The utility and accuracy of intraoperative neurophysiological monitoring (IONM) has evolved greatly following the recent development of new devices for neurophysiological testing and advances in anesthesiology. Until recently, the need for IONM services has been limited to large academic hospitals, but the demand for neurophysiologists with expertise in IONM has grown rapidly across diverse types of hospital. The primary goal of the Korean Society of Intraoperative Neurophysiological Monitoring (KSION) is to promote the development of IONM research groups and to contribute to the improvement of fellowship among members and human health through academic projects. These guidelines are based on extensive literature reviews, recruitment of expert opinions, and consensus among KSION board members. This version of the guidelines was fully approved by the KSION, Korean Association of EMG Electrodiagnostic Medicine, the Korean Society of Clinical Neurophysiology, the Korean Academy of Rehabilitation Medicine, and the Korean Neurological Association.

Citations

• Intraoperative Monitoring of Sensory Evoked Potentials in Neurosurgery: A Personalized Approach
  Evgeny A. Levin
  Journal of Personalized Medicine.2025; 15(1): 26.     CrossRef
• Role of Intraoperative Neurophysiological Monitoring in Pediatric Tethered Cord Syndrome Surgeries and Technical Insights
  Wael Abd Elrahman Ali Elmesallamy, Alshaimaa Abdel Fattah Kamel, Ahmad Fahmy, Mohamed Elbana, Mahmoud M. Taha
  Indian Journal of Neurosurgery.2025;[Epub]     CrossRef
• A multichannel electromyography dataset for continuous intraoperative neurophysiological monitoring of cranial nerve
  Wanting Ma, Lin Chen, Xiaofan Pang, Yuanwen Zou
  Data in Brief.2024; 53: 110250.     CrossRef
• Intraoperative neuromonitoring in intracranial surgery
  G.B. Adkins, A. Mirallave Pescador, A.H. Koht, S.P. Gosavi
  BJA Education.2024; 24(5): 173.     CrossRef
• Neurophysiological monitoring during endovascular treatment of brain arteriovenous malformations: A meta-analysis
  Francesco Diana, Michele Romoli, Federico Sabuzi, Aymeric Rouchaud, Charbel Mounayer, Géraud Forestier, Alejandro Tomasello, Manuel Requena, David Hernández, Marta De Dios Lascuevas, José Luis Cuevas, Simone Peschillo, Jildaz Caroff, Thanh N. Nguyen, Moha
  Interventional Neuroradiology.2023;[Epub]     CrossRef
• Intraoperative neurophysiological monitoring during the surgeries for the ossification of the posterior longitudinal ligament
  Seol-Hee Baek
  Journal of Intraoperative Neurophysiology.2022; 4(2): 55.     CrossRef
• Hemodynamic Consideration in Intraoperative Neurophysiological Monitoring in Neuromuscular Scoliosis Surgery
  Seok Young Chung, Chae Hwan Lim, Yoon Ghil Park, Hak Sun Kim, Dawoon Kim, Jinyoung Park
  Annals of Rehabilitation Medicine.2022; 46(6): 292.     CrossRef
• Undetected abulic state after anterior communicating artery aneurysm surgery under motor evoked potential (MEP) and somatosensory evoked potential (SEP) monitoring
  Hyesun Lee, Jinseok Park
  Journal of Intraoperative Neurophysiology.2022; 4(2): 78.     CrossRef
• Intraoperative neurophysiological monitoring in pituitary adenoma surgery: case report
  Hyun-Wook Nam, Seol-Hee Baek
  Journal of Intraoperative Neurophysiology.2021; 3(2): 108.     CrossRef

Carotid duplex ultrasound is commonly used to diagnose various carotid artery diseases due to it being noninvasive and easy to perform. Carotid atherosclerosis is a major indicator for the need to perform carotid duplex ultrasound, which can determine the degree of stenosis, plaque characteristics, and intima-media thickness. It can also be used to screen and follow-up after carotid revascularization. Here we discuss the standard techniques, interpretations, and clinical indicators for carotid duplex ultrasounds.

