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Cognitive impairment in amyotrophic lateral sclerosis: evidence from neuropsychological investigation and event-related potentials.

The presence of subclinical cognitive impairment in patients with amyotrophic lateral sclerosis (ALS) is investigated using neuropsychological assessment and event-related potential recordings (ERP). An extensive battery of neuropsychological tests assessing the domains of attention, memory, language, visuo-spatial and executive functions were administered to 20 non-demented patients with sporadic ALS and 13 age- and education-matched healthy control subjects. Mismatch negativity (MMN), P3b, P3a (novelty P300) and contingent negative variation (CNV) were recorded. ALS patients were significantly impaired in tests of working memory, sustained attention, response inhibition, naming, verbal fluency and complex visuo-spatial processing. The memory impairment seemed to be secondary to deficits in forming learning strategies and retrieval. In ERP recordings, P3a and P3b amplitudes of ALS patients were lower compared with the controls, P3a latencies were significantly longer and mean CNV amplitudes were higher. These results indicate subclinical impairment of cognitive functions in patients with ALS. The pattern of cognitive impairment suggests the dysfunction of the frontal network.

Adult↗

Age-related changes of evoked potentials.

The aim of this review is to analyse the current state of our knowledge on evoked potentials (EPs) in ageing and to report some conclusions on the relation between EPs and elder age. Evoked potentials provide a measure of the function of sensory systems that change during the different stages of life. Each sensory system has its own time of maturation. The individuation of the exact period of life when brain ageing starts is difficult to define. Normally, the amplitude of EPs decreases, and their latency increases from adult to elder life. Many authors speculate that these modifications might depend on neuronal loss, changes in cell membrane, composition or senile plaques present in older patients, but there is no evidence that these changes might modify the cerebral function in healthy aged individuals. This review emphasises some incongruities present in different studies confirmed by daily neurophysiologic practice. Different techniques as event-related desynchronization (ERD), contingent negative variation (CNV) and Bereitschaftspotential, are available to study central neuronal changes in normal and pathologic ageing.

Aging↗

Event-related potentials, CNV, readiness potential, and movement accompanying potential recorded from posterior thalamus in human subjects. A SEEG study.

Intracranial recordings were obtained from three patients with intractable chronic pain who underwent analgesic electrical stimulation of the contralateral thalamus. Multilead electrode made it possible to record from several thalamic nuclei. The electrode was targeted into the ventroposterolateral (VPL) nucleus of the thalamus. During separate recording sessions, the following tests were performed: somatosensory evoked potentials (SEP) of the median or posterior tibial nerve, event-related cognitive potentials (auditory oddball P3 wave), readiness potential (RP) and contingent negative variation (CNV) using auditory warning (S1) and visual imperative (S2) stimuli. The movement accompanying potential (MAP), which was present in the VPL in all but one of the recordings, behaved as a far-field potential. Recordings obtained from the VPL confirmed its established role as a relay nucleus, processing somatosensory information to the primary somatosensory cortex. The VPL generated the 'thalamic' SEP, which was the only potential regularly recorded in this nucleus. In the recordings from one patient (No. 3), auditory and visual evoked potentials of the CNV protocol, peaking at approximately 300 ms, were obtained from the VPL and appeared to be generated in situ. Neither RP, CNV nor 'oddball' ERPs appeared in the VPL. From the pulvinar, only a visually evoked potential was recorded. Oddball P3, RP, CNV, and middle and long latency auditory and visual potentials (evoked in the CNV paradigm) appeared to be generated 'dorsally' to the VPL, probably in the nucleus posterolateralis (PL). This structure may therefore be involved in both the processing of afferent information and in cognitive operations.

Aged↗

A review of electrophysiology in attention-deficit/hyperactivity disorder: II. Event-related potentials.

