Clinical Neurophysiology Practice最新文献

{"title":"Real-time artificial intelligence-based texture analysis of muscle ultrasound data for neuromuscular disorder assessment","authors":"Yoshikatsu Noda ,&nbsp;Kenji Sekiguchi ,&nbsp;Shun Matoba ,&nbsp;Hirotomo Suehiro ,&nbsp;Katsuya Nishida ,&nbsp;Riki Matsumoto","doi":"10.1016/j.cnp.2024.08.003","DOIUrl":"10.1016/j.cnp.2024.08.003","url":null,"abstract":"<div><h3>Objective</h3><p>Many artificial intelligence approaches to muscle ultrasound image analysis have not been implemented on usable devices in clinical neuromuscular medicine practice, owing to high computational demands and lack of standardised testing protocols. This study evaluated the feasibility of using real-time texture analysis to differentiate between various pathological conditions.</p></div><div><h3>Methods</h3><p>We analysed 17,021 cross-sectional ultrasound images of the biceps brachii of 75 participants, including 25 each with neurogenic disorders, myogenic disorders, and healthy controls. The size and location of the regions of interest were randomly selected to minimise bias. A random forest classifier utilising texture features such as Dissimilarity and Homogeneity was developed and deployed on a mobile PC, enabling real-time analysis.</p></div><div><h3>Results</h3><p>The classifier distinguished patients with an accuracy of 81 %. Echogenicity and Contrast from the Co-Occurrence Matrix were significant predictive features. Validation on 15 patients achieved accuracies of 78 %/93 % per image/patient over 15-second videos, respectively. The use of a mobile PC facilitated real-time estimation of the underlying pathology during ultrasound examination, without influencing procedures.</p></div><div><h3>Conclusions</h3><p>Real-time automatic texture analysis is feasible as an adjunct for the diagnosis of neuromuscular disorders.</p></div><div><h3>Significance</h3><p>Artificial intelligence using texture analysis with a light computational load supports the semi-quantitative evaluation of neuromuscular ultrasound.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 242-248"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000246/pdfft?md5=431aeb810595f6ab00be360d3d1f8ae9&pid=1-s2.0-S2467981X24000246-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097565","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":"History of ALS and the competing theories on pathogenesis: IFCN handbook chapter","authors":"Andrew Eisen ,&nbsp;Steve Vucic ,&nbsp;Hiroshi Mitsumoto","doi":"10.1016/j.cnp.2023.11.004","DOIUrl":"https://doi.org/10.1016/j.cnp.2023.11.004","url":null,"abstract":"<div><p>Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder of the human motor system, first described in the 19th Century. The etiology of ALS appears to be multifactorial, with a complex interaction of genetic, epigenetic, and environmental factors underlying the onset of disease. Importantly, there are no known naturally occurring animal models, and transgenic mouse models fail to faithfully reproduce ALS as it manifests in patients. Debate as to the site of onset of ALS remain, with three competing theories proposed, including (i) the <em>dying-forward hypothesis</em>, whereby motor neuron degeneration is mediated by hyperexcitable corticomotoneurons via an anterograde transsynaptic excitotoxic mechanism, (ii) <em>dying-back hypothesis,</em> proposing the ALS begins in the peripheral nervous system with a toxic factor(s) retrogradely transported into the central nervous system and mediating upper motor neuron dysfunction, and (iii) <em>independent hypothesis</em>, suggesting that upper and lower motor neuron degenerated independently. Transcranial magnetic stimulation studies, along with pathological and genetic findings have supported the dying forward hypothesis theory, although the science is yet to be settled. The review provides a historical overview of ALS, discusses phenotypes and likely pathogenic mechanisms.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 1-12"},"PeriodicalIF":1.7,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X2300032X/pdfft?md5=1663dee64e5520a61798aaea89ec82c4&pid=1-s2.0-S2467981X2300032X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138838442","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 test–retest reliability of large and small fiber nerve excitability testing with threshold tracking","authors":"Hossein Pia ,&nbsp;Zahra Nochi ,&nbsp;Alexander Gramm Kristensen ,&nbsp;Bernhard Pelz ,&nbsp;Marcus Goetz ,&nbsp;Jan-Niclas Hoeink ,&nbsp;Anthony James Blockeel ,&nbsp;André Mouraux ,&nbsp;Andrea Truini ,&nbsp;Nanna Brix Finnerup ,&nbsp;Keith Geoffrey Phillips ,&nbsp;Rolf-Detlef Treede ,&nbsp;Hatice Tankisi","doi":"10.1016/j.cnp.2023.03.003","DOIUrl":"10.1016/j.cnp.2023.