Citations

• The diagnosis and treatment of asymptomatic and symptomatic patients with carotid artery stenosis
  Robert J. Henning, Brian L. Hoh
  Current Problems in Cardiology.2025; 50(6): 102992.     CrossRef
• Symptomatic Cervical Carotid Artery Stenosis: Evolving Paradigms in Risk Stratification and Intervention
  Ivy Anne Sebastian, Kazbek Barakhanov, Aravind Ganesh
  Annals of Indian Academy of Neurology.2025; 28(1): 1.     CrossRef
• Eagle Syndrome: Case Report, Literature Review, Proposed Classification, and Role of Ultrasound in its Diagnosis and Management
  David M. Williams, Elizabeth M. Wooster, Charles E. Stonerock, Douglas L. Wooster
  Journal for Vascular Ultrasound.2024; 48(4): 225.     CrossRef
• Ultrasound Score of Liver Steatosis Severity in the Diagnosis of Peripheral Arterial Atherosclerosis in Patients with Nonalcoholic Fatty Liver Disease
  A. S. Kuznetsova, A. I. Dolgushina, V. V. Pospelov, T. A. Sokolova, E. V. Lebedev, V. V. Genkel
  The Russian Archives of Internal Medicine.2023; 13(3): 196.     CrossRef
• The Use of Ultrasound for Detecting the Association Between Endothelial Dysfunction and lp13.3 Genomic Region rs646776 Polymorphism in Patients With Rheumatoid Arthritis From the Suez Canal Region
  Afaf Ahmed, Aziza Omar, Maivel Ghattas, Mona Ghaly, Mohammad al-Shatouri
  Cureus.2023;[Epub]     CrossRef
• Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA): A Systematic Review and Meta-Analysis
  Simon Takadiyi Gunda, Nonhlanhla Chambara, Xiangyan Fiona Chen, Marco Yiu Chung Pang, Michael Tin-cheung Ying
  Children.2022; 9(11): 1676.     CrossRef

Noninvasive stimulation of the nervous system for treating chronic neuropathic pain has received attention because of its tolerability and relative efficacy. Repetitive transcranial magnetic stimulation (rTMS) is a representative method of noninvasive brain stimulation. Evidence-based guidelines on therapeutic use of rTMS have been proposed recently for several neurological diseases. These guidelines recommend treating neuropathic pain by applying high-frequency (≥ 5 Hz) rTMS to the primary motor cortex contralateral to the painful side. This review summarizes the mechanisms and guidelines of rTMS for treating neuropathic pain, and proposes directions for future research.

Citations

• Efficacy of repetitive transcranial magnetic stimulation for phantom limb pain- a meta analysis of randomized controlled trials
  FNU Chandni, FNU Savanti, Rohit Kumar, Murk Raj, Aakash Kumar, Aashish Kumar, Sejal Kinger, Sahil Kumar, Himat Rai, Afsana Ansari Shaik, Muhammad Sohaib Asghar
  Neurological Sciences.2025; 46(5): 2019.     CrossRef
• Impact of Titanium Skull Plate on Transcranial Magnetic Stimulation: Analysis of Induced Electric Fields
  Mai Lu, Shoogo Ueno
  Life.2024; 14(5): 642.     CrossRef
• Synaptic sensitization in the anterior cingulate cortex sustains the consciousness of pain via synchronized oscillating electromagnetic waves
  Richard Ambron
  Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
• Dualism, Materialism, and the relationship between the brain and the mind in experiencing pain
  Richard Ambron
  Neuroscience.2024; 561: 139.     CrossRef

Complex regional pain syndrome (CRPS) is a chronic regional pain disorder that most frequently affects the limbs. It is characterized by hyperalgesia, allodynia, edema, motor disturbance, and vasomotor instability, and typically occurs following surgery or trauma. In type-I CRPS there is no confirmed nerve injury, while peripheral nerve injury is present in type-II CRPS. The multifactorial pathophysiological etiology of CRPS includes inflammation, autoimmune responses, abnormal cytokine production, autonomic dysfunction, altered blood flow, psychological factors, and central cortical reorganization. There are no specific laboratory diagnostic tools for CRPS, and so it is diagnosed clinically. The Budapest criteria are currently the most-accepted diagnostic criteria.

Citations

• Complex Regional Pain Syndrome: Updates and Current Evidence
  Yeng F. Her, Eva Kubrova, Marissa Dombovy-Johnson, Mariam ElSaban, Karson Mostert, Ryan S. D’Souza
  Current Physical Medicine and Rehabilitation Repor.2024; 12(1): 50.     CrossRef
• Task-based and Magnified Mirror Therapy for Unilateral Spatial Neglect among post-stroke subjects: Study protocol for a randomized controlled trial
  Kamal Narayan Arya, Shanta Pandian, Divya Pandey, G. G. Agarwal, Neera Chaudhary, Monika Halicka
  PLOS ONE.2024; 19(1): e0296276.     CrossRef
• Diagnosis and Management of Knee Arthrofibrosis and Associated Pain-Related Fear Using Multidimensional Clinical Reasoning and Exposure In Vivo Concept: A Case Report
  Mohammad Jamali, Kevin McEnroy, Logan W. Gaudette, Zafeer Baber, Ryan J. Stoddard
  JOSPT Cases.2024; 4(3): 121.     CrossRef
• Nuclear Imaging in Orthopaedic Practice
  Alvaro Ibaseta, Ahmed Emara, Ignacio Pasqualini, Benjamin Jevnikar, Ceylan Colak, Oguz Turan, Shujaa T. Khan, Matthew E. Deren, Nicolas S. Piuzzi
  JBJS Reviews.2024;[Epub]     CrossRef

The pathogenesis of many strokes originates in the vessel wall. Despite this, most traditional imaging focuses on the vascular lumen. Vessel-wall magnetic resonance imaging (VWMRI) is useful for establishing the etiology of intracranial stenosis. It also provides information regarding atherosclerotic plaque composition and thus plaque vulnerability, which is an indication of its potential to cause a stroke. In this review we focus on the characteristics of VWMRI findings in various arteriopathies related to intracranial artery stenosis, and discuss the clinical implications of these findings.

