Clinical Neurophysiology Practice最新文献

{"title":"Sympathetic skin response in fibromyalgia patients with small fibre pathology","authors":"Elena Ammendola,&nbsp;Giulia Paparella,&nbsp;Emmanuella Ladisa,&nbsp;Giusy Tancredi,&nbsp;Giulia Paparella,&nbsp;Grazia Devigili,&nbsp;Marianna Diletta Delussi,&nbsp;Katia Ricci,&nbsp;Livio Clemente,&nbsp;Marina de Tommaso","doi":"10.1016/j.cnp.2026.06.001","DOIUrl":"10.1016/j.cnp.2026.06.001","url":null,"abstract":"<div><div>Objective: Fibromyalgia (FM) is a chronic disease characterised by small fibre pathology and autonomic dysfunction. Sympathetic Skin Response (SSR) can be easily obtained in clinical practice as a marker of autonomic dysfunction. This study aims to assess SSR abnormalities in small fibre pathology associated with FM.</div><div>Methods: This was a retrospective, observational, single-centre, cross-sectional study including 393 patients with FM, who underwent skin biopsy from the thigh and ankle, SSR obtained with a standard electromyographic active electrode attached to the right palm and sole, and clinical evaluation.</div><div>Results: SSR at the hand and foot was similarly absent in patients with both normal and abnormal skin biopsy results. Hand amplitude was reduced in patients with denervation (Wilcoxon z = 1.89, <em>p</em> = 0.029), while latencies were similar between groups (z = 1.12, <em>p</em> = 0.13). Foot latency was prolonged in patients with abnormal skin biopsy (z = 2.17, <em>p</em> = 0.014), while amplitudes were similar between groups (chi-square = 2.28, <em>p</em> = 0.21). SSR showed low predictive performance for skin biopsy results (r² = 0.04). Latency of SSR at the foot and Intraepidermal Nerve Fibre Density (IENFD) correlated with the score for associated symptoms. Amplitude of SSR at the foot also negatively correlated with anxiety, depression, and fatigue scores.</div><div>Conclusions: SSR abnormalities did not correspond to small fibre impairment detected by skin biopsy in patients with FM.</div><div>Significance: SSR and skin biopsy may capture different aspects of the complex clinical picture of FM, including psychopathological features and fatigue, and therefore represent complementary yet distinct biomarkers of the disease.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 442-447"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362823","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":"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}

{"title":"The impact of Independent Component Analysis on TMS-evoked potentials: a within-subject comparison across motor and prefrontal areas","authors":"Eva Oostra ,&nbsp;Emile d’Angremont ,&nbsp;Timo van Hattem ,&nbsp;Shilpa Anand ,&nbsp;Sophie Schubert ,&nbsp;Odile A. van den Heuvel ,&nbsp;Ysbrand D. van der Werf","doi":"10.1016/j.cnp.2026.03.007","DOIUrl":"10.1016/j.cnp.2026.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Independent component analysis (ICA) is a common method to remove artifacts and improve signal quality in transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) data. However, the impact of applying different rounds of ICA for TMS-EEG datasets are lacking. Here, we investigated the impact of applying zero, one, or two rounds of ICA on TMS-evoked potentials (TEPs) in the motor cortex and prefrontal cortex using a within-subject design.</div></div><div><h3>Methods</h3><div>Twenty-three healthy participants received 51 single-pulses over the left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC), with simultaneous EEG-recording. Data were preprocessed three times: with zero, one, or two rounds of ICA. We compared the TEP-amplitudes and local mean field potential-area under the curve (LMFP-AUC).</div></div><div><h3>Results</h3><div>After M1 stimulation, preprocessing two ICA rounds resulted in significantly more N40-peaks identified, and smaller P30 (3.84 µV ± 0.78) and P60 (3.08 µV ± 0.96) amplitudes compared to 0 ICA rounds. After DLPFC stimulation, zero ICA rounds led to significantly fewer identified P30 (n = 4) and N40-peaks (n = 5), and larger P60 (5.63 µV ± 1.34) and P180-amplitudes (8.62 µV ± 0.76) compared to 0 ICA. The N100-component remained stable across ICA conditions for both brain areas.</div></div><div><h3>Discussion</h3><div>Our results showed a large impact of ICA, compared to zero ICA rounds, particularly after DLPFC stimulation; likely due to increased eye-blink artifacts. We therefore recommend implementing eye-blink artefact removal during the first round of ICA. In M1, the addition of an ICA round only impacted the early-TEPs. This study is the first to directly compare ICA-effects on both motor and non-motor TMS-EEG data using a within-subject design.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 273-281"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147649502","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":"Diagnostic accuracy of somatosensory evoked potentials in lumbar spine surgery: A systematic review and meta-analysis","authors":"Prasuna L. Velur,&nbsp;Vibha Velur,&nbsp;Marvin Gong","doi":"10.1016/j.cnp.2026.07.005","DOIUrl":"10.1016/j.cnp.2026.07.005","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative somatosensory evoked potential (SSEP) monitoring is widely employed during lumbar spine surgery, yet its diagnostic accuracy remains incompletely characterised for contemporary minimally invasive approaches.</div></div><div><h3>Objective</h3><div>To evaluate the diagnostic accuracy of intraoperative SSEP changes for predicting postoperative neurologic deficits and assess whether reversibility differentially influences performance.</div></div><div><h3>Methods</h3><div>Systematic review and meta-analysis (PROSPERO: CRD422026135172) restricted to studies published after the <span><span>Chang et al. (2021)</span></span> search cutoff (October 2019 to January 2026); five studies (1017 patients). DerSimonian–Laird random-effects logit models estimated pooled sensitivity, specificity, and diagnostic odds ratio (DOR); subgroup analyses by reversibility. Heterogeneity: Cochran Q and I² with 95% CIs; quality: QUADAS-2.