Clinical Neurophysiology Practice最新文献_第8页

EEG focal delta slowing in focal epilepsy – A didactic review 局灶性癫痫的脑电图局灶δ变慢-一个教学回顾

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-09-11 DOI: 10.1016/j.cnp.2025.09.001

Laurent Sheybani , Pia De Stefano , Margitta Seeck , Serge Vulliémoz , Pierre Mégevand

{"title":"EEG focal delta slowing in focal epilepsy – A didactic review","authors":"Laurent Sheybani , Pia De Stefano , Margitta Seeck , Serge Vulliémoz , Pierre Mégevand","doi":"10.1016/j.cnp.2025.09.001","DOIUrl":"10.1016/j.cnp.2025.09.001","url":null,"abstract":"<div><div>Focal slowing in scalp electroencephalography (EEG) is classically seen as an unspecific entity in terms of its association with both epilepsy and distinct aetiologies. This could be due to a lack of standardization in the assessment of slowing morphology, in distinction to precise guidelines utilized in the evaluation of pathological activities, such as interictal epileptiform discharges (IEDs). However, consistent features can be identified, which can be informative about the underlying brain pathology and risk of seizures. In this review, we discuss the different kinds of focal slowing, focusing mainly on the delta range (0.5–4 Hz), their respective pathological processes and their prognostic value in terms of likelihood to be associated with acute seizures or epilepsy. We then present new findings on source localization of focal slowing. Last, we review recent evidence of interaction between focal slow activities and epileptic activities. Our didactic approach will guide readers through important aspects of an EEG entity that might have been neglected despite past and recent observations of its relevance in epilepsy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 392-401"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104576","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}

引用次数: 0

Longitudinal, EEG-based assessment of sleep in people with epilepsy: An automated sleep staging algorithm non-inferior to human raters 癫痫患者睡眠的纵向、基于脑电图的评估：一种不逊于人类评分者的自动睡眠分期算法

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-01-27 DOI: 10.1016/j.cnp.2025.01.001

Asbjoern W. Helge , Federico G. Arguissain , Lukas Lechner , Gerhard Gritsch , Jonas Duun-Henriksen , Esben Ahrens , Tilmann Kluge , Manfred Hartmann

{"title":"Longitudinal, EEG-based assessment of sleep in people with epilepsy: An automated sleep staging algorithm non-inferior to human raters","authors":"Asbjoern W. Helge , Federico G. Arguissain , Lukas Lechner , Gerhard Gritsch , Jonas Duun-Henriksen , Esben Ahrens , Tilmann Kluge , Manfred Hartmann","doi":"10.1016/j.cnp.2025.01.001","DOIUrl":"10.1016/j.cnp.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>There is an unmet need in epilepsy management for tools that measure sleep objectively over long timespans. Subcutaneous EEG is well-suited for the task, but it requires a reliable automatic algorithm. Here, we present and evaluate such an algorithm, and we show clinical examples of how it produces important information.</div></div><div><h3>Methods</h3><div>A mix of scalp EEG and subcutaneous EEG was used to develop an algorithm to output sleep stages and common sleep parameters. The algorithm was tested on unseen data from 11 healthy subject and 12 people with epilepsy (PwE). Lastly, data (>3months) from three exemplary PwE were analyzed for sleep.</div></div><div><h3>Results</h3><div>The algorithm proved non-inferior at sleep stage segmentation on data from PwE compared to human raters using scalp EEG. It reached a Cohen’s kappa score of 0.8 [CI 0.78 – 0.83] on healthy subjects and on data from PwE it got to 0.705 [CI 0.663–––0.744] against rater D and 0.686 [CI 0.632–––0.739] against rater E. The three examples showed that useful information can be gained from longitudinal sleep analysis.</div></div><div><h3>Conclusion</h3><div>Subcutaneous EEG and a sleep algorithm can be employed to effectively review sleep in PwE at a level that is non-inferior compared to human raters.</div></div><div><h3>Significance</h3><div>This has the potential to make objective sleep parameters available in the clinic as a valuable addition to subjective sleep assessments.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 30-39"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175361","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}

引用次数: 0

Competence of healthcare professionals performing electroencephalography test: A systematic review 医疗保健专业人员执行脑电图测试的能力：系统回顾

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-03-08 DOI: 10.1016/j.cnp.2025.03.001