Citations

• Intracranial Atherosclerotic Stenosis
  Jeong Yoon Song, Sun U. Kwon
  Cerebrovascular Diseases Extra.2025; 15(1): 62.     CrossRef
• The Role of High-Resolution Magnetic Resonance Imaging in Cerebrovascular Disease: A Narrative Review
  Xiaohui Li, Chengfang Liu, Lin Zhu, Meng Wang, Yukai Liu, Shuo Li, Qiwen Deng, Junshan Zhou
  Brain Sciences.2023; 13(4): 677.     CrossRef
• Acute Stroke Caused by Large Vessel Vasculitis in a Patient with Systemic Lupus Erythematosus
  Min A Lee, Byoung Wook Hwang, Dong Kun Lee, Chang Ju Lee, Ju Hye Kim, Seong Hwan Ahn
  Journal of Neurosonology and Neuroimaging.2022; 14(1): 51.     CrossRef
• Vessel Wall Magnetic Resonance Imaging in Cerebrovascular Diseases
  Federico Mazzacane, Valentina Mazzoleni, Elisa Scola, Sara Mancini, Ivano Lombardo, Giorgio Busto, Elisa Rognone, Anna Pichiecchio, Alessandro Padovani, Andrea Morotti, Enrico Fainardi
  Diagnostics.2022; 12(2): 258.     CrossRef

Background
Nitrous oxide (N₂O) is used in surgery and dentistry for its anesthetic and analgesic effects. However, neurological and psychiatric manifestations of N₂O abuse have been increasingly reported among Korean adults. The aim of this study was to demonstrate laboratory findings of N₂O abuse in Korean patients.
Methods
Patients diagnosed with N₂O-induced neuropathy or myelopathy from August 2018 to December 2019 were enrolled. Their clinical presentations and laboratory and imaging findings were analyzed.
Results
Sensory changes and limb weakness were present in nine of the enrolled patients. The laboratory findings revealed that seven patients had high homocysteine levels and five had high methylmalonic acid levels in their blood. Nerve conductions studies indicated that axonal neuropathy was present in four cases and longer F-wave and Hoffman’s-reflex latencies were present in two cases. Signal changes in cervical spine imaging occurred in five patients, while two had normal results.
Conclusions
Chronic N₂O abuse can cause neurological damage or psychiatric problems. Because N₂O is illegal for recreational use in Korea, patients tend to hide their history of use. Even though the spinal imaging results were normal, clinicians should consider the possibility of N₂O use, and further electrophysiological tests should be applied for precise evaluations.

Citations

• The prevalence, risks, and detection of driving under the influence of nitrous oxide
  Frederick R. J. Vinckenbosch, Dinesh Durán Jiménez, Hendrik Helmerhorst, Albert Dahan, Leon Aarts, Floris Bikker, Eef Theunissen, Johannes G. Ramaekers
  WIREs Forensic Science.2024;[Epub]     CrossRef
• Nitrous‐oxide‐induced polyneuropathy and subacute combined degeneration of the spine: clinical and diagnostic characteristics in 70 patients, with focus on electrodiagnostic studies
  L. T. Hassing, F. Y. Jiang, R. Zutt, S. Arends
  European Journal of Neurology.2024;[Epub]     CrossRef
• Severe Isolated Peripheral Polyneuropathy without Myelopathy after Nitrous Oxide Abuse: A Case Report
  Seung-Min Baek, Seungbok Lee, Yu-Mi Kim, Eun-Sil Kim
  Journal of Electrodiagnosis and Neuromuscular Dise.2022; 24(2): 50.     CrossRef

Transcranial magnetic stimulation (TMS) is a safe and noninvasive tool for investigating the cortical excitability of the human brain and the neurophysiological functions of GABAergic, glutamatergic, and cholinergic neural circuits. Neurophysiological biomarkers based on TMS parameters can provide information on the pathophysiology of dementia, and be used to diagnose Alzheimer’s disease and differentiate different types of dementia. This review introduces the basic principles of TMS, TMS devices and stimulating paradigms, several neurophysiological measurements, and the clinical implications of TMS for Alzheimer’s disease.

