Clinical Neurophysiology Practice最新文献

Preserved D-waves may not exclude distal motor deficits during cervicothoracic spinal cord tumor resection: A letter to the editor. 保留的d波可能不能排除颈胸脊髓肿瘤切除时的远端运动缺陷：致编辑的一封信。

IF 2.3 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-10-14 eCollection Date: 2026-01-01 DOI: 10.1016/j.cnp.2026.10.005

Apratim Maity, Jacob Gluski, Ethan D L Brown, Aryaa Karkare, Aladine A Elsamadicy, Randy S D'Amico, Sheng-Fu Larry Lo, Gabrielle Santangelo, Justin W Silverstein DHSc, Daniel M Sciubba

引用次数: 0

Stimulation selectivity in transcranial motor evoked potentials for monitoring during surgery for supratentorial lesions 幕上病变手术中监测经颅运动诱发电位的刺激选择性

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.1016/j.cnp.2026.01.006

Tammam Abboud , Jan-Bernd Wemhoff , Fares Komboz , Angelina Nazarenus , Tatiana Chacon , Dorothee Mielke , Veit Rohde

Objective

To identify the most selective electrode configuration for monitoring of transcranial motor evoked potentials (TcMEP) during supratentorial tumor surgery and determine the stimulation threshold at which bilateral corticospinal tract (CST) activation occurs at deeper white matter levels.

Methods

Fifty-six patients undergoing resection of supratentorial tumors without preoperative motor deficits were prospectively included. TcMEPs were elicited under general anesthesia using three electrode configurations: C1 ↔ C2, C3 ↔ C4, and C3/4 → Cz. Motor thresholds (MT) were recorded bilaterally from the abductor pollicis brevis (APB), and the selectivity ratio (ipsilateral/contralateral MT) was calculated. Electrode combinations were compared using paired t-tests. Linear regression assessed the influence of age, sex, height, and weight.

Results

The C3/4 → Cz montage demonstrated the highest selectivity ratio (median 248%, range: 140–364%), significantly greater than C1 ↔ C2 and C3 ↔ C4 (p < 0.001). Bilateral CST activation with C3/4 → Cz began at 140% of the contralateral MT. Age correlated with lower MTs; sex, height, and weight had no significant effect.

Conclusions

C3/4 → Cz is the most selective configuration for eliciting contralateral TcMEP and requires higher stimulation intensity before activating bilateral CST fibers at deeper levels.

Significance

This study supports using C3/4 → Cz to optimize TcMEP selectivity and reduce the risk of false-negative monitoring due to deep white matter stimulation.

目的确定幕上肿瘤手术中经颅运动诱发电位（TcMEP）监测的最选择性电极配置，并确定双侧皮质脊髓束（CST）在更深白质水平激活的刺激阈值。方法前瞻性分析56例术前无运动障碍的幕上肿瘤切除术患者。tcmep在全身麻醉下用三种电极配置引起：C1↔C2， C3↔C4和C3/4→Cz。记录双侧短拇外展肌（APB）的运动阈值（MT），并计算选择性比（同侧/对侧MT）。电极组合采用配对t检验进行比较。线性回归评估了年龄、性别、身高和体重的影响。结果C3/4→Cz蒙太奇表现出最高的选择比（中位数248%，范围：140-364%），显著高于C1↔C2和C3↔C4 （p < 0.001）。C3/4→Cz的双侧CST激活始于对侧MT的140%。年龄与较低的MT相关；性别、身高和体重没有显著影响。结论sc3 /4→Cz是激发对侧TcMEP最具选择性的配置，在激活双侧CST纤维之前需要较高的刺激强度。意义本研究支持C3/4→Cz优化TcMEP选择性，降低深部白质刺激导致的假阴性监测风险。

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引用次数: 0

A movie in the operating theater: Guided story narration as a pragmatic language screening tool during awake craniotomy 手术室电影：引导故事叙事作为清醒开颅术中语用筛选工具

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-01-10 DOI: 10.1016/j.cnp.2026.01.002

Nishanth Sampath , Sunil Kapilavayi Raghavendra , Vishwaraj Ratha , Gomathi Sivakumar , Vijay Sankaran , Suresh Bapu K.R.

引用次数: 0

Estimating paediatric normative values for nerve studies using clustering techniques 使用聚类技术估计神经研究的儿科规范值

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-02-28 DOI: 10.1016/j.cnp.2026.02.006

G.K. Cooray , D. Motan , K. Howse , L. Nastasi , J. Deeb

Objective:

To estimate normative values from mixed clinical paediatric electroneurography data using an unsupervised clustering approach.

