Enhanced gamma-band activity in ADHD patients lacks correlation with memory performance found in healthy children

Electroencephalogram (EEG) Based Prediction of Attention Deficit Hyperactivity Disorder (ADHD) Using Machine Learning

Objective

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition with challenges in timely and accurate diagnosis. This study evaluates the effectiveness of combining electroencephalogram (EEG) data with machine learning techniques to enhance ADHD diagnostic accuracy.

Methods

A total of 168 participants, comprising 107 ADHD and 61 neurotypical (NT) individuals, were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version Korean Version (K-SADS-PL-K). EEG data from 19 channels were analyzed across five frequency bands: delta (1-4 hz), theta (4-8 hz), alpha (8-12 hz), beta (12-30 hz), and gamma (30-51 hz). The Extreme Gradient Boosting (XGBoost) classifier was employed for classification, and Leave-One-Subject-Out (LOSO) cross-validation was used to ensure model robustness.

Results

Data augmentation through 30-second segmentations generated 2434 EEG segments for ADHD and 1060 for NT. The XGBoost model achieved a test accuracy of 90.81% and an F1-score of 0.9347. Feature importance analysis using SHAP (SHapley Additive exPlanations) values identified middle beta frequency features, particularly from the O1 electrode site, as significant contributors to classification.

Conclusion

EEG-based machine learning models, such as the XGBoost classifier, show potential as non-invasive tools for ADHD diagnosis, offering high accuracy and interpretability. The novelty of this approach lies in combining SHAP analysis with data augmentation techniques and LOSO cross-validation, ensuring both explainability and robust generalizability. Future research with larger datasets and diverse populations is recommended to validate findings and explore clinical applications.

The utility of wearable electroencephalography combined with behavioral measures to establish a practical multi-domain model for facilitating the diagnosis of young children with attention-deficit/hyperactivity disorder

BACKGROUND

A multi-method, multi-informant approach is crucial for evaluating attention-deficit/hyperactivity disorders (ADHD) in preschool children due to the diagnostic complexities and challenges at this developmental stage. However, most artificial intelligence (AI) studies on the automated detection of ADHD have relied on using a single datatype. This study aims to develop a reliable multimodal AI-detection system to facilitate the diagnosis of ADHD in young children.

METHODS

78 young children were recruited, including 43 diagnosed with ADHD (mean age: 68.07 ± 6.19 months) and 35 with typical development (mean age: 67.40 ± 5.44 months). Machine learning and deep learning methods were adopted to develop three individual predictive models using electroencephalography (EEG) data recorded with a wearable wireless device, scores from the computerized attention assessment via Conners' Kiddie Continuous Performance Test Second Edition (K-CPT-2), and ratings from ADHD-related symptom scales. Finally, these models were combined to form a single ensemble model.

RESULTS

The ensemble model achieved an accuracy of 0.974. While individual modality provided the optimal classification with an accuracy rate of 0.909, 0.922, and 0.950 using the ADHD-related symptom rating scale, the K-CPT-2 score, and the EEG measure, respectively. Moreover, the findings suggest that teacher ratings, K-CPT-2 reaction time, and occipital high-frequency EEG band power values are significant features in identifying young children with ADHD.

CONCLUSIONS

This study addresses three common issues in ADHD-related AI research: the utility of wearable technologies, integrating databases from diverse ADHD diagnostic instruments, and appropriately interpreting the models. This established multimodal system is potentially reliable and practical for distinguishing ADHD from TD, thus further facilitating the clinical diagnosis of ADHD in preschool young children.

