, during and after CPM (conditioning: icepack on forearm). Evoked responses were analysed in the primary somatosensory and anterior cingulate cortices.</div></div><div><h3>Results</h3><div>Before CPM, the highest evoked response amplitude occurred under sham SCS, followed by tonic SCS. During CPM pain ratings remained unchanged. However, CPM reduced evoked response amplitudes in the primary somatosensory cortex under tonic and sham SCS and in the anterior cingulate cortex under all SCS paradigms.</div></div><div><h3>Conclusions</h3><div>CPM reduced evoked response amplitudes, while pain ratings were unaffected, suggesting neurophysiological measures provide additional insights into CPM effects. Tonic and burst SCS both appeared to reduce cortical capacity to attend to stimuli, with burst showing the greatest effect.</div></div><div><h3>Significance</h3><div>Cortical responses offer a valuable tool to assess pain pathways. Larger scale studies are needed to enhance our understanding of SCS mechanisms.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 167-171"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935730","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}

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Correlation analysis between excitability in the somatosensory cortex and structural changes in amyotrophic lateral sclerosis 肌萎缩性侧索硬化症体感觉皮层兴奋性与结构变化的相关性分析

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.06.003

Aysegul Gunduz , Tuba Akıncı , Osman Aykan Kargın , Melih Tutuncu , Serdar Arslan , Nurten Uzun

{"title":"Correlation analysis between excitability in the somatosensory cortex and structural changes in amyotrophic lateral sclerosis","authors":"Aysegul Gunduz , Tuba Akıncı , Osman Aykan Kargın , Melih Tutuncu , Serdar Arslan , Nurten Uzun","doi":"10.1016/j.cnp.2025.06.003","DOIUrl":"10.1016/j.cnp.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to investigate the excitability of the somatosensory cortex and its relationship to structural changes in motor and sensory pathways, and motor excitability in amyotrophic lateral sclerosis (ALS).</div></div><div><h3>Patients and method</h3><div>We included all consecutive individuals with ALS, fulfilling the “definite” or “probable” ALS criteria. We recorded surround inhibition (SI) and recovery function (RC) of somatosensory evoked potentials (SEPs), resting motor threshold, and cortical silent period (cSP), and performed volumetric analysis and diffusion tensor imaging (DTI).</div></div><div><h3>Results</h3><div>We included 15 patients with ALS and 12 healthy individuals of similar age and sex. At the group level, the mean SEP-RC% at ISI 5 ms was higher in the ALS group than in healthy participants (all SEP-RC% at 5 ms p < 0.001). SEP-SI was lost in one-third of individuals with ALS. A negative correlation was found between the duration of the cSP and SEP-RC%, whereas no correlations were observed between SEP parameters and radiological volumetric analysis of the corticospinal tract, medial lemniscus, or cortical thickness of the precentral and postcentral gyri.</div></div><div><h3>Conclusion</h3><div>Somatosensory hyperexcitability is present in ALS, and SI is lost in a subset of patients with ALS.</div></div><div><h3>Significance</h3><div>Somatosensory hyperexcitability correlates well with cSP but not with structural changes.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 202-208"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366657","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}

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Methotrexate-induced neurotoxicity: Diagnostic challenges and the role of neurophysiological testing 甲氨蝶呤诱导的神经毒性：诊断挑战和神经生理测试的作用

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.06.004

Pauline D’hoore , Joke Terryn

{"title":"Methotrexate-induced neurotoxicity: Diagnostic challenges and the role of neurophysiological testing","authors":"Pauline D’hoore , Joke Terryn","doi":"10.1016/j.cnp.2025.06.004","DOIUrl":"10.1016/j.cnp.2025.06.004","url":null,"abstract":"<div><div>Methotrexate (MTX) is widely used in the treatment of acute lymphocytic leukemia (ALL) and other onco-hematological conditions. Although subacute MTX-related neurotoxicity is relatively rare, it can present with dramatic, fluctuating neurological deficits that mimic other serious conditions. Diagnosis may be complicated by the frequent presence of asymptomatic white matter abnormalities on MRI, commonly attributed to chronic MTX toxicity.</div><div>We report an 18-year-old ALL patient who developed severe, fluctuating neurological symptoms 11 days after the third intrathecal administration of MTX. MRI showed bilateral, symmetric diffusion-restrictive white matter lesions. Absent cortical motor evoked potentials (MEPs) with preserved responses to spinal stimulation indicated corticospinal tract involvement localized to the brain, supporting a diagnosis of MTX-induced neurotoxicity. Treatment with high-dose dextromethorphan led to rapid and complete recovery.</div><div>This case underscores the value of early neurophysiological testing – particularly MEPs – in identifying corticospinal tract involvement and differentiating symptomatic neurotoxicity from chronic, asymptomatic MRI findings. Prompt recognition can accelerate diagnosis, guide treatment, and prevent unnecessary interventions.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 218-221"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501197","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}

