ExCo unmasked
One of my hopes is to demystify the workings of the IFCN and of its Executive Committee (ExCo) for our membership and become more accountable. My own first meeting of ExCo was a two-day meeting, in Florence, to determine our strategic goals for the coming four years. I watched the big beasts of ExCo debating matters I knew little about, trying to contribute where I could, without appearing too great a fool. After that, emails would flow between ExCo, but the main meetings were face-to-face twice a year, at chapter or other congresses. That way it could have a full day’s business meeting, but it also enabled its members to lecture at the congress.
Covid stopped that, and meetings moved to on-line, usually every two months for two hours over two days. For Europeans the time was midday, for Asians it was late at night, while for our American members, north and south, these were at the start of their day. Since then we have been able to meet, and plan to return to the twice yearly face to face format for the moment, but we have also retained the Zoom meetings as well, since there seems more to do.
Meetings are usually open and vigorous debates of the various concerns. Topics the last few months have include management of our ICCN congresses, conflict of interest, finance, education, research, chapter and Masterclass updates, journal news from the two editors in chief, and oversight of our transition between management companies.
There are ten members of ExCo, of whom three are women, though the gender imbalance is lessened by our executive director. ExCo is very aware that the IFCN has historically been run by a very small number of people. In addition to ExCo there were a Rules Committee, (for society application etc.) and an Election Committee. But, over the last few years under Professor Paulus’ presidency, IFCN committees have expanded to include a finance committee to assist our treasurer, and an education committee, together with the addition of Special Interest Groups. The hope is for the IFCN do more, and for more people to be involved. So, please, watch this space.
Our next face to face meeting is at the forthcoming ECCN in Marseille, May 9th-12th, when we plan another two days of hammering out our strategic goals for the next term. Please remember that the EMEAC-IFCN is offering 100 bursaries, €500 each, to help young neurophysiologists attend. I hope many of you will attend; https://www.eccn2023-marseille.com/ .
Editor in Chief, Clinical Neurophysiology
May I just remind readers that the closing date for applications to become incoming Editor-in-Chief, Clinical Neurophysiology is the end of March. The term of Editor-in-Chief is four years, renewable once, and includes a position on the Executive Committee of the IFCN. Starting with this appointment, IFCN will provide an annual sum, to be negotiated with the successful applicant, for office expenses and/or stipend of the appointee and his/her Editorial team. If you are interested in this position, please complete the details found on the IFCN website : Editor in Chief Application Please send to me at; jonathan.cole@uhd.nhs.uk.
IFCN Educational and Research Fellowships
The IFCN is offering a total of $100,000 to fund fellowships in education and research for clinical neurophysiologists to study at centres other than their own. Most of these will be in education, to allow trainees to gain expertise not available in their own departments in order to take their new found knowledge back as they develop their careers. There will also be awards in research to acquire new techniques and experience. For more information: IFCN Education and Research Fellowship
Masterclass, Professor Yoshikazu Ugawa, MD, Quadripluse stimulation (QPS) in 2023. Saturday, April 8, 2023 at 6:00 pm (EDT)
May I recommend the next Masterclass by one of our members of ExCo, who has a wealth of experience of non-invasive brain stimulation and who is a passionate proponent of research and education. He will be talking about Quadripluse stimulation and brain plasticity. Note that he will be talking live from Japan, which is good for our Asian and Oceania members, but late evening for European and quite early for our North and South American ones. Not to worry, however, if that proves difficult since it will be recorded and kept on our increasingly rich archive of free educational resources on our website. To Register: April 8 2023 Masterclass
Editors’ Choices from our Journals
Lastly to our Editors’ choices for March. One is a fascinating paper on cerebral localisation of speech reception. This offers the hope that patients will not need to be conscious during some stages of resective neurosurgery. The other is a consensus paper on minimum recording standards for routine and sleep EEG. It is, importantly, a joint paper between IFCN and ILAE.
The Editor’s Choice, Clinical Neurophysiology from Professor Ulf Ziemann
Nourmohammadi A, Swift JR, de Pesters A, Guay CS, Adamo MA, Dalfino JC, Ritaccio AL, Schalk G, Brunner P. Passive functional mapping of receptive language cortex during general anesthesia using electrocorticography. Clinical Neurophysiology 2023, 147:31-44
Resective brain surgery is standard for removing pathological brain tissue, with the hope of removing most of the anomaly while preserving the integrity of brain function. For decades, the gold-standard technique to assess perilesional function has been electrocortical stimulation during awake craniotomy. In this volume of Clinical Neurophysiology, Nourmohammadi and colleagues used subdural electrocorticography (ECoG) grids to record cortical responses to speech stimuli during awake and general anesthesia (GA) in 20 patients with therapy refractory epilepsy or brain tumours. They found that ECoG broad-band gamma responses during GA identified cortical regions associated with receptive language function. Such passive mapping may reduce the need for electrocortical stimulation during awake craniotomy.