Inter-subject gamma oscillation synchronization as a biomarker of abnormal processing of social interaction in ADHD

Children with attention-deficit hyperactivity disorder (ADHD) have difficulties in social interactions. Studying brain activity during social interactions is difficult with conventional artificial stimuli. This pioneering study examined the neural correlates of social perception in children with ADHD and matched controls using naturalistic stimuli. We presented 20 children with ADHD and 20 age-and-sex-matched controls with tailored movies featuring high- or low-level social interactions while recording electroencephalographic signals. Both groups exhibited synchronized gamma-band oscillations, but controls demonstrated greater inter-subject correlations. Additionally, the difference in inter-subject correlations between high- and low-interaction movies was significantly larger in controls compared to ADHD patients. Between 55 and 75 Hz comparing viewing high interaction movies with low interaction moves, controls had a significantly larger weighting in the right parietal lobe, while ADHD patients had a significantly smaller weighting in the left occipital lobe. These findings reveal distinct spatiotemporal neural signatures in social interaction processing among children with ADHD and controls using naturalistic stimuli. These neural markers offer potential for group differentiation and assessing intervention efficacy, advancing our understanding ADHD-related social interaction mechanisms.

Object Recognition Memory Deficits in ADHD: A Meta-analysis

Object recognition memory allows us to identify previously seen objects. This type of declarative memory is a primary process for learning. Despite its crucial role in everyday life, object recognition has received far less attention in ADHD research compared to verbal recognition memory. In addition to the existence of a small number of published studies, the results have been inconsistent, possibly due to the diversity of tasks used to assess recognition memory. In the present meta-analysis, we have collected studies from Web of Science, Scopus, PubMed, and Google Scholar databases up to May 2023. We have compiled studies that assessed visual object recognition memory with specific visual recognition tests (sample-match delayed tasks) in children and adolescents diagnosed with ADHD. A total of 28 studies with 1619 participants diagnosed with ADHD were included. The studies were assessed for risk of bias using the Quadas-2 tool and for each study, Cohen's d was calculated to estimate the magnitude of the difference in performance between groups. As a main result, we have found a worse recognition memory performance in ADHD participants when compared to their matched controls (overall Cohen's d ~ 0.492). We also observed greater heterogeneity in the magnitude of this deficit among medicated participants compared to non-medicated individuals, as well as a smaller deficit in studies with a higher proportion of female participants. The magnitude of the object recognition memory impairment in ADHD also seems to depend on the assessment method used.

Decoding frontotemporal and cell-type-specific vulnerabilities to neuropsychiatric disorders and psychoactive drugs

Frontotemporal lobe abnormalities are linked to neuropsychiatric disorders and cognition, but the role of cellular heterogeneity between temporal lobe (TL) and frontal lobe (FL) in the vulnerability to genetic risk factors remains to be elucidated. We integrated single-nucleus transcriptome analysis in 'fresh' human FL and TL with genetic susceptibility, gene dysregulation in neuropsychiatric disease and psychoactive drug response data. We show how intrinsic differences between TL and FL contribute to the vulnerability of specific cell types to both genetic risk factors and psychoactive drugs. Neuronal populations, specifically PVALB neurons, were most highly vulnerable to genetic risk factors for psychiatric disease. These psychiatric disease-associated genes were mostly upregulated in the TL, and dysregulated in the brain of patients with obsessive-compulsive disorder, bipolar disorder and schizophrenia. Among these genes, GRIN2A and SLC12A5, implicated in schizophrenia and bipolar disorder, were significantly upregulated in TL PVALB neurons and in psychiatric disease patients' brain. PVALB neurons from the TL were twofold more vulnerable to psychoactive drugs than to genetic risk factors, showing the influence and specificity of frontotemporal lobe differences on cell vulnerabilities. These studies provide a cell type resolved map of the impact of brain regional differences on cell type vulnerabilities in neuropsychiatric disorders.

