• Title/Summary/Keyword: Electrophysiological tests

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Usefulness of Electrophysiological Tests in Movement Disorders (이상운동 질환에서의 신경생리적 검사법의 유용성)

  • Seo, Man-Wook;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.1 no.2
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    • pp.126-146
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    • 1999
  • In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.

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Application of Neurophysiological Studies in Clinical Neurology (임상신경생리 분야에서의 신경생리적 검사법의 응용)

  • Lee, Kwang-Woo;Park, Kyung-Seok
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.1-9
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    • 1999
  • Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN in the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Pros (당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란: 긍정적인 관점에서)

  • Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.29-32
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    • 2008
  • Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

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Clinical and Electrophysiological Characteristics of Meralgia Paresthetica (대퇴감각이상증의 임상 및 전기생리학적 특징)

  • Choi, Mun Hee;Park, Hanul;Eom, Young In;Joo, In Soo
    • Annals of Clinical Neurophysiology
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    • v.15 no.2
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    • pp.48-52
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    • 2013
  • Background: Meralgia paresthetica (MP) is a mononeuropathy affecting the lateral femoral cutaneous nerve. The disease is often diagnosed clinically, but electrophysiological tests play an important role. The aim of this study is to clarify clinical characteristics of MP as well as the role of sensory nerve conduction study (NCS) in the diagnosis of MP. Methods: Sixty-five consecutive patients with clinical diagnosis of MP between March 2001 and June 2012 were retrospectively reviewed at a single tertiary center. General demographics, clinical characteristics and sensory NCS findings were investigated. Measurements of sensory NCS included the baseline-to-peak amplitude, side-to-side amplitude ratio and the conduction velocity. To compare between the normal and abnormal NCS groups, independent t-tests and chisquare test were performed. Results: Sixty-five patients had male predominance (56.9%) with mean age of $48.4{\pm}13.4$ years (range: 16-75). Seven patients (13.5%) had undergone operation or procedure before the symptom onset. The sensory nerve action potentials were obtainable in 52 (80%) of 65 clinically diagnosed MP patients. Sensory NCS revealed abnormalities in 38 patients (73.1%), and others (n=14, 26.9%) showed normal findings. Between the normal and abnormal NCS groups, there is no statistically significant difference on demographics or clinical features. Conclusions: We clarify the clinical features and sensory NCS findings of MP patients. Due to several limitations of sensory NCS, the diagnosis of MP could be accomplished both clinically and electrophysiologically.

Neurophysiology of the Sensory System and Clinical Applications (감각신경계의 신경생리와 임상적 이용)

  • Seo, Dae-Won
    • Annals of Clinical Neurophysiology
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    • v.12 no.2
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    • pp.35-46
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    • 2010
  • Various electrophysiological tests have provided a large body of valuable information on neuronal responses to a presented stimulus. The special and general somatic sensory pathways are main targets of evoked potentials. Two types of evoked potentials, exogenous and endogenous, are commonly used. Exogenous evoked potentials of general and special somatic sensory systems will be reviewed. One of general somatic sensory functional pathways, proprioception, can be evaluated by general somatosensory evoked potentials with electrical stimulation on nerves. The special somatosensory functional pathways, including vision, and audition, can be evaluated by visual evoked potentials and auditory evoked potentials. Also laser-evoked potentials are newly developed for pain pathway, including lateral spinothalamic pathway, and vestibular myogenic evoked potentials for sacculocollic pathways. The evoked potentials of sensory system have maximal clinical utility in evaluating functional deficits along the sensory pathways. They are used for evaluating comatose patients, hysterical patients, premature infants, patients with suspected demyelinating diseases or neoplasms, and research. We discuss the neurophysiologic tests of sensory systems in views of practical points. The organized evaluation of sensory electrophysiologic tests can be helpful in detecting and estimating the abnormalities in neurological diseases.

Intraoperative Neuromonitoring (수술 중 신경계 감시)

  • Seo, Dae-Won
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.1-12
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    • 2008
  • Intraoperative neuromonitoring (INM) is well known to be useful method to reduce intraoperative complications during the surgery of nervous system lesions. Evoked potentials are most commonly used among the electrophysiological tests. Brainstem auditory evoked potentials are for detecting the problems along the auditory pathways including the eighth cranial nerve and brainstem. Somatosensory evoked potentials are applied for preventing the spinal cord lesions. The INM is affected by many factors. In order to perform an optimal INM, the confounding factors including technical, anesthetical, and individual factors should be kept well under control. INM has frequent electrophysiologic changes during the surgery and it might be helpful to keep one's eyes on which monitoring modalities are reluctant to change during each operation. The skillful monitoring and timely interpretation of electrophysiologic changes can drive the patient to be undergone surgery, even in high surgical risk group.

