{"title":"Averted weakness from a large Martin-Gruber anastomosis","authors":"Emily Cheung, Karl Ng","doi":"10.1016/j.cnp.2024.12.003","DOIUrl":"10.1016/j.cnp.2024.12.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 10-11"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013344","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":"Shear wave elastography as a marker of anisotropy in denervated muscle tissue","authors":"Olli Kutvonen , Sari-Leena Himanen , Katri Mäkelä","doi":"10.1016/j.cnp.2025.02.007","DOIUrl":"10.1016/j.cnp.2025.02.007","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the capability of shear wave elastography (SWE) to detect muscle denervation.</div></div><div><h3>Methods</h3><div>36 patients underwent electrodiagnostic studies (EDX) of the lower limbs and volunteered to undergo ultrasound examination of the Tibialis anterior (TA) and the Gastrocnemius medialis (GCM) muscles. A variable reflecting the level of anisotropy was created by calculating the difference between the longitudinal and transverse shear wave velocity (SWE-D).</div></div><div><h3>Results</h3><div>In the TA muscles, SWE-D correlated negatively with the quantity of fibrillation potentials (FP) and the degree of interference pattern (IP) reduction (p = 0.032, r = -0.185 and p = 0.006, r = -0.236, respectively). In the GCM muscles, SWE-D only correlated with the amount of IP reduction among patients of normal weight (p = 0.030, r = -0.285). There was also a significant difference in the overall SWE-D values in the GCM muscles between patients of normal weight and obese patients (p = 0.007).</div></div><div><h3>Conclusions</h3><div>Loss of anisotropy caused by denervation of muscle tissue may be measured quantitatively by calculating the differences between longitudinal and transverse shear wave velocities. However, obesity seems to hinder the SWE-based assessment of muscle denervation.</div></div><div><h3>Significance</h3><div>Being able to measure anisotropy caused by denervation acts as a base for further development of SWE methods to evaluate neurogenic injury.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 95-103"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619967","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}
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}
{"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}
{"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}
Jinyang Zhuang , Xiyuan Lei , Xiaoli Guo , Li Ding , Jie Jia
{"title":"Motor and parietal cortex activity responses to mirror visual feedback in patients with subacute stroke: An EEG study","authors":"Jinyang Zhuang , Xiyuan Lei , Xiaoli Guo , Li Ding , Jie Jia","doi":"10.1016/j.cnp.2024.12.004","DOIUrl":"10.1016/j.cnp.2024.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>To elucidate the immediate electrophysiological effects of mirror visual feedback (MVF) combined with or without touch task in subacute stroke.</div></div><div><h3>Methods</h3><div>Subacute stroke patients and healthy controls were recruited to participate in four grasping tasks (MVF or no MVF, combined with rubber ball or no ball) under electroencephalogram (EEG) monitoring. Event-related desynchronization (ERD) /event-related synchronization (ERS) and the lateralization index (LI) were utilized to observe the electrophysiological effects.</div></div><div><h3>Results</h3><div>MVF reduced ERD suppression in the contralateral primary motor cortex (M1) of stroke patients. This reduction was observed in the low mu band for the contralateral parietal cortex during pure MVF. The laterality effects in the low mu band under MVF was noted in M1 for stroke patients and in the parietal cortex for all participants.</div></div><div><h3>Conclusions</h3><div>MVF inhibits the excitability of the contralateral M1 for subacute stroke. MVF inhibit activities in the contralateral M1 and parietal cortex, and reestablished hemispheric balance in the low mu band.</div></div><div><h3>Significance</h3><div>MVF has an instantaneous effect on subacute stroke by inhibiting the excitability of the contralateral sensorimotor cortex. The attenuated ERD in the low mu band in contralateral M1 and parietal cortex may serve as biomarkers of MVF for stroke rehabilitation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 12-21"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013284","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}
