Federally mandating motorcycle helmets in the United States

BMC Public Health

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Multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Chiropractic & Manual Therapies

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Is intracranial pressure monitoring of patients with diffuse traumatic brain injury valuable? an observational multicenter study

Neurosurgery

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The morphology of high frequency oscillations (HFO) does not improve delineating the epileptogenic zone

Publication date: April 2016
Source:Clinical Neurophysiology, Volume 127, Issue 4
Author(s): Sergey Burnos, Birgit Frauscher, Rina Zelmann, Claire Haegelen, Johannes Sarnthein, Jean Gotman
ObjectiveWe hypothesized that high frequency oscillations (HFOs) with irregular amplitude and frequency more specifically reflect epileptogenicity than HFOs with stable amplitude and frequency.MethodsWe developed a fully automatic algorithm to detect HFOs and classify them based on their morphology, with types defined according to regularity in amplitude and frequency: type 1 with regular amplitude and frequency; type 2 with irregular amplitude, which could result from filtering of sharp spikes; type 3 with irregular frequency; and type 4 with irregular amplitude and frequency. We investigated the association of different HFO types with the seizure onset zone (SOZ), resected area and surgical outcome.ResultsHFO rates of all types were significantly higher inside the SOZ than outside. HFO types 1 and 2 were strongly correlated to each other and showed the highest rates among all HFOs. Their occurrence was highly associated with the SOZ, resected area and surgical outcome. The automatic detection emulated visual markings with 93% true positives and 57% false detections.ConclusionsHFO types 1 and 2 similarly reflect epileptogenicity.SignificanceFor clinical application, it may not be necessary to separate real HFOs from "false oscillations" produced by the filter effect of sharp spikes. Also for automatically detected HFOs, surgical outcome is better when locations with higher HFO rates are included in the resection.



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2. Follow-up of five cases with Rasmussen encephalitis with magnetoencephalography

Publication date: April 2016
Source:Clinical Neurophysiology, Volume 127, Issue 4
Author(s): D.S. Rossi, E. Visani, D. Duran, F. Rotondi, L. Canafoglia, E. Freri, F. Ragona, T. Granata, F. Panzica, S. Franceschetti
Magnetoencephalography (MEG) recordings of interictal and/or ictal discharges can provide valuable information about the location of the epileptogenic area in the brain. Rasmussen Encephalitis (RE) is characterized by intractable epilepsy, progressive hemiparesis, and unilateral hemispheric atrophy. The progression of the symptoms to significant neurological impairment usually occurs within months to a few years. Five patients (mean age at first observation 7.6±3years) fitting Bien's criteria for the diagnosis of RE were enrolled for the study and follow-up for at least 1.5years (4–7MEG measures per patient), in order to evaluate correlations between the evolution of clinical picture, neuroradiological and MEG findings. MEG data were visually inspected and interictal spikes were selected for the source localization by means of equivalent current dipoles (ECDs). Cortical thickness was evaluated from Magnetic Resonance Imaging (MRI). All patients showed ictal/interictal multifocality, reduction of background cortical magnetic activity, and progressive focal cortical atrophy on MRI of the affected hemisphere. Moreover, our preliminary data showed that dipole clusters were found mainly in the most atrophic cortical regions, suggesting a close relationship between MRI and MEG alterations.



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6. Sensory-motor networks’ topology in multiple sclerosis fatigue

Publication date: April 2016
Source:Clinical Neurophysiology, Volume 127, Issue 4
Author(s): F. Miraglia, F. Vecchio, C. Porcaro, C. Cottone, A. Cancelli, P.M. Rossini, F. Tecchio
The large majority (80%) of people with multiple sclerosis (MS) complain of fatigue, which is the most disabling symptom in half of them. While the few drugs used to treat MS fatigue are limitedly useful, it was recently observed the efficacy of a personalized neuromodulation treatment, supporting the concept that interventions modifying the sensorimotor network activity balances could be suitable non-pharmacological treatments for MS fatigue. Aim of the present study is to strengthen knowledge of the brain unbalances, which proper neuromodulations should target to compensate. We collected electroencephalographic (EEG) data in 18 people with mild MS, while they were in resting state with open eyes. To ensure a wide range of fatigue, we enrolled patients to have Higher- or Lower-Fatigue based on scores of the modified Fatigue Impact Scale (mFIS). We selected the graph theory small-world index, calculated on networks of cortical nodes estimated by eLORETA, to evaluate the characteristics of left and right frontal (Motor) and parieto-occipital-temporal (Sensory) brain networks separately. Fatigue symptoms increased together with the small-world index in the Sensory network of the left dominant hemisphere. This finding hones understanding of the targets of neuromodulation interventions, indicating the sensory network of the dominant left hemisphere as a specific target.



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10. Visual electrophysiology. A good friend can help you in need

Publication date: April 2016
Source:Clinical Neurophysiology, Volume 127, Issue 4
Author(s): M.C. Tozzi, S. Silipo, S. Monaco, L. Bertolasi
Scotopic and photopic full field-Electroretinogram (ERG), pattern electroretinogram (PERG) and visual evoked potential (VEP) are stimulating and recording methods to evaluate the functionality of the different layers of retina and of the visual pathway from retina to visual cortex of the brain. Visual electrophysiology is a useful diagnostic tool which aids in cases of unexplained visual loss if the clinician is well-versed in this techniques. Furthermore the new ocular imaging tests such us OCT give only morphological informations about retina and the head of optic nerve that need functional correlations with the symptoms of the patient. We review the diagnostic protocol for neurophysiological assessment of afferent visual system performed in our lab and describe normative data from 30 healthy subjects.



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