Novel pharmacological targets for GABAergic dysfunction in ADHD

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopment disorder that affects approximately 5% of the population. The disorder is characterized by impulsivity, hyperactivity, and deficits in attention and cognition, although symptoms vary across patients due to the heterogenous and polygenic nature of the disorder. Stimulant medications are the standard of care treatment for ADHD patients, and their effectiveness has led to the dopaminergic hypothesis of ADHD in which deficits in dopaminergic signaling, especially in cortical brain regions, mechanistically underly ADHD pathophysiology. Despite their effectiveness in many individuals, almost one-third of patients do not respond to stimulant treatments and the long-term negative side effects of these medications remain unclear. Emerging clinical evidence is beginning to highlight an important role of dysregulated excitatory/inhibitory (E/I) balance in ADHD. These deficits in E/I balance are related to functional abnormalities in glutamate and Gamma-Aminobutyric Acid (GABA) signaling in the brain, with increasing emphasis placed on GABAergic interneurons driving specific aspects of ADHD pathophysiology. Recent genome-wide association studies (GWAS) have also highlighted how genes associated with GABA function are mutated in human populations with ADHD, resulting in the generation of several new genetic mouse models of ADHD. This review will discuss how GABAergic dysfunction underlies ADHD pathophysiology, and how specific receptors/proteins related to GABAergic interneuron dysfunction may be pharmacologically targeted to treat ADHD in subpopulations with specific comorbidities and symptom domains. This article is part of the Special Issue on "PFC circuit function in psychiatric disease and relevant models".

A Review of Childhood Developmental Changes in Attention as Indexed in the Electrical Activity of the Brain

This review aims to present age-related changes in the neuroelectric responses of typically developing children (TDC) who are presumed to meet developmental stages appropriately. The review is based on findings from the frequently used neuropsychological tasks of active attention, where attention is deliberately focused versus passive attention where attention is drawn to a stimulus, facilitatory attention, which enhances the processing of a stimulus versus inhibitory attention, which suppresses the processing of a stimulus. The review discusses the early and late stages of attentional selectivity that correspond to early and late information processing. Age-related changes in early attentional selectivity were quantitatively represented in latencies of the event-related potential (ERP) components. Age-related changes in late attentional selectivity are also qualitatively represented by structural and functional reorganization of attentional processing and the brain areas involved. The purely bottom-up or top-down processing is challenged with age-related findings on difficult tasks that ensure a high cognitive load. TDC findings on brain oscillatory activity are enriched by findings from attention deficit hyperactivity disorder (ADHD). The transition from the low to fast oscillations in TDC and ADHD confirmed the maturational lag hypothesis. The deviant topographical localization of the oscillations confirmed the maturational deviance model. The gamma-based match and utilization model integrates all levels of attentional processing. According to these findings and theoretical formulations, brain oscillations can potentially display the human brain's wholistic-integrative functions.

Compromised word-level neural tracking in the high-gamma band for children with attention deficit hyperactivity disorder

Children with attention deficit hyperactivity disorder (ADHD) exhibit pervasive difficulties in speech perception. Given that speech processing involves both acoustic and linguistic stages, it remains unclear which stage of speech processing is impaired in children with ADHD. To investigate this issue, we measured neural tracking of speech at syllable and word levels using electroencephalography (EEG), and evaluated the relationship between neural responses and ADHD symptoms in 6-8 years old children. Twenty-three children participated in the current study, and their ADHD symptoms were assessed with SNAP-IV questionnaires. In the experiment, the children listened to hierarchical speech sequences in which syllables and words were, respectively, repeated at 2.5 and 1.25 Hz. Using frequency domain analyses, reliable neural tracking of syllables and words was observed in both the low-frequency band (<4 Hz) and the high-gamma band (70-160 Hz). However, the neural tracking of words in the high-gamma band showed an anti-correlation with the ADHD symptom scores of the children. These results indicate that ADHD prominently impairs cortical encoding of linguistic information (e.g., words) in speech perception.