</div><div>Results: Pooled sensitivity 36.4% (95% CI: 10.7–73.2%); specificity 91.7% (95% CI: 74.6–97.6%); DOR 5.22 (95% CI: 2.17–12.52); I² = 0.0%. Irreversible changes: DOR 22.12 (95% CI: 3.06–159.7); reversible: DOR 0.69 (95% CI: 0.18–2.66; <em>P</em> = .594). Positive likelihood ratio (LR+) 4.39 (post-test probability 16.9%); negative likelihood ratio (LR−) 0.69 (3.1%). Deeks funnel test <em>P</em> = .819.</div></div><div><h3>Conclusions</h3><div>Across five contemporary lumbar surgery studies (1017 patients; 2019–2026), SSEP monitoring is highly specific (91.7%) but only moderately sensitive (36.4%) for neurologic deficits. Irreversible changes carry greater diagnostic weight (DOR 22.12; 95% CI: 3.06–159.7) than reversible changes (DOR 0.69; 95% CI: 0.18–2.66). Monitoring modality should match the neural structures at risk; adjunct MEP and EMG are recommended where motor root injury predominates.</div></div><div><h3>Significance</h3><div>Procedure-specific SSEP diagnostic accuracy estimates for contemporary lumbar surgery support a context-dependent approach; the greater diagnostic weight of irreversible versus reversible changes (DOR 22.12 vs 0.69) has direct intraoperative implications.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 579-588"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148587759","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":"Neurophysiological correlates of taVNS-mediated cognitive enhancement","authors":"Myeong Seong Bak,&nbsp;Jin-Sol Lee,&nbsp;Geehoon Chung,&nbsp;In-Seon Lee,&nbsp;Sun Kwang Kim","doi":"10.1016/j.cnp.2026.06.003","DOIUrl":"10.1016/j.cnp.2026.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the neural mechanisms underlying cognitive enhancement through transcutaneous auricular vagus nerve stimulation (taVNS) by analyzing Stroop task performance and electroencephalography (EEG) data.</div></div><div><h3>Methods</h3><div>Twenty-three healthy adults (12 males; aged 19–40) were randomly assigned to either the taVNS or sham group. The Stroop task was administered in three sessions, with taVNS (3 Hz, 0.5 mA for 10 min) applied between sessions. EEG data were collected before and after the experiment, as well as during the Stroop task, for further analysis.</div></div><div><h3>Results</h3><div>The taVNS group showed higher accuracy than the sham group under the incongruent condition in Session 3 (<em>p</em> &lt; .05), consistent with differences in signal detection metrics, suggesting changes in decision processes. Across sessions, beta-band power increased during task performance in the sham group, whereas this increase was attenuated in the taVNS group. This effect was most pronounced in the high beta range (20–30 Hz) at the Fp1 channel (FDR-corrected <em>q</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>taVNS attenuated the task-related escalation in high beta-band power typically observed during sustained Stroop performance, thereby mitigating cognitive demand and enhancing response accuracy.</div></div><div><h3>Significance</h3><div>These results position taVNS as a promising non-invasive intervention for strengthening cognitive control in healthy individuals.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 483-491"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370198","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":"Decremental responses following repetitive nerve stimulation in spinal and bulbar muscular atrophy","authors":"Keisuke Tachiyama,&nbsp;Masahiro Nakamori,&nbsp;Yuki Fujii,&nbsp;Keiichi Hokkoku,&nbsp;Dai Agari,&nbsp;Shoji Hemmi,&nbsp;Eiichi Nomura,&nbsp;Yuki Hatanaka,&nbsp;Katsumi Kurokawa,&nbsp;Masahiro Sonoo,&nbsp;Hirofumi Maruyama","doi":"10.1016/j.cnp.2026.06.011","DOIUrl":"10.1016/j.cnp.2026.06.011","url":null,"abstract":"<div><h3>Objective</h3><div>The presence of decremental responses following repetitive nerve stimulation (RNS) in amyotrophic lateral sclerosis (ALS) is well established. However, in spinal and bulbar muscular atrophy (SBMA), a rare X-linked recessive lower motor neuron disease, the incidence and distribution of decremental responses across different muscles have not been thoroughly investigated.</div></div><div><h3>Methods</h3><div>Patients with SBMA were retrospectively identified in our database. RNS at a frequency of 3 Hz was performed on five muscles: the abductor pollicis brevis (APB), abductor digiti minimi (ADM), upper trapezius, deltoid, and facial muscles (frontalis or nasalis).</div></div><div><h3>Results</h3><div>A total of forty patients were identified. A significant (&gt; 5%) decremental response in at least one muscle was observed in all patients. It was observed more frequently in proximal muscles than in distal muscles: deltoid (86%), trapezius (70%), facial muscles (44%), APB (37%) and ADM (25%). The magnitude of the decremental response in the deltoid was significantly higher than that in the other muscles.</div></div><div><h3>Conclusions</h3><div>Our results demonstrated that decremental responses were frequently observed in patients with SBMA, with a distribution pattern similar to that in ALS. The fact that the decremental responses are observed in SBMA having an extremely chronic course would be relevant for the pathophysiological mechanism of the decremental response.</div></div><div><h3>Significance</h3><div>The RNS findings provide valuable insights into the pathological mechanisms of SBMA and may contribute to the development of future treatments.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 522-527"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377639","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}