Citations

• Transcranial application of magnetic pulses for improving brain drug delivery efficiency via intranasal injection of magnetic nanoparticles
  Eunbi Ye, Eunkyoung Park, Eunseon Kim, Jung Eun Lee, Seung Ho Yang, Sung-Min Park
  Biomedical Engineering Letters.2023; 13(3): 417.     CrossRef
• Implantable acousto-optic window for monitoring ultrasound-mediated neuromodulation in vivo
  Sungho Lee, Keunhyung Lee, Myunghwan Choi, Jinhyoung Park
  Neurophotonics.2022;[Epub]     CrossRef
• Transcranial Magnetic Stimulation in the Treatment of Neurological Diseases
  Fahad A. Somaa, Tom A. de Graaf, Alexander T. Sack
  Frontiers in Neurology.2022;[Epub]     CrossRef

Background
We aimed to investigate candidates for serological biomarkers of neuropathic pain in individuals with neuromyelitis optica spectrum disorder (NMOSD).
Methods
We analyzed 38 sera samples from 38 participants with NMOSD in National Cancer Center. Neuropathic pain was evaluated using the painDETECT questionnaire. Pain with neuropathic components (painDETECT score ≥ 13) was observed in 22 participants, among whom 17 had definite neuropathic pain (painDETECT score ≥ 19). The remaining 16 participants had non-neuropathic pain (painDETECT score < 13). Serum glial fibrillary acidic protein (GFAP) levels were assessed using a single-molecule array assay. Several cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-10, and IL-17A, were measured by a multiplex bead-based immunoassay.
Results
In comparison of NMOSD participants with neuropathic pain components (or definite neuropathic pain) and those with non-neuropathic pain, the absolute values of serum GFAP, TNF-α, IL-6, and IL-10 levels were higher in participants with neuropathic pain components (or definite neuropathic pain), but these findings did not reach statistical significance.
Conclusions
Further larger-scale investigations to find reliable serological biomarkers for neuropathic pain in NMOSD are warranted.

Citations

• Neuropathic pain in multiple sclerosis: serum biomarkers and MRI lesion localization
  Mohamed Hamdy Ismail, Amal SE ELmotayam, Sara F. Saadawy, Rabab M. Elfwakhry, Hebatallah M. Fawzy, Noha T. Sarhan
  The Egyptian Journal of Neurology, Psychiatry and .2025;[Epub]     CrossRef
• Shedding light on neuropathic pain: Current and emerging tools for diagnosis, screening, and quantification
  Anas Hamdan, Rafael Galvez, Majed Katati
  SAGE Open Medicine.2024;[Epub]     CrossRef
• Systematic Review and Metanalysis of the Expression of Blood-Based and Cerebrospinal Fluid-Based Biomarkers Related to Inflammatory Mediators in Neuropathic Pain
  Marina Sanz-Gonzalez, Miguel Molina-Alvarez, Carmen Rodriguez-Rivera, David Pascual, Carlos Goicoechea
  Journal of Integrative Neuroscience.2024;[Epub]     CrossRef

The vestibular cortex is a distributed network of multisensory areas that plays a crucial role in balance, posture, and spatial orientation. The core region of the vestibular cortex is the parietoinsular vestibular cortex (PIVC), which is located at the junction between the posterior insula, parietal operculum, and retroinsular region. The PIVC is connected to other vestibular areas, the primary and secondary somatosensory cortices, and the premotor and posterior parietal cortices. It also sends projections to the vestibular nuclei in the brainstem. The PIVC is a multisensory region that integrates vestibular, visual, and somatosensory information to create a representation of head-in-space motion, which is used to control eye movements, posture, and balance. Other regions of the vestibular cortex include the primary somatosensory, posterior parietal, and frontal cortices. The primary somatosensory cortex is involved in processing information about touch and body position. The posterior parietal cortex is involved in integrating vestibular, visual, and somatosensory information to create a representation of spatial orientation. The frontal cortex is involved in controlling posture, and eye movements. The various methods used to stimulate the vestibular receptors in neuroimaging studies include caloric vestibular stimulation (CVS), galvanic vestibular stimulation (GVS), and auditory vestibular stimulation (AVS). CVS uses warm or cold water or air to stimulate the semicircular canals, GVS uses a weak electrical current to stimulate the vestibular nerve, and AVS uses high-intensity clicks or short tone bursts to stimulate the otolithic receptors.