Neural generators involved in visual cue processing in children with attention-deficit/hyperactivity disorder (ADHD)

Event-related potentials (ERP) studies report alterations in the ongoing visuo-attentional processes in children with attention-deficit/hyperactivity disorder (ADHD). We hypothesized that the neural generators progressively recruited after a cue stimulus imply executive-related areas well before engagement in executive processing in children with ADHD compared to typically developed children (TDC). We computed source localization (swLORETA) of the ERP and ERSP evoked by the Cue stimulus during a visual Cue-Go/Nogo paradigm in 15 ADHD compared to 16 TDC. A significant difference in N200/P200 amplitude over the right centro-frontal regions was observed between ADHD and TDC, supported by a stronger contribution of the left visuo-motor coordination area, premotor cortex, and prefrontal cortex in ADHD. In addition, we recorded a greater beta power spectrum in ADHD during the 80-230 ms interval, which was explained by increased activity in occipito-parieto-central areas and lower activity in the left supramarginal gyrus and prefrontal areas in ADHD. Successive analysis of the ERP generators (0-500 ms with successive periods of 50 ms) revealed significant differences beginning at 50 ms, with higher activity in the ventral anterior cingulate cortex, premotor cortex, and fusiform gyrus, and ending at 400-500 ms with higher activity of the dorsolateral prefrontal cortex and lower activity of the posterior cingulate cortex in ADHD compared to TDC. The areas contributing to ERP in ADHD and TDC differ from the early steps of visuo-attentional processing and reveal an overinvestment of the executive networks interfering with the activity of the dorsal attention network in children with ADHD.

Decreased resting gamma activity in adult attention deficit/hyperactivity disorder

Objectives: To delineate task-free gamma activity in adult ADHD and healthy control subjects based on high-density EEG recordings. Relationship of gamma activity with symptom severity was also examined, since gamma activity is considered to be an index of network functions in the brain that underlie higher-order cognitive processes.Methods: Spontaneous EEG was recorded in adult ADHD subjects (N = 42; 25 methylphenidate-naïve and 17 on methylphenidate treatment) and controls (N = 59) with eyes open. EEG absolute power gamma was investigated in the gamma₁ (30.25-39 Hz) and gamma₂ (39.25-48 Hz) frequency bands.Results: Gamma₁ and gamma₂ activity was diminished in ADHD compared with healthy control subjects. The difference between ADHD and controls was the most pronounced in the right centroparietal region for both gamma₁ and gamma₂. Inverse associations were found between gamma₁ and gamma₂ activity and ADHD symptoms in centroparietal scalp regions.Conclusions: Gamma activity is reduced in adult ADHD, and the reduction has a predominantly right centroparietal distribution. Our findings are consistent with childhood ADHD literature with respect to diminished posterior gamma activity in patients, which may reflect altered dorsal attention network functions. Gamma abnormalities might provide a link between neurophysiological functioning and neuropsychological deficiencies, thereby offering an opportunity to investigate the neurobiological mechanisms that underlie the clinical symptoms of ADHD.

Neurodevelopmental Disorders: Functional Role of Ambra1 in Autism and Schizophrenia

The activating molecule in Beclin-1-regulated autophagy (Ambra1) is a highly intrinsically disordered protein best known for its role as a mediator in autophagy, by favoring the formation of autophagosomes. Additional studies have revealed that Ambra1 is able to coordinate cell responses to stress conditions such as starvation, and it actively participates in cell proliferation, cytoskeletal modification, apoptosis, mitochondria removal, and cell cycle downregulation. All these functions highlight the importance of Ambra1 in crucial physiological events, including metabolism, cell death, and cell division. Importantly, Ambra1 is also crucial for proper embryonic development, and its complete absence in knock-out animal models leads to severe brain morphology defects. In line with this, it has recently been implicated in neurodevelopmental disorders affecting humans, particularly autism spectrum disorders and schizophrenia. Here, we discuss the recent links between Ambra1 and neurodevelopment, particularly focusing on its role during the maturation of hippocampal parvalbumin interneurons and its importance for maintaining a proper excitation/inhibition balance in the brain.

