Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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To study the association between stimulus-induced periodic epileptiform discharges (PEDs), arousal EEG responses and limb jerking in a comatose patient with reversible viral encephalitis. ⋯ Consideration of the possibility that stimulus-induced PEDs are reflexive epileptic phenomena in some comatose ICU patients may rationalise further their acute management, including antiepileptic treatment.
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We examined how corticospinal excitability was affected by motor imagery of foot dorsiflexion and motor imagery of gait. ⋯ Imagery of a simple lower extremity movement evokes increases in corticospinal excitability. Furthermore, corticospinal effects of a simple motor imagery task can predict corticospinal effects of a more complex motor imagery task involving the same muscle.
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Short-interval intracortical inhibition (SICI) is a widely used paired-pulse transcranial magnetic stimulation (TMS) measure to assess inhibition in human motor cortex. However, facilitatory processes may contaminate SICI under certain conditions. Here, we specifically address the contribution of short-interval intracortical facilitation (SICF). ⋯ SICF may contribute to apparently reduced SICI in patients with neurological or psychiatric disorders.
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Measurement of thermal pain thresholds is an essential part of quantitative sensory testing (QST). However, databases of QST show limitations due to large inter-individual variations including unreasonably low thresholds for thermal pain, lack of data on intra-individual variations over time and on the subjects' perception at threshold. This study sought to reduce inter-individual variations, investigated the reproducibility of measurements of thermal pain thresholds and included evaluation of thermally induced perceptions. ⋯ Further approaches are needed to reduce variability of thermal pain thresholds; however, good reproducibility of thermal pain thresholds and thermally induced perceptions warrants consideration of their use in larger longitudinal studies.
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Among the alternatives to drugs in the treatment of neurological and psychiatric disorders, neuromodulation techniques, including brain stimulation, have been used increasingly this past decade. Cortical targets are especially appealing, because they are easily accessible by noninvasive or invasive methods. Applicable techniques include repetitive transcranial magnetic stimulation (rTMS), transcranial electrical stimulation using pulsed or direct current, and epidural cortical stimulation (ECS) with surgically implanted electrodes. ⋯ In addition, various parameters of stimulation (such as stimulation frequency, intensity, or electrode polarity) and the configuration of the induced electrical field greatly influence the nature of the recruited circuits, and therefore, the overall efficacy. Finally, clinical changes may be delayed and prolonged beyond the time of stimulation, complicating programming algorithms in the case of implanted stimulation device. All these features need to be taken into account when considering cortical stimulation as a method of treatment.