OBJECTIVE: This article reviews the event-related potential (ERP) literature in relation to attention-deficit/hyperactivity disorder (AD/HD). METHODS: ERP studies exploring various aspects of brain functioning in AD/HD are reviewed, ranging from early preparatory processes to a focus on the auditory and visual attention systems, and the frontal inhibition system. Implications of these data for future research and development in AD/HD are considered. RESULTS: A complex range of ERP deficits has been associated with the disorder. Differences have been reported in preparatory responses, such as the contingent negative variation. In the auditory modality, AD/HD-related differences are apparent in all components from the auditory brain-stem response to the late slow wave. The most robust of these is the reduced posterior P3 in the auditory oddball task. There are fewer studies of the visual attention system, but similar differences are reported in a range of components. Results suggesting an inhibitory processing deficit have been reported, with recent studies of the frontal inhibitory system indicating problems of inhibitory regulation. CONCLUSIONS: The research to date has identified a substantial number of ERP correlates of AD/HD. Together with the robust AD/HD differences apparent in the EEG literature, these data offer potential to improve our understanding of the specific brain dysfunction(s) which result in the disorder. Increased focus on the temporal locus of the information processing deficit(s) underlying the observed range of ERP differences is recommended. Further work in this field may benefit from a broader conceptual approach, integrating EEG and ERP measures of brain function.

Attention Deficit Disorder with Hyperactivity↗

A SEEG study of ERP in motor and premotor cortices and in the basal ganglia.

OBJECTIVE: Our intention was to study the electrical activity related to the cognitive processing of simple sensory stimuli in the brain structures that participate in motor control. We focused our interest on the 250-600 ms time window, in which cognitive activity most probably provides the basis for the activity recorded. METHODS: Intracerebral stereoelectroencephalography (SEEG) recordings were made from 15 epilepsy surgery candidates. We studied potentials that were recorded in a time window in which P300 usually could be recorded on the scalp and that were directly recorded from brain structures involved in motor control: the primary motor cortex (MC, Brodmann's area 4); the lateral and mesial (SMA) premotor cortices (Brodmann's area 6); and the basal ganglia. We evaluated the first distinctive potential to occur in the 250-600 ms time window that displayed an amplitude gradient in several adjacent contacts. Four protocols were performed: an auditory oddball (aP3); a visual oddball (vP3); and contingent negative variation (CNV) protocols, in which the potentials evoked by the auditory warning (aCNV) and visual imperative (vCNV) stimuli were evaluated. In the protocols aP3, vP3, and vCNV, the tested person responded by flexing his/her thumb or hand. In the aCNV paradigm, and in a further auditory oddball paradigm (aP3c), no motor response was required. We compared the presence of an event-related potential (ERP) with an amplitude gradient to the absence of a generator. RESULTS: The frequency of P3-like potential components was statistically significantly higher in the basal ganglia when compared with the explored cortical sites. Statistically non-significant latency differences between the basal ganglia and the cortex were displayed. The differences in the distribution of the potentials in the individual cortical areas were insignificant. The mean latency of vP3 was longer than the latencies of aP3, aP3c and vCNV. There was no significant difference between the distribution and latency of aP3 and aP3c. CONCLUSIONS: (1) ERPs are generated in cortical as well as in subcortical structures. (2) The cognitive processing of sensory information in all the tested protocols occurred in the basal ganglia; the occurrence in the investigated cortical areas was less frequent and more dependent on the task. The basal ganglia may play an integrative role in cognitive information processing, in motor and non-motor tasks.

Adolescent↗

Anticipation and execution of a simple reading task enhance corticospinal excitability.

OBJECTIVE: Electromyographic responses (EMG) evoked in the right hand by transcranial magnetic stimulation (TMS) of the left motor cortex are enhanced during continuous reading. This enhancement is the result of increased excitability of the motor cortex. We proposed that anticipation and reading of single words would also enhance corticospinal excitability. We studied the temporal course of corticospinal excitability changes following left and right hemisphere TMS. METHODS: Ten normal volunteers were studied. A warning stimulus (S1) was followed by an imperative stimulus (S2) whereupon a word was presented. Subjects responded by reading the word aloud or reading it silently. In other conditions, no word was displayed and the subjects responded to S2 by saying the word 'Cat', pursing their lips, or doing nothing. EMG was recorded over the contralateral hand following a TMS pulse over the motor cortex during and after the S1-S2 period. RESULTS: Enhancement of EMG amplitudes was significantly greater following left hemisphere TMS. The enhancement in the S1-S2 period and that following S2 had a time course similar to several event-related brain potentials. CONCLUSIONS: There may be a common mechanism underlying both corticospinal excitability and the contingent negative variation, readiness potential and N400.

Adult↗

Neurophysiologic correlates of psychiatric disorders and potential applications in epilepsy.