Dopaminergic innervation and modulation of hippocampal networks

The catecholamine dopamine plays an important role in hippocampus-dependent plasticity and related learning and memory processes. Dopamine secretion in the hippocampus is activated by, e.g., salient or novel stimuli, thereby helping to establish and to stabilize hippocampus-dependent memories. Disturbed dopaminergic function in the hippocampus leads to severe pathophysiological conditions. While the role and importance of dopaminergic modulation of hippocampal networks have been unequivocally proven, there is still a lack of detailed molecular and cellular mechanistic understanding of how dopamine orchestrates these hippocampal processes. In this chapter of the special issue "Hippocampal structure and function," we will discuss the current understanding of dopaminergic modulation of basal synaptic transmission and long-lasting, activity-dependent potentiation or depression.

Inhibitory control of the excitatory/inhibitory balance in psychiatric disorders

Neuronal networks consist of different types of neurons that all play their own role in order to maintain proper network function. The two main types of neurons segregate in excitatory and inhibitory neurons, which together regulate the flow of information through the network. It has been proposed that changes in the relative strength in these two opposing forces underlie the symptoms observed in psychiatric disorders, including autism and schizophrenia. Here, we review the role of alterations to the function of the inhibitory system as a cause of psychiatric disorders. First, we explore both patient and post-mortem evidence of inhibitory deficiency. We then discuss the function of different interneuron subtypes in the network and focus on the central role of a specific class of inhibitory neurons, parvalbumin-positive interneurons. Finally, we discuss genes known to be affected in different disorders and the effects that mutations in these genes have on the inhibitory system in cortex and hippocampus. We conclude that alterations to the inhibitory system are consistently identified in animal models of psychiatric disorders and, more specifically, that mutations affecting the function of parvalbumin-positive interneurons seem to play a central role in the symptoms observed in these disorders.

EEG Dynamics of a Go/Nogo Task in Children with ADHD

Background: Studies investigating event-related potential (ERP) evoked in a Cue-Go/NoGo paradigm have shown lower frontal N1, N2 and central P3 in children with attention-deficit/hyperactivity disorder (ADHD) compared to typically developing children (TDC). However, the electroencephalographic (EEG) dynamics underlying these ERPs remain largely unexplored in ADHD. Methods: We investigate the event-related spectral perturbation and inter-trial coherence linked to the ERP triggered by visual Cue-Go/NoGo stimuli, in 14 children (7 ADHD and 7 TDC) aged 8 to 12 years. Results: Compared to TDC, the EEG dynamics of children with ADHD showed a lower theta-alpha ITC concomitant to lower occipito-parietal P1-N2 and frontal N1-P2 potentials in response to Cue, Go and Nogo stimuli; an upper alpha power preceding lower central Go-P3; a lower theta-alpha power and ITC were coupled to a lower frontal Nogo-N3; a lower low-gamma power overall scalp at 300 ms after Go and Nogo stimuli. Conclusion: These findings suggest impaired ability in children with ADHD to conserve the brain oscillations phase associated with stimulus processing. This physiological trait might serve as a target for therapeutic intervention or be used as monitoring of their effects.

Emotional Face Recognition in Children With Attention Deficit/Hyperactivity Disorder: Evidence From Event Related Gamma Oscillation

Introduction

Children with attention-deficit/hyperactivity disorder (ADHD) have some impairment in emotional relationship which can be due to problems in emotional processing. The present study investigated neural correlates of early stages of emotional face processing in this group compared with typically developing children using the Gamma Band Activity (GBA).

Methods

A total of 19 children diagnosed with ADHD (Combined type) based on DSM-IV classification were compared with 19 typically developing children matched on age, gender, and IQ. The participants performed an emotional face recognition while their brain activities were recorded using an event-related oscillation procedure.