Citations

• Vestibular Agnosia: Toward a Better Understanding of Its Mechanisms
  Assan Mary Cedras, Jonathan Dion, Arnaud Saj, François Champoux, Maxime Maheu
  Audiology Research.2025; 15(1): 15.     CrossRef
• Posture‐Dependent Modulation of Interoceptive Processing in Young Male Participants: A Heartbeat‐Evoked Potential Study
  Mayu Dohata, Naotsugu Kaneko, Ryogo Takahashi, Yuya Suzuki, Kimitaka Nakazawa
  European Journal of Neuroscience.2025;[Epub]     CrossRef

Orthostatic hypotension is a sustained and pathological drop in blood pressure upon standing. Orthostatic hypotension can be due to non-neurogenic conditions or autonomic disorders. Impaired baroreflex-mediated vasoconstriction and insufficient release of norepinephrine play key roles in the pathophysiology of neurogenic orthostatic hypotension. Its common symptoms mainly related to inadequate cerebral blood flow include dizziness, lightheadedness, and syncope. It is crucial to differentiate neurogenic orthostatic hypotension from non-neurogenic orthostatic hypotension. For the management of neurogenic orthostatic hypotension, physicians should implement non-pharmacological methods and, if possible, reverse combined non-neurological conditions. Depending on severity of symptoms, pharmacological intervention may be tried after or with non-pharmacological methods. Its management should be individualized based on intensity of symptoms, comorbid conditions, drug side effects, and etiology. In this review, we discuss the definition, pathophysiology, clinical approach, and management of neurogenic orthostatic hypotension.

Citations

• Effects of Daily Lifestyle Habits on Non-Neurogenic Orthostatic Hypotension in Older Adults in South Korea: A Cross-Sectional Study
  Nahyun Kim, Hye-Kyung Oh
  Healthcare.2025; 13(6): 674.     CrossRef
• Knowledge of Orthostatic Hypotension among Doctors Working at a Tertiary Care Hospital in Sri Lanka
  Shehan Silva, Warsha De Zoysa, Udayangani Ramadasa, Jegarajah Indrakumar
  Journal of the Indian Academy of Geriatrics.2025; 21(1): 51.     CrossRef

The ultimate role of ocular movements is to keep the image of an object within the fovea and thereby prevent image slippage on the retina. Accurate evaluations of eye movements provide very useful information for understanding the functions of the oculomotor system and determining abnormalities therein. Such evaluations also play an important role in enabling accurate diagnoses by identifying the location of lesions and discriminating from other diseases. There are various types of ocular movements, and this article focuses on saccades, fast eye movements, smooth pursuit, and slow eye movements, which are the most important types of eye movements used in evaluations performed in clinical practice.

Citations

• COMPARISON OF RANDOM SACCADE TEST AND CLINICAL SACCADOMETRY TEST RESULTS OF HEALTHY ELDERLY AND YOUNG INDIVIDUALS
  Gülce KİRAZLI, Gökçe SAYGI UYSAL, Ece ÇINAR, Aykut ÖZDOĞAN, Şüheda BARAN, Fatih TEKİN
  Turkish Journal of Geriatrics.2025;[Epub]     CrossRef
• Analysis of Eye Movements in Adults with Spinal Muscular Atrophy
  Marek Krivošík, Zuzana Košutzká, Marián Šaling, Veronika Boleková, Rebeka Brauneckerová, Martin Gábor, Peter Valkovič
  Medicina.2025; 61(4): 571.     CrossRef

The ultimate purpose of eye movement is to maintain clear vision by ensuring that images of observed objects are focused on the fovea in the retina. Accurate evaluation of ocular movements, including nystagmus and saccadic intrusions, provides very useful information for determining the overall function and abnormality of the complex oculomotor system, from the peripheral vestibular system to the cerebrum. Eye movement tests are therefore essential for the accurate diagnosis of patients who complain of dizziness and imbalance. They help to predict lesion locations from the peripheral vestibular system to the central cerebral cortex and play an important role in differentiation from other diseases. The methodology of recording and interpreting ocular movements using video-oculography are described in this review article.

Citations

• Miller Fisher syndrome initially presented as bilateral internuclear ophthalmoplegia: a case report
  Sanghyun Kim, Jusuck Lee, Daewoong Bae
  Research in Vestibular Science.2025; 24(1): 46.     CrossRef
• Transcranial temporal interference stimulation precisely targets deep brain regions to regulate eye movements
  Mo Wang, Sixian Song, Dan Li, Guangchao Zhao, Yu Luo, Yi Tian, Jiajia Zhang, Quanying Liu, Pengfei Wei
  Neuroscience Bulletin.2025;[Epub]     CrossRef

In cases of hyponatremia induced by brain damage, it is important to distinguish between the syndrome of inappropriate anti-diuretic hormone secretion (SIADH) and cerebral salt wasting syndrome. A ventriculoperitoneal (VP) shunt is the standard treatment for hydrocephalus, and external lumbar drainage (ELD) is an option to evaluate the effect of a VP shunt. However, ELD has potential complications, such as subarachnoid hemorrhage, meningitis, and rarely hyponatremia. Therefore, we report a case of a patient with cerebral salt-wasting syndrome resulting from ELD to treat normal-pressure hydrocephalus during the rehabilitation of acute ischemic stroke.

