Clinical Neurophysiology Practice最新文献

{"title":"Exploring relationships between pre-operative median nerve echointensity and short-term outcomes of carpal tunnel release − A retrospective review","authors":"Yohei Harada, Thapat Wannarong, Megan Neely, John Williams, Tyler Pidgeon, Lisa D. Hobson-Webb","doi":"10.1016/j.cnp.2024.08.004","DOIUrl":"10.1016/j.cnp.2024.08.004","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 249-251"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000258/pdfft?md5=3df551fe042617dd3d8eea6ab9ff0e07&pid=1-s2.0-S2467981X24000258-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162989","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":"Harnessing historical data to derive reference limits – A comparison of e-norms to traditionally derived reference limits","authors":"Ø. Dunker ,&nbsp;T.S. Szczepanski ,&nbsp;H.O.P. Do ,&nbsp;P. Omland ,&nbsp;M.U. Lie ,&nbsp;T. Sand ,&nbsp;J.F. Jabre ,&nbsp;K.B. Nilsen","doi":"10.1016/j.cnp.2024.04.001","DOIUrl":"10.1016/j.cnp.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Nerve conduction studies (NCS) require valid reference limits for meaningful interpretation. We aimed to further develop the extrapolated norms (e-norms) method for obtaining NCS reference limits from historical laboratory datasets for children and adults, and to validate it against traditionally derived reference limits.</p></div><div><h3>Methods</h3><p>We compared reference limits obtained by applying a further developed e-norms with reference limits from healthy controls for the age strata’s 9–18, 20–44 and 45–60 years old. The control data consisted of 65 healthy children and 578 healthy adults, matched with 1294 and 5628 patients respectively. Five commonly investigated nerves were chosen: The tibial and peroneal motor nerves (amplitudes, conduction velocities, F-waves), and the sural, superficial peroneal and medial plantar sensory nerves (amplitudes, conduction velocities). The datasets were matched by hospital to ensure identical equipment and protocols. The e-norms method was adapted, and reference limit calculation using both ±2 SD (original method) and ±2.5 SD (to compensate for predicted underestimation of population SD by the e-norms method) was compared to control data using ±2 SD. Percentage agreement between e-norms and the traditional method was calculated.</p></div><div><h3>Results</h3><p>On average, the e-norms method (mean ±2 SD) produced slightly stricter reference limits compared to the traditional method. Increasing the e-norms range to mean ±2.5 SD improved the results in children while slightly overcorrecting in the adult group. The average agreement between the two methods was 95 % (±2 SD) and 96 % (±2.5 SD).</p></div><div><h3>Conclusions</h3><p>The e-norms method yielded slightly stricter reference limits overall than ones obtained through traditional methods; However, much of the difference can be attributed to a few outlying plots where the raters found it difficult to apply e-norms correctly.<!--> <!-->The two methods disagreed on classification of 4–5% of cases. Our e-norms software is suited to analyze large amounts of raw NCS data; it should further reduce bias and facilitate more accurate ratings.</p></div><div><h3>Significance</h3><p>With small adaptations, the e-norms method adequately replicates traditionally derived reference limits, and is a viable method to produce reference limits from historical datasets.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 168-175"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000155/pdfft?md5=64f25142bfd766fa5e5d681037d332ee&pid=1-s2.0-S2467981X24000155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787470","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":"Diagnosis and differential diagnosis of MND/ALS: IFCN handbook chapter","authors":"Mamede de Carvalho ,&nbsp;Michael Swash","doi":"10.1016/j.cnp.2023.12.003","DOIUrl":"10.1016/j.cnp.2023.12.003","url":null,"abstract":"<div><p>Accurate and rapid diagnosis of amyotrophic lateral sclerosis (ALS) is essential in order to provide accurate information for patient and family, to avoid time-consuming investigations and to permit an appropriate management plan. ALS is variable regarding presentation, disease progression, genetic profile and patient reaction to the diagnosis. It is obviously important to exclude treatable conditions but, in most patients, for