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Mashup Score: 10Current Issue : Journal of Clinical Neurophysiology - 4 month(s) ago
The Journal of Clinical Neurophysiology features both topical reviews and original research in both central and peripheral neurophysiology, as related to patient evaluation and treatment. Official Journal of the American Clinical Neurophysiology Society
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Mashup Score: 13Periodic Discharges in Critically Ill Children: Predictors... : Journal of Clinical Neurophysiology - 5 month(s) ago
e performed a prospective observational study of consecutive critically ill children undergoing continuous EEG monitoring, including standardized scoring of GPDs, LPDs, and BIPDs. We identified variables associated with GPDs, LPDs, and BIPDs and assessed whether each pattern was associated with hospital discharge outcomes including the Glasgow Outcome Scale-Extended Pediatric version (GOS-E-Peds), Pediatric Cerebral Performance Category (PCPC), and mortality. Results: PDs occurred in 7% (91/1,399) of subjects. Multivariable logistic regression indicated that patients with coma (odds ratio [OR], 3.45; 95% confidence interval [CI]: 1.55, 7.68) and abnormal EEG background category (OR, 6.85; 95% CI: 3.37, 13.94) were at increased risk for GPDs. GPDs were associated with mortality (OR, 3.34; 95% CI: 1.24, 9.02) but not unfavorable GOS-E-Peds (OR, 1.93; 95% CI: 0.88, 4.23) or PCPC (OR, 1.64; 95% CI: 0.75, 3.58). Patients with acute nonstructural encephalopathy did not experience LPDs, and L
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Mashup Score: 10Real-World Continuous EEG Utilization and Outcomes in... : Journal of Clinical Neurophysiology - 5 month(s) ago
tion, (3) evaluate whether cEEG utilization is associated with outcomes in patients with cerebrovascular diseases. Methods: This cohort study of the Premier Healthcare Database (2014–2020), included hospitalized patients age >18 years with cerebrovascular diseases (identified by ICD codes). Continuous electroencephalography was identified by International Classification of Diseases (ICD)/Current Procedural Terminology (CPT) codes. Multivariable lasso logistic regression was used to identify predictors of cEEG utilization and in-hospital mortality. Propensity score-matched analysis was performed to determine the relation between cEEG use and mortality. Results: 1,179,471 admissions were included; 16,777 (1.4%) underwent cEEG. Total number of cEEGs increased by 364% over 5 years (average 32%/year). On multivariable analysis, top five predictors of cEEG use included seizure diagnosis, hospitals with >500 beds, regions Northeast and South, and anesthetic use. Top predictors of mortality in
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Mashup Score: 1Comparison Between Cz-C3/C4 and C3-C4 Montages to Protect... : Journal of Clinical Neurophysiology - 5 month(s) ago
from bilateral orbicularis oculi (Oculi) and oris (Oris) muscles. The double-train approach combining single-pulse and five-train pulse stimulation was used to determine the effect of peripheral stimulation. If the five-train pulse produced a significant waveform, it was defined as “total success.” In total success cases, “true success” was defined as a case in which no waveform appeared after the single pulse at the threshold level of the five-train pulse. The total and true success rates and the threshold value of Oculi and Oris were compared between Cz-C3/C4 and C3-C4 montages. Results: Thirty-six muscles each of Oculi and Oris of 18 patients were used for the analysis. True success was more likely to be obtained by the Cz-C3/C4 montage than the C3-C4 montage in Oculi (42% vs. 22%, p = 0.039). Both Oculi and Oris had higher thresholds to elicit facial motor-evoked potentials with the Cz-C3/C4 montage (Oculi: 101.7 vs. 71.4 mA, p = 0.038; Oris: 94.8 vs. 73.1 mA, p = 0.016). Conclusio
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Mashup Score: 1Intraoperative Monitoring of the External Urethral... : Journal of Clinical Neurophysiology - 5 month(s) ago
additional functional insight, including an evaluation for spinal shock, distinguishing upper versus lower motor neuron injury (conus vs. cauda syndromes) and prognosis for postoperative bowel and bladder function. Continuous intraoperative bulbocavernosus reflex monitoring has been utilized to provide the surgeon with an ongoing functional assessment of the anatomical elements involved in the S2–S4 mediated reflex arc including the conus, cauda equina and pudendal nerves. Intraoperative bulbocavernosus reflex monitoring typically includes the electrical activation of the dorsal nerves of the genitals to initiate the afferent component of the reflex, followed by recording the resulting muscle response using needle electromyography recordings from the external anal sphincter. Methods: Herein we describe a complementary and novel technique that includes recording electromyography responses from the external urethral sphincter to monitor the external urethral sphincter reflex. Specialized
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Mashup Score: 6Comparison of Automated Spike Detection Software in... : Journal of Clinical Neurophysiology - 6 month(s) ago