Citations

• Cerebral Salt Wasting Syndrome in a Patient with Normal Pressure Hydrocephalus with Possible Change in Pressure Setting of Adjustable Shunt by Metal Detector
  Arghya Majumdar, Simmy Tiwari
  Indian Journal of Critical Care Case Report.2025; 4(2): 54.     CrossRef
• Cerebrospinal fluid overdrainage as a potential overlooked cause of SIAD-induced hyponatremia? A case report
  Sanghamitra Sarma, Ankur Khandelwal, Priyadarshi Dikshit, Anirban Bhattacharjee
  JCA Advances.2025; 2(2): 100105.     CrossRef

Cortico-cortical evoked potential (CCEP) mapping is a rapidly developing method for visualizing the brain network and estimating cortical excitability. The CCEP comprises the early N1 component the occurs at 10-30 ms poststimulation, indicating anatomic connectivity, and the late N2 component that appears at < 200 ms poststimulation, suggesting long-lasting effective connectivity. A later component at 200-1,000 ms poststimulation can also appear as a delayed response in some studied areas. Such delayed responses occur in areas with changed excitability, such as an epileptogenic zone. CCEP mapping has been used to examine the brain connections causally in functional systems such as the language, auditory, and visual systems as well as in anatomic regions including the frontoparietal neocortices and hippocampal limbic areas. Task-based CCEPs can be used to measure behavior. In addition to evaluations of the brain connectome, single-pulse electrical stimulation (SPES) can reflect cortical excitability, and so it could be used to predict a seizure onset zone. CCEP brain mapping and SPES investigations could be applied both extraoperatively and intraoperatively. These underused electrophysiologic tools in basic and clinical neuroscience might be powerful methods for providing insight into measures of brain connectivity and dynamics. Analyses of CCEPs might enable us to identify causal relationships between brain areas during cortical processing, and to develop a new paradigm of effective therapeutic neuromodulation in the future.

Citations

• The impact of radiofrequency thermocoagulation on brain connectivity in drug‐resistant epilepsy: Insights from stereo‐electroencephalography and cortico‐cortical evoked potentials
  Justyna Gula, Rutger J. Slegers, Raf H. M. Van Hoof, Balu Krishnan, Massimo Mischi, Vivianne H. J. M. van Kranen‐Mastenbroek, Ilse E. C. W. Van Straaten, Danny Hilkman, Louis Wagner, Albert Colon, Olaf E. M. G. Schijns, Borbála Hunyadi, Jacobus F. A. Jans
  Epilepsia.2025; 66(4): 1260.     CrossRef
• Recent developments in stereo electroencephalography monitoring for epilepsy surgery
  Debopam Samanta
  Epilepsy & Behavior.2022; 135: 108914.     CrossRef

We report a patient diagnosed with a germ-cell tumor presenting with spinal muscular atrophy with lower limb predominance (SMA-LED) caused by a DYNC1H1 genetic variant. His clinical and electrophysiologic phenotype was compatible with SMA-LED. We identified a heterozygous missense variant (c.1793G>T) of DYNC1H1. This report expands the clinical spectrum of DYNC1H1-related disorders, and reinforces the importance of DYNC1H1 in both central and peripheral neuronal functions. We suggest that germ-cell tumors should be considered as a possible phenotype of DYNC1H1-related disorders.

Citations

• Osteosarcoma in an Adolescent With Germline DYNC1H1‐Related Disorder: A Novel Association With Whole Genome and Transcriptome Tumour Analysis
  Cameron J. Grisdale, Rachel V. Silverberg, Bilal M. Marwa, Trevor J. Loback, Alysa A. Poulin, Kaveer K. Chatoorgoon, Saima Alvi, Shahrad R. Rassekh, Rebecca J. Deyell, Paul R. D'Alessandro
  Pediatric Blood & Cancer.2025;[Epub]     CrossRef

Nociplastic pain refers to pain arising from altered nociception without evidence of tissue or somatosensory damage. It encompasses various clinical conditions with shared neurophysiological mechanisms involving different organ systems. Nociplastic pain can occur independently or alongside chronic pain conditions with a nociceptive or neuropathic origin. This review introduces the concept of nociplastic pain, its clinical manifestations and the underlying pathophysiology. Taking a biopsychosocial approach can lead to a better understanding of nociplastic pain and improved treatment outcomes for affected individuals.

