Neural Noise

Clinical neurophysiology in movement disorders: integration into systems-based practice

2 min read

  • Clinical neurophysiology in movement disorders is moving toward integration into systems-based practice (Clinical Neurophysiology, Lizarraga & Chen).1
  • The approach aligns with electrophysiology and systems-based neural assessment for movement disorder diagnosis and management.1
  • The review appears in Clinical Neurophysiology Volume 183 (March 2026).1 1

Gardner updates

  • Diagnostic utility of clinical neurophysiology in Wilson’s disease with hyperkinetic movements. 2

  • Cutaneous silent periods are characterized in Charcot-Marie-Tooth type 1A disease. 3

  • Clinical neurophysiology has diagnostic utility in Wilson’s disease with hyperkinetic movements (Clinical Neurophysiology, Vol 183, March 2026). 2

  • Clinical neurophysiology supports diagnosis of functional cranial–cervical dystonia (Wiley), using the same electrophysiology toolkit as BCI. 4

Weekly enrichment (2026-07-20)

  • The source article is an editorial (no abstract) by Karlo J. Lizarraga and Robert Chen in Clinical Neurophysiology Volume 183 (March 2026); Chen is the journal’s Editor-in-Chief and was recused from handling the manuscript.5
  • Context: a prospective study of a standardized non-invasive electrodiagnostic protocol (four-channel surface EMG polygraphy plus two-channel accelerometry) in 31 consecutive patients referred for tremor refined the differential diagnosis in 25/31 (80.6%) and changed therapy in 14/29 (48.3%).6
  • In that tremor cohort, therapy changes included adjusting pharmacotherapy (n=10), proceeding to deep brain stimulation surgery (n=2), and avoiding invasive procedures (n=2).6
  • A global survey in Movement Disorders Clinical Practice documented worldwide perceptions and utilization of clinical neurophysiology in movement disorders, informing the case for systems-based integration.7
  • A companion cohort reported the first neurophysiological description of movement disorders in Wilson’s disease: 12 patients (3.9% of the total cohort and 11% of those with neurological complications), assessed with sEMG plus accelerometry from December 2012 to December 2021.8
  • In those Wilson’s disease patients, neurophysiology identified tremors in 10 (seven postural, six resting, four orthostatic, four functional, two kinetic, one dystonic) and myoclonus in five.8
  • Critically, four pseudo-orthostatic tremors, five myoclonus cases, and two functional tremors were undetected on clinical examination alone and revealed only by neurophysiology; action tremor on sEMG was the only movement disorder significantly associated with a mild-to-moderate midbrain FLAIR hypersignal.8
  • These data reinforce the editorial’s thesis that electrophysiology, the same EEG/EMG toolkit underlying BCI decoding, should be embedded into systems-based movement-disorder practice for more accurate diagnosis and treatment.5

Footnotes

  1. https://www.sciencedirect.com/science/article/pii/S138824572501332X?dgcid=rss_sd_all ↩ ↩2 ↩3 ↩4

  2. https://www.sciencedirect.com/science/article/pii/S1388245725013239?dgcid=rss_sd_all ↩ ↩2

  3. https://www.sciencedirect.com/science/article/pii/S1388245725012593?dgcid=rss_sd_all ↩

  4. https://news.google.com/rss/articles/CBMiakFVX3lxTE43eEFJMmR5VEctYm9ZQlpiSlNZZVJ1THhTTU1TaWVGNEc4cGx4UWJlVDNDZFRBWGM4VFFSV0tqd3FZeW5LTVY2dmlnVVp6dUJvUG03X0RDYnVWZnBRR0VvLW9CV192ck1jOXc?oc=5 ↩

  5. https://pubmed.ncbi.nlm.nih.gov/41411833/ ↩ ↩2

  6. https://doi.org/10.1016/j.cnp.2025.05.003 ↩ ↩2

  7. https://doi.org/10.1002/mdc3.13974 ↩

  8. https://pubmed.ncbi.nlm.nih.gov/41611563/ ↩ ↩2 ↩3

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