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Although real-time event detection during video EEG recording is required to ensure patients' safety, it is limited by the technologists' availability. We sought to explore the efficiency of real-time event detection by the EEG technologists in a single tertiary academic center. We retrospectively reviewed events from continuous inpatient video EEGs (cEEGs) and epilepsy monitoring unit (EMU) recordings in January 2017, when real-time surveillance was only available during the night shift, and June 2017, when a dedicated neurodiagnostic EEG technologist was available for real-time monitoring during all shifts. The events were categorized into those detected immediately (eyes-on), later in the same shift (delayed) or identified on the subsequent shift (missed). Chi-square and Fisher's exact tests were used for statistical comparisons. In January 2017, there were 25 patients (117 days of monitoring) in the EMU and 54 inpatients (146 days of monitoring) on cEEG with 92 total events, (39% seizures). In June 2017, there were 30 patients (133 days of monitoring) in the EMU and 47 additional inpatients (80 days of monitoring) on cEEG with 110 total events, (39% seizures). The number of events identified in real time was low and did not significantly differ among shifts regardless of the availability of the monitoring technologist. Most events were identified at the time of subsequent EEG scanning by the EEG technologist. Partial staffing for continuous video EEG surveillance is insufficient to identify events in real time. EEG technologists are able to identify events during regular EEG scanning. [ABSTRACT FROM AUTHOR]

Entrapment neuropathy of the ulnar nerve at the elbow, the so-called cubital tunnel syndrome, is the second most frequent focal mononeuropathy after carpal tunnel syndrome in adults. Currently, there is a pressing need to identify cost-effective biomarkers and procedures capable of accurately detecting alterations in ulnar nerve structural and functional integrity. Established electrophysiological techniques, such as motor and sensory nerve conduction studies, along with needle electromyography of specific muscles, represent the gold standard for ulnar nerve electrodiagnosis. Concurrently, the introduction of neuromuscular ultrasound and its integration into electromyographic laboratories has significantly impacted structural diagnosis and the precise localization of ulnar nerve pathology over the past two decades. In this review, our objective is to summarize the current knowledge on both classical and advanced diagnostic methods utilized in clinical neurophysiology laboratories. We aim to provide a synthesis of modern electrodiagnostic and neurosonographic techniques, with a particular emphasis on easily attainable, clinically relevant parameters. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether a novel electropalatography (EPG) therapy, underpinned by usage-based phonology theory, can improve the accuracy of target speech sounds for school-aged children and adults with persistent speech sound disorder (SSD) secondary to cleft palate +/− lip. Method: Six consecutively treated participants (7–27 years) with long-standing speech disorders associated with cleft palate enrolled in a multiple baseline (ABA) within-participant case series. The usage-based EPG therapy technique involved high-volume production of words. Speech was assessed on three baselines prior to therapy, during weekly therapy, at completion of therapy, and 3 months post-therapy. Percent correct of target phonemes in untreated words and continuously connected speech were assessed through acoustic phonetic transcription. Intra- and inter-transcriber agreement was determined. Result: Large to medium treatment effect sizes were shown for all participants following therapy (15–33 sessions). Percentage of targets correct for untreated words improved from near 0% pre-therapy, to near 100% for most target sounds post-therapy. Generalisation of target sounds to spontaneous connected speech occurred for all participants and ranged from 78.95−100% (M = 90.66; SD = 10.14) 3 months post-therapy. Conclusion: Clinically significant speech change occurred for all participants following therapy. Response to the novel therapeutic technique is encouraging and further research is indicated. [ABSTRACT FROM AUTHOR]

A list is presented of newly credentialed technologists, with registration and certification in several fields including electroencephalography, evoked potential technology and neurophysiologic intraoperative monitoring.

