Clinical Neurophysiology Practice最新文献

{"title":"EEG Signatures of COVID-19 Survival compared to close contacts and the Cuban EEG normative database","authors":"Ana Calzada-Reyes ,&nbsp;Lidice Galán-García ,&nbsp;Trinidad Virués-Alba ,&nbsp;Lidia Charroó-Ruiz ,&nbsp;Laura Perez-Mayo ,&nbsp;Maria Luisa Bringas-Vega ,&nbsp;Jorge Bosch-Bayard ,&nbsp;Yanely Acosta-Ymas ,&nbsp;Eduardo Aubert-Vázquez ,&nbsp;Mayrim Vega-Hernández ,&nbsp;Joel Gutiérrez-Gil ,&nbsp;Antonio Caballero-Moreno ,&nbsp;Annette Valdés-Virués ,&nbsp;Mitchell Valdés-Sosa ,&nbsp;Peng Ren ,&nbsp;Dezhong Yao ,&nbsp;Luo Cheng ,&nbsp;Roberto Rodriguez-Labrada ,&nbsp;Pedro Valdés-Sosa","doi":"10.1016/j.cnp.2026.02.007","DOIUrl":"10.1016/j.cnp.2026.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>This study compared EEG findings in COVID-19 survivors, close contacts, and a normative database using visual EEG inspection, quantitative EEG (QEEG), and source density analysis.</div></div><div><h3>Methods</h3><div>Resting-state EEG, QEEG, and VARETA inverse solution were analyzed in 173 participants (87 COVID-19 cases, 86 close contacts) alongside the Cuban EEG normative database. Clinical evaluations included neurological exams and neuropsychiatric assessments.</div></div><div><h3>Results</h3><div>COVID-19 survivors showed significant EEG abnormalities, including background abnormalities, focal abnormalities and diffuse slow activity. QEEG revealed excess theta, alpha, and beta activity in COVID-19 and symptomatic groups, while close contacts had elevated alpha and beta. EEG source analysis identified functional impairments in key brain regions: COVID-19 patients had abnormalities in the supramarginal and angular gyri, while close contacts showed abnormalities in the supramarginal, postcentral, and superior temporal gyri. Symptomatic individuals exhibited superior temporal gyrus abnormalities, whereas asymptomatic cases had impairments in the supramarginal, angular, and postcentral gyri.</div></div><div><h3>Conclusions</h3><div>Long-term COVID-19 impacts brain function, with QEEG and VARETA revealing region-specific vulnerabilities linked to viral exposure. These tools help assess neurological dysfunction in post-COVID cases.</div></div><div><h3>Significance</h3><div>This approach is crucial for understanding the COVID-19 long-term effects on brain function and guiding potential therapeutic interventions.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 174-186"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385307","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":"Evaluating diaphragm motor response variability in electric and magnetic phrenic nerve stimulations during passive expiration","authors":"José Castro","doi":"10.1016/j.cnp.2026.02.009","DOIUrl":"10.1016/j.cnp.2026.02.009","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 172-173"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385308","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":"Discrimination of spontaneous activity in needle EMG based on the quantitative assessment of the discharge rhythm using “Random Index”","authors":"Taiji Mukai ,&nbsp;Takamichi Kanbayashi ,&nbsp;Masahito Kobayashi ,&nbsp;Masamichi Peter Okano ,&nbsp;Keisuke Tachiyama ,&nbsp;Yosuke Miyaji ,&nbsp;Yuki Hatanaka ,&nbsp;Shunsuke Kobayashi ,&nbsp;Masahiro Sonoo","doi":"10.1016/j.cnp.2026.01.003","DOIUrl":"10.1016/j.cnp.2026.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>Discrimination between EMG activity such as fibrillation potentials/positive sharp waves (Fib/PSW), end plate spikes (EPS), fasciculation potentials (FP), and contaminating voluntary motor unit potentials (MUP) is mandatory for EMG diagnosis. Discharge rhythm is the key for discrimination. We devised a new parameter, Random Index (RI), which quantifies the rhythm and takes a value from 0 to 1, smaller for regular trains of discharges. This study evaluated the utility of RI as well as modified versions of the regularity indices proposed in past reports.</div></div><div><h3>Methods</h3><div>EMG records of patients with amyotrophic lateral sclerosis were retrospectively reviewed. EPS were collected also from a healthy volunteer. The EMG activity was classified by an expert. RI and other regularity indices as well as the median instantaneous firing rate (IFRm) were calculated.