Methods:

Electroneurography studies from paediatric patients (2009–2024) were analysed for common motor and sensory nerves. Motor parameters included distal motor latency, CMAP amplitude, duration, area, and conduction velocity; sensory parameters included SNAP amplitude and conduction velocity. Data were grouped into age windows, and within each, t-distributed stochastic neighbour embedding (t-SNE) was applied to identify the normative distribution. The mean, 5th, and 95th centiles were derived and modelled using exponential fits.

Results:

Normative values were estimated for ages 0–18 years. Motor amplitudes increased with age, and conduction velocities rose rapidly until 3–4 years before plateauing. Distal motor latency showed a brief early dip followed by an increase. Sensory amplitudes peaked between 1 and 8 years, while sensory conduction velocities increased sharply in the first year, then gradually declined.

Conclusion:

Unsupervised clustering can derive normative paediatric electroneurography values from heterogeneous clinical data, yielding trends consistent with published references.

Significance:

This data-driven approach is practical, generalisable, and enables identification of likely healthy individuals using multivariate electrophysiological parameters.

目的：利用无监督聚类方法估计混合临床儿科神经电图数据的规范性值。方法：分析2009-2024年儿科患者常见运动神经和感觉神经的神经电图研究。运动参数包括远端运动潜伏期、CMAP振幅、持续时间、面积和传导速度；感官参数包括SNAP振幅和传导速度。数据按年龄窗分组，在每个年龄窗内，应用t分布随机邻居嵌入（t-SNE）来确定规范分布。平均值、第5百分位和第95百分位采用指数拟合方法推导和建模。结果：0-18岁的正常值估计。运动振幅随年龄增长而增加，传导速度迅速上升，直到3-4年才达到稳定期。远端运动潜伏期表现为短暂的早期下降，随后增加。感觉振幅在1 - 8岁之间达到峰值，而感觉传导速度在第一年急剧增加，然后逐渐下降。结论：无监督聚类可以从异质临床数据中得出规范的儿科神经电图值，得出与已发表文献一致的趋势。意义：这种数据驱动的方法是实用的，可推广的，并且可以使用多变量电生理参数识别可能健康的个体。

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引用次数: 0

Letter to editor re: “Stimulation selectivity in transcranial motor evoked potentials for monitoring during surgery for supratentorial lesions” 致编辑的信：“幕上病变手术中监测经颅运动诱发电位的刺激选择性”

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-03-25 DOI: 10.1016/j.cnp.2026.03.004

Justin W. Silverstein , Otakhon Matchanov , Jung Park , Daniel G. Eichberg , Jason A. Ellis , Randy S. D’Amico

引用次数: 0

Behavioral and neurophysiological changes associated with a single session of bimanual task practice after stroke 中风后单次双手任务练习的行为和神经生理变化

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-05-28 DOI: 10.1016/j.cnp.2026.05.005

Joshua Jacob , Jessica Hesling-Fox , Masahiro Yamada , Shailesh Kantak

Objective

Stroke survivors often show slower, uncoordinated bimanual performance. This study examined the effects of a single session of bimanual task practice on performance, coordination, motor corticospinal excitability (CSE), and transcallosal inhibition in stroke survivors compared to age-matched controls.

Methods

Eleven individuals with chronic stroke and ten neurotypical controls practiced a naturalistic bimanual task for 400 trials. Movement time, errors and bimanual coordination ability were assessed before and after practice. Transcranial magnetic stimulation was used to examine CSE of the ipsilesional and contralesional motor cortices (M1), and ipsilateral silent period duration and inhibition in the two M1s at pre- and post-test.

Results

Both groups significantly reduced movement time without increasing errors. Controls improved bimanual coordination, but stroke survivors did not. Controls showed significant increases in bilateral CSE, while stroke survivors showed increase only in contralesional CSE. Ipsilateral silent period duration and inhibition remained unchanged in both groups.

Conclusions

A single session of bimanual task practice improves speed, but not bimanual coordination in stroke survivors. Novel to this study, contralesional, but not ipsilesional CSE is modulated following a single bimanual task practice session.

Significance

Findings highlight potential clinical relevance for neurorehabilitation strategies targeting bimanual coordination for improved arm function.