There is increasing interest in psychiatric assessment using neurophysiologic tools such as electroencephalography (EEG), magnetoencephalography (MEG), and transcranial magnetic stimulation (TMS). This is because these technologies have good temporal resolution, are relatively noninvasive, and (with the exception of MEG) are economical. Many different experimental paradigms and analysis techniques for the assessment of psychiatric patients involving these technologies are reviewed including conventional quantitative electroencephalography (QEEG), EEG cordance, low-resolution electromagnetic tomography (LORETA), frontal midline theta, midlatency auditory evoked potentials (P50, N100, P300), loudness dependency of the auditory evoked potential (LDAEP), mismatch negativity (MMN), contingent negative variation (CNV), and transcranial magnetic stimulation (TMS). Many of these neurophysiologic stimulus paradigms hold the promise of improving psychiatric patient care by improving diagnostic precision, predicting treatment response, and providing new phenotypes for genetic studies. Large cooperative multisite studies need to be designed to test and validate a few of these paradigms so that they might find use in routine clinical practice.

Brain↗

Aversive Pavlovian conditioning in psychopaths: peripheral and central correlates.

Differential aversive Pavlovian conditioning with a foul odor as unconditioned stimulus (US) and neutral faces as conditioned stimuli (CS) was compared between 9 noncriminal psychopaths as defined by the Hare Psychopathy Checklist Revised and 12 healthy controls. Event-related potentials (ERP), heart rate, skin conductance response, corrugator EMG, and startle response potentiation as well as valence, arousal, and contingency of the CS were assessed. Whereas the healthy controls (HC) showed significant CS +/CS- differentiation, the psychopaths (PP) failed to exhibit a conditioned response although unconditioned responses were comparable between the groups. N100, P200, and P300 to the CSs revealed that psychopaths were not deficient in information processing and showed even better anticipatory responding than the HC group indicated by the terminal contingent negative variation (tCNV), that lacked, however, CS+ and CS- differentiation. These data indicate a deficit in association formation in psychopaths that may be related to deficient interaction of limbic-subcortical and cortical structures.

Adult↗

On the pathophysiology of migraine--links for "empirically based treatment" with neurofeedback.

Psychophysiological data support the concept that migraine is the result of cortical hypersensitivity, hyperactivity, and a lack of habituation. There is evidence that this is a brain-stem related information processing dysfunction. This cortical activity reflects a periodicity between 2 migraine attacks and it may be due to endogenous or exogenous factors. In the few days preceding the next attack slow cortical potentials are highest and habituation delay experimentally recorded during contingent negative variation is at a maximum. These striking features of slow cortical potentials are predictors of the next attack. The pronounced negativity can be fed back to the patient. The data support the hypothesis that a change in amplitudes of slow cortical potentials is caused by altered habituation during the recording session. This kind of neurofeedback can be characterized as "empirically based" because it improves habituation and it proves to be clinically efficient.

Adolescent↗

Intentional and unintentional contributions to nonspecific preparation: electrophysiological evidence.

The authors hypothesized that there are distinct intentional and unintentional influences on nonspecific preparation for a future event. In 2 experiments, participants responded to an imperative stimulus (S-sub-2) that was presented equiprobably either 400 ms or 1,200 ms after the offset of a warning stimulus (S-sub-1). During the S-sub-1-S-sub-2 interval, the authors measured the contingent negative variation (CNV), an event-related brain potential reflecting nonspecific preparation. S-sub-1 provided either no information or reliable information about the duration of the impending S-sub-1-S-sub-2 interval, thereby allowing an intentional influence on the state of preparation. The effect of S-sub-1 information on the CNV was approximately additive to the effect of the S-sub-1-S-sub-2 interval that was used on the preceding trial. This supports the view that the preceding S-sub-1-S-sub-2 interval contributes unintentionally to the state of nonspecific preparation guided by a process of trace conditioning.

Adult↗

Cortical sensorimotor interactions during the expectancy of a go/no-go task: effects of painful stimuli.

The intent of this electroencephalography study was to investigate the competition between cortical nociceptive and cognitive-motor processes preceding sensorimotor interactions. Sensorimotor expectancy processes to painful stimulation and motor go/no-go demands were indexed over primary sensorimotor and midline cortical areas by contingent negative variation (CNV). Before the sensorimotor interaction, CNV was observed over midline posterior and bilateral central areas. Early expectancy of painful stimulation and the go/no-go task induced an evident midline posterior CNV. During the late expectancy period. CNV extended to the right central area contralateral to the stimulation. These findings suggest a sequential activation of midline posterior and primary sensorimotor areas contralateral to the painful stimulation as a reflection of the enhanced nociceptive processes preceding painful sensorimotor interactions.

