المؤلفون: Lefaucheur, Jean-Pascal, Aleman, Andre, Baeken, Chris, Benninger, David H., Brunelin, Jerome, Di Lazzaro, Vincenzo, Filipović, Saša, Grefkes, Christian, Hasan, Alkomiet, Hummel, Friedhelm C., Jaaskelainen, Satu K., Langguth, Berthold, Leocani, Letizia, Londero, Alain, Nardone, Raffaele, Nguyen, Jean-Paul, Nyffeler, Thomas, Oliveira-Maia, Albino J., Oliviero, Antonio, Padberg, Frank, Palm, Ulrich, Paulus, Walter, Poulet, Emmanuel, Quartarone, Angelo, Rachid, Fady, Rektorova, Irena, Rossi, Simone, Sahlsten, Hanna, Schecklmann, Martin, Szekely, David, Ziemann, Ulf

المصدر: Clinical Neurophysiology

مصطلحات موضوعية: Cortex, Indication, Neurology, Neuromodulation, Noninvasive brain stimulation, Psychiatry, Treatment

الوصف: A group of European experts reappraised the guidelines on the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS) previously published in 2014 [Lefaucheur et al., Clin Neurophysiol 2014;125:2150-206]. These updated recommendations take into account all rTMS publications, including data prior to 2014, as well as currently reviewed literature until the end of 2018. Level A evidence (definite efficacy) was reached for: high-frequency (HF) rTMS of the primary motor cortex (M1) contralateral to the painful side for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) using a figure-of-8 or a Hl-coil for depression; low-frequency (LF) rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke. Level B evidence (probable efficacy) was reached for: HF-rTMS of the left M1 or DLPFC for improving quality of life or pain, respectively, in fibromyalgia; HF-rTMS of bilateral M1 regions or the left DLPFC for improving motor impairment or depression, respectively, in Parkinson's disease; HF-rTMS of ipsilesional M1 for promoting motor recovery at the post-acute stage of stroke; intermittent theta burst stimulation targeted to the leg motor cortex for lower limb spasticity in multiple sclerosis; HF-rTMS of the right DLPFC in posttraumatic stress disorder; LF-rTMS of the right inferior frontal gyrus in chronic post-stroke non-fluent aphasia; LF-rTMS of the right DLPFC in depression; and bihemispheric stimulation of the DLPFC combining right-sided LF-rTMS (or continuous theta burst stimulation) and left-sided HF-rTMS (or intermittent theta burst stimulation) in depression. Level A/B evidence is not reached concerning efficacy of rTMS in any other condition. The current recommendations are based on the differences reached in therapeutic efficacy of real vs. sham rTMS protocols, replicated in a sufficient number of independent studies. This does not mean that the benefit produced by rTMS inevitably reaches a level of clinical relevance.

العلاقة: info:eu-repo/grantAgreement/MESTD/Basic Research (BR or ON)/175012/RS//; Fundacao para a Ciencia e Tecnologia (FCT/MCTES -) [FCT-PTDC/ME C-PSQ/30302/2017-IC&DT-LISBOA-01-0145-FEDER, FCT-PTDC/MED-NEU/31331/2017]; Czech Ministry of HealthMinistry of Health, Czech Republic [AZV 16-31868A]; FEDER, under the Partnership Agreement Lisboa 2020 - Programa Operacional Regional de Lisboa; http://rimi.imi.bg.ac.rs/handle/123456789/1032Test; http://rimi.imi.bg.ac.rs/bitstream/id/22/1029.pdfTest; 2-s2.0-85077913954; 000507859400021

الإتاحة: https://doi.org/10.1016/j.clinph.2019.11.002Test
http://rimi.imi.bg.ac.rs/handle/123456789/1032Test
http://rimi.imi.bg.ac.rs/bitstream/id/22/1029.pdfTest

المؤلفون: Roberto Cantello, Lorenzo Coppo, Piergiorgio Lochner, Maurizio Leone, Raffaele Nardone, Marialuisa Zedde, Francesco Brigo

المصدر: Clinical Neurophysiology. 127:803-809

مصطلحات موضوعية: transorbital sonography, medicine.medical_specialty, Optic Neuritis, genetic structures, business.operation, Visual evoked potentials, optic nerve diameter, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), acute optic neuritis, optic nerve sheath, Humans, Medicine, In patient, Optic neuritis, Papilledema, Ultrasonography, Doppler, Duplex, business.industry, Multiple sclerosis, Optic Nerve, medicine.disease, eye diseases, Sensory Systems, Surgery, Neurology, Acute Disease, Inclusion and exclusion criteria, Optic nerve, Neurology (clinical), Radiology, medicine.symptom, business, Orbit, Transorbital, 030217 neurology & neurosurgery

