Although intraoperative motor-evoked potential (MEP) monitoring is widely performed during neurosurgical operations, there is controversy regarding the evaluation of its results. The cutoff point, sensitivity and specificity of MEP recorded during spinal operations were examined by receiver operating characteristic (ROC) analyses. In 349 spinal operations for the patients without preoperative motor palsy under transcranial (TC) MEP monitoring, amplitude reduction of 77.9% and 80.6% as cutoff points for motor palsy with and without normalization by compound muscle action potential (CMAP) after peripheral nerve stimulation, respectively gave sensitivity of 100%, and specificity of 96.8% and 96.2%. In 130 operations for the treatment of compressive spinal cord disease, cutoff points of 64.4% and 50.6% relative amplitude rate gave specificities of 90.0% and 70.0%, sensitivities of 75.8% and 88.3%, with and without CMAP normalization, respectively. In 185 operations for the treatment of compressive cauda equina nerve disease, cutoff points of 11.4% and 17.9% amplitude reduction gave specificities of 58.0% and 72.4%, sensitivities of 100% and 50.0%, with and without CMAP normalization, respectively. CMAP normalization is seemed to be effective for predicting neurological recovery after the operation for compressive spinal and spinal nerve disease.

Cerebral cortex plays a crucial role in swallowing. Previous studies revealed swallowing-related multiple cerebral loci, but temporal profile of neural activities during swallowing has not been unveiled clearly. In the present study, we used human electrocorticograms with high spatiotemporal resolution to investigate swallowing-related neural oscillatory changes. Here, we show that high gamma power increases in the precentral and postcentral gyri were observed during mouth movement and water injection. During swallowing, power increases in the high gamma band appeared in the frontal operculum and the subcentral area. We distinguished discrete cortical activities that previous studies demonstrated were equivalent activities that related to swallowing, and we showed that the frontal operculum and the subcentral area were mainly activated during swallowing.

[Background] The previous study has revealed that PRRI-6 (pulse rate rise index by more than six beats per hour) is a useful screening index for obstructive sleep apnea rather than ODI-3 (three percent oxygen desaturation index). However, patients with long-term diabetes often show smaller heart rate variability than healthy controls. In addition, patients with long diabetic history has not been evaluated.
[Objective] To investigate whether PRRI-6 is a useful screening even for patients with long-term diabetes.
[Methods] Retrospective analysis was performed on a total of 449 patients with suspected obstructive sleep apnea who underwent pulse oximetry (POx) at Kansai Electric Power Hospital between April 2014 and April 2016. The patients who showed ODI-3≧15 were evaluated. They were classified into two categories, Non-DM, and DM. The DM group was categorized into three groups by the duration of the disease (under 5 years, 5–10 years, over 10 years).
[Results] Of 108 patients, 57 had Non-DM and 51 had DM. Of the latter 51 patients, 21 were with the disease duration of under 5 years, 10 were 5–10 years, and 20 were over 10 years. ODI-3 and PRRI-6 were 29.9±17.2 (15.2–77.7) and 30.7±20.0 (4.3–82.1) in the Non-DM group, while in the DM group they were 31.5±15.2 (15.8–92.6) and 29.7±18.9 (2.9–79.6). Spearman’s rank-correlation coefficient showed a weak correlation between ODI-3 and PRRI-6 in Non-DM and overall DM (rs=0.58 vs. rs=0.48). Whereas, there is poor correlation in the over 10 years group (rs=0.28).
[Conclusions] It is necessary to take the duration of diabetes into consideration when we aim at making the use of PRRI-6 for OSA screening.

Ten healthy volunteers participated in this study. Accuracy and expeditiousness were compared before and after motor imagery. F-waves were recorded in the resting and motor imagery conditions from the thenar muscle. The persistence and F/M amplitude ratio of the F-waves were analyzed. Results. Persistence was higher in the motor imagery condition than in the resting condition. All subjects showed worse accuracy after than before motor imagery. Subjects were further grouped based on whether they showed an improvement in expeditiousness. Subjects who showed improved expeditiousness showed worse accuracy than did those with no improvement in expeditiousness. In those subjects who showed worse accuracy, the persistence was increased over the 17% or under the 4% in the motor imagery condition than in the resting condition. Moreover, the F/M amplitude ratio was 0.5% higher in the motor imagery than in the resting condition. Conclusions. The excitability of spinal anterior horn cells might increase moderately in motor imagery conditions, preventing for not worsen accuracy.

It is important to detect non-convulsive seizures in the treatment of critically ill children in ICU. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is characterized by a febrile status epilepticus as the initial neurological symptom, followed by secondary seizures and subcortical white matter edema at day 4 to 6. As MRI shows no acute abnormality at the onset, EEG is useful to distinguish AESD from febrile status epilepticus in early stage. Recently therapeutic hypothermia is applied as a treatment of AESD, and continuous EEG monitoring during the therapy is also important. Amplitude-integrated EEG (aEEG) and dense spectral array (DSA) are useful for the identification of non-convulsive seizures in long-term EEG monitoring in ICU.