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>Standard nerve excitability testing (NET) predominantly assesses Aα- and Aβ-fiber function, but a method examining small afferents would be of great interest in pain studies. Here, we examined the properties of a novel perception threshold tracking (PTT) method that preferentially activates Aδ-fibers using weak currents delivered by a novel multipin electrode and compared its reliability with NET.</p></div><div><h3>Methods</h3><p>Eighteen healthy subjects (mean age:34.06 ± 2.0) were examined three times with motor and sensory NET and PTT in morning and afternoon sessions on the same day (intra-day reliability) and after a week (inter-day reliability). NET was performed on the median nerve, while PTT stimuli were delivered through a multipin electrode located on the forearm. During PTT, subjects indicated stimulus perception via a button press and the intensity of the current was automatically increased or decreased accordingly by Qtrac software. This allowed changes in the perception threshold to be tracked during strength-duration time constant (SDTC) and threshold electrotonus protocols.</p></div><div><h3>Results</h3><p>The coefficient of variation (CoV) and interclass coefficient of variation (ICC) showed good–excellent reliability for most NET parameters. PTT showed poor reliability for both SDTC and threshold electrotonus parameters. There was a significant correlation between large (sensory NET) and small (PTT) fiber SDTC when all sessions were pooled (r = 0.29, p = 0.03).</p></div><div><h3>Conclusions</h3><p>Threshold tracking technique can be applied directly to small fibers via a psychophysical readout, but with the current technique, the reliability is poor.</p></div><div><h3>Significance</h3><p>Further studies are needed to examine whether Aβ-fiber SDTC may be a surrogate biomarker for peripheral nociceptive signalling.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 71-78"},"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/9e/c9/main.PMC10172996.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469092","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":"Acknowledgement to reviewers","authors":"","doi":"10.1016/j.cnp.2023.11.001","DOIUrl":"10.1016/j.cnp.2023.11.001","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Page 235"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X23000276/pdfft?md5=0cceeb37104a30eed6d828d5c5dc846c&pid=1-s2.0-S2467981X23000276-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135614016","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":"Keeping up appearances: Don’t frown upon the effects of botulinum toxin injections in facial muscles","authors":"Anna Rostedt Punga ,&nbsp;Mohammad Alimohammadi ,&nbsp;Maarika Liik","doi":"10.1016/j.cnp.2023.05.005","DOIUrl":"10.1016/j.cnp.2023.05.005","url":null,"abstract":"<div><p>Aesthetic use of low doses of Botulinum toxin (BoNT) injections into the facial muscles has become a leading non-surgical aesthetic treatment worldwide to reduce facial wrinkles, including glabellar lines, forehead lines, and periorbital wrinkles. Within these aesthetic applications, BoNT injections intend to reduce and prevent wrinkles, and the recommended usage of 2 years is often exceeded, which may result in atrophy of the injected muscles. The long-term effects of BoNT injections in the facial muscles and the evidence of diffusion of BoNT to surrounding muscles are obvious pitfalls and challenges for clinical neurophysiologists in differential diagnosing neuromuscular transmission failures. Also, this is further complicated by the risk of developing side effects upon permanent chemical denervation of facial muscles, with less possibility for reinnervation.</p><p>This review summarizes the known long-term effects of BoNT over time in different facial muscles and the use of objective electrophysiological measures to evaluate these. A better understanding of the long-term effects of BoNT is essential to avoid misdiagnosing other neuromuscular disorders.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 169-173"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10186527","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":"Some reasons for frowning upon the effects of botulinum toxin injections in facial muscles","authors":"Hacer Erdem Tilki","doi":"10.1016/j.cnp.2023.08.001","DOIUrl":"10.1016/j.cnp.2023.08.001","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 174-176"},"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/54/d7/main.PMC10480585.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10186531","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":"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}