The NeuroAnalyst role is relatively new with the NA-CLTM credential first becoming available in 2021. Many institutions express interest in utilizing this new role in neurodiagnostic departments, but there is a relative dearth of information about the benefits and challenges of developing a NeuroAnalyst role to support clinical neurophysiologists. The aim of this article is to share the positive experience of one institution in developing a team of NeuroAnalysts. The addition of the role can decrease EEG report turnaround time and balance the workload of clinical neurophysiologists, which improves patient care and allows physicians to increase productivity in other ways [ABSTRACT FROM AUTHOR]

The purpose of this strategic staffing study was to retrospectively evaluate the impact of the charge neurodiagnostic technologist (NDT) within a 24/7 pediatric NAEC Level IV, ABRET LAB-LTM accredited epilepsy monitoring unit (EMU) during a 4-month pilot. The association between a high-reliability organization (HRO), Lean thinking, and organizational strategic goals were utilized as guiding principles. This paper reviews the operational need to further develop frontline neurodiagnostic leadership roles within Ann & Robert H. Lurie Children's Hospital of Chicago along with the design and implementation, training, and competencies required. [ABSTRACT FROM AUTHOR]

The article introduces the committees, task forces and councils of the American Society of Electroneurodiagnostic Technologists (ASET). These include the Awards Committee, Benchmarking Task Force, Board of Trustees, Committee for Education in Neurodiagnostic Technology, Chapter Presidents Council, Continuing Education Committee, Editorial Board, Fellows Committee, Governmental Advocacy Committee, Historical Advocacy Committee, Innovation Task Force, and International Committee.

The article presents organizations that administer and award credentials to technologists in the field of neurodiagnostics. These include ABRET Neurodiagnostic Credentialing and Accreditation, American Association for Electrodoagnostic Technologists, and the Board Registered Polysomnographic Technologists. A list of credentialed technologists is also presented.

Electrophysiology plays a crucial role in Guillain-Barré syndrome (GBS) diagnosis and subtype classification. The aim of our study was to assess the potential role of distal compound muscle action potential (dCMAP) for early differentiation between acute inflammatory demyelinating polyneuropathy (AIDP) and axonal GBS. We retrospectively reviewed the medical records of 24 subjects with AIDP and 18 subjects with axonal GBS. We built up receiver operating characteristic curves for total dCMAP duration and negative phase of dCMAP duration, in order to derive cut-off values able to differentiate between AIDP and axonal GBS. The total duration of dCMAP was significantly prolonged in AIDP compared to axonal GBS. AUCs, odds ratio and positive predictive values were higher for total duration than for negative peak duration. Nerve conduction parameters in the lower limbs were more sensitive than those in the upper limbs in distinguishing AIDP from axonal GBS. Total duration of dCMAP dispersion may capture an adjunctive component of distal demyelination, not measured by the more traditional parameters and may thus represent a useful tool for early differentiation between AIDP and axonal GBS. [ABSTRACT FROM AUTHOR]

Advocacy should be thought of as a permanent part of recognition efforts during Neurodiagnostic Week (April 16–22, 2023) for Neurodiagnostic professionals. It is the perfect opportunity to engage in advocacy and educate others on the importance of using well qualified Neurodiagnostic Technologists to perform neurodiagnostic procedures. Why is advocacy important? Because there is strength in numbers and constituent voices matter. If Neurodiagnostic Technologists do not advocate for the profession and educate decision makers, legislators, and the public about the importance of professional competency in Neurodiagnostics, no one else will. Advocacy works and is a critical part of moving the profession forward to ensure that lawmakers and policy understand that those performing the procedures should be the best qualified professionals to do so. [ABSTRACT FROM AUTHOR]

The Guidelines for Qualifications of Neurodiagnostic Personnel (QNP) document has been created through the collaboration of the American Clinical Neurophysiology Society (ACNS), the American Society of Neurophysiological Monitoring (ASNM), the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), and ASET – The Neurodiagnostic Society (ASET). The quality of patient care is optimized when neurophysiological procedures are performed and interpreted by appropriately trained and qualified practitioners at every level. These Societies recognize that Neurodiagnostics is a large field with practitioners who have entered the field through a variety of training paths. This document suggests job titles, associated job responsibilities, and the recommended levels of education, certification, experience, and ongoing education appropriate for each job. This is important because of the growth and development of standardized training programs, board certifications, and continuing education in recent years. This document matches training, education, and credentials to the various tasks required for performing and interpreting Neurodiagnostic procedures. This document does not intend to restrict the practice of those already working in Neurodiagnostics. It represents recommendations of these Societies with the understanding that federal, state, and local regulations, as well as individual hospital bylaws, supersede these recommendations. As Neurodiagnostics is a growing and dynamic field, we fully intend this document to change over time. [ABSTRACT FROM AUTHOR]

The article lists the neurodiangostic credentialing organizations in 2022 which includes ABRET Neurodiagnostic Credentialing and Accreditation Credentials, and the American Association of Electrodiagnostic Technologists (AEET) Credentials, and newly credentialed technologists including Justin Davis and Andrew Namkoong.