Citations

• Aktualisierung der DEGAM-S1-Handlungsempfehlung zum chronischen, nichttumorbedingten Schmerz
  Cornelia Straßner, Annette Becker
  Zeitschrift für Allgemeinmedizin.2024; 100(6): 307.     CrossRef

Tram-track and doughnut-shaped enhancements of the optic nerve sheath in axial and coronal magnetic resonance imaging (MRI) views, respectively, play crucial roles in the diagnosis of optic nerve sheath meningioma (ONSM). However, this finding is not specific to ONSM since it can also be observed in optic perineuritis (OPN). Here we report a 42-year-old female with ONSM who presented with clinical and MRI findings similar to those of OPN.

Citations

• Freiburg Neuropathology Case Conference: Progressive Optic Nerve Lesion Over a 16-Year Period
  I. E. Duman Kavus, R. Sankowski, R. Rölz, A. Dressing, M. Prinz, H. Urbach, D. Erny, C. A. Taschner
  Clinical Neuroradiology.2025; 35(1): 215.     CrossRef

Autonomic dysfunction occurs frequently in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Patients with either condition may present with autonomic symptoms such as bladder, sexual, cardiovascular, thermoregulatory, and gastrointestinal dysfunction, and fatigue, but autonomic symptoms that affect quality of life are underrecognized in clinical practice. The immunopathogenesis of MS has been considered to be associated with autonomic dysfunction. Applying appropriate treatment strategies for autonomic dysfunction is important to improve the quality of life of patients. Here we review autonomic dysfunction and how this is managed in patients with MS and NMOSD.

Citations

• Sexual function and related predictors in male with multiple sclerosis and neuromyelitis optica spectrum disorder: a case–control study
  Saeed Vaheb, Mohammad Yazdan Panah, Mohammad Mohammadi, Mohammad Amin Sadri, Narges Ebrahimi, Sarina Loghmani, Marjan Beigi, Vahid Shaygannejad, Omid Mirmosayyeb
  The Journal of Sexual Medicine.2025; 22(2): 274.     CrossRef

Breathing is controlled by complex interactions between the central and peripheral nervous systems in conjunction with the respiratory system. Neurological diseases predispose patients to nocturnal desaturation and pneumonia due to respiratory dysfunction, which increases mortality, daytime sleepiness and fatigue, and reduces the quality of life. Respiratory function tests are required to identify respiratory function decline and to consider compensatory management. This review summarizes the characteristics of several respiratory function tests and their applications to neurological diseases.

Citations

• Acute Neuromuscular Respiratory Failure
  Jeong Hee Cho
  Korean Journal of Neuromuscular Disorders.2023; 15(1): 1.     CrossRef

Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.

Citations

• A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation
  Valentina Paggi, Florian Fallegger, Ludovic Serex, Olivier Rizzo, Katia Galan, Alice Giannotti, Ivan Furfaro, Ciro Zinno, Fabio Bernini, Silvestro Micera, Stéphanie P. Lacour
  Bioelectronic Medicine.2024;[Epub]     CrossRef

Background
There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes.
Methods
From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes.
Results
Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0–81.4%; specificity, 10.3–53.4%), diabetic neuropathy (PPV, 55.0–81.3%; specificity, 66.7–76.7%) and diabetic retinopathy (PPV, 77.0–96.6%; specificity, 2.2–89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals.
Conclusions
Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

Citations

• The effect of sarpogrelate compared to aspirin in high- or very-high-risk diabetes for primary prevention
  Soo Hyun Kang, Kilyoon Pack, Jung Ho Kim, Youngwoo Jang
  Scientific Reports.2025;[Epub]     CrossRef

The newly identified frontal aslant tract (FAT) that connects the posterior Broca’s area to the supplementary motor area is known to be involved in speech and language functions. We successfully intraoperatively monitored FAT using cortico-cortical evoked potentials generated by single-pulse electrical cortical stimulation in a patient with oligodendroglioma.

Citations

• Developmental trajectory of transmission speed in the human brain
  Dorien van Blooijs, Max A. van den Boom, Jaap F. van der Aar, Geertjan M. Huiskamp, Giulio Castegnaro, Matteo Demuru, Willemiek J. E. M. Zweiphenning, Pieter van Eijsden, Kai J. Miller, Frans S. S. Leijten, Dora Hermes
  Nature Neuroscience.2023; 26(4): 537.     CrossRef

Small fiber neuropathy is a painful neuropathy that cannot be assessed using nerve conduction studies. A skin biopsy and quantitative sensory testing (QST) are the gold standards for small fiber neuropathy diagnosis. However, a skin biopsy is invasive and commercially unavailable in Korea. QST is a method involving a thermal threshold, but its results can be affected by cognition as well as lesions of the central nervous system. Quantitative sudomotor axon reflex test (QSART) is a quantitative method of assessing sweat glands innervated by small fibers. In this review, we assessed the utility of QSART in evaluating small fiber neuropathy.