experienced neurologists the diagnosis is clear-cut, depending on the presence of progressive upper and lower motor neuron signs. Patients with signs of restricted lower motor neuron (LMN) or upper motor neuron (UMN) dysfunction may present diagnostic difficulty, but electromyography (EMG) is often a determinant diagnostic test since it may exclude other disorders. Transcranial magnetic stimulation may aid detection of UMN dysfunction, and brain and spinal cord MRI, ultrasound and blood neurofilament measurements, have begun to have clinical impact, although none are themselves diagnostic tests. Several sets of diagnostic criteria have been proposed in the past; all rely on clinical LMN and UMN signs in different anatomic territories, EMG changes, exclusion of other disorders, and disease progression, in particular evidence of spreading to other anatomic territories. Fasciculations are a characteristic clinical feature and increased importance is now attached to fasciculation potentials detected by EMG, when associated with classical signs of denervation and reinnervation. The Gold Coast diagnostic criteria rely on the presence of UMN and LMN signs in one (or more) anatomic territory, or LMN signs in two (or more) anatomic territories, recognizing the fundamental clinical requirements of disease progression and exclusion of other diseases. Recent studies confirm a high sensitivity without loss of specificity using these Gold Coast criteria. In considering the diagnosis of ALS a critical question for future understanding is whether ALS should be considered a syndrome or a specific clinico-pathologic entity; this can only be addressed in the light of more complete knowledge.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 27-38"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X23000355/pdfft?md5=a5fa4ccc67823182f5565a3f5a377e49&pid=1-s2.0-S2467981X23000355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139019674","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":"REM parasomnias: Straddling the sleep-wake line","authors":"Jayant N. Acharya,&nbsp;Vinita J. Acharya","doi":"10.1016/j.cnp.2024.01.002","DOIUrl":"10.1016/j.cnp.2024.01.002","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 51-52"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000039/pdfft?md5=90c8ff173712075f56fbe8fb9f775611&pid=1-s2.0-S2467981X24000039-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139456916","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":"Spinal lumbar multimodal neurophysiological monitoring in a patient with deep brain Stimulator: A case report","authors":"Daniel San-juan ,&nbsp;Rafael Diaz-Martinez ,&nbsp;Victor Alcocer-Barradas ,&nbsp;Luis Alberto Ortega-Porcayo ,&nbsp;Marcela Amparo Osuna-Zazueta ,&nbsp;Maria Fernanda Tejada-Pineda","doi":"10.1016/j.cnp.2024.10.003","DOIUrl":"10.1016/j.cnp.2024.10.003","url":null,"abstract":"<div><div>Intraoperative neurophysiological monitoring (IONM) is a highly valuable tool in spinal surgery. It allows for real-time evaluation of nervous system function and alerts the surgeon to any warning signs. Among the various techniques used are motor evoked potentials (MEPs) through transcranial electrical stimulation, which involve applying an electrical stimulus to the scalp in the primary motor cortex region and recording it in the corresponding muscles of the corticospinal tract. There are relative contraindications for this technique, such as in patients who have an implantable device. There is no consensus on how to perform this technique in patients with a deep brain stimulator.</div><div>We present the case of a 61-year-old patient with Parkinson’s disease and a deep brain stimulator (DBS), and who underwent spinal surgery for lumbar discopathy. IONM was performed during the procedure using MEPs, necessitating the deactivation of the DBS to protect its function. Upon completion of the surgical procedure, the device was reactivated, confirming its proper function. We demonstrate that this technique can be safe for these patients, weighing the potential risks and benefits. However, it will be necessary to develop specific guidelines for performing these techniques in the future.