Clinical Neurophysiology Practice最新文献

{"title":"Short-term effect of coil handle orientations on fMRI-guided rTMS on insomnia: A case report","authors":"Zi-Jian Feng ,&nbsp;Qiu-Ying Song ,&nbsp;Yu Han ,&nbsp;Zi-Yu Wei ,&nbsp;Cong Fu ,&nbsp;Yu-Feng Zang","doi":"10.1016/j.cnp.2023.08.004","DOIUrl":"10.1016/j.cnp.2023.08.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The coil handle orientation plays a pivotal role in the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS). However, there is currently no consensus on the optimal individualized coil handle orientation, especially for non-motor areas.</p></div><div><h3>Case presentation</h3><p>The present case reported a short-term effect of functional connectivity (FC)-guided rTMS with coil handle posterior-anterior 45° (PA45°) and posterior-anterior 135° (PA135°) on a patient with insomnia. Notably, in this case, the PA45° orientation was nearly perpendicular to the adjacent sulcus, while the PA135° orientation was almost parallel to it. Local brain activity and functional connectivity were assessed using resting-state functional magnetic resonance imaging (RS-fMRI). Additionally, motor evoked potentials (MEPs) were captured both pre and post-rTMS sessions.</p></div><div><h3>Findings</h3><p>The coil handle orientation PA45° outperformed the PA135° in both RS-fMRI and MEP outcomes. Moreover, a 9-day rTMS treatment led to discernible improvements in symptoms of depression and anxiety, complemented by a modest enhancement in sleep quality.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 194-196"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44868391","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":"Challenges in evaluating forearm muscle activity based on the compound muscle action potential of the flexors of the whole forearm","authors":"Tomoo Mano ,&nbsp;Naohiko Iguchi ,&nbsp;Naoki Iwasa ,&nbsp;Shigekazu Fujimura ,&nbsp;Tsunenori Takatani ,&nbsp;Kazuma Sugie","doi":"10.1016/j.cnp.2023.05.004","DOIUrl":"10.1016/j.cnp.2023.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>Muscle strength, which correlates with the compound muscle action potential (CMAP), can also be estimated by measuring the CMAP. Therefore, we evaluated the CMAP of the flexor muscles of the whole forearm to identify their muscle strength.</p></div><div><h3>Methods</h3><p>Fourteen healthy volunteers were enrolled. The elbow was determined to be the stimulation point, and the recording site for the flexor muscles of the whole forearm was set at approximately 8 cm distal to the elbow. We prospectively evaluated the baseline-to-peak amplitude of the CMAP of the whole forearm flexor muscles (WFFM), including that obtained from the median nerve stimulation (WFFMm), ulnar nerve stimulation (WFFMu), and their sum (WFFMsum). Additionally, we analyzed the relationships between WFFMm and WFFMu amplitudes with other quantitative parameters, including grip strength and routine CMAP amplitudes.</p></div><div><h3>Results</h3><p>The CMAP’s test–retest analysis revealed high reliability. Grip power was significantly correlated with WFFMm and WFFMsum and mildly correlated with WFFMu. Tip-pinch strength with WFFMm and flexor pollicis longus (FPL) measurements correlated significantly. Lateral-pinch strength was significantly correlated with the first dorsal interosseous muscle (FDI) measurements but not with WFFM. The abductor digiti minimi (ADM) and abductor pollicis brevis (APB) were not correlated with grip power or pinch strength.</p></div><div><h3>Conclusions</h3><p>By electrophysiology examination, this study demonstrated that WFFMm is involved in grip power and other pinch strengths. This method may serve as a novel tool for measurement of distal muscle strengths.</p></div><div><h3>Significance</h3><p>This is the first study to attempt to evaluate the muscle strength of forearm flexor muscles by measuring the CMAP.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 132-136"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/bb/main.PMC10387516.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9928735","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":"Clinical neurophysiological tests as objective measures for acute and long-term COVID-19","authors":"Margitta Seeck,&nbsp;Hatice Tankisi","doi":"10.1016/j.cnp.2022.10.002","DOIUrl":"10.1016/j.cnp.2022.10.002","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 1-2"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/b9/main.PMC9733941.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10399943","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 effect of acute respiratory events and respiratory stimulants on EEG-recorded brain activity in neonates: A systematic review","authors":"Fatima Usman ,&nbsp;Simon Marchant ,&nbsp;Luke Baxter ,&nbsp;Hamisu M. Salihu ,&nbsp;Muktar H. Aliyu ,&nbsp;Eleri Adams ,&nbsp;Caroline Hartley","doi":"10.1016/j.cnp.2023.11.002","DOIUrl":"10.1016/j.cnp.2023.11.002","url":null,"abstract":"<div><h3>Objective</h3><p>We conducted a systematic review to investigate electroencephalography (EEG) changes during periods of acute respiratory events such as apnoea and the effect of respiratory stimulants on EEG features in infants.</p></div><div><h3>Methods</h3><p>Studies examining respiration and EEG-recorded brain activity in human neonates between 28 and 42 weeks postmenstrual age were included. Two reviewers independently screened all records and included studies were assessed using the Joanna Briggs Institute Critical Appraisal Tool. The protocol was registered in PROSPERO (CRD42022339873).