Elina Linnavuori , Irina Virtanen , Minna Stolt

{"title":"Competence of healthcare professionals performing electroencephalography test: A systematic review","authors":"Elina Linnavuori , Irina Virtanen , Minna Stolt","doi":"10.1016/j.cnp.2025.03.001","DOIUrl":"10.1016/j.cnp.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the EEG competence of healthcare professionals and how this competence has been measured in previous literature.</div></div><div><h3>Methods</h3><div>A systematic review following the preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted in CINAHL, PubMed, Scopus, and Web of Science databases focusing on studies that empirically examined the EEG competence of healthcare professionals.</div></div><div><h3>Results</h3><div>A total of 28 studies were included. EEG competence consists of two main categories: knowledge and skills of EEG, and attitudes and values towards EEG. The EEG competence of healthcare professionals was assessed in three different settings: tests, simulations, and real life. The data collection methods were knowledge tests, self-assessments, and observations. The tools were developed by a researcher(s) for the single study and were not psychometrically tested.</div></div><div><h3>Conclusion</h3><div>EEG competence is a multidimensional concept that includes knowledge, skills, attitudes, and values that need to be considered when defining EEG competence and developing tools to measure it.</div></div><div><h3>Significance</h3><div>This systematic review provides information to the educators of healthcare professionals and healthcare organizations involved in developing comprehensive EEG training programs and assessments to foster professional development and ensure reliable diagnostic test results for patients.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 104-115"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619968","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}

引用次数: 0

Increased central serotonergic activity in patients after an acute ischemic stroke. An EEG study 急性缺血性脑卒中后患者中枢血清素活性增高。脑电图研究

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-10-17 DOI: 10.1016/j.cnp.2025.10.003

Vera Flasbeck , Andreas Ebert , Bettina Klostermann , Daniel Richter , Ralf Gold , Christos Krogias , Georg Juckel

{"title":"Increased central serotonergic activity in patients after an acute ischemic stroke. An EEG study","authors":"Vera Flasbeck , Andreas Ebert , Bettina Klostermann , Daniel Richter , Ralf Gold , Christos Krogias , Georg Juckel","doi":"10.1016/j.cnp.2025.10.003","DOIUrl":"10.1016/j.cnp.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>Acute ischemic stroke (AIS) is often accompanied by functional impairments and post-stroke depression (PSD), affecting ∼30 % of patients. Since central serotonergic dysfunction may contribute to PSD, similar to major depressive disorder, we examined depressive symptoms and serotonergic neurotransmission after AIS using the loudness dependence of auditory evoked potentials (LDAEP), a non-invasive EEG marker.</div></div><div><h3>Methods</h3><div>19 patients with AIS and 18 age-matched healthy participants completed depression questionnaires (BDI, HAMD). LDAEP was assessed within 14 days after AIS and after three months, analyzed with mixed-models ANOVA.</div></div><div><h3>Results</h3><div>Shortly after AIS, patients showed lower LDAEP compared to controls for all electrodes (AIS <em>M</em> = 0.072 ± 0.077; controls <em>M</em> = 0.133 ± 0.095; <em>p</em> = 0.037), frontal (<em>p</em> = 0.011) and frontocentral (<em>p</em> = 0.027) electrodes. After three months, differences reached trend-level (<em>p</em> = 0.12). Depression scores were higher in patients, but not clinically relevant.</div></div><div><h3>Conclusions</h3><div>AIS appears to be associated with altered serotonergic neurotransmission, with attenuated LDAEP differences at three months possibly reflecting remission. As depression scores were not clinically relevant, serotonergic changes likely reflect a general AIS effect rather than being specific to PSD.</div></div><div><h3>Significance</h3><div>Early LDAEP measurement may serve as a non-invasive biomarker to identify patients with altered serotonergic functioning and guide interventions, such as SSRI therapy, to reduce PSD risk and improve recovery.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 480-486"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319534","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}

引用次数: 0

Corrigendum to “Neurophysiological monitoring during anterior cervical discectomy and fusion for ossification of the posterior longitudinal ligament” [Clin. Neurophysiol. Pract. 6 (2021) 56–62] “颈椎前路椎间盘切除术和融合治疗后纵韧带骨化的神经生理监测”的勘误[临床。Neurophysiol。惯例6 (2021)56-62]

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-02-21 DOI: 10.1016/j.cnp.2025.02.001

Jee-Eun Kim , Jun-Soon Kim , Sejin Yang , Jongsuk Choi , Seung-Jae Hyun , Ki-Jeong Kim , Kyung Seok Park

引用次数: 0

The role of EEG in the emergency department: Its contribution to the patient’s diagnostic–therapeutic pathway. The EMINENCE study 脑电图在急诊科的作用：它对病人的诊断-治疗途径的贡献。隆起研究