</div></div><div><h3>Results</h3><div>Analyzed sequences were 73 Fib/PSW, 27 EPS, 24 FP, and 36 MUP. The four types were clearly separated over the 2-dimensional plots of regularity indices vs. IFRm. Especially, Fib/PSW and EPS were far separated in these plots. RI achieved significantly better discrimination between Fib/PSW and MUP than other indices.</div></div><div><h3>Conclusion</h3><div>RI is a robust tool for discriminating EMG activity.</div></div><div><h3>Significance</h3><div>RI and other regularity indices would be useful for educational purpose.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 65-71"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023153","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":"Precision, accuracy, and reliability of a threshold hunting method for transcranial magnetic stimulation","authors":"Yuichiro Shirota ,&nbsp;Juuri Otsuka ,&nbsp;Masashi Hamada","doi":"10.1016/j.cnp.2025.12.008","DOIUrl":"10.1016/j.cnp.2025.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate precision, accuracy, and reliability of a threshold hunting method to estimate resting motor threshold (RMT) using parameter estimation by sequential testing and maximum likelihood estimation (PEST-MLE).</div></div><div><h3>Methods</h3><div>In 53 healthy participants, single pulse transcranial magnetic stimulation was delivered to estimate RMT with cutoff values of 0.05 mV and 0.2 mV. RMT was inferred from 30-trial PEST-MLE algorithm for at maximum two days with two estimation sessions per day, comprising Sessions 1 to 4. Precision and accuracy were assessed within each session. Repeatability was assessed using intraclass correlation coefficient (ICC), reproducibility coefficient (RC), and standard error of measurement (SEM).</div></div><div><h3>Results</h3><div>For both 0.05 mV and 0.2 mV, 18 trials were needed to have good accuracy. ICC greater than 0.8 was achieved for within-day comparison but the ICC of between-day comparison was lower. RC and SEM were around 10 % and 5 %, respectively.</div></div><div><h3>Conclusions</h3><div>At 18th trial the estimations were converged in terms of precision and accuracy, and good reliability was achieved at that stage.</div></div><div><h3>Significance</h3><div>RMT estimation with the PEST-MLE is a rapid and reliable approach that can be implemented for future clinical and scientific studies.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 24-31"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884737","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":"Evaluating diaphragm motor response variability in electric and magnetic phrenic nerve stimulations during passive expiration","authors":"Ivan Chakalov","doi":"10.1016/j.cnp.2026.03.003","DOIUrl":"10.1016/j.cnp.2026.03.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 197-198"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147537692","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":"Regional and cannabis-related differences in prefrontal multiscale entropy of resting-state EEG","authors":"William T. Creel,&nbsp;Colleen A. Brenner,&nbsp;Richard E Hartman","doi":"10.1016/j.cnp.2026.02.003","DOIUrl":"10.1016/j.cnp.2026.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>Entropy analysis of electroencephalographic (EEG) data provides insight into the complexity of neural activity. This study primarily examined whether cannabis use frequency is associated with alterations in multiscale entropy (MSE) in the prefrontal cortex (PFC) and mapped baseline MSE differences across cortical regions.</div></div><div><h3>Methods</h3><div>Resting-state EEG was collected from 57 adults: non-users (n = 18), low-frequency users (≤ 1x/week; n = 24), and frequent users (≥ 2x/week; n = 15). MSE values were binned into fine, medium, coarse, and very-coarse scale ranges. Linear mixed-effects models assessed group × scale bin interactions in the PFC and regional differences among lobes, irrespective of cannabis use.</div></div><div><h3>Results</h3><div>Entropy increased with coarser scales in all groups, but the slope was significantly flatter in frequent users. From the medium bin onward, their PFC scale–entropy slope was ∼ 0.12 bits lower than in non-users, widening to ∼ 0.16 bits at very-coarse scales (FDR-corrected q &lt; 0.012). Across all participants, the PFC exhibited lower MSE than parietal, occipital, and temporal lobes, with regional gaps expanding at coarser scales.</div></div><div><h3>Conclusions</h3><div>The PFC exhibits intrinsically reduced signal complexity compared with other cortical regions, with further attenuation in frequent cannabis users.