{"title":"如何在功能性神经障碍(FND)中应用临床神经生理学?]","authors":"Yoshikazu Ugawa","doi":"10.5692/clinicalneurol.cn-002050","DOIUrl":null,"url":null,"abstract":"<p><p>I have reviewed the utility of clinical neurophysiological examinations in recently highlighted functional neurological disorders (FND) focusing mainly on functional movement disorders (FMD). There are many neurophysiological methods useful for diagnosis of FMD. I will hereafter summarize a few of them in the following part. Surface EMG: This is one of minimally required examinations for clinical analysis of movement disorders. It plays roles in the exclusion of organic disorders and showing positive findings to support FND, especially for functional tremor. The power spectral analysis of surface EMG clearly proves a few useful findings, such as entrainment, distraction and others. Somatosensory evoked potential (SEP): Giant SEP is critical because it proves organic disorders with hyperexcitability of the sensory cortex. Single pulse transcranial magnetic stimulation (TMS): Normal motor evoked potential (MEP) showing intact corticospinal tracts is a positive finding for functional paresis patients. It is also useful to exclude the corticospinal tracts organic dysfunction. Jerk-locked back averaging (JLA), bereitschaftspotential (BP), event related desynchronization (ERD): These are sometimes used for functional disorders, but their clinical validity remains to be determined.</p>","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"1-7"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[How to use clinical neurophysiology in functional neurological disorders (FND)?]\",\"authors\":\"Yoshikazu Ugawa\",\"doi\":\"10.5692/clinicalneurol.cn-002050\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>I have reviewed the utility of clinical neurophysiological examinations in recently highlighted functional neurological disorders (FND) focusing mainly on functional movement disorders (FMD). There are many neurophysiological methods useful for diagnosis of FMD. I will hereafter summarize a few of them in the following part. Surface EMG: This is one of minimally required examinations for clinical analysis of movement disorders. It plays roles in the exclusion of organic disorders and showing positive findings to support FND, especially for functional tremor. The power spectral analysis of surface EMG clearly proves a few useful findings, such as entrainment, distraction and others. Somatosensory evoked potential (SEP): Giant SEP is critical because it proves organic disorders with hyperexcitability of the sensory cortex. Single pulse transcranial magnetic stimulation (TMS): Normal motor evoked potential (MEP) showing intact corticospinal tracts is a positive finding for functional paresis patients. It is also useful to exclude the corticospinal tracts organic dysfunction. Jerk-locked back averaging (JLA), bereitschaftspotential (BP), event related desynchronization (ERD): These are sometimes used for functional disorders, but their clinical validity remains to be determined.</p>\",\"PeriodicalId\":39292,\"journal\":{\"name\":\"Clinical Neurology\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5692/clinicalneurol.cn-002050\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5692/clinicalneurol.cn-002050","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/21 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
我回顾了临床神经生理学检查在最近突出的功能性神经障碍(FND)中的应用,主要集中在功能性运动障碍(FMD)上。有许多神经生理学方法可用于口蹄疫的诊断。我将在接下来的部分中总结其中的一些。表面肌电图:这是运动障碍临床分析中最低要求的检查之一。它在排除器质性疾病方面发挥作用,并显示出支持FND的积极发现,特别是对功能性震颤。表面肌电的功率谱分析清楚地证明了一些有用的发现,如干扰、分心等。体感诱发电位(SEP):巨大的SEP是至关重要的,因为它证明器质性障碍与感觉皮层的高兴奋性。单脉冲经颅磁刺激(TMS):运动诱发电位(MEP)正常显示完整的皮质脊髓束是功能性轻瘫患者的阳性发现。排除皮质脊髓束器质性功能障碍也是有用的。Jerk-locked back averaging (JLA)、bereitschaftpotential (BP)、事件相关去同步化(ERD):这些有时用于功能障碍,但其临床有效性仍有待确定。
[How to use clinical neurophysiology in functional neurological disorders (FND)?]
I have reviewed the utility of clinical neurophysiological examinations in recently highlighted functional neurological disorders (FND) focusing mainly on functional movement disorders (FMD). There are many neurophysiological methods useful for diagnosis of FMD. I will hereafter summarize a few of them in the following part. Surface EMG: This is one of minimally required examinations for clinical analysis of movement disorders. It plays roles in the exclusion of organic disorders and showing positive findings to support FND, especially for functional tremor. The power spectral analysis of surface EMG clearly proves a few useful findings, such as entrainment, distraction and others. Somatosensory evoked potential (SEP): Giant SEP is critical because it proves organic disorders with hyperexcitability of the sensory cortex. Single pulse transcranial magnetic stimulation (TMS): Normal motor evoked potential (MEP) showing intact corticospinal tracts is a positive finding for functional paresis patients. It is also useful to exclude the corticospinal tracts organic dysfunction. Jerk-locked back averaging (JLA), bereitschaftspotential (BP), event related desynchronization (ERD): These are sometimes used for functional disorders, but their clinical validity remains to be determined.