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Averted weakness from a large Martin-Gruber anastomosis 避免了马丁-格鲁伯吻合术造成的虚弱。

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2024.12.003

Emily Cheung, Karl Ng

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Quantitative electroencephalography in the diagnosis of dementia with Lewy bodies 定量脑电图在路易体痴呆诊断中的应用

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.06.008

Abhimanyu Mahajan , Alberto Jaramillo-Jimenez , Anita D’Anselmo , Giulia Prete , Lucrezia Bristot , Sara Varanese , Alberto Di Domenico , Nicola Mammarella , Luca Tommasi , Michele Tinazzi , Dag Aarsland , Claudio Babiloni , Alberto J. Espay , Laura Bonanni

{"title":"Quantitative electroencephalography in the diagnosis of dementia with Lewy bodies","authors":"Abhimanyu Mahajan , Alberto Jaramillo-Jimenez , Anita D’Anselmo , Giulia Prete , Lucrezia Bristot , Sara Varanese , Alberto Di Domenico , Nicola Mammarella , Luca Tommasi , Michele Tinazzi , Dag Aarsland , Claudio Babiloni , Alberto J. Espay , Laura Bonanni","doi":"10.1016/j.cnp.2025.06.008","DOIUrl":"10.1016/j.cnp.2025.06.008","url":null,"abstract":"<div><div>The spectral analysis of the resting-state eyes-closed electroencephalographic (rsEEG) activity typically shows abnormal delta (< 4 Hz), theta (4–7 Hz), and alpha (8–12 Hz) power in older patients with cognitive deficits due to progressive neurodegenerative diseases. Interestingly, abnormally prominent posterior rsEEG power < 8 Hz with periodic fluctuations in the pre-alpha/theta range has been considered a supportive biomarker for diagnosing patients with prodromal or manifest dementia due to Lewy bodies (DLB) in international guidelines. Here, a panel of experts shortly reviews the concepts of thalamocortical dysrhythmia as a possible neurophysiological oscillatory mechanism generating those rsEEG abnormalities in DLB patients. It also recommends how to record and quantitatively analyze rsEEG activity in prodromal and manifesting DLB patients for the application of that cost-effective and largely available diagnostic procedure in clinical practice.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 222-233"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548595","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}

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Prognostic factors of mechanical ventilation in Guillain–Barré syndrome among adults and children in Vietnam 越南成人和儿童格林-巴- <s:1>综合征机械通气预后因素分析

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.009

Hung Hoang Dang , Khang Vinh Nguyen , Si Tri Le , Thuy Thi Vu , Vy Thi Yen Le , Thang Ba Nguyen , Hieu Le Trung Nguyen

{"title":"Prognostic factors of mechanical ventilation in Guillain–Barré syndrome among adults and children in Vietnam","authors":"Hung Hoang Dang , Khang Vinh Nguyen , Si Tri Le , Thuy Thi Vu , Vy Thi Yen Le , Thang Ba Nguyen , Hieu Le Trung Nguyen","doi":"10.1016/j.cnp.2025.02.009","DOIUrl":"10.1016/j.cnp.2025.02.009","url":null,"abstract":"<div><h3>Objective</h3><div>Numerous studies have investigated predictors for mechanical ventilation (MV) in Guillain-Barré syndrome (GBS), with varying results. This study identifies factors associated with MV in both populations in Vietnam.</div></div><div><h3>Methods</h3><div>We retrospectively collected data on GBS patients at Children’s Hospital 2 and the University Medical Center Ho Chi Minh City from 2017 to 2021. Clinical characteristics were analyzed using multivariable logistic regression to identify predictors of MV. A bootstrapping stepwise approach was used to select the most appropriate predictors for the model.</div></div><div><h3>Results</h3><div>A total of 108 adults and 112 children were included, with 15 adults (13.8 %) and 10 children (8.9 %) requiring MV. Dysautonomia and facial palsy/bulbar weakness were more common in ventilated patients (P < 0.05). Multivariable analysis identified dysautonomia as the only significant predictor for MV in both adults (OR: 7.43, 95 % CI: 1.78–30.98) and children (OR: 13.6, 95 % CI: 1.20–154.79).</div></div><div><h3>Conclusions</h3><div>Dysautonomia is a significant predictor of MV in adults and children with GBS. Although facial palsy and bulbar weakness were not statistically significant predictors, their presence warrants careful monitoring.</div></div><div><h3>Significance</h3><div>This study provides insights into GBS in Vietnam and underscores dysautonomia as a predictor for MV, distinguishing it from findings in previous prognostic models.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 90-94"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600923","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}

