Neurophysiology Plus 

e-Bulletin

Icelandic AVH-TMS clinical trial

Brain Ecology Journal Club

Intraoperative Neuromonitoring MION Synapse

Neurotechnician Corner




Peter Falk

American actor and comedian, known for his role as Lieutenant Columbo

Neurophysiology Plus  e-Bulletin 


25 April 2024  Funcionamiento y aplicabilidad de la estimulación magnetica transcraneal repetitiva (RTMS) en pacientes con depresión mayor y schizophrenia, Ovidiu C. Banea. Initiative Psyqhiatry, HOSPITAL SANT RAFAEL Barcelona (here)


26 February 2024  Application of RTMS in patients with Major Depressive Disorder. Public domain, Creative Commons 4.0 Attribution International. Project Proposal for the Hospital Sant Rafael, HM Delfos, and Hospital del Mar, Ovidiu C. Banea (here)


01 December 2022  Atypical or Typical Triphasic Waves—Is There a Difference? A Review Fernández-Torre, José L. Kaplan, Peter W. (HERE) REVIEW OF TRIPHASIC WAVES


23 Oct 2022 ASNER MION SYNAPSE Group Romania (here)

23 Oct 2022 ASNER RTMS SCZ (here)


30 September 2022 Lecture at Euskadiko Neurofisiologia Klinika Elkartea VII REUNIÓN ANUAL 

HOSPITAL DE SANTIAGO Viernes, 30 de Septiembre de 2022 Thesis works 50 min Ovidiu C. Banea

Sala Urbil Baietz – Gerencia – (here)


19 July 2022

Conference ScienceOngoing by Ovidiu C. Banea "EEG Cantitativ și potențiale auditive evocate înainte și după tratamentul cu stimulare transcraniană magnetică la pacienți cu schizofrenie" (here)


15 April 2022

Zilele Medicale Sibiene, Sibiu Romania, Oral Communication on Research and studies towards biomarkers to assess RTMS treatment in patients with schizophrenia (here) and full Ph.D. Dissertation thesis defense of Ovidiu Banea 31 of January 2022 - 119 slides (here)


28 November 2021

Towards neurophysiological biomarkers to assess the repetitive transcranial magnetic stimulation treatment for patients with schizophrenia and auditory verbal hallucinations. Ph.D. in Clinical Neurophysiology. Dissertation Thesis by Ovidiu C. Banea, January 2022. Department of Engineering, Reykjavík University, Iceland (here)


28 of October 2021 

IONM plan for a lesion in the right temporal region in a patient with possible right language dominance (speech arrest with 15Hz stimulation from right Broca area) (here)


13 October 2021 

RoZOOM Press Valul 4 COVID19 (here)


21 April 2021

New technology is available in Iceland. A nerve conduction study is used to assess nerve lesion recovery in small mammals Mus musculus and Rattus norvegicus (here). Possible joint research with Kerecis Biological Regenerative Tissues company.


12 April 2021

Prerecorded conference Beta and Gamma Oscillations during AM Task "Zilele medicale Sibiene" 12-14 May 2021 PPT and video


10 February 2021

American Clinical Neurophysiology Society 2016 Guidelines: Standard EEG montages for Clinical Use (here)


08 February 2021, Aids to the examination of the peripheral nervous system (Brigadier, NIC, 1943, London) HERE


14th of January 2021

Road map and meeting in Neurophysiology Unit, EEG monitoring in ICU. Brief review by Ovidiu C. Banea (here)


9 January 2021

Review on Anti Covid19 vaccine (here)


20 November 2020

Padua Muscle Days oral communication "Use of HD EEG to assess RTMS treatment in patients with schizophrenia" (here)


29 October 2020

Relative power during auditory-motor task in patients with schizophrenia after rTMS (UPDATE)


5 October 2020

Three abstracts were submitted to the virtual 7th International Conference on Non-invasive Brain Stimulation, to be organized in Germany, 10-12 November 2020:

1) TMS-related cortical silent period and electrical cutaneous silent period changes after ethanol acute intake in healthy subjects by Aron D. Jónasson, Eysteinn Ívarsson, Viktor D. Jónasson, and Ovidiu C. Banea (here) PDF poster