الوصف: Objective In patients with acute optic neuritis (AON) transorbital sonography may reveal a thickening of the retrobulbar portion of the optic nerve. Our aim was to systematically review the diagnostic accuracy of ultrasonography of optic nerve diameter (OND) for assessment of AON. Methods MEDLINE, EMBASE (1966–October 2014) was searched to identify studies reporting data on patients with AON (with/without multiple sclerosis) assessed by B-mode transorbital ultrasonography. Thereafter, the studies retrieved were screened based on predefined inclusion and exclusion criteria. Data were extracted and the quality of the included studies was evaluated. Results Seven studies (162 patients) were included. The OND was significantly thicker in the affected eye compared with its unaffected fellow or controls. An increased OND was found in 78–100% of patients. Four studies determined papilledema in 6–43% of patients. Conclusions Transorbital sonography is a sensitive, highly accessible and user-friendly technique for the detection of significant optic nerve thickening on the side affected by AON and represents an adjunctive tool for the diagnosis of AON. Compared to visual evoked potentials, TOS may provide different, though complementary, information on the pathophysiology of AON. Significance B-mode transorbital ultrasonography provides promising support for the clinical diagnosis of AON.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::30012814d6b9d483fed7dfb105c81db4Test
https://doi.org/10.1016/j.clinph.2015.05.005Test

المؤلفون: Elisabeth Schmid, Raffaele Nardone, Kevin Butz, Jürgen Bergmann, Yvonne Höller, Peter Höller, Martin Kronbichler, Eugen Trinka, Aljoscha Thomschewski, Julia Sophia Crone

المصدر: Clinical Neurophysiology. 125:1545-1555

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Support Vector Machine, Consciousness, Rest, media_common.quotation_subject, Models, Neurological, Electroencephalography, Audiology, Diagnosis, Differential, Level of consciousness, Discriminative model, Physiology (medical), medicine, Humans, Resting eeg, Aged, Probability, media_common, Resting state fMRI, medicine.diagnostic_test, Persistent Vegetative State, Brain, Coherence (statistics), Middle Aged, Sensory Systems, Neurology, Female, Neurology (clinical), Psychology, Social psychology, Partial coherence

الوصف: Objective In the present study, we searched for resting-EEG biomarkers that distinguish different levels of consciousness on a single subject level with an accuracy that is significantly above chance. Methods We assessed 44 biomarkers extracted from the resting EEG with respect to their discriminative value between groups of minimally conscious (MCS, N =22) patients, vegetative state patients (VS, N =27), and – for a proof of concept – healthy participants ( N =23). We applied classification with support vector machines. Results Partial coherence, directed transfer function, and generalized partial directed coherence yielded accuracies that were significantly above chance for the group distinction of MCS vs. VS (.88, .80, and .78, respectively), as well as healthy participants vs. MCS (.96, .87, and .93, respectively) and VS (.98, .84, and .96, respectively) patients. Conclusions The concept of connectivity is crucial for determining the level of consciousness, supporting the view that assessing brain networks in the resting state is the golden way to examine brain functions such as consciousness. Significance The present results directly show that it is possible to distinguish patients with different levels of consciousness on the basis of resting-state EEG.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7c10e91825cec6e9d80e729c92d3cf09Test
https://doi.org/10.1016/j.clinph.2013.12.095Test

المؤلفون: Nardone, Raffaele^1,2,3,4 (AUTHOR) raffaele.nardone@asbmeran-o.it, Versace, Viviana⁵ (AUTHOR), Sebastianelli, Luca⁵ (AUTHOR), Brigo, Francesco^1,6 (AUTHOR), Golaszewski, Stefan^2,4 (AUTHOR), Christova, Monica^7,8 (AUTHOR), Saltuari, Leopold^5,9 (AUTHOR), Trinka, Eugen^2,10,11 (AUTHOR)

المصدر: Clinical Neurophysiology. Nov2019, Vol. 130 Issue 11, p2032-2037. 6p.