Results

The results indicated that ADHD children compared to normal group showed a significant reduction in the gamma band activity, which is thought to reflect early perceptual emotion discrimination for happy and angry emotions (P<0.05).

Conclusion

The present study supports the notion that individuals with ADHD have some impairments in early stage of emotion processing which can cause their misinterpretation of emotional faces.

Early Gamma-Band Activity During Interference Predicts Working Memory Distractibility in ADHD

OBJECTIVES

Patients with attention-deficit/hyperactivity disorder (ADHD) display deficits in working memory (WM) and enhanced distractibility.

METHODS

Evoked gamma-band response (GBR) occurs already 50 ms after stimulus onset and is modulated by attention. 16 boys with ADHD and 20 healthy controls (10-14 years) completed a WM task with distraction.

RESULTS

Occipitally evoked 40 Hz-GBR was higher during distraction in ADHD than controls. GBR correlated negatively with interference control.

CONCLUSION

These data suggest that ADHD patients are disturbed by interference on an early level of perception.

Are ASD and ADHD a Continuum? A Comparison of Pathophysiological Similarities Between the Disorders

OBJECTIVE

The objective of this study was to review and compare the similarities between autism spectrum disorder (ASD) and ADHD with regard to symptomatology, neurological deficits, metabolic and endocrine-related conditions, and brain pathology.

METHOD

A comprehensive review of the relevant research literature was carried out.

RESULTS

A number of important similarities between ASD and ADHD were identified, including recent increases in prevalence, male-biased incidence, shared involvement of sensory processing, motor and impulse control, abnormal patterns of neural connectivity, and sleep disturbances. Studies suggest involvement of androgen metabolism, impaired methylation, and heavy metal toxicity as possible contributing factors for both disorders.

CONCLUSION

ASD and ADHD share a number of features and pathophysiological conditions, which suggests that the two disorders may be a continuum and have a common origin.

Quantitative Electroencephalography Reflects Inattention, Visual Error Responses, and Reaction Times in Male Patients with Attention Deficit Hyperactivity Disorder

Objective

Quantitative electroencephalography (qEEG) has been increasingly used to evaluate patients with attention deficit hyperactivity disorder (ADHD). The aim of this study was to assess the correlation between qEEG data and symptom severity in patients with ADHD.

Methods

Fifteen patients with ADHD and 20 healthy controls (HCs) were recruited. Electroencephalography was assessed in the resting-state, and qEEG data were obtained in the eyes-closed state. The Korean version of the ADHD Rating Scale (K-ARS) and continuous performance tests (CPTs) were used to assess all participants.

Results

Theta-band (4–7 Hz) power across the brain was significantly positively correlated with inattention scores on the K-ARS, reaction times and commission errors on the CPTs in ADHD patients. Gamma-band (31–50 Hz) power was significantly positively correlated with the results of the auditory CPTs in ADHD patients. The theta/alpha (8–12 Hz) and theta/beta (13–30 Hz) ratios were significantly negatively correlated with commission and omission errors on auditory CPTs in ADHD patients. No significant correlations between qEEG relative power and K-ARS and CPT scores were observed in HCs.

Conclusion

Our results suggest that qEEG may be a useful adjunctive tool in patients with ADHD.

Cholinergic control of gamma power in the midbrain spatial attention network

The modulation of gamma power (25-90 Hz) is associated with attention and has been observed across species and brain areas. However, mechanisms that control these modulations are poorly understood. The midbrain spatial attention network in birds generates high-amplitude gamma oscillations in the local field potential that are thought to represent the highest priority location for attention. Here we explore, in midbrain slices from chickens, mechanisms that regulate the power of these oscillations, using high-resolution techniques including intracellular recordings from neurons targeted by calcium imaging. The results identify a specific subtype of neuron, expressing non-α7 nicotinic acetylcholine receptors, that directly drives inhibition in the gamma-generating circuit and switches the network into a primed state capable of producing high-amplitude oscillations. The special properties of this mechanism enable rapid, persistent changes in gamma power. The brain may employ this mechanism wherever rapid modulations of gamma power are critical to information processing.