2) Low-frequency rTMS changes on resting-state beta and gamma EEG activity in patients with schizophrenia and auditory verbal hallucinations by Ovidiu C. Banea, Eysteinn Ívarsson, and Sara Marcu (here) PDF poster

3) After effects of rTMS on evoked beta and gamma bands activity related to auditory-motor task in patients with schizophrenia and auditory verbal hallucinations by Eysteinn Ívarsson, Sara Marcu, Aron D. Jónasson, Viktor D. Jónasson, Paolo Gargiulo and Ovidiu C. Banea (here) PDF poster


28 August 2020 

Intraoperative Neuromonitoring IONM. Trigemino - facial and trigemino - vagal reflexes during vestibulocochlear Schwannoma tumor monitoring (here)


9 July 2020 SARS-Cov2 infection (COVID-19) with involvement of peripheral nervous system.  Case report: Sensory axonal polyneuropathy and mixed mononeuritis multiplex in Iceland. Ovidiu C. Banea and Eysteinn Ívarsson (here)


25 April 2020 Updates to Brain Ecology, free will and auditory motor task (here)


17 February 2020

IONM proposal protocol for right sensory-motor eloquent area cavernoma (here)


6 February 2020

Practice course of EMG and Nerve Conduction Studies for students from Biomedical Engineering HR at Landspitali (here) Ovidiu C. Banea, Bjarni Guðmundsson, Paolo Gargiulo, Eysteinn Ivarsson, and Aron Jonasson


31 January 2020

AVH-TMS Icelandic Clinical trial, road map, and limitations. Meeting at Reykjavik University and at Fossvogur, Neurology Department of National University Hospital of Iceland. (here) 


13 December 2019

Meeting with Dr Paolo Gargiulo at Reykjavík University. Two teams were formed to a better results presentation and processing for the schizophrenia-related AVH-TMS Icelandic Clinical trial (here)


01 November 2019

Assessment of the lower limb weakness and suspected amyotrophic lateral sclerosis (here)


27 August 2019

Muscle fibers and how to run at #ReykjavikMarathon 2019 without specific physical training (here)


25 June 2019 

Intraoperative Neuromonitoring IONM in Iceland. Right frontal oligodendroglioma. Reintervention (here)


03 June 2019 

European Congress of Clinical Neurophysiology ECCN 2019, 4th to 9th of June 2019, Warsaw, Poland. Eysteinn Ívarsson, Aron Dalin Jónasson, and Ovidiu Constantin Banea will represent the Clinical Neurophysiology Unit of the Neurology Department in the National University Hospital of Iceland and School of Science and Bio-engineering, Reykjavík University Iceland to the 17th meeting of European Chapter. Four original works are presented in posters as follows:


13 May 2019

Intraoperative Neuromonitoring IONM. Lipomyelomeningocele, multi-modal approach with neurosurgery guided by I.O.N.M. (Tarnoveanu et al, 2019) (here). Romanian Initiative Group "MIONSynapse" had the first important meeting at Marie Curie Emergency Children's Hospital Bucharest, on the 3rd of May 2018.


7 May 2019

Orchestral music training might help children with ADHD to control their impulsiveness.

2nd Journal Club meeting of SAMTÖK UM HEILA VISTFRÆÐI at 19.00H. We talked about the Center for Music in the Brain (MIB), in Aarhus, Denmark.

They just published a new paper (HERE) stating that short, systematic music interventions rationalizing financial and teachers’ resources and well-grounded pedagogical principles might represent a potential educational for school-age children with Hyperactivity, and ADHD. Changes in SDAI (teacher-related) or SDAB (children-related) scales of hyperactivity-impulsiveness and inattention (Batteria Italiana per l’ADHD).


8 April 2019 

Brain Ecology Journal Club first edition in Iceland (here).  Adding (Daylight Saving) Time or DST in Iceland and Magneto-reception, the newest sense supposedly discovered in humans were intensely debated during the First Journal Club Meeting organized at Den Danske Kro by  Aron Jónasson, Eysteinn Ívarsson, Viktor D. Jónasson and Ovidiu C. Banea, members of Samtök um Heila Vistfræði. Next meetings will be organized at the facilities of the National University Hospital of Iceland, Landspitali Fossvogur, Rannsóknastofa í Taugalifeðlisfræði, E2 or at Reykjavík University, Institute of Biomedical and Neural Engineering. The next speaker will be Eysteinn on the 7th of May 2019, 19.00H. The voted "wheel" is E.V.O.A. and the voted frequency of the debated journal is 2 weeks.