مصطلحات موضوعية: *NEUROGENIC bladder, *TRANSCRANIAL magnetic stimulation, *PELVIC floor, *BLADDER injuries, *BLADDER, *INTERSTITIAL cystitis, *META-analysis, *URINARY organs

مستخلص: • Motor evoked potentials can be recorded from pelvic floor muscles but poor reproducibility has been observed. • Some studies have used therapeutic repetitive TMS in patients with lower urinary tract dysfunctions. • The promising results should be replicated in controlled studies with larger sample size. We aimed at assessing the usefulness of motor evoked potentials (MEPs) for exploring the integrity of striated sphincters and pelvic floor motor innervation in normal subjects and of repetitive transcranial magnetic stimulation TMS (rTMS) in patients with neurogenic bladder dysfunction. A systematic literature search was conducted using PubMed and Embase. We identified, reviewed and discussed 11 articles matching the inclusion criteria. The assessment of MEPs could represent a useful tool in the investigation of patients with urologic disorders. High frequency rTMS can improve detrusor contraction and/or urethral sphincter relaxation in patients with multiple sclerosis and bladder dysfunction. Low frequency (LF) rTMS seems to be an effective treatment of neurogenic lower urinary tract dysfunctions in subjects with Parkinson's disease and possibly other neurodegenerative disorders. Furthermore, rTMS might have the potential to restore bladder and bowel sphincter function after incomplete spinal cord injury. LF rTMS could also relieve some symptoms of bladder pain syndrome and chronic pelvic pain. The clinical applicability of MEPs appears to be questionable, since a poor reproducibility was detected for all pelvic floor muscles. The use of rTMS in this field is emerging and the results of a few preliminary studies should be replicated in controlled, randomized studies with larger sample sizes. [ABSTRACT FROM AUTHOR]

المؤلفون: Dietmar Rafolt, Martin Kronbichler, Stefan Golaszewski, Wolfgang Staffen, Eugen Gallasch, Jürgen Bergmann, Alexander Kunz, Eugen Trinka, Monica Christova, Raffaele Nardone

المصدر: Clinical Neurophysiology. 123:193-199

مصطلحات موضوعية: Adult, Male, Traumatic brain injury, medicine.medical_treatment, Sensory system, Stimulation, Brain damage, Stimulus (physiology), Young Adult, Physiology (medical), Neuroplasticity, medicine, Humans, Motor Cortex, Evoked Potentials, Motor, Hand, medicine.disease, Transcranial Magnetic Stimulation, Electric Stimulation, Sensory Systems, Transcranial magnetic stimulation, medicine.anatomical_structure, Neurology, Female, Neurology (clinical), medicine.symptom, Psychology, Neuroscience, Motor cortex

الوصف: Objective In a previous transcranial magnetic stimulation (TMS) study we demonstrated that suprathreshold mesh-glove (MG) whole-hand stimulation elicits lasting changes in motor cortical excitability. Currently, there is no consensus with regard to the optimal parameters for the induction of sensorimotor cortical plasticity using peripheral electrical stimulation. Thus, in the present study we explore the modulatory effects of MG stimulation at different stimulus intensities and different frequencies in order to identify an optimal stimulation protocol. Methods MG stimulation was performed on 12 healthy subjects in separate sessions at different stimulation levels: sub-sensory at 50Hz, sensory at 50Hz and motor at 2Hz. To verify if stimulation at lower frequencies is less effective, an additional experiment at sensory level with 2Hz was performed. TMS was used to assess motor threshold (MT), motor evoked potentials (MEPs) recruitment curve (RC), short latency intracortical inhibition (SICI) and intracortical facilitation (ICF) to paired-pulse TMS at baseline ( T 0), immediately after ( T 1) and 1h ( T 2) after 30min of MG stimulation. F-wave studies were performed to assess spinal motoneuron excitability. Results MG stimulation at sub-sensory/50Hz and sensory/2Hz level determines no significant cortical excitability changes; at sensory/50Hz level and at motor/2Hz level we found decreased MT, increased MEP RC as well as reduced SICI and increased ICF at T 1 and T 2. Conclusions MG stimulation at sensory/50Hz and motor/2Hz level induces similar long-lasting modulatory effects on motor cortical excitability. Both the strength of the corticospinal projections and the intracortical networks are influenced to the same extend. Significance The study provides further evidence that stimulation intensity and frequency can independently modulate motor cortical plasticity. The selection of optimal stimulation parameters has potentially important implications for the neurorehabilitation of patients after brain damage (e.g. stroke, traumatic brain injury) with hand motor deficits.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3546701bf0825030bc2b1825fe8008c1Test
https://doi.org/10.1016/j.clinph.2011.06.010Test