中风幸存者通常表现出较慢、不协调的双手动作。本研究考察了单次双手任务练习对中风幸存者的表现、协调、运动皮质脊髓兴奋性（CSE）和经胼胝体抑制的影响，并与年龄匹配的对照组进行了比较。方法在400个试验中，慢性中风患者和10个神经正常的对照组进行了自然的手工任务。练习前后对动作时间、误差、双手协调能力进行评估。经颅磁刺激检测同侧和对侧运动皮质（M1）的CSE，以及测试前后同侧两个M1的沉默期持续时间和抑制情况。结果两组在不增加误差的情况下均显著缩短了运动时间。对照组改善了双手协调能力，但中风幸存者没有。对照组显示双侧CSE显著增加，而卒中幸存者仅显示对侧CSE增加。两组同侧沉默期持续时间和抑制作用保持不变。结论单次的双手任务练习提高了脑卒中幸存者的速度，但没有提高他们的双手协调能力。本研究的新颖之处在于，对偶性而非同位性的CSE在单次手工任务练习后被调节。研究结果强调了针对双手协调改善手臂功能的神经康复策略的潜在临床相关性。

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引用次数: 0

Long-term neuromuscular alterations during botulinum toxin treatment for chronic migraine 肉毒杆菌毒素治疗慢性偏头痛期间的长期神经肌肉改变。

IF 2.3 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-06-22 DOI: 10.1016/j.cnp.2026.06.010

Tina Plensäll, Maarika Liik, Artor Pogosean, Annika Eriksson, Malin Garrett, Jan Olszowy, Sven Jackmann, Anna Rostedt Punga

Objective

To evaluate early and long-term neuromuscular and clinical effects of botulinum toxin type A (BoNTA) in women with chronic migraine undergoing sustained treatment.

Methods

Forty female patients were stratified by cumulative BoNTA exposure (treatment-naïve, ∼1 year, 2–5 years, >5 years). Clinical outcomes included migraine frequency, pain burden, and quality of life. Neurophysiological assessments during one treatment cycle comprised motor nerve conduction studies, quantitative EMG, jitter analysis, and blink reflex. Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were also measured.

Results

BoNTA significantly reduced migraine days (p = 0.0008) with sustained benefit across treatment groups. Neuromuscular side effects were reported in 75% of patients treated for ≥1 year, including ptosis, diplopia, and shoulder weakness. In treatment-naive patients, frontalis CMAP amplitudes declined significantly from baseline to week 12 (p = 0.0006), whereas cumulative reductions were most pronounced in the trapezius muscle in patients treated for 2–5 years (p < 0.0001). EMG showed spontaneous activity consistent with denervation in up to 60% of patients and myopathic patterns in 30–40% of long-term-treated individuals. Abnormal jitter in the orbicularis oculi was present in 47% at week 12. NfL levels were higher in long-term treated groups at week 4 (p = 0.0095), while GFAP remained unchanged. Subtle blink reflex abnormalities suggested possible central modulation.

Conclusions

BoNTA is associated with persistent neuromuscular alterations, with early effects in facial muscles and cumulative changes in the trapezius.

Significance

These findings support the occurrence of treatment-dependent neuromuscular side effects and highlight the need for monitoring during long-term therapy.

目的：评价A型肉毒杆菌毒素（BoNTA）对女性慢性偏头痛持续治疗的早期和长期神经肌肉及临床效果。方法：40例女性患者按BoNTA累积暴露量进行分层（treatment-naïve， ~ 1年，2-5年，bbb50年）。临床结果包括偏头痛频率、疼痛负担和生活质量。在一个治疗周期内的神经生理学评估包括运动神经传导研究、定量肌电图、抖动分析和眨眼反射。测定血清神经丝轻链（NfL）和胶质原纤维酸性蛋白（GFAP）。结果：BoNTA显著减少偏头痛天数（p = 0.0008），并在治疗组中持续获益。75%的治疗≥1年的患者出现神经肌肉副作用，包括上睑下垂、复视和肩关节无力。在未接受治疗的患者中，额肌CMAP振幅从基线到第12周显著下降（p = 0.0006），而治疗2-5年的患者斜方肌的累积下降最为明显（p = 0.0095），而GFAP保持不变。细微的眨眼反射异常提示可能是中央调制。结论：BoNTA与持续的神经肌肉改变有关，早期影响面部肌肉和斜方肌的累积变化。意义：这些发现支持治疗依赖性神经肌肉副作用的发生，并强调在长期治疗期间监测的必要性。

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引用次数: 0

Foot dorsum thermal quantitative sensory testing thresholds in healthy Vietnamese adults: Reference data 越南健康成人足背热定量感觉测试阈值：参考数据。

IF 2.3 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-06-25 DOI: 10.1016/j.cnp.2026.06.009

Phan Hoang Phuong Khanh MD, Pham Dinh San MD, Phan Hoang Dang Khoa MD, MSc, Nguyen Huu Cong MD, PhD, Nguyen Le Viet Hung MD, PhD, Nguyen Le Trung Hieu MD, PhD

Objective: To provide preliminary reference data for thermal quantitative sensory testing (QST) at the foot dorsum in healthy Vietnamese adults and to examine associations with demographic and metabolic variables.