8 of April 2019

Intraoperative Neuromonitoring IONM. "B" and "C" trains seen during right CPA tumor surgery (here).


14 March 2019

Intraoperative Neuromonitoring IONM. T9-T10 herniation. Use of MEP to rectus abdominal T8, T9, T11, T12 spinal nerves. (here)


12 February 2019

Acute architectural and surface EMG changes in distal biceps brachii muscle with different contraction types: A combined EMG Ultrasound study. Part of Clinical Engineer students’ course, Assoc. Prof. Dr. Paolo Gargiulo. 2019, By Ovidiu C. Banea, Eysteinn Ívarsson, Aron D. Jónasson and Paolo Gargiulo (here)


7 February 2019 

Visual sympathetic skin response (VSSR) and pain SSR were recorded simultaneously in multiple subjects. Recently, in National University Hospital of Iceland and Del Mar Hospital Barcelona, Spain developed a novel technique to measure SSR simultaneously from two subjects.  A study was proposed by OC Banea and CA Delgado Pugley to assess VSSR and pain SSR together with facial EMG at the pre-attentive level.  This study will be submitted for the upcoming ECCN meeting which will be held during 5-8 June 2019 in Warsaw, Poland (PDF proposal).


1 February 2019 

Empathy and male anorgasmia. A case report from Brain Ecology Lab (here).


23 January 2019 

Intraoperative Neuromonitoring IONM. Use of D-wave. Medular Herniation at T5 spinal level (here). 


16-19 January 2019 

Beaune, Burgundy France, ANT Neuro Meeting.  AVH-TMS Icelandic project researchers traveled to Beaune, Burgundy France to present three related works: Jónasson A.D. et al, January 2019 (here), Ívarsson E. et al, January 2019 (here) and Marcu  S. et al, January 2019 (here).


13 December 2018 Thesis proposal defense "Neurophysiological assessment of repetitive transcranial magnetic stimulation as a treatment for schizophrenia patients with auditory verbal hallucinations" Ovidiu C. Banea, Reykjavik University Room V101, (here)


9 August 2018 

VAFO Project Iceland: P300, P50, and QEEG, objective neurophysiological measurements of brain activity were successfully acquired with a dense array 256 channel EEG system at the Icelandic Center for Neurophysiology, Department of Biomedical Engineering, Reykjavík University (here)


1-6 May 2018 

The clinical Neurophysiology Unit of Landspitali participated to the 31st International Congress of Clinical Neurophysiology (ICCN) of the International Federation of Clinical Neurophysiology (IFCN) in Washington, DC, USA with the  work "Intraoperative recording of somatosensory evoked potentials from both peripheral median nerve and proximal upper trunk to assess C5, C6 brachial plexus injury" (here)


16 March 2018

Intraoperative Neuromonitoring IONM. Intramedular tumor C6-T8 (here)


26 February 2018

Intraoperative Neuromonitoring IONM. Right cerebellopontine angle (CPA) mass (here)


18 January 2018

ANT Neuromeeting Beaune, Burgundy France. Study proposal and critical view: BNN assessment with TEPs (here)


20 November 2017

Neurophysiology Plus group is represented at the TMS workshop in Denmark: TMS-EEG modality related to an *Icelandic clinically applied proposed study* for patients with brain tumors and symptomatic epilepsy located in eloquent brain areas is critically analyzed during a TMS workshop in Denmark (here). 


02 November 2017

TMS Neuronavigation in Iceland: The neuronavigated transcranial magnetic stimulation (neuronavigated-TMS) was initiated with a pilot study of a healthy subject on the 1st of November 2017 to find motor "hot-spots" and "speech area" (by inducing the speech arrest) in total relaxation and safety (here). This technique is used extensively for preoperative mapping of eloquent areas before craniotomy. 