Demonstration of the possibility to obtain the sensory nerve action potential (SNAP) of sural nerve in patients over 60 years old, without peripheral neuropathy. Prospective study on 101 patients older than 60 years of age. Stimulation was applied 12 cm proximal to the recording point. Two hundred and two SNAPs of the sural nerve were collected with an average peak latency of 3.2 ms, onset latency of 2.6 ms, peak-to-peak amplitude of 15.2 μV and velocity of 45.7 m/s. It was possible to obtain the sural nerve SNAP in all tested patients older than 60, without peripheral neuropathy. The values obtained in this study prove to be useful as a reference in the evaluation of patients older than 60 years of age. [ABSTRACT FROM AUTHOR]

The process of determining the prognosis and subsequent facial nerve decompression has become an important factor in determining the patient's quality of life. In this study, the prognosis of facial paralysis was verified in detail based on the timing of electroneurography (ENOG) and nerve conduction study (NCS). The ENOG and NCS of 368 facial palsy patients were analyzed. House–Brackmann (HB) scale after 6 months was used as an outcome. For the ENOG, nasalis muscle/levator labii superioris alaeque nasi (NL), and orbicularis oculi (OO) muscle were used and NCS performed using temporal, zygomatic, and buccal branches. ENOG at the OO performed 4–6 d after onset was ≤10% (p =.002, 10.0-fold) and showed unfavorable results (when the standard was ≥30%). In addition, the ENOG at the NL performed 13–15 d after onset was ≤10% (p =.001, 10.5-fold) and showed unfavorable results (when the standard was ≥30%). The results indicated that ENOG at the OO performed 4–6 d after onset and ENOG at the NL performed 13–15 d after onset had more prognostic value for the outcomes of acute peripheral facial palsy. [ABSTRACT FROM AUTHOR]

The article lists the credentialing organizations for neurodiagnostic technologists, including the American Association of Electrodiagnostic Technologists (AAET), the American Board of Electrodiagnostic Medicine (ABEM), and the Board of Registered Polysomnographic Technologists (BRPT).

The article lists several credentialing organizations and newly certified technologists as of September 2021, including the American Association of Electrodiagnostic Technologists (AAET) and American Board of Electrodiagnostic Medicine (ABEM).

Statistical reports all around the world have deemed cardiovascular diseases (CVDs) as the largest contributor to the death count. The electrocardiogram (ECG) is a widely accepted technology employed for investigation of CVDs of the person. The proposed solution deals with an efficient internet of things (IoT) enabled real-time ECG monitoring system using cloud computing technologies. The article presents a cloud-centric solution to provide remote monitoring of CVD. Sensed ECG data are transmitted to S3 bucket provided by Amazon web service (AWS) through a mobile gateway. AWS cloud uses HTTP and MQTT servers to provide data visualisation, quick response and long-live connection to device and user. Bluetooth low energy (BLE 4.0) is used as a communication protocol for low-power data transmission between device and mobile gateway. The proposed system is implemented with filtering algorithms to ignore distractions, environmental noise and motion artefacts. It offers an analysis of ECG signals to detect various parameters such as heartbeat, PQRST wave and QRS complex intervals along with respiration rate. The proposed system prototype has been tested and validated for reliable ECG monitoring remotely in real-time. [ABSTRACT FROM AUTHOR]

The interpretation of electrocardiograms (ECGs) is key for the diagnosis and monitoring of cardiovascular health. Despite the progressive digital transformation in healthcare, it is still common for clinicians to analyse ECG printed on paper. Although some systems provide signal processing-based ECG classification, clinicians often find it unreliable. Artificial Intelligence (AI) techniques are becoming state-of-the-art for ECG processing but the lack of digitised ECG has hampered the clinical translation of these techniques. Concurrently, we are living a rise in augmented reality (AR) technologies, with an increasing availability of devices. In this work, we present an automatic digitisation and assisted interpretation of ECG based on an AI-enabled Augmented Reality headset. The AR headset is used to acquire an image of the printed ECG, from which the digitised ECG signal is extracted. Afterwards, the digitised ECG is introduced into a Deep Learning (DL) algorithm pre-trained on a public database of 12-lead ECG recordings. The output of the DL algorithm classifies the ECG signal onto different cardiomyopathy categories, which is then visualized back in the AR headset. Preliminary classification results on simulated ECG images (96.5% of accuracy) confirm the potential of the developed approach to contribute on the digital transformation of ECG processing. [ABSTRACT FROM AUTHOR]