</div></div><div><h3>Significance</h3><div>MSE captures regional cortical dynamics in resting EEG and detects cannabis-related reductions in prefrontal signal complexity at longer temporal scales.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 135-141"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327711","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":"Is accuracy enough? trust and barriers to AI-based clinical decision support in clinical neurophysiology","authors":"Øystein Dunker ,&nbsp;Leonora Onarheim Bergsjø ,&nbsp;Gro-Hilde Severinsen ,&nbsp;Henrik Glette ,&nbsp;Kristian Bernhard Nilsen","doi":"10.1016/j.cnp.2026.04.003","DOIUrl":"10.1016/j.cnp.2026.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate attitudes, trust, expectations and concerns among patients and healthcare personnel regarding the use of AI-based clinical decision support systems (AI-CDSS) in clinical neurophysiology.</div></div><div><h3>Methods</h3><div>We iteratively designed a questionnaire and conducted a national survey of patients and healthcare personnel in Norway. Patients were recruited from a quality registry, while healthcare personnel and technicians were recruited from hospital laboratories. Items included binary and Likert-scale questions addressing attitudes, expectations, concerns and trust, as well as a scenario-based trust assessment. Between-group comparisons were performed using non-parametric and categorical statistical tests.</div></div><div><h3>Results</h3><div>Both groups reported positive attitudes toward AI-CDSS. Patients more often expected AI-CDSS to improve diagnostic accuracy (p = 0.005), while healthcare personnel anticipated improved equity of services across regions (p = 0.017). Key concerns in both groups were related to responsibility, doctor-patient relationships, AI literacy, overreliance on AI, and potential deskilling. The scenario-based question revealed lower trust when AI-CDSS directly influenced decision-making without physician involvement. Trust in public institutions was high, whereas trust in commercial or industry use of health data was consistently low.</div></div><div><h3>Conclusions</h3><div>Attitudes toward AI-CDSS in clinical neurophysiology are positive, but diagnostic accuracy isn’t enough: Acceptance is conditional on human oversight, delineated responsibilities, and steps taken to improve transparency and minimize deskilling. Patients want to share health data for AI purposes, but the commercial sector needs to build trust.</div></div><div><h3>Significance</h3><div>AI-CDSS in clinical neurophysiology is promising, but design and implementation need to address key concerns shared by both patients and health care personnel.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 262-270"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147649501","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":"Neuromuscular ultrasound of the brachial plexus: know-how, know-when","authors":"Eman A. Tawfik,&nbsp;Erisela Qerama,&nbsp;Antonios Kerasnoudis,&nbsp;Nens van Alfen","doi":"10.1016/j.cnp.2026.06.007","DOIUrl":"10.1016/j.cnp.2026.06.007","url":null,"abstract":"<div><div>Neuromuscular ultrasound has become an integral diagnostic tool for brachial plexopathies, complementing electrodiagnostic studies and MRI. Despite the complex anatomy of the brachial plexus, nearly its entire postganglionic course is accessible by ultrasound, providing real-time, high-resolution structural information at the bedside. Characteristic sonographic findings have been described in traumatic plexopathies, neurogenic thoracic outlet syndrome, neuralgic amyotrophy, immune-mediated polyneuropathies, and neoplastic plexopathies. Evidence of moderate-to-high certainty now supports the use of ultrasound as a diagnostic adjunct in these conditions. Integration into clinical practice requires thorough knowledge of plexus anatomy and sonoanatomy, appropriate scanning techniques, and familiarity with condition-specific sonographic patterns. This review provides a practical framework for brachial plexus ultrasound, covering applied anatomy, systematic scanning approach, sonographic parameters and their interpretation, condition-specific findings, scanning protocols, and an evidence-based summary of its current indications.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 453-471"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370223","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":"Gold coast criteria but not neurofilaments improve diagnostic sensitivity in a specialized ALS university center","authors":"Caroline Klyk,&nbsp;Camilla Wohnrade,&nbsp;Susanne Petri,&nbsp;Aiden Haghikia,&nbsp;Sonja Körner,&nbsp;Lars Hendrik Volk","doi":"10.1016/j.cnp.2026.06.004","DOIUrl":"10.1016/j.cnp.2026.