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 261-265"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571621","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":"Directional deep brain stimulation of the centromedian thalamic nucleus reduces DBS-induced ataxia and dysarthria in Lennox-Gastaut Syndrome: A single case study","authors":"Stephan Neidhart ,&nbsp;Oona Kohnen ,&nbsp;Lennart Stieglitz ,&nbsp;Lukas Imbach","doi":"10.1016/j.cnp.2024.08.001","DOIUrl":"10.1016/j.cnp.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><p>We present a case of a 46-year-old man with Lennox-Gastaut syndrome and drug-resistant epilepsy. An adjunctive neurostimulation therapy strategy was implemented involving bilateral deep brain stimulation (DBS) of the centromedian thalamic nucleus (CMT).</p></div><div><h3>Methods</h3><p>Robotically assisted implantation of bilateral DBS directional lead system with 8 contacts in the CMT was performed. The clinical course was assessed in repeated in-patient follow-ups.</p></div><div><h3>Results</h3><p>Initial DBS stimulation resulted in progressive ataxia and dysarthria significantly beyond the level seen before surgery. Deactivation of DBS coincided with improvement of dysarthria. A DBS stimulation paradigm with reduction of lateral and superior stimulation resulted in improvement and eventually complete resolution of the stimulation side effect.</p></div><div><h3>Discussion</h3><p>This case suggests that stimulation-induced dysarthria in DBS can be improved by targeted reduction of lateral and/or superior thalamic stimulation. When dysarthria and ataxia occur during DBS, directed stimulation to medial thalamic structures and more inferior electrode contacts offers a promising strategy to reduce side effects while maintaining positive effects.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 233-235"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000222/pdfft?md5=be5e66cca745f2972659627bfc20c150&pid=1-s2.0-S2467981X24000222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097607","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 ultrasound-guidance of nerves and muscles for patient tolerance and parameters electrodiagnostic studies","authors":"Marie Laure Inghilleri ,&nbsp;Sandrine Alonso ,&nbsp;Hélène Moron ,&nbsp;Hector Ruiz ,&nbsp;Sophie Bastide ,&nbsp;Sarah Coudray","doi":"10.1016/j.cnp.2024.01.003","DOIUrl":"10.1016/j.cnp.2024.01.003","url":null,"abstract":"<div><h3>Objective</h3><p>To assess impact of ultrasound guidance (USG) on patient’s perception of nerve conduction studies (NCS).</p></div><div><h3>Methods</h3><p>In this single-center, randomized, sham-controlled, parallel, single-blind trial, we evaluated ultrasound (US) in identifying NCS stimulation site. Consecutive adults (18–80 old) without neuropathy referred for NCS were electronically randomized 1:1 to USG or Sham US. The primary outcome was sensory supramaximal intensity (SSMI) for each site/nerve; motor supramaximal intensity (MSMI), amplitudes, number of non-routine muscle punctured, Visual Analogue Scale (VAS), satisfaction were secondary outcomes.</p></div><div><h3>Results</h3><p>290 participants were randomized, with 145 in the USG and 144 Sham US groups, respectively. No difference in SSMI, CMAP or SNAP, VAS, satisfaction was recorded. With USG, the median at the elbow and fibular MMSI were lower (p = 0.04; p = 0.02). With normal NCS or overweight and obese subgroups patients had lower median SSMI (p = 0.05/ p = 0.02), higher median and sural SNAP with normal NCS (p = 0.04; p = 0.007) and the sural SNAP for the expert US subgroup (p = 0.02).</p></div><div><h3>Conclusions</h3><p>USG is useful for nerves, that are anatomically variable or in obesity. The sural SNAP gain with US in the normal NCS subgroup could facilitate routine NCS.</p></div><div><h3>Significance</h3><p>In standard NCS the USG does not modify the patient’s tolerance.</p><p><strong>Trial Registration:</strong> clinicaltrials.gov (NCT03868189).