Cross-Sectional Area and Echogenicity Reference Values for Sonography of Peripheral Nerves in the Lithuanian Population.

Objectives: We aimed to provide data of nerve sizes and echogenicity reference values of the Lithuanian population.

Methods: High-resolution ultrasound was bilaterally performed according to the Ultrasound Pattern Sum Score and Neuropathy ultrasound protocols for healthy Lithuanian adults. Cross-sectional area (CSA) measurement and echogenicity were used as the main parameters for investigation.

Accurate identification of EEG recordings with interictal epileptiform discharges using a hybrid approach: Artificial intelligence supervised by human experts.

Objective: To evaluate the diagnostic performance of artificial intelligence (AI)-based algorithms for identifying the presence of interictal epileptiform discharges (IEDs) in routine (20-min) electroencephalography (EEG) recordings.

Methods: We evaluated two approaches: a fully automated one and a hybrid approach, where three human raters applied an operational IED definition to assess the automated detections grouped into clusters by the algorithms. We used three previously developed AI algorithms: Encevis, SpikeNet, and Persyst.

Clamping of the Aortic Arch Vessels During Normothermic Regional Perfusion After Circulatory Death Prevents the Return of Brain Activity in a Porcine Model.

Background: The cerebral effect of clamping following normothermic regional perfusion (NRP) in donation after circulatory death (DCD) remains unknown. We investigated the effect of cerebral reperfusion during NRP and the preventive effect of clamping on brain function in a porcine model.

Methods: In 16 pigs, intracranial physiological parameters were recorded, including pressure, cerebral blood perfusion (CBF), temperature, and oxygen.

Comparison of ultrasound with electrodiagnosis of scapular winging: A prospective case control study.

Objective: Compare high-resolution ultrasound (HRUS) and electrodiagnostic examination (EDX) in the diagnostic workup of patients with scapulae alatae.

Methods: 27 patients with scapulae alatae and 41 healthy subjects (HS) and underwent a standardized clinical examination (CEX), EDX and HRUS. We measured the thickness of the serratus anterior (SER), rhomboid major and trapezius muscles and the diameter of the long thoracic (LTN), dorsal scapular and spinal accessory nerves (SAN).

The influence of the abundance and morphology of epileptiform discharges on diagnostic accuracy: How many spikes you need to spot in an EEG.

Objective: The operational definition of interictal epileptiform discharges (IEDs) of the International Federation of Clinical Neurophysiology (IFCN) described six morphological criteria. Our objective was to assess the impact of pattern-repetition in the EEG-recording, on the diagnostic accuracy of using the IFCN criteria. For clinical implementation, specificity over 95% was set as target.

[Intraoperative neuromonitoring during brain surgery].

Intraoperative neuromonitoring is a perioperative method, supplementary to stealth navigation and fluorescence microscopic imaging in brain surgery. It allows cortical and subcortical mapping, hence real time identification of eloquent brain areas through electrical stimulation of the cerebral cortex and subcortical areas. The method allows for functional guidance during both awake and asleep neurosurgery and aids in optimizing the extent of resection of the relevant pathology while preserving neurological function as summarised in this review.

Neuromuscular ultrasound of the scapular stabilisers in healthy subjects.

Objectives: To obtain normative high-resolution ultrasound (HRUS) data for thickness of the serratus anterior, the trapezius and the rhomboid major muscles and diameter of their corresponding nerves, the long thoracic, the spinal accessory and the dorsal scapular nerve. Moreover, we aimed to examine intra- and inter-examiner agreement of the HRUS measurements.

Methods: We included 41 healthy subjects.

Seizure detection using heart rate variability: A prospective validation study.

Although several validated seizure detection algorithms are available for convulsive seizures, detection of nonconvulsive seizures remains challenging. In this phase 2 study, we have validated a predefined seizure detection algorithm based on heart rate variability (HRV) using patient-specific cutoff values. The validation data set was independent from the previously published data set.