Citations

• Diagnostic Performance of Infrared Thermography, Quantitative Sudomotor Axonal Reflex Testing, and 3-Phase Bone Scintigraphy for Complex Regional Pain Syndrome Diagnosis: A Retrospective Observational Study
  Chan Noh, Jiyong Lee, Hye Young Choi, Eunhye Park, Yong Sup Shin, Boohwi Hong, Youngkwon Ko, Chahyun Oh, Sun Yeul Lee
  Journal of Pain Research.2025; Volume 18: 1305.     CrossRef

Anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (anti-HMGCR) antibody related immune-mediated necrotizing myopathy (IMNM) are usually associated with statin use. The disease has features of persistent muscle weakness and creatine kinase (CK) elevation after statin discontinuation. This report describes a 65-year-old female taking atorvastatin, presenting with both proximal lower extremity weakness. IMNM feature were detected on muscle biopsy and high anti-HMGCR autoantibody titer on enzyme-linked immunosorbent assay (ELISA). This patient was treated with corticosteroid. Muscle weakness and CK are improved after immunosuppressive therapy.

Citations

Glycogen storage disease (GSD) type V, also known as McArdle’s disease, is an autosomal recessive genetic disease caused by a mutation of the PYGM gene related to the synthesis of the myophosphorylase enzyme. Here, we presented the case of an 83-year-old woman who was admitted for progressively worsening weakness of her legs due to rhabdomyolysis after a COVID-19 vaccination. In the muscle biopsy, myopathy with subsarcolemmal glycogen accumulation was revealed and she was diagnosed with a mild form of GSD type V. Although COVID-19 vaccines are generally safe and encouraged for everyone, adverse events following COVID-19 vaccinations are increasing. We should pay attention to the side effects of COVID-19 vaccination including rhabdomyolysis.

Citations

• COVID-19 Vaccine Side Effect Analysis by Leveraging Social Media: Focusing on Connectivity and Cluster Characteristics of Vaccine Side Effects
  Sunguk Yun, Jaekyun Jeong, Jungeun Kim
  IEEE Transactions on Computational Social Systems.2024; 11(5): 6487.     CrossRef

Previous studies show few cases of concomitant Guillain-Barré syndrome (GBS) and acute transverse myelitis (ATM), also described as GBS and ATM overlap syndrome. We experienced a patient who presented with acute progressive leg weakness and hyperreflexia at initial stage, but was followed by areflexia. The spine magnetic resonance imaging revealed radiological findings of ATM and nerve conduction studies showed electrodiagnostic findings of acute motor axonal neuropathy, known as GBS subtype. The response to treatment with intravenous immune globulin was good.

Citations

Background
Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function.
Methods
This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS.
Results
No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS.
Conclusions
IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

Citations

• Infrared medical thermography, medical applications, and its basic principles: A review
  Ali Faisal Abdulkareem, Auns Qusai Hashim, N. Aldahan, A.J. Ramadhan
  BIO Web of Conferences.2024; 97: 00140.     CrossRef

A brain-computer interface (BCI) is a technology that acquires and analyzes electrical signals from the brain to control external devices. BCI technologies can generally be used to control a computer cursor, limb orthosis, or word processing. This technology can also be used as a neurological rehabilitation tool for people with poor motor control. We reviewed historical attempts and methods toward predicting arm movements using brain waves. In addition, representative studies of minimally invasive and noninvasive BCI were summarized.

Citations

• Dynamic decision-making framework for benchmarking brain–computer interface applications: a fuzzy-weighted zero-inconsistency method for consistent weights and VIKOR for stable rank
  Z. T. Al-qaysi, A. S. Albahri, M. A. Ahmed, Mahmood M. Salih
  Neural Computing and Applications.2024; 36(17): 10355.     CrossRef

Bell’s palsy is an acute peripheral facial paralysis with no detectable cause. Although the prognosis of Bell’s palsy is generally good, some patients experience poor recoveries and there is no established treatment for those that do not recover even after receiving the conventional treatment. Here we present two cases of refractory Bell’s palsy with facial nerve enhancement in magnetic resonance imaging who showed symptomatic improvement after the late administration of high-dose intravenous methylprednisolone.

Citations

• Development of the Korean Medicine Core Outcome Set for Facial Palsy: herbal medicine treatment of patients with facial palsy in primary clinics
  Soo-Dam Kim, Sungha Kim, Mi Ju Son, Jiyun Cha, Pyung-Wha Kim, Mi Mi Ko, Soobin Jang, Changsop Yang, Myeong Soo Lee
  Frontiers in Medicine.2024;[Epub]     CrossRef

Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.

Citations

• Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report
  Arezoo Ahmadi, Elahe Karimpour‐Razkenari, Ramin Ansari, Mahforouzalsadat Marashi, Hamidreza Sharifnia, Atabak Najafi, Mojtaba Mojtahedzadeh
  Clinical Case Reports.2023;[Epub]     CrossRef