The article lists credentialing organizations on neurodiagnostics as of June 2021, including the Board of Registered Posysomnographic Technologists (BRPT), the American Board of Electrodiagnostic Medicine (ABEMI), and the newly credentialed technologists.

In healthcare, it is not uncommon for neurodiagnostic technologists to provide care and testing for patients who are in restraints or in need of restraints. When properly used, restraints ensure patient safety and the safety of others while allowing the continuation of life saving tests and treatments. Oversight for restraint use is provided by outside agencies such as the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC). Improper use of restraints can lead to serious sanctions by both organizations and can negatively impact patients, leaving them with emotional and psychological trauma. The process of restraint management such as ordering, implementing, or monitoring restrained patients is not within the scope of practice for neurodiagnostic technologists. Restraints should only be utilized as a last resort for the safety of the patient to receive proper care. This paper seeks to inform Technologists on what does and does not constitute a restraint, and the factors that should be considered before making the decision to request use of restraints in order to perform neurodiagnostic testing. [ABSTRACT FROM AUTHOR]

The article lists several credentialing organizations as of March 2021, including the Board of Registered Polysomnographic Technologists (BRPT), the American Board of Electrodiagnostic Medicine (ABEM), and ABRET Neurodiagnost Credentialing and Accreditation.

The human-machine interface (HMI) and bio-signals have been used to control rehabilitation equipment and improve the lives of people with severe disabilities. This research depicts a review of electromyogram (EMG) or electrooculogram (EOG) signal-based control system for driving the wheelchair for disabled. For a paralysed person, EOG is one of the most useful signals that help to successfully communicate with the environment by using eye movements. In the case of amputation, the selection of muscles according to the distribution of power and frequency highly contributes to the specific motion of a wheelchair. Taking into account the day-to-day activities of persons with disabilities, both technologies are being used to design EMG or EOG based wheelchairs. This review paper examines a total of 70 EMG studies and 25 EOG studies published from 2000 to 2019. In addition, this paper covers current technologies used in wheelchair systems for signal capture, filtering, characterisation, and classification, including control commands such as left and right turns, forward and reverse motion, acceleration, deceleration, and wheelchair stop. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to verify the intra- and inter-rater reliability and agreement of the stimulus electrodiagnostic test (SET) measurements obtained by pen and square electrodes in the vastus lateralis and tibialis anterior muscles. Design: An intra- and inter-rater reliability and agreement study was performed for the SET by two independent raters. Two different sizes of cathode electrodes (1 cm2 and 25 cm2) and two muscles were assessed (tibialis anterior and vastus lateralis). Results: Chronaxie did not change according to the different electrodes. A high intra-rater reliability (0.72 ≤ r ≤ 0.88) was detected independently of the electrode and muscle assessed. Moreover, moderate and almost perfect agreements (0.51 ≤ Kappa ≤ 1.00) were detected on intra-rater assessment. Similar correlations (0.74 ≤ r ≤ 0.79) were found for intra-rater reliability. However, dissimilar inter-rater agreement was detected: Kappa ≤ 0.40 for tibialis anterior and Kappa = 1.00 for vastus lateralis. Conclusion: The SET presented high reliability and moderate agreement in intra-rater evaluations. A fair agreement was found in the inter-rater assessment of the tibialis anterior. Evaluations performed with different electrode sizes did not influence the results. Therefore, the SET should be performed by a unique rater in test retest situations. [ABSTRACT FROM AUTHOR]

Since 1995, ASET has periodically published updates to recommendations for best practices in infection prevention for Neurodiagnostic technologists. The latest installment was accepted in December 2019 for publication in Volume 60, Issue 1, before we had much knowledge or understanding about the SARS-CoV-2, the virus that causes COVID-19. This Technical Tips article is presented as an addendum to the 2020 update and includes important information about infection prevention measures specific to procedure protocols when working with patients positive or under investigation for a highly infectious disease, and when working with patients in general during the current pandemic. All Neurodiagnostic technologists who have direct patient care are responsible for ensuring the use of best practices to prevent the spread of infection. [ABSTRACT FROM AUTHOR]