Latency-shift of intra-operative visual evoked potential predicts reversible homonymous hemianopia after intra-ventricular meningioma surgery.

Objectives: Intraoperative visual evoked potentials (VEPs) are used to monitor the function of optic radiation during neurosurgery with the P100 amplitude decrement as a predictor of post-operative visual deficit. However, there is currently no evidence of early VEP changes indicating reversible visual field affection.

Methods: In this case report, we used VEPs during surgery for a benign meningioma located in the atrium of the right lateral ventricle.

Neuromas and postamputation pain.

Postamputation stump and phantom pain are highly prevalent but remain a difficult condition to treat. The underlying mechanisms are not fully clarified, but growing evidence suggests that changes in afferent nerves, including the formation of neuromas, play an important role. The main objective of this cross-sectional study was to investigate whether ultrasound-verified neuroma swellings are more frequent in amputees with postamputation pain than in amputees without pain (primary outcome).

Seizure detection based on heart rate variability using a wearable electrocardiography device.

Objective: To assess the feasibility and accuracy of seizure detection based on heart rate variability (HRV) using a wearable electrocardiography (ECG) device. Noninvasive devices for detection of convulsive seizures (generalized tonic-clonic and focal to bilateral tonic-clonic seizures) have been validated in phase 2 and 3 studies. However, detection of nonconvulsive seizures still needs further research, since currently available methods have either low sensitivity or an extremely high false alarm rate (FAR).

A prospective study of high resolution ultrasound in brachial plexopathies - Correlation with electrophysiological measurements.

Objectives: To evaluate the diagnostic role of ultrasound in brachial plexopathies.

Methods: We included 59 healthy subjects (HS) and 42 patients consecutively referred with clinical suspicion of brachial plexopathy from October 2015 to May 2016. Patients underwent routine electrodiagnostic testing (EDx) as reference standard and a blinded standardised ultrasound examination of the brachial plexus as index test with cross-sectional area (CSA) as the ultrasound parameter of choice.

Segmental innervation of the Göttingen minipig hind body. An electrophysiological study.

The Göttingen minipig is being used increasingly in biomedical research. The anatomical structure of the porcine peripheral nervous system has been extensively characterized, but no equivalent to the dermatome map, which is so valuable in human neurophysiological research, has been created. We characterized the medullar segmental skin and muscle innervations of the minipig hind body, using neurophysiological methodology.

Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study.

Background: Several EEG criteria have been proposed for diagnosis of non-convulsive status epilepticus (NCSE), but none have been clinically validated. We aimed to assess the diagnostic accuracy of the EEG criteria proposed by a panel of experts at the fourth London-Innsbruck Colloquium on Status Epilepticus in Salzburg, 2013 (henceforth called the Salzburg criteria).

Methods: We did a retrospective, diagnostic accuracy study using EEG recordings from patients admitted for neurological symptoms or signs to three centres in two countries (Danish Epilepsy Centre, Dianalund, Denmark; Aarhus University Hospital, Aarhus, Denmark; and Paracelsus Medical University, Salzburg, Austria).

High-resolution ultrasound in ulnar neuropathy at the elbow: A prospective study.

Introduction: We examined the role of ultrasound in diagnosing and localizing ulnar neuropathy (UN) at the elbow.

Methods: Forty-one patients referred for UN and 43 healthy subjects were included. Cross-sectional area (CSA) of the ulnar nerve was measured by ultrasound at 5 locations across the elbow and at the wrist.

A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study.

Objectives: An initial stratification of acute whiplash patients into seven risk-strata in relation to 1-year work disability as primary outcome is presented.

Design: The design was an observational prospective study of risk factors embedded in a randomised controlled study.

Setting: Acute whiplash patients from units, general practitioners in four Danish counties were referred to two research centres.

The risk assessment score in acute whiplash injury predicts outcome and reflects biopsychosocial factors.

