Mechanisms and Application of Clinical Neurophysiology: State of the Art

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurotechnology and Neuroimaging".

Deadline for manuscript submissions: closed (30 December 2020) | Viewed by 9849

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Guest Editor
Division of Human Anatomy-Neuronal Networks Morphology and Systems Biology Lab, Department of Mental, Physical Health and Preventive Medicine University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: maladaptive synaptic plasticity; reactive gliosis; neuroinflammation; spinal cord; non-invasive stimulation
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Special Issue Information

Dear Colleagues,

Despite enormous advances in neuroimaging over the past 25 years, clinical neurophysiology is still one of the main diagnostic tools of the clinical neurologist.
Examination in the clinical neurophysiology field demands specific technical training and a very precise clinical framework for patients’ care: in other words, clinical neurophysiology is thought of as an extension of the neurologic evaluation.
Clinical neurophysiology is required for the diagnosis of neuromuscular/peripheral and central nervous system disorders, as well as to quantify, monitor, and follow the progression of such conditions. Moreover, non-invasive brain stimulation techniques, mainly through electric and magnetic fields, have demonstrated therapeutic efficacy due to their long-term neurobiological after-effects.
Despite a large knowledge of the technical aspects, the mechanisms leading to therapeutic benefits are far from being fully elucidated, and only the clinical and experimental application of clinical neurophysiology techniques will increase our understanding of how the central nervous system operates.
Original research articles describing innovative applications or experimental clinical procedures related to clinical neurophysiology are solicited for this Special Issue. Clinical cases presenting a key role of clinical neurophysiology techniques and reviews providing an analytical perspective based on the existing literature are also welcome.

Dr. Giovanni Cirillo
Guest Editor

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Keywords

  • clinical neurophysiology
  • rTMS
  • electric stimulation
  • evoked potentials
  • electromyography
  • neuromuscular disorders
  • EEG
  • dysimmune neuropathies

Published Papers (2 papers)

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Research

19 pages, 3637 KiB  
Article
The Effects of Spinal Manipulation on Motor Unit Behavior
by Lucien Robinault, Aleš Holobar, Sylvain Crémoux, Usman Rashid, Imran Khan Niazi, Kelly Holt, Jimmy Lauber and Heidi Haavik
Brain Sci. 2021, 11(1), 105; https://doi.org/10.3390/brainsci11010105 - 14 Jan 2021
Cited by 3 | Viewed by 4217
Abstract
Over recent years, a growing body of research has highlighted the neural plastic effects of spinal manipulation on the central nervous system. Recently, it has been shown that spinal manipulation improved outcomes, such as maximum voluntary force and limb joint position sense, reflecting [...] Read more.
Over recent years, a growing body of research has highlighted the neural plastic effects of spinal manipulation on the central nervous system. Recently, it has been shown that spinal manipulation improved outcomes, such as maximum voluntary force and limb joint position sense, reflecting improved sensorimotor integration and processing. This study aimed to further evaluate how spinal manipulation can alter neuromuscular activity. High density electromyography (HD sEMG) signals from the tibialis anterior were recorded and decomposed in order to study motor unit changes in 14 subjects following spinal manipulation or a passive movement control session in a crossover study design. Participants were asked to produce ankle dorsiflexion at two force levels, 5% and 10% of maximum voluntary contraction (MVC), following two different patterns of force production (“ramp” and “ramp and maintain”). A significant decrease in the conduction velocity (p = 0.01) was observed during the “ramp and maintain” condition at 5% MVC after spinal manipulation. A decrease in conduction velocity suggests that spinal manipulation alters motor unit recruitment patterns with an increased recruitment of lower threshold, lower twitch torque motor units. Full article
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15 pages, 3999 KiB  
Article
Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review with Meta-Analysis and Trial Sequential Analysis
by Chih-Hao Chen, Chii-Yuan Huang, Chun-Yu Chang and Yen-Fu Cheng
Brain Sci. 2020, 10(12), 931; https://doi.org/10.3390/brainsci10120931 - 02 Dec 2020
Cited by 3 | Viewed by 5074
Abstract
Study Objective: Tinnitus is a common disorder characterized by sound in the ear in the absence of external or internal stimuli. Low-level laser therapy (LLLT) was discovered enhancing tissue repair via increasing the blood microcirculation and cell proliferation in 1960s. In the last [...] Read more.
Study Objective: Tinnitus is a common disorder characterized by sound in the ear in the absence of external or internal stimuli. Low-level laser therapy (LLLT) was discovered enhancing tissue repair via increasing the blood microcirculation and cell proliferation in 1960s. In the last two decades, LLLT delivered to the cochlea has frequently been used to reduce the severity of tinnitus. However, whether LLLT effectively attenuates the severity of tinnitus remains controversial. We aimed to evaluate the efficacy of low-level laser therapy on adult patients with complaints of tinnitus. Design: Systematic review and meta-analysis with trial sequential analysis. Interventions: Low-level laser therapy (LLLT). Measurements: Tinnitus Handicap Inventory (THI) score; improvement rates of the visual analog scale (VAS), verbal rating scale (VRS) and numeric rating scale (NRS) scores. Methods: We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from inception through 17 September 2020. Randomized control trials that involved adult patients with complaints of tinnitus, compared LLLT to a placebo and provided sufficient information for meta-analysis were considered eligible. Main Results: Overall, 11 studies involving 670 patients were included. No significant difference in the overall effect according to the THI score (mean difference (MD), −2.85; 95% CI, −8.99 to 3.28; p = 0.362; I2 = 0%) and the rating scale score improvement rate (risk ratio (RR), 1.35; 95% CI, 0.81 to 2.27; p = 0.250; I2 = 67%) was demonstrated between patients receiving LLLT and those receiving a placebo. None of the subgroup analyses showed significant differences, regardless of underlying sensorineural hearing loss, the number of irradiation sessions or the wavelength used. Conclusions: Our meta-analysis suggests that the value of LLLT in controlling the severity of tinnitus remains unclear, in part due to the relatively small number of patients and underlying heterogeneity. More large-scale investigations of LLLT for tinnitus related to inner ear disease are required to further elucidate the therapeutic effects. Full article
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