Steven Falowski , Mingyue Tang , Ashlesha Deshmukh , Ameya Nanivadekar , David Page , Mingming Zhang
{"title":"Case report: Potential physiological sources of the late response in epidural spinal recordings induced by spinal cord stimulation during intraoperative neuromonitoring","authors":"Steven Falowski , Mingyue Tang , Ashlesha Deshmukh , Ameya Nanivadekar , David Page , Mingming Zhang","doi":"10.1016/j.cnp.2024.12.005","DOIUrl":"10.1016/j.cnp.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the sources of later response in epidural spinal recordings (ESRs) obtained from implanted leads during spinal cord stimulation, a topic has not been widely studied in previous research.</div></div><div><h3>Methods</h3><div>Two patients with lower back and lower extremity pain underwent SCS implantation with intraoperative neuromonitoring (IONM). The timing of extracted peaks in ESRs and intramuscular electromyography (EMG) recordings were analyzed and compared to a Monte Carlo simulation for synchronization analysis.</div></div><div><h3>Results</h3><div>Our data show that, when using two most caudal electrodes for stimulation, late response in ESRs collected from SCS leads was not synchronized with EMG recordings from lower extremity muscles. However, parts of the late responses were synchronized with EMG recordings from abdominal muscle groups.</div></div><div><h3>Conclusions</h3><div>Late response in ESRs is believed to result from muscle contractions, although the exact sources have not been fully identified. They are likely to originate from muscles near the implanted leads.</div></div><div><h3>Significance</h3><div>This research indicates that components of the late response may originate beyond the abdominal region, potentially offering additional information for current IONM practice. Additionally, understanding the sources of the late response may be useful for emerging clinical applications in neurorehabilitation.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 22-29"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048233","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}
Kai Michael Schubert, Anton Schmick, Miranda Stattmann, Marian Galovic
{"title":"Prognostic models for seizures and epilepsy after stroke, tumors and traumatic brain injury","authors":"Kai Michael Schubert, Anton Schmick, Miranda Stattmann, Marian Galovic","doi":"10.1016/j.cnp.2025.02.008","DOIUrl":"10.1016/j.cnp.2025.02.008","url":null,"abstract":"<div><div>Epilepsy is a frequent consequence of acute brain injuries, such as stroke, brain tumors, and traumatic brain injury (TBI). Accurate prediction of epilepsy is essential for early intervention and improved patient outcomes. This review evaluates the best-established prognostic models, including the SeLECT and CAVE scores, which estimate the risk of developing seizures and epilepsy following these injuries. The review highlights their clinical applicability, predictive accuracy, and limitations for different etiologies. In addition to providing practical tables for risk estimation, we also offer user-friendly online calculators for these models at <span><span>www.predictepilepsy.com</span><svg><path></path></svg></span> to facilitate clinical implementation. These tools help identify high-risk patients and support decision-making for follow-up and treatment. Furthermore, we discuss the potential of integrating electrophysiological data, including EEG biomarkers, to further enhance prediction accuracy and patient care. These insights highlight the need for further refinement and validation of predictive models, enabling more personalized treatment strategies and better patient care.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 116-128"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628171","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}
Julian Theuriet , Adrien Bohic , Maxime Bonjour , Emilien Bernard , Florent Cluse , Juliette Svahn , Laurent Jomir , Anne-Evelyne Vallet , Marion Demia , Lucie Roux , Ioana Cristina Bârsan , Léa Alves , Matthias Dion , Lionel Meens , Martin Moussy , Françoise Bouhour , Yann Péréon , Antoine Pegat
