https://jneurophysiologicalmonitoring.com/index.php/pub <p>The Journal of Neurophysiological Monitoring is an open-access, independent, and unbiased online journal that publishes articles in neurophysiological monitoring research per the double-blind peer-review process. The print version of the journal is not available, and it is only accessible at <a href="https://jneurophysiologicalmonitoring.com">https://jneurophysiologicalmonitoring.com</a>.</p> <p>The manuscripts published on this web page can be read free of charge, and files can be downloaded in PDF format. Four issues are released yearly (March, June, September, and December). The publication language of the journal is English.</p> Dr. Faisal Jahangiri en-US J of Neurophysiological Monitoring 2995-4886 https://jneurophysiologicalmonitoring.com/index.php/pub/article/view/60 <p>The 30-day stroke rate following a Carotid Endarterectomy (CEA) ranges between 2-6% and is associated with a three-fold increase in mortality. Various types of Intraoperative Neurological Monitoring (IONM) modalities are available to help detect changes in cerebral blood flow during this procedure. The primary aim of this meta-analysis was to evaluate the efficacy of the different (IONM) techniques used for this surgery and compare them to multiple modality studies. We identified relevant articles on PubMed (2000-2024), EBSCOhost (2000-2024), and Science Direct (2000-2024) to identify studies to include in this meta-analysis. We included literature that consisted of adult patients who underwent a CEA procedure under general anesthesia and were monitored with the specified IONM modalities. We calculated the mean specificities and sensitivities for each IONM Modality studied and are as follows: mean EEG sensitivity 41% and specificity 90%; mean TCD sensitivity 99% and specificity 83%; mean SSEP sensitivity 64% and specificity 88%; combined SSEP+EEG sensitivity 59% and specificity 99%. Each IONM modality presents its own unique set of challenges to determine severe deficits in cerebral blood flow. Given the high specificity or sensitivity observed across virtually all modalities, additional studies are needed to assess the effectiveness of combining the strengths of two modalities to enhance their capabilities.</p> Faisal R Jahangiri Mark Salazar Rohita Arjarapu Emily Gutierrez Copyright (c) 2024 J of Neurophysiological Monitoring https://creativecommons.org/licenses/by/4.0 2024-06-29 2024-06-29 2 3 1 11 10.5281/zenodo.12588227 https://jneurophysiologicalmonitoring.com/index.php/pub/article/view/61 <p><strong>Introduction.</strong></p> <p>Down syndrome arises from a trisomy of chromosome 21. Neurophysiological aspects of Down syndrome have not been well studied. Subjects often have delayed motor milestones, an increased risk of epilepsy, and an early onset form of Alzheimer’s disease. <br /><strong>Methods.</strong></p> <p>This report describes differences between Down syndrome individuals and neurologically normal control subjects using standard neurophysiological tests, such as motor and somatosensory evoked potentials and coherence between pairs of neurophysiological signals.</p> <p> <strong>Results.</strong></p> <p>Subjects with Down Syndrome required a smaller voltage to elicit an equivalent motor evoked potential compared to control subjects (174V vs. 650V) and had larger cortical, but not spinal, somatosensory evoked potentials (52mV vs. 4.2mV). Both EEG-EEG and EMG-EMG coherence was higher in Down Syndrome than in control subjects.</p> <p><strong>Conclusions.</strong></p> <p>Because the sensory input to the nervous system is controlled between subjects, as evidenced by the consistent spinal amplitude, we believe that the increased amplitude results from supraspinal (thalamic or cortical) differences rather than spinal gating. We hypothesize that these findings represent a novel set of neurophysiological findings and may be due to an altered pattern of cortical excitability, possibly due to an increased presence of gap junctions in cortical cells.</p> Jonathan Norton Shannon Haughain Salah Almubarak Copyright (c) 2024 J of Neurophysiological Monitoring https://creativecommons.org/licenses/by/4.0 2024-08-10 2024-08-10 2 3 12 20 10.5281/zenodo.13292884