Adult↗

No effect of prophylactic treatment with metoprolol on cerebrovascular CO2 reactivity in migraineurs.

The prophylactic effect of metoprolol in the treatment of migraine is well known, but its mode of action is still unclear. In the past, increased CO2 reactivity has been reported as one pathognomic finding in interictal migraineurs. Using transcranial Doppler we assessed CO2 reactivity in 20 migraineurs before and 3 h after the first intake of 50 mg metoprolol, and subsequently twice after 1 and 8 weeks of continuous therapy with 150 mg metoprolol/d. Before initiation of therapy, migraineurs as a group had increased CO2 reactivity (p=0.07) compared to 20 age- and sex-matched volunteers. While treatment with metoprolol has been reported to affect amplitudes of increased contingent negative variation or visual evoked potentials in interictal migraineurs, it had no influence on enhanced CO2 reactivity in the present study. Moreover, the pretreatment value of CO2 reactivity did not correlate with the clinical efficacy of metoprolol after a 2-month treatment period.

Adrenergic beta-Antagonists↗

Effects of an acute dose of palm alcohol on normal brain functioning: an auditory, event-related-potential study.

The effects of an acute and high dose of palm alcohol (900 mg/kg bodyweight) on brain functioning were investigated in 10 healthy, non-alcoholic men. Each was given randomly-interspaced, paired, frequent standard (80%) and rare target auditory stimuli and asked to detect and signal the target tone by pressing a push button. These brain function tests were carried out before (control) and 1 and 4 h after the subjects began drinking the alcohol. During each experimental session, late, event-related-potential (ERP) components were recorded at the central midline scalp location (Cz). At both times after alcoholization, contingent negative variations and late auditory ERP were lower than those recorded during the control session. Maximal amplitude reduction for N1 and P3 waves was seen 240 min after ingesting alcohol. Reaction times were not significantly longer than those recorded pre-alcoholization but performances were lower at both times post-alcoholization. The results are consistent with the ERP changes reported in subjects under acute ethanol intoxication but they are more pronounced and probably reflect a momentary disruption of central processes rather than sensory impairment at the peripheral level.

Adult↗

Performance differences in reaction tasks are reflected in event-related brain potentials (ERPs).

Event-related potentials (ERPs), which can be extracted from the electroencephalogram (EEG), are assumed to reflect distinct cognitive processes in real time. Hence ERP analysis could be used in cognitive ergonomics as a tool to specify, for example, bottlenecks or sources of individual performance differences. Such specific results may be helpful to change the tasks or train the subjects specifically. In the present exploratory study, the authors investigated whether subjects with large spontaneous differences in performance accuracy, as defined by their error rates in a speeded binary choice reaction task, also differ in the structure of their ERPs. The ten subjects were divided post hoc into two groups with relatively low (about 6%) and high (about 20%) error rates. While the reaction times were not significantly different for both groups, the ERPs revealed clear group differences. First, large differences were seen in the late part of the contingent negative variation (late CNV), which is assumed to reflect preparatory processes. Subjects with few errors ('GOOD') had a large late CNV, while subjects with many errors ('POOR') showed virtually no late CNV. Second, the late P300-subcomponent (which is related to response identification) was smaller and delayed for POOR compared to GOOD subjects. Finally, the ERP shows signs of poor movement control in POOR subjects. The high error rate of POOR subjects can hence be explained by: (1) their insufficient preparation for the next trial (small late CNV), which impaired response identification (small and delayed late P300 subcomponent); and (2) their poor movement control. These interpretations have to be regarded as preliminary and should be validated with larger groups of subjects. In conclusion, the main reasons for the profound performance differences between the groups, namely differential preparation and movement control, could be elucidated by ERP analysis. A potential ergonomics application of these results is that they suggest specific strategies (for example, a preparation and motor control training) to improve the performance of POOR subjects in comparable work conditions.

Adult↗

Psychophysiological effect of odor.

