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Evolution of Substance Supply Methods for Persistent Aphthous Stomatitis.
The structure-activity relationship laid a good foundation for the identification of novel squaramides as a potential treatment of drug-resistant tuberculosis.Electroencephalographic (EEG) source imaging localizes the generators of neural activity in the brain. During presurgical epilepsy evaluation, EEG source imaging of interictal epileptiform discharges is an established tool to estimate the irritative zone. #link# However, the origin of interictal activity can be partly or fully discordant with the origin of seizures. Therefore, source imaging based on ictal EEG data to determine the seizure onset zone can provide precious clinical information. In this descriptive review, we address the importance of localizing the seizure onset zone based on noninvasive EEG recordings as a complementary analysis that might reduce the burden of the presurgical evaluation. We identify three major challenges (low signal-to-noise ratio of the ictal EEG data, spread of ictal activity in the brain, and validation of the developed methods) and discuss practical solutions. link2 We provide an extensive overview of the existing clinical studies to illustrate the potential clinical utility of EEG-based localization of the seizure onset zone. Finally, we conclude with future perspectives and the needs for translating ictal EEG source imaging into clinical practice.
Motor Unit Number Estimation (MUNE) methods may be valuable in tracking motor unit loss in diabetic polyneuropathy (DPN). Muscle Velocity Recovery Cycles (MVRCs) provide information about muscle membrane properties. This study aimed to examine the utility of the MScanFit MUNE in detecting motor unit loss and to test whether the MVRCs could improve understanding of DPN pathophysiology.

Seventy-nine type-2 diabetic patients were compared to 32 control subjects. All participants were examined with MScanFit MUNE and MVRCs in anterior tibial muscle. Lower limb nerve conduction studies (NCS) in peroneal, tibial and sural nerves were applied to diagnose large fiber neuropathy.

NCS confirmed DPN for 47 patients (DPN+), with 32 not showing DPN (DPN-). MScanFit showed significantly decreased MUNE values and increased motor unit sizes, when comparing DPN+patients with controls (MUNE=71.3±4.7 vs 122.7±3.8), and also when comparing DPN- patients (MUNE=103.2±5.1) with controls. MVRCs did not differ between groups.

MScanFit is more sensitive in showing motor unit loss than NCS in type-2 diabetic patients, whereas MVRCs do not provide additional information.

The MScanFit results suggest that motor changes are seen as early as sensory, and the role of axonal membrane properties in DPN pathophysiology should be revisited.
The MScanFit results suggest that motor changes are seen as early as sensory, and the role of axonal membrane properties in DPN pathophysiology should be revisited.
Despite the clinical effectiveness of Spinal Cord Stimulation (SCS), potential structural brain modifications have not been explored. Our aim was to identify structural volumetric changes during subsensory SCS, in patients with Failed Back Surgery Syndrome (FBSS).

In this cohort study, twenty-two FBSS patients underwent a magnetic resonance imaging protocol before SCS and 3months after SCS. Clinical parameters were correlated with volumetric changes, calculated with voxel-based morphometry.

After 3months, a significant volume decrease was found in the inferior frontal gyrus, precuneus, cerebellar posterior lobe and middle temporal gyrus. Significant increases were found in the inferior temporal gyrus, precentral gyrus and the middle frontal gyrus after SCS. Additionally, significant increases in volume of superior frontal and parietal white matter and a significant decrease in volume of white matter underlying the premotor/middle frontal gyrus were revealed after SCS. A significant correlation was highlighted between white matter volume underlying premotor/middle frontal gyrus and leg pain relief.

This study revealed for the first time that SCS is able to induce volumetric changes in gray and white matter, suggesting the reversibility of brain alterations after chronic pain treatment.

Volumetric brain alterations are observable after 3months of subsensory SCS in FBSS patients.
Volumetric brain alterations are observable after 3 months of subsensory SCS in FBSS patients.
We investigated whether pre-anesthesia dynamic frontal-parietal functional connectivity was correlated with the observed interindividual differences in propofol susceptibility.

Three resting-state EEG datasets were used in the study (N=29, N=21 and N=20). We estimated the pre-anesthesia strength and fluctuations of frontal-parietal functional connectivity by using sliding-window analysis. Propofol served as the sole anesthetic drug, and it was administered by using a target-controlled infusion system. Individual susceptibility to propofol was assessed by the induction time, from infusion onset until a bispectral index value of 60 was reached, for subjects in dataset-1 and dataset-2, and susceptibility was assessed by behavioral data for subjects in the external dataset.

We observed in the three datasets that subjects with high susceptibility to propofol had lower pre-anesthesia strength and lower fluctuation of frontal-parietal functional connectivity than the low-susceptibility group at alpha band. Moreover, the induction time was significantly correlated with the estimated pre-anesthesia frontal-parietal functional connectivity measures. We also validated the robustness of these findings by using different window lengths in sliding-window analysis.