المؤلفون: Raffaele Nardone, Eugen Trinka

المصدر: Clinical Neurophysiology. 128:1028-1029

مصطلحات موضوعية: 0301 basic medicine, Parkinson's disease, medicine.medical_treatment, Cholinergic Agents, 03 medical and health sciences, 0302 clinical medicine, Text mining, In vivo, Physiology (medical), Humans, Medicine, business.industry, Motor Cortex, Parkinson Disease, Evoked Potentials, Motor, medicine.disease, Transcranial Magnetic Stimulation, Sensory Systems, Transcranial magnetic stimulation, 030104 developmental biology, medicine.anatomical_structure, Neurology, Cholinergic, Neurology (clinical), business, Neuroscience, 030217 neurology & neurosurgery, Motor cortex

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::583d9c2fcdebbb875ef8de720af33d0aTest
https://doi.org/10.1016/j.clinph.2017.03.037Test

المؤلفون: Arianna Bratti, Raffaele Nardone, Frediano Tezzon, Harald Ausserer, Roland Marth, Piergiorgio Lochner

المصدر: Clinical Neurophysiology. 118:1149-1154

مصطلحات موضوعية: Adult, Male, medicine.medical_treatment, Neural Conduction, Action Potentials, Glutamic Acid, Central nervous system disease, Glutamatergic, Degenerative disease, Huntington's disease, Physiology (medical), medicine, Humans, Electromyography, Neurodegeneration, Motor Cortex, Middle Aged, medicine.disease, Transcranial Magnetic Stimulation, Sensory Systems, Transcranial magnetic stimulation, Huntington Disease, medicine.anatomical_structure, Neurology, Disease Progression, Female, Silent period, Neurology (clinical), Psychology, Neuroscience, Motor cortex

الوصف: Objective It is known from neuropathological and imaging studies that the neuronal degeneration in Huntington’s disease (HD) is already quite severe when the first symptoms of the disease become clinically evident. This study was aimed at detecting neurophysiological changes, as assessed by means of transcranial magnetic stimulation (TMS), involved in the early pathogenesis of the neurodegeneration in HD. Methods Motor cortex excitability was examined in 12 patients with HD in the early clinical stage of the disease and in 15 age-matched control subjects, using a range of TMS protocols. Central motor conduction time, resting and active motor threshold, duration of the cortical silent period, the short-interval paired-pulse intracortical inhibition (SICI) and the paired-pulse intracortical facilitation (ICF) were examined. Results The early-stage HD patients showed a statistically significant reduction in ICF. The other measures did not differ significantly from the control subjects. Conclusions Our findings provide neurophysiological evidence that changes in motor function are present in the early HD. Since ICF is thought to depend upon the activity of intracortical glutamatergic excitatory circuits, the results of our study support the theory that altered NMDA receptor function plays an important role in the pathogenesis of HD. Significance These findings may provide clues to the underlying pathophysiology of the disease. A more complete understanding of the changes in motor cortex excitability that occur early in the course of HD will lead to a better definition of the disease process and may allow earlier diagnosis and intervention.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::37321c388b26e007940847007c811dacTest
https://doi.org/10.1016/j.clinph.2007.01.009Test

المؤلفون: Marco Schieppati, Davide Pareyson, Massimo Galante, Antonio Nardone

المصدر: Clinical Neurophysiology. 118:538-550

مصطلحات موضوعية: Male, Reflex, Stretch, medicine.medical_specialty, Ataxia, Electromyography, Nerve Fibers, Physical medicine and rehabilitation, Diabetic Neuropathies, Physiology (medical), Sensation, Reaction Time, medicine, Humans, Neurons, Afferent, Postural Balance, Aged, Vestibular system, medicine.diagnostic_test, Proprioception, Body movement, Sensory loss, Middle Aged, Vestibular nerve, Sensory Systems, Electrophysiology, Neurology, Case-Control Studies, Female, Neurology (clinical), Nervous System Diseases, medicine.symptom, Psychology, Neuroscience