The relationship between Parkinson Disease (PD) and peripheral neuropathy (PN) has gained attention in recent years. There is increasing evidence of a-synuclein deposition and pointing to a form of small fiber neuropathy intrinsic to PD, medium-large fiber PN is also a relatively frequent and potentially severe complication in advanced levodopa-treated PD, but degenerative factors and vitamin deficiency were related. Objective: To determine the neurophysiological characteristics of patients with PD and the clinical manifestations of suspected PN. Methods: We performed a cross-sectional study between January 2014 and December 2017, of 36 patients diagnosed with PD who were referred for electrodiagnostic studies (EDX) with suspected clinical PN. We performed electromyography of five muscle or more (brachial biceps, first dorsal interosseous, thumb abductor, anterior tibial, medial gastrocnemius and short finger extensor), and nerve conduction/velocity studies on fibular and tibial nerves (motor) sural and superficial fibular nerves (sensory) and median and ulnar, (both motor and sensory). Results: Twenty-one females (58.3%) with an average age of 69.6 years and fifteen males (41.7%) with an average age of 68.0 years who were submitted for EDX were included in this study. All had a tremor and the average evolution of PD was 5 years. Thirty-two patients were receiving oral levodopa treatment. EDX of twenty-two patients demonstrated neuropathy abnormalities, and in 90.9% of these patients, sensory neuropathy was confirmed. The most common nerve found to be compromised was the superficial fibular nerve (55.0%), followed by the sural (50.0%). Conclusions: Sensory neuropathy was the main finding. Diagnosing PN based on symptom prevalence assessed by checklists and questionnaire has a risk of overestimating the prevalence of PN. The age and the time of disease evolution were factors related to neuropathy. In our study we found that 39% of the patients did not have neuropathic alterations despite clinical suspicion, which opens up new questions about the mechanisms of PD neuropathy and the possibility of fine fiber neuropathy in these patients, motivating further research. [ABSTRACT FROM AUTHOR]

Lists of neurodiagnostic credentialing and accreditation organizations in the U.S. and registered electroencephalographic technologists as of February 29, 2020 are presented.

The coronavirus disease 2019, SARS-COV-2 (the cause of COVID-19), has led to a worldwide shortage of personal protective equipment (PPE) and an increased stress on hospital resources, which has resulted in a spike in the anxiety of the frontline healthcare workers. News reports and information about the virus are rapidly changing. We present a case of a patient with COVID-19 who had a seizure-like spell for which an EEG was performed. In early to mid-March, there were no clear guidelines or recommendations available from neurodiagnostic-related organizations or hospitals on how to adapt procedure workflow to those with COVID-19. When caring for COVID-19 patients, as when caring for any patient with an infectious disease, it is hospital protocol to follow contact, droplet/airborne precautions by wearing appropriate PPE. However, because we knew very little about the coronavirus, this case was different. In this article, we discuss our experience with our EEG workflow and concerns for staff exposure. We then discuss our adaptations and modifications to our standard procedures and protocols. A time analysis comparing our standard EEG protocol with our modified COVID-19 protocol revealed a significant decrease in technologist exposure time (99 minutes versus 51 minutes), which theoretically would reduce the chance of virus transmission to our technologist. At this critical moment in time, we hope such modifications will allow us to continue delivering high quality patient care while optimizing resource utilization and above all keeping our technologists safe. [ABSTRACT FROM AUTHOR]

Since 1995, ASET has published recommendations for infection prevention. With the aim of keeping our readers current with updates in infection prevention initiatives, this article reviews ASET's past publications by Altman 1995, Altman 2000, Scott 2013, and Sullivan & Altman 2008, and incorporates new information from published scientific literature, online resources, print publications, national and international guidelines, OSHA and other regulatory agencies. Knowledge of current infection control practices and recommendations is essential for every Neurodiagnostic technologist, whether working in a hospital, an ambulatory setting, intensive care unit or in the operating room. All technologists who have direct patient contact are responsible for ensuring use of best practices to prevent the spread of infection. [ABSTRACT FROM AUTHOR]

The article announces the recipients of the 2023 Maureen Berkeley Award, including Sumika Ouchida, Armin Nikpour and Greg Fairbrother, and the Theda Sannit Outstanding Educator Award presented to Dorothy Gaiter.