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Correlation between decremental responses in repetitive nerve stimulation and disease progression rate in patients with amyotrophic lateral sclerosis 肌萎缩性脊髓侧索硬化症患者重复性神经刺激的递减反应与疾病进展率之间的相关性

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.003

Yuki Fujii , Takamichi Kanbayashi , Kazusa Takahashi , Yuichi Hamada , Shunsuke Kobayashi , Masahiro Sonoo

{"title":"Correlation between decremental responses in repetitive nerve stimulation and disease progression rate in patients with amyotrophic lateral sclerosis","authors":"Yuki Fujii , Takamichi Kanbayashi , Kazusa Takahashi , Yuichi Hamada , Shunsuke Kobayashi , Masahiro Sonoo","doi":"10.1016/j.cnp.2025.02.003","DOIUrl":"10.1016/j.cnp.2025.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>Decrement responses in repetitive nerve stimulation (RNS) are theoretically expected to correlate with the disease progression speed in amyotrophic lateral sclerosis (ALS). However, actual results have been controversial. We investigated this issue using ΔFS calculated from the ALS functional rating scale revised version (ALSFRS-R) and the duration of illness.</div></div><div><h3>Methods</h3><div>RNS results of the abductor pollicis brevis, trapezius, and deltoid muscles in our previous study were reviewed. We investigated correlations and multiple regressions regarding decremental percentage (Decr%), the amplitude of the initial compound muscle action potential (Amp), and progression speed parameters, i.e. ΔFS or ΔUL-FS, the latter being the ΔFS for the upper-limb questions in ALSFRS-R.</div></div><div><h3>Results</h3><div>Included subjects were 124 patients with ALS, 47 of whom were upper-limb onset. Multiple regression analyses revealed that Decr% is largely determined by Amp and that Δ FS or ΔUL-FS showed no or little contributions to Decr%.</div></div><div><h3>Conclusions</h3><div>Decremental responses in RNS does not predict the speed of progression of the functional impairment in patients with ALS.</div></div><div><h3>Significance</h3><div>This study suggests that the decremental responses in RNS in ALS are contributed by the impaired neuromuscular transmission in chronic sprouts following extensive reinnervation, as well as by the immature sprouts.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 40-46"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488300","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}

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Changing characteristics of somatosensory evoked potentials in adolescents 青少年体感诱发电位的变化特征

IF 2

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.03.004

Aoi Mase , Manabu Shibasaki , Hiroki Nakata

{"title":"Changing characteristics of somatosensory evoked potentials in adolescents","authors":"Aoi Mase , Manabu Shibasaki , Hiroki Nakata","doi":"10.1016/j.cnp.2025.03.004","DOIUrl":"10.1016/j.cnp.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated changing characteristics of somatosensory processing in adolescents, particularly sex differences, by comparing children, young adults, and males and females.</div></div><div><h3>Methods</h3><div>Participants included 26 elementary school children (ESC), 36 adolescents (ADO), and 36 college students (CS). We recorded somatosensory evoked potentials (SEPs) using electrical stimulation of the right median nerve. Peak latencies and amplitudes were measured for P12, N15, P18, and N30 at Fz, and for P12 (P1), N18 (N1), P22 (P2), N27 (N2), P3, N3, P45 (P4), and N60 (N4) at C3′.</div></div><div><h3>Results</h3><div>The P22 (P2) amplitude at C3′ decreased with age. The N15 amplitude at Fz was larger in females across all groups. P3 and N3 occurrence at C3′ decreased with age but remained high in ADO compared to CS. Correlation analysis showed a significant negative correlation between P22 (P2) amplitude at C3′ and age in ADO boys, but not in ADO girls, ESC boys, or ESC girls.</div></div><div><h3>Conclusions</h3><div>Somatosensory processing in ADO is not as mature as in CS, with sex differences between ADO boys and girls.</div></div><div><h3>Significance</h3><div>Our findings may aid understanding of neural activity in children with developmental disorders, supporting sensory-based therapies.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 141-149"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820946","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}

引用次数: 0