Study Design: One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls.

Objective: This study investigates a priori determined potential risk factors to develop a risk assessment tool, for which the expediency was examined.

Summary Of Background Data: The whiplash-associated disorders (WAD) grading system that emerged from The Quebec Task-Force-on-Whiplash has been of limited value for predicting work-related recovery and for explaining biopsychosocial disability after whiplash and new predictive factors, for example, risk criteria that comprehensively differentiate acute WLP in a biopsychosocial manner are needed.

The role of botulinum toxin in management of pain: an evidence-based review.

Purpose Of Review: In the present review we discuss the role of botulinum neurotoxins (BoNTs) in the management of different pain conditions, with evidence-based data on the toxins' efficacy on pain and its mechanisms.

Recent Findings: Experimental in-vitro studies have reported promising results of a novel recombinant chimera of BoNT A and E that inhibits the calcitonin gene-related peptide exocytosis from brainstem sensory neurons. Animal studies in neuropathic pain rat models have reported an analgesic effect of BoNT A given after the neuropathic procedure and a bilateral antinociceptive effect to the unilateral noxious stimuli.

Electrophysiological characteristics of motor units and muscle fibers in trained and untrained young male subjects.

We hypothesized that the amplitudes of compound muscle action potentials (CMAPs) and interference pattern analysis (IPA) would be larger in trained subjects compared with untrained subjects, possibly due to hypertrophy of muscle fibers and/or increased central drive. Moreover, we hypothesized that the untrained muscle is less excitable compared with the trained muscle. An electromyographic (EMG) needle electrode was used to record the IPA at maximal voluntary effort.

Education of patients after whiplash injury: is oral advice any better than a pamphlet?

Study Design: Randomized parallel-group trial with 1-year follow-up.

Objective: To evaluate whether education of patients communicated orally by a specially trained nurse is superior to giving patients a pamphlet after a whiplash injury.

Summary Of Background Data: Long-lasting pain and physical disability after whiplash injuries are related to both serious personal suffering and huge socio-economic costs.

Occurrence of myofascial pain in patients with possible carpal tunnel syndrome - a single-blinded study.

Background: There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle.

Aim: The aim was to examine what proportion of patients referred with a clinical suspicion of CTS had myofascial pain in the infraspinatus muscles and how their occurrence was related to the outcome of nerve conduction studies (NCS).

Methods: We examined the occurrence of CTS and of TPs in infraspinatus muscles in a cohort of patients suspected for CTS and referred to the Department of Clinical Neurophysiology, Aarhus University Hospital from October 2003 to February 2004.

Deep muscle pain, tender points and recovery in acute whiplash patients: a 1-year follow-up study.

Local sensitization to noxious stimuli has been previously described in acute whiplash injury and has been suggested to be a risk factor for chronic sequelae following acute whiplash injury. In this study, we prospectively examined the development of tender points and mechano-sensitivity in 157 acute whiplash injured patients, who fulfilled criteria for WAD grade 2 (n=153) or grade 3 (n=4) seen about 5 days after injury (4.8+/-2.

Are altered smooth pursuit eye movements related to chronic pain and disability following whiplash injuries? A prospective trial with one-year follow-up.

Objective: To evaluate the ability of early smooth pursuit testing to predict chronic whiplash-associated disorders, and to study whether the presence of abnormal smooth pursuit eye movements at one-year follow-up is associated with symptoms at that time.

Design: Prospective cohort study with one-year follow-up.

Setting: The study was carried out at a university research centre and participants were recruited from emergency units and general practitioners.

Acute stress response and recovery after whiplash injuries. A one-year prospective study.

Chronic whiplash-associated disorder (WAD) represents a major medical and psycho-social problem. The typical symptomatology presented in WAD is to some extent similar to symptoms of post traumatic stress disorder. In this study we examined if the acute stress reaction following a whiplash injury predicted long-term sequelae.