Subjects with weaker pre-anesthesia dynamic frontal-parietal communication are more likely to be anesthetized.

These observations suggest that the titration procedure for propofol should consider the pre-anesthesia brain functional state.
These observations suggest that the titration procedure for propofol should consider the pre-anesthesia brain functional state.
The current study sought to determine whether there is a Bereitschaftspotential (BP) before uninstructed, spontaneous movements.

14 participants were seated on a comfortable armchair for one hour without any instruction except not to fall asleep and to keep their eyes open. Electroencephalography (EEG) and electromyography (EMG) activity were recorded during the whole session. EEG activity was analyzed before spontaneous movements and compared with EEG activity before repetitive, instructed movements in a separate session.

BPs were identified in most participants with the spontaneous movements. The BPs with spontaneous movements were mostly localized in the medial frontocentral regions. The BPs with the instructed movements were localized primarily in the central regions and had larger amplitude.

Presence of a BP before movement does not depend on instruction and may be independent of conscious volition. The amplitude of the BP may depend on the amount of attention.

This study shows that the presence of a BP before movement is not an "artifact" of the experimental instructions.
This study shows that the presence of a BP before movement is not an "artifact" of the experimental instructions.
To characterise the effect of altering transcranial magnetic stimulation parameters on the magnitude of interhemispheric inhibition (IHI) from dorsal premotor (PMd) to primary motor cortex (M1).

We used a fully automated adaptive threshold hunting paradigm to quantify PMd-M1 IHI across a range of conditioning stimulus (CS) intensities (90%, 110%, 130% of resting motor threshold, rMT) and interstimulus intervals (ISIs) (8, 10, 40ms). M1-M1 IHI was examined with CS intensities of 110%, 120%, and 130% rMT and ISIs of 10 and 40ms. Two test coil orientations (inducing posterior-anterior or anterior-posterior current) were used.

PMd-M1 IHI was obtained consistently with posterior-anterior (but not anterior-posterior) test stimuli and increased with CS intensity. M1-M1 IHI was expressed across all conditions and increased with CS intensity when posterior-anterior but not anterior-posterior induced current was used.

The expression of PMd-M1 IHI is contingent on test coil orientation (requiring posterior-anterior induced current) and increases as a function of CS intensity. The expression of M1-M1 IHI is not dependent on test coil orientation.

We defined a range of parameters that elicit reliable PMd-M1 IHI. This (threshold hunting) methodology may provide a means to quantify premotor-motor pathology and reveal novel quantitative biomarkers.
We defined a range of parameters that elicit reliable PMd-M1 IHI. This (threshold hunting) methodology may provide a means to quantify premotor-motor pathology and reveal novel quantitative biomarkers.
Studies of high frequency oscillations (HFOs) in epilepsy have primarily tested the HFO rate as a biomarker of the seizure onset zone (SOZ), but the rate varies over time and is not robust for all individual subjects. As an alternative, we tested the performance of HFO amplitude as a potential SOZ biomarker using two automated detection algorithms.

read more were detected in intracranial electroencephalogram (iEEG) from 11 patients using a machine learning algorithm and a standard amplitude-based algorithm. For each detector, SOZ and non-SOZ channels were classified using the rate and amplitude of high frequency events, and performance was compared using receiver operating characteristic curves.

The amplitude of detected events was significantly higher in SOZ. Across subjects, amplitude more accurately classified SOZ/non-SOZ than rate (higher values of area under the ROC curve and sensitivity, and lower false positive rates). link3 Moreover, amplitude was more consistent across segments of data, indicated by lower coefficient of variation.

As an SOZ biomarker, HFO amplitude offers advantages over HFO rate it exhibits higher classification accuracy, more consistency over time, and robustness to parameter changes.

This biomarker has the potential to increase the generalizability of HFOs and facilitate clinical implementation as a tool for SOZ localization.
This biomarker has the potential to increase the generalizability of HFOs and facilitate clinical implementation as a tool for SOZ localization.
To investigate the diagnostic utility of high frequency oscillations (HFOs) via scalp electroencephalogram (EEG) in infantile spasms.

We retrospectively analyzed interictal slow-wave sleep EEGs sampled at 2,000Hz recorded from 30 consecutive patients who were suspected of having infantile spasms. We measured the rate of HFOs (80-500Hz) and the strength of the cross-frequency coupling between HFOs and slow-wave activity (SWA) at 3-4Hz and 0.5-1Hz as quantified with modulation indices (MIs).

Twenty-three patients (77%) exhibited active spasms during the overnight EEG recording. Although the HFOs were detected in all children, increased HFO rate and MIs correlated with the presence of active spasms (p<0.001 by HFO rate; p<0.01 by MIs at 3-4Hz; p=0.02 by MIs at 0.5-1Hz). The presence of active spasms was predicted by the logistic regression models incorporating HFO-related metrics (AUC 0.80-0.98) better than that incorporating hypsarrhythmia (AUC 0.61). The predictive performance of the best model remained favorable (87.
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