الوصف: Objective Balance control under static and dynamic conditions was assessed in patients with Sensory Neuron Disease (SND) in order to shed further light on the pathophysiology of ataxia. Methods Fourteen patients with diabetic polyneuropathy and 11 with SND underwent clinical and neurophysiological evaluation, stabilometric recording of body sway during quiet stance with and without vision, stereometric analysis of body segment displacement while riding a platform translating in anterior–posterior direction with and without vision (dynamic condition), and EMG recording of leg muscle responses to abrupt stance perturbation produced by rotation of a supporting platform. The findings were compared to those of age matched normal subjects. Results Clinical and neurophysiological evaluation revealed a more severe motor impairment in patients with diabetes than SND, while sensory impairment was superimposable. Some patients with SND had vestibular dysfunction of diverse severity. Body sway during stance was larger in patients with SND than diabetes with and without vision. In the stance perturbation condition, the latency of the long-loop EMG response to platform rotation was disproportionately increased with respect to the spinal response in the SND but not in diabetic patients. Under dynamic condition, patients with SND oscillated more than diabetic patients and several of them easily lost balance with eyes closed. Conclusions Patients with SND show severe unsteadiness under both static and dynamic conditions, particularly with eyes closed. The patchy sensory loss of SND, disrupting sensation from territories other than the lower limbs and possibly including the vestibular nerve, could be responsible for this instability. Ataxia is correlated to the abnormal latency of the muscle responses to stance perturbation. Since increased response latencies cannot be attributed to a vestibular deficit, the deterioration of equilibrium control would be ascribed mainly to the degeneration of the central branch of the afferent fibres. Significance Measures of body balance under quiet stance and dynamic conditions can provide relevant diagnostic information as to the pathophysiology and severity of ataxia and viability of the central branch of the sensory fibres, and help in separating patients with peripheral neuropathy from patients with loss of sensory neurones.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::de6acce0d808c9a8e6f3ab79ec42c367Test
https://doi.org/10.1016/j.clinph.2006.11.012Test

المؤلفون: Nardone, Raffaele^1,2, Brigo, Francesco^1,3, Golaszewski, Stefan², Trinka, Eugen^2,4,5, Versace, Viviana⁶, Sebastianelli, Luca⁶, Saltuari, Leopold⁶, Gallasch, Eugen⁶, Christova, Monica⁶

المصدر: Clinical Neurophysiology. Oct2017, Vol. 128 Issue 10, p1971-1977. 7p.

مصطلحات موضوعية: *TRANSCRANIAL magnetic stimulation, *CENTRAL nervous system, *MUSCLE diseases, *NEUROPHYSIOLOGY, *NEUROMUSCULAR diseases, *AWARDS

مستخلص: Objective There is increasing evidence that an involvement of central nervous system (CNS) can occur in several myopathies. Transcranial magnetic stimulation (TMS) may represent a valuable tool for investigating important neurophysiological and pathophysiological aspects of cortical involvement in neuromuscular disorders. In this review paper we aimed to perform a systematic search of the studies employing TMS techniques in subjects suffering from myopathies. Methods A literature search was conducted using PubMed and Embase. We identified and reviewed 9 articles matching the inclusion criteria. One hundred twenty patients were included in these studies, which have applied TMS in patients with muscle disorders. Results To date, a few studies using TMS have been performed in myopathic patients and detected subclinical abnormalities in cortical reactivity and plasticity. The most consistent finding was a decrease in intracortical inhibition, which likely represents a non-specific compensatory mechanism of the CNS in an attempt to overcome the muscle deficit through an increase of the motor cortex output to deficient muscles. Conclusions Application of TMS to characterize the pathophysiology of the CNS in these subjects appears to be safe and may lead to the development of valuable biomarkers. Well-defined motor cortical excitability patterns can be identified in the different muscle diseases, even if preliminary findings should be confirmed in future studies in larger cohorts of patients. Significance TMS studies may shed new light on the physiological and pathophysiological mechanisms underlying the cortical involvement in muscle disorders. [ABSTRACT FROM AUTHOR]

المؤلفون: Nardone, Antonio^1,2 antonio.nardone@fsm.it, Corna, Stefano¹, Turcato, Anna Maria¹, Schieppati, Marco^3,4

المصدر: Clinical Neurophysiology. Feb2014, Vol. 125 Issue 2, p327-335. 9p.

مصطلحات موضوعية: *AFFERENT pathways, *WALKING, *CHARCOT-Marie-Tooth disease, *DIABETIC neuropathies, *PERIPHERAL nervous system, *FEEDBACK control systems, *MYELINATED nerve fibers

مستخلص: Highlights: [•] Charcot–Marie–Tooth disease type 1A (CMT1A) and diabetic neuropathy (DNP) affect peripheral nerve fibres of different diameter. [•] During stance, patients with CMT1A show normal body sway, whilst patients with DNP oscillate more than both healthy subjects and CMT1A patients. Gait pattern is affected in both patient groups, more severely so in DNP. [•] The input from smaller diameter myelinated fibres may play a key role in the feedback control of the stance phase of gait. [Copyright &y& Elsevier]