</p></div><div><h3>Results</h3><p>We identified 14 studies with a total of 534 infants. Nine articles assessed EEG changes in relation to apnoea, one assessed hiccups, and four investigated the effect of respiratory stimulants. The relationship between neonatal apnoea and EEG changes was inconsistent; EEG suppression and decreased amplitude and frequency were observed during some, but not all, apnoeas. Respiratory stimulants increased EEG continuity compared with before use.</p></div><div><h3>Conclusions</h3><p>Current studies in this area are constrained by small sample sizes. Diverse exposure definitions and outcome measures impact inference.</p></div><div><h3>Significance</h3><p>This review highlights the need for further work; understanding the relationship between respiration and the developing brain is key to mitigating the long-term effects of apnoea.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 203-225"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X23000288/pdfft?md5=4ae5b3c83b07fe67579ea70360d2dde7&pid=1-s2.0-S2467981X23000288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135566589","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":"Nerve ultrasound: Unravelling the different patterns of nerve enlargement in CIDP subtypes","authors":"Cheng-Yin Tan,&nbsp;Mingsheng Liu,&nbsp;Nortina Shahrizaila","doi":"10.1016/j.cnp.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.cnp.2023.11.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 226-227"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X2300029X/pdfft?md5=592814db10991fb45387fd23c1bd3a67&pid=1-s2.0-S2467981X2300029X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557586","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":"Rapid response EEG with needle electrodes in an intensive care unit with limited resources","authors":"Karine J. Abou Khaled ,&nbsp;Mei Bou Nasif ,&nbsp;Claudia Freiji ,&nbsp;Lawrence J. Hirsch ,&nbsp;Michael W.K. Fong","doi":"10.1016/j.cnp.2023.02.002","DOIUrl":"10.1016/j.cnp.2023.02.002","url":null,"abstract":"<div><h3>Objective</h3><p>Continuous EEG (cEEG) is the gold standard for detecting seizures and rhythmic and periodic patterns (RPPs) in critically ill patients but is often not available in health systems with limited resources. The current study aims to determine the feasibility and utility of low-cost, practical, limited montage, sub-dermal needle electrode EEG in a setting where otherwise no EEG would be available.</p></div><div><h3>Methods</h3><p>The study included all adult patients admitted to the intensive care unit of a single center over a 24-month period. Members of the existing ICU care team, mostly nurses, were trained to place 8 sub-dermal needle EEG electrodes to achieve rapid, limited montage-EEG recording. Clinical outcomes were recorded, including any reported major complications; and the EEG findings documented, including background characterization, RPPs, and seizures.</p></div><div><h3>Results</h3><p>One hundred twenty-three patients, mean age 68 years, underwent an average of 15.6 min of EEG recording. There were no complications of electrode placement. Overall, 13.0% had seizures (8.1% qualifying as status epilepticus [SE]), 18.7 % had generalized periodic discharges (GPDs), 4.9% had lateralized periodic discharges (LPDs), and 11.4 % sporadic epileptiform discharges (sEDs). Greater mortality was observed in patients with worse background EEGs, seizures, LPDs, or sEDs.</p></div><div><h3>Conclusions</h3><p>Rapid, limited montage EEG could be achieved safely and inexpensively in a broad population of critically ill patients following minimal training of existing care teams.</p></div><div><h3>Significance</h3><p>For resource poor centers or centers outside of major metropolitan areas who otherwise have no access to EEG, this may prove a useful method for screening for non-convulsive seizures and status epilepticus.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 44-48"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/90/main.PMC10025002.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9174569","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":"Median nerve ultrasound cross sectional area and wrist-to-forearm ratio in relation to carpal tunnel syndrome related axonal damage and patient age","authors":"Henri Grönfors ,&nbsp;Sari-Leena Himanen ,&nbsp;Lauri Martikkala ,&nbsp;Mika Kallio ,&nbsp;Katri Mäkelä","doi":"10.1016/j.cnp.2023.02.003","DOIUrl":"10.1016/j.cnp.2023.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>Primary objective was to retrospectively examine the effects of patient age and carpal tunnel syndrome (CTS) related axon loss on median nerve (MN) high resolution ultrasound (HRUS) in younger and older patients. HRUS parameters evaluated in this study were MN cross sectional area at the wrist (CSA) and wrist-to-forearm ratio (WFR).</p></div><div><h3>Methods</h3><p>The material comprised 467 wrists of 329 patients. The patients were categorized into younger (&lt;65 years) and older (≥65 years) groups. Patients with moderate to extreme CTS were included in the study. Axon loss of the MN was assessed by needle EMG and graded by the interference pattern (IP) density. The association between axon loss and CSA and WFR was studied.</p></div><div><h3>Results</h3><p>The older patients had smaller mean CSA and WFR values compared to the younger patients. CSA correlated positively to the CTS severity only in the younger group. However, WFR correlated positively to CTS severity in both groups. In both age groups, CSA and WFR correlated positively with IP reduction.