Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Mar 2017
Randomized Controlled Trial Comparative StudyA Randomized Prospective Comparison of Ultrasound-Guided and Landmark-Guided Steroid Injections for Carpal Tunnel Syndrome.
The aim of this study was to compare the clinical and electrodiagnostic efficacy of ultrasound (US)-guided versus landmark (LM)-guided steroid injections in patients with carpal tunnel syndrome (CTS). ⋯ Both US-guided and LM-guided steroid injections were effective in reducing the symptoms, improving the function and electrodiagnostic findings of CTS. Although there was better symptomatic improvement with US-guided injections and better increase in sensory nerve action potential amplitude with LM-guided injection, a significant difference was not generally observed between US-guided and LM-guided CTS injections.
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J Clin Neurophysiol · Feb 2015
Randomized Controlled TrialInhibitory transcranial direct current stimulation enhances weak beta event-related synchronization after foot motor imagery in patients with lower limb amputation.
Sensorimotor rhythm patterns in patients with lower limb amputations might be altered because of reorganization of the sensorimotor cortices. The authors evaluated the sensorimotor rhythm of motor imagery (MI) in healthy subjects and patients with lower limb amputations. In addition, the authors investigated whether transcranial direct current stimulation (tDCS) could modulate sensorimotor rhythm control. ⋯ This is the first study to demonstrate that cathodal tDCS can enhance a weak beta ERS of foot MI in patients with lower limb amputations. These findings might contribute in improving the effectiveness of sensorimotor rhythm-based brain computer interface for gait restoration after lower limb amputation.
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J Clin Neurophysiol · Feb 2015
Randomized Controlled TrialSleep in the neurological intensive care unit: feasibility of quantifying sleep after melatonin supplementation with environmental light and noise reduction.
Sleep deprivation may be particularly detrimental to intensive care unit (ICU) patients. Polysomnography has demonstrated abnormal sleep in medical and surgical ICU populations. Both environmental factors and circadian disruption have been implicated. We hypothesized that patients in a neurologic ICU would demonstrate similar sleep disturbances and that a combination of sleep-promoting interventions would increase sleep time. ⋯ Although sleep-promoting interventions were feasible, sleep quantification based on currently accepted criteria limited the ability to score sleep. Similar to other ICUs, sleep in the neurologic ICU is abnormal; patients with unscorable sleep-like states have greater injury severity. This study was limited by strict enrollment criteria. A reliable method to quantify sleep and sleep-like states in the ICU is needed.
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J Clin Neurophysiol · Jun 2013
Randomized Controlled TrialDifferences in spinothalamic function of cervical and thoracic dermatomes: insights using contact heat evoked potentials.
After spinal cord injury, contact heat evoked potentials (CHEPs) may represent a means to refine the clinical assessment of sensory function from each spinal cord segment by quantifying nociception, including conduction along the spinothalamic tract. ⋯ The study supports CHEPs as a feasible tool for assessing discrete dermatomes corresponding to spinal cord segments. The results suggest that the proximodistal pattern in the intensity of perceived pain and CHEP amplitudes is likely attributable to the distribution of heat nociceptors and the increase in conduction distance from proximal to distal dermatomes. The present findings emphasize on the importance that if patients are assessed segment by segment, the underlying topographical differences need to be accounted for.
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J Clin Neurophysiol · Jun 2012
Randomized Controlled TrialAdvanced pharmaco-EEG reveals morphine induced changes in the brain's pain network.
By using a novel brain source modeling approach, where the evoked potential (EP) signal was decomposed with multichannel matching pursuit (MMP) before source localization, we investigated brain generators of EPs after a pain stimulus in the esophagus before and after administration of placebo/morphine. We showed that this new approach of pharmaco-electroencephalogram (EEG) analysis can shed light on subtle changes, which cannot be foreseen from conventional analysis (amplitude/latency/topography). ⋯ Decomposing the EPs into the original brain generators showed that morphine mainly changes the low frequency electrical activity in the frontal brain area. This method can be used to increase the basic understanding of the opioid effect on the brain's processing of pain and eventually identify biomarkers of analgesia in experimental pain models.