Input-dependent frequency modulation of cortical gamma oscillations shapes spatial synchronization and enables phase coding

Fine-scale temporal organization of cortical activity in the gamma range (∼25-80Hz) may play a significant role in information processing, for example by neural grouping ('binding') and phase coding. Recent experimental studies have shown that the precise frequency of gamma oscillations varies with input drive (e.g. visual contrast) and that it can differ among nearby cortical locations. This has challenged theories assuming widespread gamma synchronization at a fixed common frequency. In the present study, we investigated which principles govern gamma synchronization in the presence of input-dependent frequency modulations and whether they are detrimental for meaningful input-dependent gamma-mediated temporal organization. To this aim, we constructed a biophysically realistic excitatory-inhibitory network able to express different oscillation frequencies at nearby spatial locations. Similarly to cortical networks, the model was topographically organized with spatially local connectivity and spatially-varying input drive. We analyzed gamma synchronization with respect to phase-locking, phase-relations and frequency differences, and quantified the stimulus-related information represented by gamma phase and frequency. By stepwise simplification of our models, we found that the gamma-mediated temporal organization could be reduced to basic synchronization principles of weakly coupled oscillators, where input drive determines the intrinsic (natural) frequency of oscillators. The gamma phase-locking, the precise phase relation and the emergent (measurable) frequencies were determined by two principal factors: the detuning (intrinsic frequency difference, i.e. local input difference) and the coupling strength. In addition to frequency coding, gamma phase contained complementary stimulus information. Crucially, the phase code reflected input differences, but not the absolute input level. This property of relative input-to-phase conversion, contrasting with latency codes or slower oscillation phase codes, may resolve conflicting experimental observations on gamma phase coding. Our modeling results offer clear testable experimental predictions. We conclude that input-dependency of gamma frequencies could be essential rather than detrimental for meaningful gamma-mediated temporal organization of cortical activity.

Hypothesis-driven methods to augment human cognition by optimizing cortical oscillations

Cortical oscillations have been shown to represent fundamental functions of a working brain, e.g., communication, stimulus binding, error monitoring, and inhibition, and are directly linked to behavior. Recent studies intervening with these oscillations have demonstrated effective modulation of both the oscillations and behavior. In this review, we collect evidence in favor of how hypothesis-driven methods can be used to augment cognition by optimizing cortical oscillations. We elaborate their potential usefulness for three target groups: healthy elderly, patients with attention deficit/hyperactivity disorder, and healthy young adults. We discuss the relevance of neuronal oscillations in each group and show how each of them can benefit from the manipulation of functionally-related oscillations. Further, we describe methods for manipulation of neuronal oscillations including direct brain stimulation as well as indirect task alterations. We also discuss practical considerations about the proposed techniques. In conclusion, we propose that insights from neuroscience should guide techniques to augment human cognition, which in turn can provide a better understanding of how the human brain works.

A distributed effects perspective of dimensionally defined psychiatric disorders: and convergent versus core deficit effects in ADHD

The focus of psychiatric and psychological research has arguably shifted from brain damage and psychosis to more common forms of psychopathology that reflect extremes variants of otherwise normal cognitive and behavioral characteristics. Now, in addition to trying to understand overtly damaged brain-function (flat tire effects), we are also seeking to understand liabilities associated with non-optimized, but otherwise intact, cognitive and behavioral abilities (poor tuning effects). This shift has pushed us to evolve our investigational strategies to more broadly consider whole-brain integrated brain systems, as well as seek to develop more specific quantifiable indicators of impoverished brain function and behavior. This paper discusses such challenges in relation to dimensionally defined psychiatric disorders and presents a novel whole-brain integrated perspective of ADHD brain function pathology.