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-03-03 DOI: 10.1016/j.cnp.2025.02.010

Scarpino Maenia , Verna Maria Teresa , Grippo Antonello , Lolli Francesco , Piccardi Benedetta , Nazerian Peiman , Nencini Patrizia , Boccardi Cristina , Nencioni Andrea

{"title":"The role of EEG in the emergency department: Its contribution to the patient’s diagnostic–therapeutic pathway. The EMINENCE study","authors":"Scarpino Maenia , Verna Maria Teresa , Grippo Antonello , Lolli Francesco , Piccardi Benedetta , Nazerian Peiman , Nencini Patrizia , Boccardi Cristina , Nencioni Andrea","doi":"10.1016/j.cnp.2025.02.010","DOIUrl":"10.1016/j.cnp.2025.02.010","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the utility of the emergency electroencephalogram(emEEG) in the diagnostic work-up of patients admitted to the Emergency Department(ED).</div></div><div><h3>Methods</h3><div>Data from consecutive patients admitted to the ED during a 1-year period. We evaluated the usefulness of emEEGs based on the subsequent patient clinical management.</div></div><div><h3>Results</h3><div>1125 emEEGs from 1018 patients were analyzed. The overall usefulness of an emEEG was 86.7%, mainly influenced by its contribution to diagnosis(75.0%), often excluding initial working diagnosis(50.0%), and to patient management(78.0%). EmEEGs showed their best overall usefulness in Status Epilepticus(SE) and altered level of consciousness both in contributing to the final diagnosis and in patient management and therapeutic pathway. In speech and cognitive/behavioural disorders, emEEGs contributed to the diagnosis(80.6% and 79.8%, respectively), often excluding the initial suspicion of seizures/SE. Normal emEEGs contributed to diagnosis(79.0%), patient management(87.0%) and discharge to home(82.0%).</div></div><div><h3>Conclusions</h3><div>In ED, attending physicians have to make quick decisions about the diagnostic–therapeutic management of patients, and also the ruling out of the initial diagnosis and safely discharging the patient to home are also important goals.</div></div><div><h3>Significance</h3><div>This study provides valuable guidance to ED clinicians in selecting patients for an emEEG and evaluates its contribution to their diagnostic–therapeutic management.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 70-77"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580355","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}

引用次数: 0

Multiple factors contribute to pupillary light reflex: implications for screening of traumatic brain injury in military service members 多种因素影响瞳孔光反射：对军人创伤性脑损伤筛查的意义

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-07-09 DOI: 10.1016/j.cnp.2025.07.002

Michael N. Dretsch , Katie M. Williams , Diana P. Evans , Katrina S. Monti , Brian J. Guise , Mark L. Ettenhofer , Jamie N. Hershaw

{"title":"Multiple factors contribute to pupillary light reflex: implications for screening of traumatic brain injury in military service members","authors":"Michael N. Dretsch , Katie M. Williams , Diana P. Evans , Katrina S. Monti , Brian J. Guise , Mark L. Ettenhofer , Jamie N. Hershaw","doi":"10.1016/j.cnp.2025.07.002","DOIUrl":"10.1016/j.cnp.2025.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the contribution of demographics, medical history, and psychological health to pupillary light reflex (PLR) indices in Service members with and without a history of mild traumatic brain injury (mTBI).</div></div><div><h3>Methods</h3><div>PLR data from NeurOptics NPi-300 were analyzed on 216 participants who were categorized as non-injured controls (NIC), mTBI with no loss of consciousness (mTBI<sup>LOC-</sup>), or mTBI with LOC (mTBI<sup>LOC+</sup>). Multiple independent regression models were conducted for each PLR index to assess the contribution of these factors to the variability of PLR indices by group.</div></div><div><h3>Results</h3><div>There were no significant group differences on the PLR indices. Age was a significant factor across groups, but more robust for those with mTBI. Sleep duration, injury characteristics, and psychological health effects on PLR indices were primarily observed in the mTBI<sup>LOC+</sup> group. Posttraumatic stress and sex were not significant predictors in any of the models.</div></div><div><h3>Conclusions</h3><div>When using PLR for screening of mTBI, an individual’s age, history of prior mTBI, total lifetime TBI-related alterations in consciousness, sleep, and anxiety and depression symptoms should be considered when interpreting PLR metrics.</div></div><div><h3>Significance</h3><div>Controlling for these factors is essential for validating the use of PLR for screening of mTBI.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 256-264"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605723","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}