Methods: This cross-sectional study included 68 healthy Vietnamese adults (23–80 years). Participants were screened to exclude diabetes and prediabetes according to ADA 2024 criteria. Cold Detection Threshold (CDT), Warm Detection Threshold (WDT), and Heat Pain Threshold (HPT) were assessed bilaterally at the foot dorsum using the Q-Sense device and the Method of Limits protocol. Reference intervals (2.5th–97.5th percentiles) were estimated using non-parametric methods. Multivariable linear regression was used to evaluate associations with age, sex, BMI, LDL-C, triglycerides, and HbA1c.

Results: Bilateral symmetry supported the use of averaged bilateral values. Age was independently associated with all QST parameters (CDT β = −0.0299; WDT β = 0.0801; HPT β = 0.0739; all p < 0.001). In the reduced model, BMI was associated with CDT (β = 0.0929, p = 0.030), but this was not observed in the full model. LDL-C was associated with WDT in both models (β = 0.0122, p = 0.007; β = 0.0121, p = 0.011). Sex was not consistently associated with any parameter.

Conclusions: This study provides preliminary reference data for thermal QST in a Vietnamese population. Age was the most determinant of thermal thresholds. LDL-C was associated with warm detection thresholds, while BMI was not significant in the full model.

Significance: These data may support interpretation of thermal QST in clinical practice.

目的：为越南健康成人足背热定量感觉测试（QST）提供初步参考数据，并探讨其与人口统计学和代谢变量的关系。方法：本横断面研究包括68名23-80岁的健康越南成年人。根据ADA 2024标准对参与者进行筛查，排除糖尿病和前驱糖尿病。冷检测阈值（CDT）、热检测阈值（WDT）和热痛阈值（HPT）采用Q-Sense装置和极限法方案在足背两侧进行评估。使用非参数方法估计参考区间（2.5 -97.5百分位数）。使用多变量线性回归来评估与年龄、性别、BMI、LDL-C、甘油三酯和HbA1c的关系。结果：双侧对称性支持双侧平均值的使用。年龄与所有QST参数独立相关（CDT β = -0.0299; WDT β = 0.0801; HPT β = 0.0739；所有p p = 0.030），但在完整模型中未观察到这一点。两种模型中LDL-C均与WDT相关（β = 0.0122, p = 0.007; β = 0.0121, p = 0.011）。性别并不总是与任何参数相关联。结论：本研究为越南人群热性QST提供了初步参考数据。年龄是热阈值的最决定性因素。LDL-C与热检测阈值相关，而BMI在全模型中不显著。意义：这些数据可能支持临床实践中热QST的解释。

{"title":"Foot dorsum thermal quantitative sensory testing thresholds in healthy Vietnamese adults: Reference data","authors":"Phan Hoang Phuong Khanh MD, Pham Dinh San MD, Phan Hoang Dang Khoa MD, MSc, Nguyen Huu Cong MD, PhD, Nguyen Le Viet Hung MD, PhD, Nguyen Le Trung Hieu MD, PhD","doi":"10.1016/j.cnp.2026.06.009","DOIUrl":"10.1016/j.cnp.2026.06.009","url":null,"abstract":"<div><div><strong>Objective:</strong> To provide preliminary reference data for thermal quantitative sensory testing (QST) at the foot dorsum in healthy Vietnamese adults and to examine associations with demographic and metabolic variables.</div><div><strong>Methods:</strong> This cross-sectional study included 68 healthy Vietnamese adults (23–80 years). Participants were screened to exclude diabetes and prediabetes according to ADA 2024 criteria. Cold Detection Threshold (CDT), Warm Detection Threshold (WDT), and Heat Pain Threshold (HPT) were assessed bilaterally at the foot dorsum using the Q-Sense device and the Method of Limits protocol. Reference intervals (2.5th–97.5th percentiles) were estimated using non-parametric methods. Multivariable linear regression was used to evaluate associations with age, sex, BMI, LDL-C, triglycerides, and HbA1c.</div><div><strong>Results:</strong> Bilateral symmetry supported the use of averaged bilateral values. Age was independently associated with all QST parameters (CDT β = −0.0299; WDT β = 0.0801; HPT β = 0.0739; all <em>p</em> < 0.001). In the reduced model, BMI was associated with CDT (β = 0.0929, <em>p</em> = 0.030), but this was not observed in the full model. LDL-C was associated with WDT in both models (β = 0.0122, <em>p</em> = 0.007; β = 0.0121, <em>p</em> = 0.011). Sex was not consistently associated with any parameter.</div><div><strong>Conclusions:</strong> This study provides preliminary reference data for thermal QST in a Vietnamese population. Age was the most determinant of thermal thresholds. LDL-C was associated with warm detection thresholds, while BMI was not significant in the full model.</div><div><strong>Significance:</strong> These data may support interpretation of thermal QST in clinical practice.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 562-569"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Heart rate variability and heart rate in a sample of medicated and unmedicated adolescents with obsessive-compulsive disorder 患有强迫症的青少年接受药物治疗和未接受药物治疗的样本的心率变异性和心率