29 September 2017

TMS-EEG evoked potentials, a joint meeting of Clinical Neurophysiology expert team with Dr Paolo Gargiulo, Assist Prof in Reykjavik University. We tried to connect the Medtronic multichannel amplifier (IONM Nim-Eclipse) with TMS Dantec to assess the RMT of the right APB to perform TMS-EEG evoked potentials (TEPs). Video-report (on the front page) was recorded by Egill Axfjörður Friðgeirsson, PhD student in Amsterdam, Netherlands working in the field of functional connectivity and deep brain stimulation (DBS). Abstract submitted to ANT Neuromeeting 2018 (clinical research proposal study and critical view)


4 September 2017

Guyon Type II Syndrome (pure motor) was diagnosed today in our laboratory of electromyography in a 72-year-old male with weakness in the right hand and right FDI atrophy for more than 6 months (Case report)


26 July 2017 

Mixed silent period (MSP) and cutaneous silent period (CSP)  in diagnostic of a severe carpal tunnel syndrome  (severe CTS)

The cutaneous silent period can be preserved in entrapment neuropathies (KofIer et al 2003). It is known that the more severe the neuropathy is, the more impairment of A-delta fibers can be found (Duarte et al 2016). In patient with severe CTS the mean onset latency was increased to 85.0 ms (SD 8.7 ms, P < 0.01) Silvpauskaite et al 2005.

CASE REPORT Patient 66 year-old with motor weakness in hands and hypoesthesia

After we diagnosed very severe CTS in the right side and severe CTS in the left we performed A-delta & alpha motorneurons driven CSP from 2 digit and there was no clear inhibition of the voluntary contraction (onset 107ms). Then, we checked again from the palm-thenar region and we observed CSP with onset 100ms, end 155 ms and 55ms duration. Also a clear silent period was obtained after stimulation from the wrist, the mixed median nerve and record from abductor pollicis brevis.

Conclusion: Sensory fibers (small and fast) are the last to be damaged and the injury does not occur at the wrist carpal tunnel as it happened with axonal loss of the large sensory fibers.  At this moment it is not clear if those fibers are only the A-delta or if there might be another sensory input by direct electrical stimulation of another fiber type (proprioceptors? muscle spindles?)


20 July 2017

Repetitive Transcranial Magnetic Stimulation (rTMS); Experimental research for Intractable Catastrophic Tinnitus

In Iceland, our first patient started the 10-session treatment with 1200 daily pulses 100%RMT applied in 60 series of 20 pulses (1Hz frequency) on 17th of July 2017. The location of coil was set to stimulate between T3 and C3/T5 using 10-20 international EEG system (Lee H.Y. et al 2013). 

We use the same protocol used in the Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul (Lee H.Y. et al 2013, Clinical and Experimental Otorhinolaryngology Vol. 6, No. 2: 63-67, June 2013). To assess the progression of a possible rTMS effect on tinnitus perception we used the Tinnitus Handicap Inventory THI questionnaire and Visual Analogue Scale for both tinnitus annoyance and loudness (here).


6 April 2017 

Repetitive Transcranial Magnetic Stimulation (rTMS) in Iceland; Mood Depressive Disorder and Chronic Neuropathic Pain

A few years ago, in 2004 and 2005 in Landspítali Fossvogur Iceland,  Sigurjón Stefánsson and Anna L. Þórisdóttir started to use rTMS for patients with unipolar major depressive episodes in a clinical research program. The aim was to investigate the effectiveness using a placebo-controlled crossover design to evaluate the antidepressant efficacy of 5 days of left prefrontal 10 Hz rTMS.  They controlled the patients with changes in depressive symptoms and with P300 wave (auditory ERP) as a measure of concomitant changes in brain functioning (Möller et al 2006) (here).  The amplitude of the auditory P300 wave is reduced in patients with depression and Sigurjón and Anna used it as an objective measure together with the Hamilton scale. There was a decrease in the Hamilton depression scores after 5 days of active left prefrontal transcranial magnetic therapy. This apparent improvement did, however, not reach a significant level when compared with the results of similar placebo treatments. No correlation was found between changes in P300 amplitude and the Hamilton score, suggesting the rTMS effects on the P300 are unrelated to changes in depressive symptoms. The authors stated that the P300 increased after real rTMS but after sham, there were no significant differences probably because this protocol was used after 4 weeks of the real treatment and the P300 was already modified by the treatment.

rTMS of the DLPFC can be proposed as a relevant technique to treat drug-resistant major depression, except for depression with psychotic features for which the use of ECT is recommended as the first-line adjunctive treatment. The recommendations on the use of rTMS in the treatment of mood disorders, Lefaucher et al 2014 (here) are consistent with those of CANMAT (Canadian Network for Mood and Anxiety Treatments) clinical guidelines, Kennedy et al, 2009 (here).  