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease marked by upper and lower motor neuron loss. Diagnosing ALS may still be challenging due to the absence of specific biomarkers and requires thorough clinical evaluation, comprehensive electromyography (EMG), and exclusion of differential diagnoses by laboratory analyses and imaging. The Gold Coast criteria (GCC) replaced the revised El Escorial (rEEC) and Awaji criteria (AC), simplifying ALS diagnosis and standardizing communication with patients.</div></div><div><h3>Methods</h3><div>This retrospective study compared the sensitivity of the GCC with the rEEC and AC in a specialized neuromuscular center.</div></div><div><h3>Results</h3><div>431 patients with suspected ALS were included, and 426 patients ultimately received an ALS diagnosis. The GCC showed higher sensitivity than both the rEEC and AC. The explorative inclusion of neurofilament levels into an extended diagnostic framework did not increase the sensitivity of rEEC and AC.</div></div><div><h3>Conclusions</h3><div>Continued clinical use of the GCC should be considered the standard for ALS diagnosis. Careful clinical and electrophysiological examination is particularly essential in this context, supplemented by biomarkers such as neurofilaments.</div></div><div><h3>Significance</h3><div>This retrospective real-world study demonstrates a high sensitivity of the GCC in a specialized neuromuscular clinic.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 512-521"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565836","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":"Epileptic hub in MRI-negative focal cortical dysplasia using advanced dynamic statistical parametric mapping and magnetoencephalography","authors":"Yasuyoshi Hiramatsu,&nbsp;Midori Nakajima,&nbsp;Fumiya Takeuchi,&nbsp;Masashi Narugami,&nbsp;Satoshi Yamada,&nbsp;Sachiko Nakakubo,&nbsp;Takeru Goto,&nbsp;Shuhei Kimura,&nbsp;Yuki Ueda,&nbsp;Noriyuki Fujima,&nbsp;Kenji Hirata,&nbsp;Yuuki Ishida,&nbsp;Yoko Aburakawa,&nbsp;Keiya Iijima,&nbsp;Masaki Iwasaki,&nbsp;Rei Enatsu,&nbsp;Nobuhiro Mikuni,&nbsp;Hideaki Shiraishi,&nbsp;Atsushi Manabe,&nbsp;Kiyoshi Egawa","doi":"10.1016/j.cnp.2026.09.007","DOIUrl":"10.1016/j.cnp.2026.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>Localization of epileptogenic MRI-negative focal cortical dysplasia at the bottom of the sulcus (FCDB) is challenging. This study evaluated the utility of advanced dynamic statistical parametric mapping (AdSPM), a magnetoencephalography (MEG)-based source analysis method, for detecting epileptic MRI-negative FCDB.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed MEG data using AdSPM in four patients with pathologically confirmed MRI-negative FCDB, whose seizure onset zones were identified by intracranial video-EEG (IVEEG). The most active area identified by the AdSPM was designated as the AdSPM spike source. We compared the spatial concordance of the AdSPM spike source, single moving dipole (SMD) findings, and ¹⁸F-FDG PET/MRI findings with seizure onset and resection areas. An additional MRI-negative patient without seizures during IVEEG monitoring was analyzed separately for concordance with the resection area.</div></div><div><h3>Results</h3><div>The AdSPM spike source localized to the seizure onset zone and was included in the resection area in all four patients with an identified seizure onset zone. SMD findings were mislocalized relative to the seizure onset zone and resection area. PET/MRI was concordant with the seizure onset zone in one of three evaluable patients and with the resection area in three of four patients. In the patient without seizures during IVEEG, AdSPM and PET/MRI were concordant with the resection area; however, the SMD findings were mislocalized.</div></div><div><h3>Conclusions</h3><div>AdSPM noninvasively and neurophysiologically localizes epileptic MRI-negative FCDB and may provide useful information for presurgical evaluations.</div></div><div><h3>Significance</h3><div>This is the first diagnostic application of AdSPM for MRI-negative FCDB.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 878-887"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149211074","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}