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Antipruritic effect of curcumin on histamine-induced itching in mice

  • Lee, Han Kyu;Park, Seok Bum;Chang, Su-youne;Jung, Sung Jun
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.5
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    • pp.547-554
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    • 2018
  • Itching is a common clinical symptom of skin disease that significantly affects a patient's quality of life. Transient receptor potential vanilloid 1 (TRPV1) receptors of keratinocytes and peripheral nerve fibers in skin are involved in the regulation of itching as well as pain. In this study, we investigated whether curcumin, which acts on TRPV1 receptors, affects histamine-induced itching in mice, using behavioral tests and electrophysiological approaches. We found that histamine-induced itching was blocked by topical application of curcumin in a concentration-dependent manner. In ex-vivo recordings, histamine-induced discharges of peripheral nerves were reduced by the application of curcumin, indicating that curcumin acts directly on peripheral nerves. Additionally, curcumin blocked the histamine-induced inward current via activation of TRPV1 (curcumin $IC_{50}=523nM$). However, it did not alter chloroquine-induced itching behavior in mice, which is associated with transient receptor potential ankyrin 1 (TRPA1). Taken together, our results suggest that histamine-induced itching can be blocked by topical application of curcumin through the inhibitory action of curcumin on TRPV1 receptors in peripheral nerves.

Linear/Non-Linear Tools and Their Applications to Sleep EEG : Spectral, Detrended Fluctuation, and Synchrony Analyses (컴퓨터를 이용한 수면 뇌파 분석 : 스펙트럼, 비경향 변동, 동기화 분석 예시)

  • Kim, Jong-Won
    • Sleep Medicine and Psychophysiology
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    • v.15 no.1
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    • pp.5-11
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    • 2008
  • Sleep is an essential process maintaining the life cycle of the human. In parallel with physiological, cognitive, subjective, and behavioral changes that take place during the sleep, there are remarkable changes in the electroencephalogram (EEG) that reflect the underlying electro-physiological activity of the brain. However, analyzing EEG and relating the results to clinical observations is often very hard due to the complexity and a huge data amount. In this article, I introduce several linear and non-linear tools, developed to analyze a huge time series data in many scientific researches, and apply them to EEG to characterize various sleep states. In particular, the spectral analysis, detrended fluctuation analysis (DFA), and synchrony analysis are administered to EEG recorded during nocturnal polysomnography (NPSG) processes and daytime multiple sleep latency tests (MSLT). I report that 1) sleep stages could be differentiated by the spectral analysis and the DFA ; 2) the gradual transition from Wake to Sleep during the sleep onset could be illustrated by the spectral analysis and the DFA ; 3) electrophysiological properties of narcolepsy could be characterized by the DFA ; 4) hypnic jerks (sleep starts) could be quantified by the synchrony analysis.

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Molecular Basis of Hexanoic Acid Taste in Drosophila melanogaster

  • Roshani Nhuchhen Pradhan;Bhanu Shrestha;Youngseok Lee
    • Molecules and Cells
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    • v.46 no.7
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    • pp.451-460
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    • 2023
  • Animals generally prefer nutrients and avoid toxic and harmful chemicals. Recent behavioral and physiological studies have identified that sweet-sensing gustatory receptor neurons (GRNs) in Drosophila melanogaster mediate appetitive behaviors toward fatty acids. Sweet-sensing GRN activation requires the function of the ionotropic receptors IR25a, IR56d, and IR76b, as well as the gustatory receptor GR64e. However, we reveal that hexanoic acid (HA) is toxic rather than nutritious to D. melanogaster. HA is one of the major components of the fruit Morinda citrifolia (noni). Thus, we analyzed the gustatory responses to one of major noni fatty acids, HA, via electrophysiology and proboscis extension response (PER) assay. Electrophysiological tests show this is reminiscent of arginine-mediated neuronal responses. Here, we determined that a low concentration of HA induced attraction, which was mediated by sweet-sensing GRNs, and a high concentration of HA induced aversion, which was mediated by bitter-sensing GRNs. We also demonstrated that a low concentration of HA elicits attraction mainly mediated by GR64d and IR56d expressed by sweet-sensing GRNs, but a high concentration of HA activates three gustatory receptors (GR32a, GR33a, and GR66a) expressed by bitter-sensing GRNs. The mechanism of sensing HA is biphasic in a dose dependent manner. Furthermore, HA inhibit sugar-mediated activation like other bitter compounds. Taken together, we discovered a binary HA-sensing mechanism that may be evolutionarily meaningful in the foraging niche of insects.

A Comparative Study of the Brainstem Auditory-Evoked Response during Medetomidine, Propofol and Propofol-Isoflurane Anesthesia in Dogs

  • Sorin Choi;Myeong-Yeon Lee;Young Joo Kim;Dong-In Jung
    • Journal of Veterinary Clinics
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    • v.40 no.4
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    • pp.260-267
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    • 2023
  • Specialized hearing tests for pets are currently in demand. A brainstem auditory evoked response (BAER) test is an objective, non-invasive, and practical electrophysiological method that records electric signals from the peripheral auditory system to the brainstem when an auditory stimulation is provided. In veterinary medicine, sedation or anesthesia is essential for a successful examination. In human medicine, research has established the indications for various sedatives, anesthetics, and drugs according to the depth of anesthesia required. However, in veterinary medicine, there are very few comparative studies on propofol or isoflurane, which are the most common anesthetics used. Therefore, the present study aimed to analyze the difference in BAER test results between sedation with medetomidine, anesthesia using propofol, and inhalation anesthesia with isoflurane after propofol administration. The test was conducted on four healthy adult dogs. There was no statistically significant difference in latency, interpeak latency, or amplitude between the various drugs. The results suggest that a sedative or anesthetic for the administration of a BAER test can be selected according to the patient's needs.