</p></div><div><h3>Conclusions</h3><p>Our study complemented recent findings on the effects of patient age on the CSA of the MN. However, although the MN CSA did not correlate with the CTS severity in older patients, the CSA increased in respect to the amount of axon loss. Also, as a new result, we presented the positive association of WFR with CTS severity among older patients.</p></div><div><h3>Significance</h3><p>Our study supports the recently speculated need for different MN CSA and WFR cut-off values for younger and older patients in assessing the severity of CTS. With older patients, WFR may be a more reliable parameter to assess the CTS severity than the CSA. CTS related axonal damage of the MN is associated to additional nerve enlargement at the carpal tunnel intel site.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 81-87"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/ad/main.PMC10196766.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557872","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":"EEG-Delta brushes in DPPX encephalitis – Welcome to the club","authors":"Christine Heuer ,&nbsp;Leah Disse ,&nbsp;Debora Ledergerber ,&nbsp;Ilijas Jelcic ,&nbsp;Lukas L. Imbach","doi":"10.1016/j.cnp.2022.11.003","DOIUrl":"10.1016/j.cnp.2022.11.003","url":null,"abstract":"<div><h3>Background</h3><p>Extreme Delta Brushes are a rare interictal EEG pattern that was first described in NMDA-R encephalitis and has been considered a pathognomonic pattern for this subtype of autoimmune encephalitis. Recently, extreme delta brushes have been described as a rare EEG phenomenon in other forms of encephalitis.</p></div><div><h3>Case report</h3><p>We describe to our knowledge the first occurrence of EEG Delta brushes in DPPX encephalitis. In this article, we present a comprehensive case report and discuss clinical differential diagnosis with special emphasis on the diagnostic value of the EEG, leading the way to the correct diagnosis. We also present current diagnostic criteria and clinical screening scales for initial evaluation for patients with suspected autoimmune encephalitis.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 12-15"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/41/main.PMC9792293.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10460053","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":"Utility of nerve ultrasound in the management of primary neurolymphomatosis: Case report and review of the literature","authors":"Arena Wada ,&nbsp;Yudai Uchida ,&nbsp;Keiichi Hokkoku ,&nbsp;Amuro Kondo ,&nbsp;Yuki Fujii ,&nbsp;Takashi Chiba ,&nbsp;Takuji Matsuo ,&nbsp;Hiroshi Tsukamoto ,&nbsp;Yuki Hatanaka ,&nbsp;Shunsuke Kobayashi ,&nbsp;Masahiro Sonoo","doi":"10.1016/j.cnp.2023.04.003","DOIUrl":"10.1016/j.cnp.2023.04.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Primary neurolymphomatosis (NL) is a critical differential diagnosis of asymmetric multiple mononeuropathy and radiculoplexopathy. Its diagnosis is often challenging due to the lack of typical clinical signs of systemic lymphoma. We report a case of primary NL where nerve ultrasound (NUS) played an important role in the diagnosis and follow-up of the disease.</p></div><div><h3>Case presentation</h3><p>A 52-year-old man developed asymmetric painful multiple mononeuropathy in the right upper limb with cranial nerve involvement. After being referred to our department, the patient underwent NUS, which revealed marked enlargement and increased vascularity in the right upper limb nerves, brachial plexus, and cervical nerve roots. Furthermore, an epineural hypoechoic mass, a characteristic finding of NL, was seen in the right median nerve. These NUS findings prompted us to perform 18F-fluorodeoxyglucose positron emission tomography/computed tomography and a subsequent biopsy on the right axillary lymph node, confirming NL. Notably, the NUS abnormalities dramatically subsided, demonstrating the effectiveness of chemotherapy.</p></div><div><h3>Discussion</h3><p>The diagnostic utility of NUS for NL has been documented by many recent reports. Additionally, NUS can work as a quick follow-up tool for NL, as seen in our case.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 92-96"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/e4/main.PMC10225816.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9924283","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":"Repetitive transcranial magnetic stimulation for early-onset Alzheimer’s disease – A case report","authors":"Ali Elahi,&nbsp;Tiffany Frechette","doi":"10.1016/j.cnp.2023.07.003","DOIUrl":"10.1016/j.cnp.2023.07.003","url":null,"abstract":"<div><h3>Background</h3><p>Early-onset Alzheimer’s Disease (AD) is a rare form of AD defined as exhibiting signs and symptoms before age 65. Several studies have shown high frequency repetitive transcranial magnetic stimulation (rTMS) to be an effective treatment for individuals with mild cognitive impairment (MCI) and AD when applied to the left and/or right dorsolateral prefrontal cortex (DLPFC) with clear improvements found on standardized assessments of cognitive function.</p></div><div><h3>Case report</h3><p>Here, we present a case report of a 44-year-old patient with clinical and laboratory characteristics of definite early-onset AD.</p></div><div><h3>Findings</h3><p>rTMS led to marked cognitive improvements. We hope to inspire more clinical interest in exploring rTMS for treatment of dementia.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 161-163"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/bf/main.PMC10425613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10010667","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}