IF 2.3 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-08-07 DOI: 10.1016/j.cnp.2026.08.002

Manuel Burkart, Sophie P. Scheer, Lea L. Backhausen, Magdalena K. Wekenborg, Nicole Beyer, Maria McDonald, Veit Roessner, Nora C. Vetter

Objective

Alterations in autonomic nervous system activity – measured by heart rate variability (HRV) and heart rate (HR) - have been proposed as a relevant biopsychological mechanism in several psychiatric disorders. However, only few studies have examined these parameters in OCD, and evidence from pediatric samples is particularly limited. The aim of this study was to investigate autonomic activity in pediatric OCD.

Methods

A five minute resting state electrocardiogram was recorded in adolescents with OCD (n = 64) and age- and IQ-matched healthy controls (HC, n = 52). Autonomic activity was compared using the logarithmized root mean square of differences between successive R-R intervals (logRMSSD), the logarithmized high-frequency HRV (logHF-HRV), the percentage of adjacent NN intervals differing from each other by more than 50 ms (pNN50) and HR. Associations with psychotropic medication status and symptom severity were assessed.

Results

Adolescents with OCD showed lower logRMSSD and higher HR than HC, whereas logHF-HRV and pNN50 did not differ between groups. No associations were found between cardiac measures and OCD symptom severity. Exploratory subgroup analyses suggested lower logHF-HRV and logRMSSD in medicated adolescents with OCD.

Conclusions

Our findings add to evidence for altered autonomic activity in pediatric OCD, reflected by elevated HR and lower RMSSD. The observed reduction in HRV did not increase with greater symptom severity and appeared most pronounced among medicated adolescents with OCD.

Significance

The autonomic imbalance observable in adolescents with OCD is common across anxiety disorders and has been linked to cardiovascular risk.

{"title":"Heart rate variability and heart rate in a sample of medicated and unmedicated adolescents with obsessive-compulsive disorder","authors":"Manuel Burkart, Sophie P. Scheer, Lea L. Backhausen, Magdalena K. Wekenborg, Nicole Beyer, Maria McDonald, Veit Roessner, Nora C. Vetter","doi":"10.1016/j.cnp.2026.08.002","DOIUrl":"10.1016/j.cnp.2026.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>Alterations in autonomic nervous system activity – measured by heart rate variability (HRV) and heart rate (HR) - have been proposed as a relevant biopsychological mechanism in several psychiatric disorders. However, only few studies have examined these parameters in OCD, and evidence from pediatric samples is particularly limited. The aim of this study was to investigate autonomic activity in pediatric OCD.</div></div><div><h3>Methods</h3><div>A five minute resting state electrocardiogram was recorded in adolescents with OCD (<em>n</em> = 64) and age- and IQ-matched healthy controls (HC, <em>n</em> = 52). Autonomic activity was compared using the logarithmized root mean square of differences between successive R-R intervals (logRMSSD), the logarithmized high-frequency HRV (logHF-HRV), the percentage of adjacent NN intervals differing from each other by more than 50ms (pNN50) and HR. Associations with psychotropic medication status and symptom severity were assessed.</div></div><div><h3>Results</h3><div>Adolescents with OCD showed lower logRMSSD and higher HR than HC, whereas logHF-HRV and pNN50 did not differ between groups. No associations were found between cardiac measures and OCD symptom severity. Exploratory subgroup analyses suggested lower logHF-HRV and logRMSSD in medicated adolescents with OCD.</div></div><div><h3>Conclusions</h3><div>Our findings add to evidence for altered autonomic activity in pediatric OCD, reflected by elevated HR and lower RMSSD. The observed reduction in HRV did not increase with greater symptom severity and appeared most pronounced among medicated adolescents with OCD.</div></div><div><h3>Significance</h3><div>The autonomic imbalance observable in adolescents with OCD is common across anxiety disorders and has been linked to cardiovascular risk.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 689-696"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cathodal tDCS in obsessive-compulsive disorder: cognitive and neurophysiological outcomes in a double-blind sham-controlled trial 强迫症的阴极tDCS：双盲假对照试验的认知和神经生理结果

