Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Feb 2013
Facilitation of corticospinal connections in able-bodied people and people with central nervous system disorders using eight interventions.
Voluntary contractions (VOL), functional electrical stimulation (FES), and transcranial magnetic stimulation (TMS) can facilitate corticospinal connections. ⋯ (1) Short-term application of FES, TMS, and VOL can facilitate corticospinal pathways, particularly when methods are combined. (2) The effects may depend on the total activation of neural pathways, which is reduced in central nervous system disorders.
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J Clin Neurophysiol · Feb 2013
Noninvasive predictors of subdural grid seizure localization in children with nonlesional focal epilepsy.
Subdural grid evaluation (SDE) in refractory focal epilepsy aims to precisely define the ictal onset zone and map eloquent cortex. In a small but significant proportion of children, SDE shows multifocal or diffuse, rather than focal, seizure onset. Resective epilepsy surgery is denied, or is unsuccessful, in the majority of such patients. The authors investigated whether the noninvasive data could be abstracted to predict subsequent SDE electrographic outcome (focal vs. multifocal/diffuse ictal onset). ⋯ (1) Diffuse or multifocal ictal onsets on SDE are almost three times as likely in nonlesional patients as in those with a single definite MRI brain lesion. (ii) The noninvasive data of children with nonlesional brain MRI may be summarized by a score that rewards localizing information and intermodality concordance: low-scoring patients are more likely to exhibit diffuse or multifocal ictal onset on subsequent SDE. (iii) Bayesian likelihood ratios predictive of ictal focality on SDE are highly favorable for concordant scalp interictal-ictal EEG combinations. (iv) Decision-theoretic methods of this type may find use in the selection of nonlesional pediatric presurgical candidates offered SDE.