A list of the newly registered electroencephalographic technologists credentialed by neurodiagnostic credentialing and accreditation organizations in the U.S. as of September 15, 2019, is presented, including Beatrice Furaha, Chadwick Bever and James Rajecki.

Background: Although steroids are effective for multiple types of acute facial palsies, an appropriate dosage remains to be established. Aims/Objectives: The objective of this study is to compare the efficacy of high, low, and moderate doses of steroids in patients with acute facial palsy. Materials and methods: We retrospectively reviewed the medical records of 49 patients with Bell palsy, Ramsay Hunt syndrome, or traumatic facial palsy. The patients were divided into 3 groups. We determined the initial House-Brackmann (HB) grade of each patient and the HB grade at the 3-month follow-up to determine whether complete recovery was achieved. Results: Results of electroneurography showed that the average and maximum rates of degeneration were not statistically different among the groups. Although the HB grade showed improvement after 3 months, the initial score was not significantly different from that at the follow-up. The degree of recovery was not significantly different among the groups. Conclusion and significance: Our findings showed that a high dose of steroids did not achieve outcomes that were more clinically meaningful than did that of a moderate or a low-dose steroid. Therefore, moderate or low doses of steroids may be sufficient for the treatment of acute facial palsy. [ABSTRACT FROM AUTHOR]

Background and Purpose: The Neuromuscular ultrasound and Nerve conduction studies/Electromyography (NCS/EMG) are valuable diagnostic tools that examine and diagnose several nerve problems. The purpose of this case report is to describe a diagnostic electrophysiologic evaluation that differentiates between carpal tunnel syndrome (CTS) and radiculopathy in very mild or early stage cases. Case Description: The patient was a 30-year-old woman who sustained a tingling sensation in the second and third digits of her left hand, radiating pain in her left upper extremity and occasional neck pain. The patient cannot determine whether her radiating pain starts from the neck to her hand or starts from her hand up to the neck. Physical examination was not conclusive. Neuromuscular ultrasound and NCS/EMG were used to assess the median nerve at the carpal tunnel and the C6-7 nerve roots. A proof of the median nerve injury at the wrist was confirmed. The patient was treated with a night wrist splint. Outcomes: The patient's symptoms were diminished after the use of the night splint for a period of approximately 4 weeks. A follow-up electrodiagnostic evaluation reveals improvement compared to the previous data with no electrophysiologic evidence of a current nerve injury status. Discussion: Neuromuscular ultrasound and NCS/EMG combined techniques helped in the differential diagnosis between CTS and C6-7 nerve roots radiculopathy. In this case, physical examination could not give an immediate conclusive answer. [ABSTRACT FROM AUTHOR]

Gait analysis is a significant diagnostic procedure for the clinicians who manage musculoskeletal disorders. Surface electromyography (sEMG) combined with kinematic and kinetic data is a useful tool for decision making of the appropriate method needed to treat such patients. sEMG has been used for decades to evaluate neuromuscular responses during a range of activities and develop rehabilitation protocols. The sEMG methodology followed by researchers assessed the issues of noise control, wave frequency, cross talk, low signal reception, muscle co-contraction, electrode placement protocol and procedure as well as EMG signal timing, intensity and normalisation so as to collect accurate, adequate and meaningful data. Further research should be done to provide more information related to the muscle activity recorded by sEMG and the force produced by the corresponding muscle during gait analysis. [ABSTRACT FROM AUTHOR]

This paper reports the use of two techniques which were used to evaluate the important design parameters in a cranking type task. Namely, electromyography served as an indicator of physiological costs for the task, and biomechanical analysis provided quantitative data concerning the mechanical costs for the task. Both these measures were shown to support the importance of handle radius, torque, and working height as critical criteria in design of a cranking task. [ABSTRACT FROM AUTHOR]

The editor expresses gratitude for being granted the privilege of managing the journal. The editor commends the journal's editors for the efforts and contributions to the publication and recognizes the role of authors in improving neurodiagnostic practices and patient care through their articles. The editor encourages technologists to author articles and engage in original research to inform and guide decisions of legislators and hospital administrators.