IF 2.3 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2026-01-01 Epub Date: 2026-09-02 DOI: 10.1016/j.cnp.2026.08.009

Rut Zaks-Ohayon, Talia Beit-On Hakmon, Hagit Cohen, Itay Besser, Zippi Frenkel, Jonathan Guez, Doron Todder

Objective

This preliminary study examined the efficacy of cathodal transcranial direct current stimulation (tDCS) targeting the medial prefrontal cortex (mPFC) in reducing symptom severity, enhancing cognitive flexibility, and modulating brain-derived neurotrophic factor (BDNF) levels in individuals with obsessive-compulsive disorder (OCD).

Methods

A double-blind, randomized, sham-controlled trial was conducted with 20 patients meeting DSM-V criteria for OCD, of whom 15 completed the intervention and were included in the final analysis. Participants received cathodal mPFC-tDCS (2 mA, 20 min, 10 sessions) or sham stimulation. Symptom severity (Y-BOCS), cognitive flexibility (task-switching), salivary BDNF, and frontal alpha activity (qEEG at Fz) were measured at baseline, post-treatment, and follow-up.

Results

The tDCS group exhibited greater reductions in Y-BOCS scores over time (F(2, 26) = 12.562, p < 0.001, partial η² = 0.425). Task-switching performance improved in the experimental group compared with controls (F(2, 26) = 20.351, p < 0.001, partial η² = 0.531). Salivary BDNF levels increased significantly in the tDCS group at follow-up (F(2, 16) = 6.086, p = 0.01, partial η² = 0.432). Trends toward normalization of frontal alpha activity were observed, but did not reach statistical significance.

Conclusions

Cathodal mPFC-tDCS was associated with reduced OCD symptom severity, improved cognitive flexibility, and increased salivary BDNF. These preliminary findings warrant replication in larger controlled samples.

Significance

This study extends previous tDCS research in OCD by integrating clinical outcomes with cognitive performance and a peripheral marker of neuroplasticity. It provides preliminary support for mPFC-targeted tDCS as a potential intervention for OCD.

目的探讨针对内侧前额叶皮质（mPFC）的阴极经颅直流电刺激（tDCS）在减轻强迫症（OCD）患者症状严重程度、增强认知灵活性和调节脑源性神经营养因子（BDNF）水平方面的疗效。方法采用双盲、随机、假对照试验，选取符合DSM-V标准的强迫症患者20例，其中15例完成干预并纳入最终分析。参与者接受mPFC-tDCS阴极刺激（2 mA， 20分钟，10次）或假刺激。在基线、治疗后和随访时测量症状严重程度（Y-BOCS）、认知灵活性（任务切换）、唾液BDNF和额叶α活动（Fz时的qEEG）。结果tDCS组Y-BOCS评分随时间降低幅度更大（F(2,26) = 12.562, p < 0.001，偏η2 = 0.425）。与对照组相比，实验组的任务切换性能有所改善（F(2,26) = 20.351, p < 0.001，偏η2 = 0.531）。随访时，tDCS组唾液BDNF水平显著升高（F(2,16) = 6.086, p = 0.01，偏η2 = 0.432）。观察到额叶α活动趋于正常化的趋势，但没有达到统计学意义。结论经侧mPFC-tDCS可减轻强迫症症状严重程度，改善认知灵活性，增加唾液BDNF。这些初步发现可以在更大的对照样本中复制。意义本研究通过将临床结果与认知表现和神经可塑性的外周标志物结合起来，扩展了之前在强迫症中的tDCS研究。它为mpfc靶向tDCS作为强迫症的潜在干预措施提供了初步支持。

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引用次数: 0