</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 78-84"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000064/pdfft?md5=b429328969813cf5ba4ede5768daa0d1&pid=1-s2.0-S2467981X24000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139637403","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":"Пepeвoд и aдaптaция для pyccкoгo языкa пepecмoтpeннoгo глoccapия тepминoв, нaибoлee чacтo иcпoльзyeмыx в клиничecкoй элeктpoэнцeфaлoгpaфии, и oбнoвлённoгo пpeдлoжeния пo фopмe зaключeния ЭЭГ (IFCN, 2017 г.)","authors":"Mikhail Sinkin ,&nbsp;Nadezhda Kvaskova ,&nbsp;Vasily Nogovitsyn ,&nbsp;Alexey Troitsky ,&nbsp;Irina Ivanova ,&nbsp;Alexandra Belyakova-Bodina ,&nbsp;Amayak Broutian","doi":"10.1016/j.cnp.2024.01.004","DOIUrl":"10.1016/j.cnp.2024.01.004","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 138-161"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000076/pdfft?md5=6770f16b4d4b1ac193d5b3645e4ad0e3&pid=1-s2.0-S2467981X24000076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139877901","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":"Compound muscle action potential of whole-forearm flexors: A clinical biomarker for inclusion body myositis","authors":"Tomoo Mano ,&nbsp;Naohiko Iguchi ,&nbsp;Naoki Iwasa ,&nbsp;Nanami Yamada ,&nbsp;Kazuma Sugie","doi":"10.1016/j.cnp.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.cnp.2024.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to investigate the potential of whole-forearm flexor muscle (WFFM) compound muscle action potential (CMAP) as a quantitative biomarker for inclusion body myositis (IBM) pathology.</p></div><div><h3>Methods</h3><p>We prospectively enrolled 14 consecutive patients (10 men and 4 women) diagnosed with IBM based on muscle biopsies. We evaluated the baseline-to-peak amplitude of the WFFM CMAP and other quantitative parameters, including grip and pinch strength, Inclusion Body Myositis Functional Rating Scale (IBMFRS) score, and other routine muscle CMAP amplitudes.</p></div><div><h3>Results</h3><p>The WFFM CMAP was strongly correlated with disease duration and the IBMFRS score. The WFFM CMAP on the more affected side was lower than that on the less affected side. Furthermore, grip power was strongly correlated with the WFFM CMAP, whereas lateral pinch strength was strongly correlated with the WFFM and first dorsal interosseous CMAPs. The 3-point pinch strength was also correlated with the WFFM CMAP.</p></div><div><h3>Conclusions</h3><p>This study demonstrates that the WFFM CMAP may serve as a biomarker of severity in IBM.</p></div><div><h3>Significance</h3><p>Identification of this biomarker can support drug development, diagnosis, prognosis, and treatment options for patients with IBM.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 162-167"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000143/pdfft?md5=c5ee443e624833861e41f2e57e89ec24&pid=1-s2.0-S2467981X24000143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140651037","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":"Surface recording of the H-reflex from a relaxed flexor carpi ulnaris: Reliability and normative values for healthy young adults","authors":"Hesham N. Alrowayeh","doi":"10.1016/j.cnp.2024.06.001","DOIUrl":"10.1016/j.cnp.2024.06.001","url":null,"abstract":"<div><p><em>Objective:</em> H-reflex recordings of the relaxed flexor carpi ulnaris (FCU) muscle are not frequently performed in clinical or laboratory settings. There are no normative values or reliability standards. This is most likely because of technical difficulties associated with this technique. This study performed surface recordings of the H-reflex of relaxed FCU muscles to establish the normative values and the reliability of these recordings. <em>Methods:</em> The maximum amplitude and latency of the FCU H-reflex were recorded bilaterally in 53 healthy young adults. Normative values and interclass correlation coefficients (ICCs) were calculated. <em>Results:</em> The amplitude of the relaxed FCU H-reflex were recorded in nearly all participants (96 %). The FCU H-reflex average maximum amplitude was 1.35 mV. The average latency was 18.8 ms. H-reflex amplitude and latency were not statistically different among gender or limb sides. Amplitude and latency were recoded reliably both within and between sessions with ICCs ranging from 0.96 to 0.99. <em>Conclusions:</em> Recordings of the relaxed FCU H-reflex were readily available and could be assessed reliably within and between sessions. <em>Significance:</em> This method might be used more frequently in clinical and laboratory settings to examine C7 and C8 spinal segments and upper limb muscle normal function or neuromuscular pathology.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 205-210"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000179/pdfft?md5=13b4b259c3ef8951cee3bc76e41fad76&pid=1-s2.0-S2467981X24000179-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402216","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}