Techniques to measure the activity of the taste and odor molecules at the olfactory epithelium, taste bud, and brain response levels are now being used to determine and measure the actual transduction of the chemical information to the brain waves. We studied a number of methods of measuring brain wave responses to odorants and we settled on an electroencephalographic method of measuring the slow brain waves [> 13 Hz] at the frontal location on the scalp. This technique known as contingent negative variation (CNV) measures the early component [at 400 to 1000 ms] of the beta wave variation, which can be negative, positive, or neutral depending on the odorant being presented to the subject. This component is almost independent of the subject's psychological state, degree of arousal, or level of consciousness and is known as the external component. The experimental paradigm creates a reproducible result in which odorants may be classified as stimulating, sedating, or neutral. These psychophysiological effects of odors on man appear to offer a means to determine precognitive responses directly related to the effect of the chemical messenger. There does not appear to be any bias as to sex, national origin, or race. At this point in our research efforts, we do not see evidence that there is a bias related to age. It is proposed that some of the problems of classical sensory evaluation can be helped by the use of psychophysiological recording techniques, such as CNV, as a measurement of brain activity and response to flavor and aroma.

Brain↗

Movement preparation in Parkinson's disease. Time course and distribution of movement-related potentials in a movement precueing task.

Investigations of the effects of advance information on movement preparation in Parkinson's disease using reaction time (RT) measures have yielded contradictory results. In order to obtain direct information regarding the time course of movement preparation, we combined RT measurements in a movement precueing task with multi-channel recordings of movement-related potentials in the present study. Movements of the index and middle fingers of the left and right hand were either precued or not by advance information regarding the side (left or right hand) of the required response. Reaction times were slower for patients than for control subjects. Both groups benefited equally from informative precues, indicating that patients utilized the advance information as effectively as control subjects. Lateralization of the movement-preceding cerebral activity [i.e. the lateralized readiness potential (LRP)] confirmed that patients used the available partial information to prepare their responses and started this process no later than controls. In conjunction with EMG onset times, the LRP onset measures allowed for a fractionation of the RTs, which provided clues to the stages where the slowness of Parkinson's disease patients might arise. No definite abnormalities of temporal parameters were found, but differences in the distribution of the lateralized movement-preceding activity between patients and controls suggested differences in the cortical organization of movement preparation. Differences in amplitude of the contingent negative variation (CNV) and differences in the way in which the CNV was modulated by the information given by the precue pointed in the same direction. A difference in amplitude of the P300 between patients and controls suggested that preprogramming a response required more effort from patients than from control subjects.

Adult↗

Dynamic cortical networks of verbal and spatial working memory: effects of memory load and task practice.

Working memory (WM), the ability to briefly retain and manipulate information in mind, is central to intelligent behavior. Here we take advantage of the high temporal resolution of electrophysiological measures to obtain a millisecond timescale view of the activity induced in distributed cortical networks by tasks that impose significant WM demands. We examined how these networks are affected by the type and amount of information to be remembered, and by the amount of task practice. Evoked potentials (EPs) were obtained from eight subjects performing spatial and verbal versions of a visual n-back WM task (n = 1, 2, 3) on each of three testing days. In well-trained subjects, WM tasks elicited transient responses reflecting different subcomponents of task processing, including transient (lasting 0.02-0.3 s) task-sensitive and load-sensitive EPs, as well as sustained responses (lasting 1-1.5 s), including the prestimulus Contingent Negative Variation (CNV), and post-stimulus frontal and parietal Slow Waves. The transient responses, with the exception of the P300, differed between the verbal and spatial task versions, and between trials with different response requirements. The P300 and the Slow Waves were not affected by task version but were affected by increased WM load. These results suggest that WM emerges from the formation of a dynamic cortical network linking task-specific processes with non-specific, capacity-limited, higher-order attentional processes. Practice effects on the EPs suggested that practice led to the development of a more effective cognitive strategy for dealing with lower-order aspects of task processing, but did not diminish demands made on higher order processes. Thus a simple WM task is shown to be composed of numerous elementary subsecond neural processes whose characteristics vary with type and amount of information being remembered, and amount of practice.

Adult↗

A review of psychophysiology in early onset psychosis.

Research on psychophysiological functioning in early onset psychosis is reviewed within the context of etiological formulations stressing perceptual and selective attention abnormalities. Electroencephalographic (EEG) measures, including resting EEG level, alpha blocking, average evoked response, and contingent negative variation, have received most attention in the literature; cardiovascular and electrodermal indices have not been so extensively explored in this group of children. While the nature of differential reactivity in early onset psychosis has not been thoroughly investigated, limited evidence suggests that the central behavioral anomalies associated with the condition may result from abnormal neurophysiological reactivity to sensory stimulation. Further studies of the psychophysiological functioning of these children should yield data useful in the clarification of etiology.

Adolescent↗