{"title":"Contralateral R1 response in blink reflex in patients with amyotrophic lateral sclerosis","authors":"Julian Theuriet , Adrien Bohic , Maxime Bonjour , Emilien Bernard , Florent Cluse , Juliette Svahn , Laurent Jomir , Anne-Evelyne Vallet , Marion Demia , Lucie Roux , Ioana Cristina Bârsan , Léa Alves , Matthias Dion , Lionel Meens , Martin Moussy , Françoise Bouhour , Yann Péréon , Antoine Pegat","doi":"10.1016/j.cnp.2025.02.005","DOIUrl":"10.1016/j.cnp.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the frequency of blink reflex’s contralateral R1 responses (R1′) between patients with amyotrophic lateral sclerosis (ALS), non-ALS motor deficit patients, and healthy volunteers.</div></div><div><h3>Methods</h3><div>A total of 120 participants were prospectively recruited: 40 with ALS, 40 with a non-ALS motor deficit, and 40 healthy volunteers. Blink reflexes were recorded from orbicularis oculi muscles following supraorbital nerve stimulation.</div></div><div><h3>Results</h3><div>R1′ was more frequent in the ALS group (42.5 %) compared to healthy volunteers (12.5 %, p = 0.00588), and compared to non-ALS patients (7.5 %, p = 0.000789). Bilateral R1′ was observed only in ALS patients (22.5 %). No clinically significant difference was found in the latencies or amplitudes of the R1, R2, or R1′ responses among groups. R1′ was more frequent in ALS patients with pseudobulbar affect (71.4 %) compared to those without (36.4 %).</div></div><div><h3>Conclusions</h3><div>The higher frequency of R1′ in ALS highlights its potential role in distinguishing ALS from other motor disorders. Its sensitivity was low, but bilateral R1′ was specific to ALS. The higher frequency of R1′ among ALS patients with pseudobulbar affect potentially reflects corticobulbar neuron degeneration.</div></div><div><h3>Significance</h3><div>The R1′, especially when bilateral, could serve as an additional diagnostic biomarker for ALS, although its clinical relevance should be considered within the broader diagnostic context.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 47-51"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509107","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}
Chen Yang , Nicole C. Veit , Kelly A. McKenzie , Shreya Aalla , Ameen Kishta , Kyle Embry , Elliot J. Roth , Richard L. Lieber , Arun Jayaraman
{"title":"The effects of stimulation waveform and carrier frequency on tolerance and motor thresholds elicited by transcutaneous spinal cord stimulation in stroke","authors":"Chen Yang , Nicole C. Veit , Kelly A. McKenzie , Shreya Aalla , Ameen Kishta , Kyle Embry , Elliot J. Roth , Richard L. Lieber , Arun Jayaraman","doi":"10.1016/j.cnp.2025.04.001","DOIUrl":"10.1016/j.cnp.2025.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>With growing interest in translating transcutaneous spinal cord stimulation (tSCS) into rehabilitation for different neurologic injuries, understanding the effects of various combinations of stimulation parameters becomes essential.</div></div><div><h3>Methods</h3><div>Twenty-one participants post-stroke completed an assessment to determine their resting motor threshold (RMT) (minimum current required to elicit a muscle response) and tolerance levels (uncomfortable current intensity) to 12 stimulation configurations: two square waveforms, biphasic and monophasic, paired with six carrier frequencies (unmodulated: 0, and modulated: 1, 3, 5, 7, and 10 kHz).</div></div><div><h3>Results</h3><div>The results demonstrated that increasing carrier frequency increased participants’ tolerance level and RMTs. Carrier frequency nor waveform type significantly altered discomfort when tolerance was normalized to the motor threshold, with 57 ± 23 % tolerated across all configurations. However, higher carrier frequencies, particularly biphasic waveforms at frequencies > 5 kHz, required more charge to reach a muscle activation and activated fewer muscles compared to unmodulated waveforms. No significant differences in discomfort relative to RMT were found between monophasic and biphasic waveforms.</div></div><div><h3>Conclusions</h3><div>Higher carrier frequency allows stimulation to be more comfortable at a given intensity, but it also requires more current to reach RMTs.</div></div><div><h3>Significance</h3><div>This study provides an essential feasibility assessment of tSCS configurations in a neurological population.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 150-158"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876696","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}