Epilepsy in MS and its association with cognitive and psychological burden.

Background: Epilepsy is two to three times more common in patients with multiple sclerosis (pwMS) compared to the general population. Patients with MS and epilepsy without other identifiable causes (MS + E) show greater cortical damage than those without epilepsy (MS-E). However, it's unclear whether MS + E patients exhibit distinct cognitive and neuropsychological features requiring specific management.

Brain bright spotty lesions and leukodystrophy-like patterns in NMOSD relapse.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare disease that primarily affects the optic nerve and the spinal cord but less frequently can also involve the brain. We present the case of a woman who experienced an atypical NMOSD relapse characterized by MRI white matter brain lesions with a leukodystrophy-like pattern. Additionally, lesions in the middle cerebellum peduncles exhibited a distinctive T2w hyperintense/FLAIR hypointense signal resembling the brain's bright spotty lesions (BSLs) previously described in the spinal cord.

Changes in the thalamocortical component of high frequency oscillations following botulinum toxin treatment in cervical dystonia.

Objective: This study aims to investigate the central effects of Botulinum toxin type A (BoNT-A) on the somatosensory system in patients with cervical dystonia (CD), focusing on the thalamocortical pathway using high-frequency oscillations (HFOs) and short-latency afferent inhibition (SAI).

Methods: An observational longitudinal study was conducted on 10CD patients and 10 healthy controls (HC). HFOs and SAI were assessed for CD and HC at baseline (T0; the day before BoNT-A treatment).

Long-Term Safety and Efficacy of Lacosamide Combined with NOACs in Post-Stroke Epilepsy and Atrial Fibrillation: A Prospective Longitudinal Study.

Stroke is the leading cause of seizures and epilepsy in adults; however, current guidelines lack robust recommendations for treating post-stroke seizures (PSSs) and epilepsy (PSE). This study aims to demonstrate the long-term safety and efficacy of lacosamide combined with non-vitamin K antagonist oral anticoagulants (NOACs) in patients with PSE and atrial fibrillation (AF). In this prospective longitudinal single-center study, 53 patients with concomitant PSE and AF, admitted between 2022 and 2023, received NOACs for AF management and lacosamide for seizure control.

The effects of transcutaneous auricular vagus nerve stimulation (taVNS) on cholinergic neural networks in humans: A neurophysiological study.

Objective: The mechanisms of actions of transcutaneous auricular vagus nerve stimulation (taVNS) are still unclear, however the activity of the cholinergic system seems to be critical for the induction of VNS-mediated plasticity. Transcranial Magnetic Stimulation (TMS) is a well-suited, non-invasive tool to investigate cortical microcircuits involving different neurotransmitters. Herein, we evaluated the effect of taVNS on short-latency afferent inhibition (SAI), a TMS paradigm specifically measuring cholinergic neurotransmission.

Neurophysiological methods for assessing and treating cognitive impairment in multiple sclerosis: A scoping review of the literature.

In recent years, there has been a growing interest in exploring the non-classical symptoms of multiple sclerosis (MS), with a particular focus on cognitive impairments associated with the disease's progression. These cognitive symptoms are now recognized as crucial elements in the assessment of disease activity. In this context, neurophysiology has emerged as a valuable and accessible tool for studying and addressing cognitive decline in individuals with MS.

Cortical plasticity in AQP4-positive NMOSD: a transcranial magnetic stimulation study.

Aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) is an autoimmune disease characterized by suboptimal recovery from attacks and long-term disability. Experimental data suggest that AQP4 antibodies can disrupt neuroplasticity, a fundamental driver of brain recovery. A well-established method to assess brain LTP is through intermittent theta-burst stimulation (iTBS).

Cerebellar Non-Invasive Brain Stimulation: A Frontier in Chronic Pain Therapy.

Chronic pain poses a widespread and distressing challenge; it can be resistant to conventional therapies, often having significant side effects. Non-invasive brain stimulation (NIBS) techniques offer promising avenues for the safe and swift modulation of brain excitability. NIBS approaches for chronic pain management targeting the primary motor area have yielded variable outcomes.

Bilateral median nerve stimulation and High-Frequency Oscillations unveil interhemispheric inhibition of primary sensory cortex.

Objective: This study aimed at investigating the effect of median nerve stimulation on ipsilateral cortical potentials evoked by contralateral median nerve electrical stimulation.

Methods: We recorded somatosensory-evoked potentials (SEPs) from the left parietal cortex in 15 right-handed, healthy subjects. We administered bilateral median nerve stimulation, with the ipsilateral stimulation preceding the stimulation on the contralateral by intervals of 5, 10, 20, or 40 ms.