The Editor’s Choice, Clinical Neurophysiology Practice, from Professor Margitta Seeck.
Peltola ME, Leitinger M, Halford J, Vinayan KP, Kobayahsi K, Pressler RM, Mindruta I, Mayor LC, Lauronen, L and Benicsky S. Routine and sleep EEG: minimum recording standards of the IFCN and ILAE. Clinical Neurophysiology Practice, 147, (2023), 108-120.
In this paper an international consortium sat down and defined the minimal requirement to do standard EEG, a worldwide established procedure to determine epilepsy conditions, coma or sleep studies. All current guidelines for reviewing the literature were applied to obtain a high-quality recommendation. We are proud to publish this important paper which is a joint product of the IFCN and the International League against Epilepsy. 16 recommendations were formulated, both for children and adults, resulting in an important statement paper for modern clinical EEG and epileptology work-up.
For full articles : https://www.ifcn.info/my-editors-choice.asp
Best wishes,
Jonathan Cole
Editor’s Choice – Clinical Neurophysiology
Professor Ulf Ziemann, Editor’s Choice – Clinical Neurophysiology, January 2023.
Ozaki I, Akaza M, Watanabe T, Miyano Y, Adachi Y, Kawabata S. Detailed magnetoelectric analysis of nerve
impulse propagation along the brachial plexus. Clin Neurophysiol. 2023; 145.
This paper shows results from magnetoneurography, a novel non-invasive functional imaging modality, which may allow visualization of nerve impulse conduction along the brachial plexus. Ozaki and colleagues recorded neuromagnetic fields following median nerve stimulation above the clavicle with a SQUID biomagnetometer system in control participants, and compared these data with compound nerve action potentials (CNAPs) recordings using 12 electrodes over the brachial plexus. They found that, in the magnetic field analysis, the peaks and troughs of the intra-axonal biphasic current waveforms coincided with the zero-crossings of triphasic CNAP waveforms and that the amplitudes of CNAPs and current moments were linearly correlated. Magnetic field analysis visualizes not only intra-axonal currents, but also transmembrane volume currents, which were in turn in good agreement with the surface potential field. These findings show that time-resolved imaging of impulse propagation through the brachial plexus after peripheral nerve stimulation is possible. Their next will be to the demonstrate utility of magnetoneurography in clinical populations with pathology of the brachial plexus.
Professor Margitta Seeck, Editor’s Choice, Clinical Neurophysiology Practice, January 2023.
Haykal MA, Menkes DL. The clinical neurophysiology of COVID-19-direct
infection, long-term sequelae and para-immunization responses: A literature review
It became soon evident that the disease associated with SARS-CoV-2 affects also both the central and peripheral system. Later the long-term consequences, mainly on the nervous system, emerged, many aspects of which are best investigated with neurophysiological methods. Menkes and Haykal summarize the scope of diagnostic studies and their relation to acute and chronic effects, including complications of SARS-CoV-2 vaccination. The disease is not over yet, and we expect more studies with neurophysiological tools, in particular regarding the monitoring of long-term effects and their treatment.
Professor Ulf Ziemann, Editor’s Choice – Clinical Neurophysiology, December 2022.
Visani E, Panzica F, Eleopra R, Rossi Sebastiano D, Lanteri P, Devigili G, Dotta S, Rinaldo S, Franceschetti
S. MRI-guided focused-ultrasound thalamotomy in essential tremor: Immediate and delayed changes in cortico-muscular coherence and cortico-cortical out-strength. Clinical Neurophysiology 2022;144:67-71.
Magnetic-Resonance-guided Focused-Ultrasound (MRgFUS) targeting the ventralis-intermediate nucleus (VIM) in the thalamus has emerged as a promising treatment for medication-refractory ET patients, with immediate clinical effects. This study used MEG and EMG to measure cortico-muscular coherence, (CMC), and cortico-cortical out-strength in the motor cortical network during isometric extension of the right hand to show the underlying neurophysiological mechanisms of this response. The clinical benefits were associated with restoration of CMC to the affected hand which may be sustained by long-term plasticity in cortico-cortical network communication.
Professor Margitta Seeck, Editor’s Choice, Clinical Neurophysiology Practice, December 2022.
Pia De Stefano, Eric Ménétré, Serge Vulliémoz, Pieter Van Mierlo, Margitta Seeck, Changes
of interictal epileptiform discharges during medication withdrawal and seizures: A scalp EEG marker of epileptogenicity, Clinical Neurophysiology Practice, Volume 7, 2022, 279-284.
Using semi-automatic spike counting, the authors showed that withdrawal of antiseizure medication (ASM) increased the rate of interictal (focal) epileptiform discharges (IEDs), compared to baseline, and was related to increased likelihood of seizure occurrence. This means that an increase of IEDs in the routine EEG during follow-up is not a benign finding, but may reflect worsening of the epileptic disorder and should initiate a request for drug levels.
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