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Within five weeks: Rapidly grown glioblastoma discovered on repeat MRI after pathologic EEG 5周内：病理脑电图后复查MRI发现快速生长的胶质母细胞瘤

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-02-22 DOI: 10.1016/j.cnp.2025.02.002

Zsuzsanna Szankai , Egle Huggenberger , Christoph Metzler , Christian Musahl , Markus Gschwind

引用次数: 0

Correlation analysis between excitability in the somatosensory cortex and structural changes in amyotrophic lateral sclerosis 肌萎缩性侧索硬化症体感觉皮层兴奋性与结构变化的相关性分析

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-06-18 DOI: 10.1016/j.cnp.2025.06.003

Aysegul Gunduz , Tuba Akıncı , Osman Aykan Kargın , Melih Tutuncu , Serdar Arslan , Nurten Uzun

{"title":"Correlation analysis between excitability in the somatosensory cortex and structural changes in amyotrophic lateral sclerosis","authors":"Aysegul Gunduz , Tuba Akıncı , Osman Aykan Kargın , Melih Tutuncu , Serdar Arslan , Nurten Uzun","doi":"10.1016/j.cnp.2025.06.003","DOIUrl":"10.1016/j.cnp.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to investigate the excitability of the somatosensory cortex and its relationship to structural changes in motor and sensory pathways, and motor excitability in amyotrophic lateral sclerosis (ALS).</div></div><div><h3>Patients and method</h3><div>We included all consecutive individuals with ALS, fulfilling the “definite” or “probable” ALS criteria. We recorded surround inhibition (SI) and recovery function (RC) of somatosensory evoked potentials (SEPs), resting motor threshold, and cortical silent period (cSP), and performed volumetric analysis and diffusion tensor imaging (DTI).</div></div><div><h3>Results</h3><div>We included 15 patients with ALS and 12 healthy individuals of similar age and sex. At the group level, the mean SEP-RC% at ISI 5 ms was higher in the ALS group than in healthy participants (all SEP-RC% at 5 ms p < 0.001). SEP-SI was lost in one-third of individuals with ALS. A negative correlation was found between the duration of the cSP and SEP-RC%, whereas no correlations were observed between SEP parameters and radiological volumetric analysis of the corticospinal tract, medial lemniscus, or cortical thickness of the precentral and postcentral gyri.</div></div><div><h3>Conclusion</h3><div>Somatosensory hyperexcitability is present in ALS, and SI is lost in a subset of patients with ALS.</div></div><div><h3>Significance</h3><div>Somatosensory hyperexcitability correlates well with cSP but not with structural changes.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 202-208"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366657","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}

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Methotrexate-induced neurotoxicity: Diagnostic challenges and the role of neurophysiological testing 甲氨蝶呤诱导的神经毒性：诊断挑战和神经生理测试的作用

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Clinical Neurophysiology Practice Pub Date : 2025-01-01 Epub Date: 2025-06-17 DOI: 10.1016/j.cnp.2025.06.004

Pauline D’hoore , Joke Terryn

{"title":"Methotrexate-induced neurotoxicity: Diagnostic challenges and the role of neurophysiological testing","authors":"Pauline D’hoore , Joke Terryn","doi":"10.1016/j.cnp.2025.06.004","DOIUrl":"10.1016/j.cnp.2025.06.004","url":null,"abstract":"<div><div>Methotrexate (MTX) is widely used in the treatment of acute lymphocytic leukemia (ALL) and other onco-hematological conditions. Although subacute MTX-related neurotoxicity is relatively rare, it can present with dramatic, fluctuating neurological deficits that mimic other serious conditions. Diagnosis may be complicated by the frequent presence of asymptomatic white matter abnormalities on MRI, commonly attributed to chronic MTX toxicity.</div><div>We report an 18-year-old ALL patient who developed severe, fluctuating neurological symptoms 11 days after the third intrathecal administration of MTX. MRI showed bilateral, symmetric diffusion-restrictive white matter lesions. Absent cortical motor evoked potentials (MEPs) with preserved responses to spinal stimulation indicated corticospinal tract involvement localized to the brain, supporting a diagnosis of MTX-induced neurotoxicity. Treatment with high-dose dextromethorphan led to rapid and complete recovery.</div><div>This case underscores the value of early neurophysiological testing – particularly MEPs – in identifying corticospinal tract involvement and differentiating symptomatic neurotoxicity from chronic, asymptomatic MRI findings. Prompt recognition can accelerate diagnosis, guide treatment, and prevent unnecessary interventions.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 218-221"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501197","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}

引用次数: 0