Unusual CLIPPERS presentation with a predominant spinal cord involvement: case report and review of the literature.

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a discrete nosological entity characterized by punctate and curvilinear gadolinium enhancement "peppering" the pons and a strong response to steroids. MRI images typically show pontine and cerebellar punctate-enhancing lesions, which occasionally spread up to the juxtacortical areas and down to the spinal cord. Interestingly, the more distant the lesion is from the pons, the less intense they become.

High-frequency transcranial alternating current stimulation matching individual frequency of somatosensory evoked high-frequency oscillations can modulate the somatosensory system through thalamocortical pathway.

tACS (transcranial alternating current stimulation) is a technique for modulating brain activity through electrical current. Its effects depend on cortical entrainment, which is most effective when transcranial alternating current stimulation matches the brain's natural rhythm. High-frequency oscillations produced by external stimuli are useful for studying the somatosensory pathway.

Using TMS-EEG to assess the effects of neuromodulation techniques: a narrative review.

Over the past decades, among all the non-invasive brain stimulation (NIBS) techniques, those aiming for neuromodulatory protocols have gained special attention. The traditional neurophysiological outcome to estimate the neuromodulatory effect is the motor evoked potential (MEP), the impact of NIBS techniques is commonly estimated as the change in MEP amplitude. This approach has several limitations: first, the use of MEP limits the evaluation of stimulation to the motor cortex excluding all the other brain areas.

Feasibility and efficacy of an at-home, smart-device aided mindfulness program in people with Multiple Sclerosis.

Background: Multiple Sclerosis (MS) is a chronic disease with a high prevalence of neuropsychiatric symptoms. Mindfulness is a practice that encourages individuals to cultivate a present-focused, acceptance-based approach for managing psychological distress. Its positive effect on MS has been demonstrated, but learning such technique is expensive and time-consuming.

The role of neurophysiological tools in the evaluation of ischemic stroke evolution: a narrative review.

Ischemic stroke is characterized by a complex cascade of events starting from vessel occlusion. The term "penumbra" denotes the area of severely hypo-perfused brain tissue surrounding the ischemic core that can be potentially recovered if blood flow is reestablished. From the neurophysiological perspective, there are local alterations-reflecting the loss of function of the core and the penumbra-and widespread changes in neural networks functioning, since structural and functional connectivity is disrupted.

Focal vibrations enhance somatosensory facilitation in healthy subjects: A pilot study on Equistasi and high-frequency oscillations.

Background: Equistasi is a vibrotactile device composed of nanotechnology fibers that converts temperature change into mechanical energy by self-producing a focal vibration. It is used in non-pharmacological rehabilitation in patients with movement disorders and multiple sclerosis sequelae. Nonetheless, the mechanism underlying such an improvement in motor functions is still poorly understood.

May Dual Transcranial Direct Current Stimulation Enhance the Efficacy of Robot-Assisted Therapy for Promoting Upper Limb Recovery in Chronic Stroke?

Objective: To assess whether dual transcranial direct current stimulation (tDCS) may enhance the efficacy of exoskeleton robotic training on upper limb motor functions in patients with chronic stroke.

Methods: A prospective, bi-center, double-blind, randomized clinical trial study was performed. Patients with moderate-to-severe stroke (according to The National Institute of Health Stroke Scale) were randomly assigned to receive dual or sham tDCS immediately before robotic therapy (10 sessions, 2 weeks).

High-frequency oscillations-based precise temporal resolution of short latency afferent inhibition in the human brain.

Objective: Sensorimotor integration is a crucial process for adaptive behaviour and can be explored non-invasively with a conditioned transcranial magnetic stimulation (TMS) paradigm - i.e. short-latency afferent inhibition (SAI).

A true isolated cognitive relapse in multiple sclerosis.

Isolated cognitive relapses (ICRs) have been a matter of debate for the past few years. Currently, there is no clear consensus on such an entity, as cognitive decline usually accompanies typical multiple sclerosis (MS) relapses. Herein, we present the neuropsychological and neurophysiological manifestations of a patient who suddenly complained of confusion and memory loss, showing insight into her deficit, in absence of sensorimotor disturbances.

Safety, immunogenicity, efficacy, and acceptability of COVID-19 vaccination in people with multiple sclerosis: a narrative review.

In the last two years, a new severe acute respiratory syndrome coronavirus (SARS-CoV) infection has spread worldwide leading to the death of millions. Vaccination represents the key factor in the global strategy against this pandemic, but it also poses several problems, especially for vulnerable people such as patients with multiple sclerosis. In this review, we have briefly summarized the main findings of the safety, efficacy, and acceptability of Coronavirus Disease 2019 (COVID-19) vaccination for multiple sclerosis patients.