ee epileptologists labelled IEDs manually of EEGs from three centres. All Interictal epileptiform discharge (IED) markings predicted by two commercial software (Encevis 1.11 and Persyst 14) were reviewed individually to assess for suspicious missed markings and were integrated into the reference standard if overlooked during manual annotation during a second phase. Sensitivity, precision, specificity, and F1-score were used to assess the performance of the software packages against the adjusted reference standard. Results: One hundred and twenty-five routine scalp EEG recordings from different subjects were included (total recording time, 310.7 hours). The total epileptiform discharge reference count was 5,907 (including spikes and fragments). Encevis demonstrated a mean sensitivity for detection of IEDs of 0.46 (SD 0.32), mean precision of 0.37 (SD 0.31), and mean F1-score of 0.43 (SD 0.23). Using the default medium setting, the sensitivity of Persyst was 0.67 (SD 0.31), with a precis
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Mashup Score: 7Long-Term Intracranial EEG Lateralization of... : Journal of Clinical Neurophysiology - 6 month(s) ago
ating patients with neurostimulation. We reviewed iEEG seizure lateralization and clinical outcomes in bilateral MTL patients at University of Utah. Methods: Long-term RNS System iEEG seizure lateralization was compared with pre-RNS System lateralization obtained during surgical evaluation. Safety and clinical outcomes were extracted retrospectively from patient records. Results: Twenty-six patients received an RNS System with bilateral MTL leads. Fifteen of the patients had adequate follow-up to report clinical outcomes (>1 year), and 25 patients had enough recorded data (>6 months) to perform iEEG analysis. Median percent reduction in clinical seizures at last follow-up was 58%, and 40% reported being seizure-free at last follow-up, for variable durations. The electrographic seizure lateralization (unilateral vs. bilateral) differed between surgical evaluation and long-term iEEG in 44% of our patients. In the subset of eight patients (32%) who had only unilateral seizures recorded du
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Mashup Score: 0Correlations Between Quantitative EEG Parameters and... : Journal of Clinical Neurophysiology - 6 month(s) ago
copy and EEG measure cerebral perfusion and neuronal function, respectively. We hypothesized that encephalopathic ECMO patients with greater degree of irreversible cerebral injury demonstrate less correlation between electrographic activity and cerebral perfusion than those whose encephalopathy is attributable to medications. Methods: We performed a prospective observational study of adults undergoing ECMO who underwent simultaneous continuous EEG and diffuse correlation spectroscopy monitoring. (Alpha + beta)/delta ratio and alpha/delta Rartio derived from quantitative EEG analysis were correlated with frontal cortical blood flow index. Patients who awakened and followed commands during sedation pauses were included in group 1, whereas patients who could not follow commands for most neuromonitoring were placed in group 2. (Alpha + beta)/delta ratio–blood flow index and ADR-BFI correlations were compared between the groups. Results: Ten patients (five in each group) underwent 39 concom
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Mashup Score: 5Association of Scalp High-Frequency Oscillation Detection... : Journal of Clinical Neurophysiology - 6 month(s) ago
p HFO in pediatric patients with various types of epilepsy, using multivariable regression models to correct for possible confounding factors. Methods: The authors analyzed 97 subjects who were divided into groups with active epilepsy (within 1 year of seizure), seizure-free epilepsy (>1 year without seizure), and nonepilepsy. Regarding the frequency of seizure occurrence as an indicator of epileptic activity, we categorized subjects into four groups (Daily/Weekly, Monthly, Yearly, and Rarely). Results: Multiple linear regression analysis showed that the scalp HFO detection rate was significantly higher in patients with active epilepsy than in those with nonepilepsy (β [95% confidence interval] = 2.77 [1.79–4.29]; P < 0.001). The association between scalp HFO detection rate and frequency of seizure occurrence was highest in the Daily/Weekly group (β [95% confidence interval] = 3.38 [1.57–7.27]; P = 0.002), followed by Monthly and Yearly groups (β [95% confidence interval] = 2.42 [1.02–
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Mashup Score: 2Neurophysiological and Clinical Outcomes in Episodic... : Journal of Clinical Neurophysiology - 6 month(s) ago
executive function. Methods: A cross-sectional study was performed, including the following outcomes: pressure pain thresholds with algometry; resting motor threshold, short-interval intracortical inhibition, and intracortical facilitation with transcranial magnetic stimulation; and executive functions with the trail making test and the frontal assessment battery. Results: Thirty adults with migraine (36 ± 10 years) and 30 healthy controls (29 ± 14 years) were included in this study. Compared with the healthy controls, participants with migraine presented lower pressure pain thresholds values in all the assessed muscles (P < 0.001), lower resting motor threshold (−10.5% of the stimulator output, 95% CI: −16.8 to −4.2, P = 0.001, Cohen d = 0.869) and higher short-interval intracortical inhibition motor-evoked potential's amplitude at 3 ms (0.25, 95% CI: 0.05 to 0.46, P = 0.015, Cohen d = 0.662), and worse performances both in trail making test (7.1, 95% CI: 0.9 to 13.4, P = 0.027, Cohen
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Issue Alert❗️Our 41.1 January Issue is now live and features a Topical Issue on #EEG Source Imaging (#ESI) edited by Jay Gavvala (@McGovernMed) and John Ebersole. Check it out here: https://t.co/mKyz4TiVVZ @ACNS_org https://t.co/cuTGcBTAlM