Nowadays, according to Anna & Sigurjón ´s original work conclusions (that 5 days are not enough to produce effects in depressive symptoms), the rTMS for MDD patients reached Level 1 evidence as second-line treatment with an increased number of daily sessions up to 10 or 20 with similar HF protocols.

Facial Chronic Neuropathic Pain and rTMS

Today rTMS returned to Iceland as an alternative for patients with central chronic neuropathic pain (here).  A review of implantable pulse generators and motor cortex stimulation for FCNP by Monsalve 2012 can be reached here or another one with guidelines for rTMS by Lefaucher et al 2014 here. Another review we consider useful by Klein et al 2015 can be reached here. We are using the Visual Analogue Scale to assess the rTMS efficacy.


20 January 2017

Bereitschaftspotential used for neurophysiological assessment of apparent spinal spontaneous myoclonus. Patient with abdominal stereotyped jerks (Case Report here).


18 January 2017

Using one cortical 8 contacts strip electrode for IONM corticography, direct cortical MEP, and SSEP in awake surgery.  Cortical excitability was assessed inter-hemispherical with resting motor threshold obtained by using transcranial magnetic stimulation (Case Report here).


9 January 2017

Preoperative motor and speech mapping using TMS. Cortical eloquent areas and their interconnected circuitry in patients with growing brain tumors and surgical removal indications are represented by disturbed biological neural networks. These networks need an integrated assessment due to their potential associated symptomatic epileptic syndromes and modified structure. To avoid new devastating neurological postoperative deficits functional anatomy holistic approach became a very useful instrument. This includes motor, visual, or speech eloquent areas identification and is used to identify and characterize the structures and neurological pathways that would permit an optimal surgical procedure. The first study in Iceland was performed with Physiologist and Psychologist Anna L Þórisdóttir on the 9th and 11th of January 2017 (Case Report here). We were able to determine motor hot spots of bilateral APB and lower limbs.  Speech naming test was performed using HF 15Hz and 2 or 1 second duration trials, assistants: Njáll Ingi Dalberg (MD) and Aron Dalin Jónasson (CN technician, Naturalist). Speech arrest was obtained during the second examination.


21 December 2016

Trancranial Magnetic Stimulation technique could be reintroduced in Neurophysiology Laboratory Landspítali Fossvogur, Iceland.  Neurophysiology Plus group and Staff from the Neurology Department will open two specific practical and learning programs with  Intracortical dynamics studies using single pulse and paired-pulse paradigms but also with Cortical Silent Period.  TMS will be used to assess diagnosis in myelopathic syndromes and pelvic floor dysfunctions (neuropathies, urinary incontinence, constipation, etc.) besides the functional and neurological examination.


14 December 2016 

Cutaneous Silent Period and Isometric Exercise on the first dorsal interosseous (FDI) muscle project was continued today by the Neurophysiology Plus group.  We now performed the tests in 5 Healthy subjects using stimulation from both ulnaris and median nerves to the correspondent abductor pollicis brevis (APB) and FDI muscles, but also in a crossed manner from 3rd digit and recording from ulnaris FDI or 5th digit and recording from APB. Two exercise were performed: isometric and isokinetic FDI for 5 minutes. 

The team of this work includes external medical students to Neurology Department Landspitali Reykjavik  Xiao Chun Ling (Taipei, Taiwan), Joaquín Soto Guerrero (Santiago de Chile, Chile), neuroscience Madrid & Reykjavik Universities MSc student Pablo Botella Lucena (Valencia, Spain), Physiotherapist Anna Maria Urban (Poland) and Clinical Neurophysiologist Ovidiu C. Banea (Sibiu, Romania). In the summer 2016, we started to collect data on a general basis and tried to guide our hypothesis.


9 December 2016 

Narcolepsy, Approximation to diagnostic, Multiple Sleep Latency Test (MSLT) by Ovidiu C. Banea (here)


1 December 2016 

First awake surgery in Iceland, Left frontal lobe space-occupying lesion, 41/35 mm in diameter. (here)