Visual Network Asymmetry and Default Mode Network Function in ADHD: An fMRI Study

BACKGROUND

A growing body of research has identified abnormal visual information processing in attention-deficit hyperactivity disorder (ADHD). In particular, slow processing speed and increased reliance on visuo-perceptual strategies have become evident.

OBJECTIVE

The current study used recently developed fMRI methods to replicate and further examine abnormal rightward biased visual information processing in ADHD and to further characterize the nature of this effect; we tested its association with several large-scale distributed network systems.

METHOD

We examined fMRI BOLD response during letter and location judgment tasks, and directly assessed visual network asymmetry and its association with large-scale networks using both a voxelwise and an averaged signal approach.

RESULTS

Initial within-group analyses revealed a pattern of left-lateralized visual cortical activity in controls but right-lateralized visual cortical activity in ADHD children. Direct analyses of visual network asymmetry confirmed atypical rightward bias in ADHD children compared to controls. This ADHD characteristic was atypically associated with reduced activation across several extra-visual networks, including the default mode network (DMN). We also found atypical associations between DMN activation and ADHD subjects' inattentive symptoms and task performance.

CONCLUSION

The current study demonstrated rightward VNA in ADHD during a simple letter discrimination task. This result adds an important novel consideration to the growing literature identifying abnormal visual processing in ADHD. We postulate that this characteristic reflects greater perceptual engagement of task-extraneous content, and that it may be a basic feature of less efficient top-down task-directed control over visual processing. We additionally argue that abnormal DMN function may contribute to this characteristic.

Estimating the passage of minutes: deviant oscillatory frontal activity in medicated and unmedicated ADHD

OBJECTIVE

Attention-deficit/hyperactivity disorder (ADHD) is a common and extensively treated psychiatric disorder in children, which often persists into adulthood. The core diagnostic symptoms include inappropriate levels of hyperactivity, impulsivity, and/or pervasive inattention. Another crucial aspect of the disorder involves aberrations in temporal perception, which have been well documented in behavioral studies and, recently, have been the focus of neuroimaging studies. These functional magnetic resonance imaging studies have shown reduced activation in anterior cingulate and prefrontal cortices in ADHD using a time-interval discrimination task, whereby participants distinguish intervals differing by only hundreds of milliseconds.

METHOD

We used magnetoencephalography (MEG) to evaluate the cortical network serving temporal perception during a continuous, long-duration (in minutes) time estimation experiment. Briefly, medicated and unmedicated persons with ADHD, and a control group responded each time they estimated 60 s had elapsed for an undisclosed amount of time in two separate MEG sessions. All MEG data were transformed into regional source activity, and subjected to spectral analyses to derive amplitude estimates of gamma-band activity.

RESULTS

Compared to controls, unmedicated patients were less accurate time estimators and had weaker gamma activity in the anterior cingulate, supplementary motor area, and left prefrontal cortex. After medication, these patients exhibited small but significant increases in gamma across these same neural regions and significant improvements in time estimation accuracy, which correlated with the gamma activity increases.

CONCLUSION

We found deficient gamma activity in brain areas known to be crucial for timing functions, which may underlie the day-to-day abnormalities in time perception that are common in ADHD.

Transcranial alternating current stimulation: a review of the underlying mechanisms and modulation of cognitive processes

Brain oscillations of different frequencies have been associated with a variety of cognitive functions. Convincing evidence supporting those associations has been provided by studies using intracranial stimulation, pharmacological interventions and lesion studies. The emergence of novel non-invasive brain stimulation techniques like repetitive transcranial magnetic stimulation (rTMS) and transcranial alternating current stimulation (tACS) now allows to modulate brain oscillations directly. Particularly, tACS offers the unique opportunity to causally link brain oscillations of a specific frequency range to cognitive processes, because it uses sinusoidal currents that are bound to one frequency only. Using tACS allows to modulate brain oscillations and in turn to influence cognitive processes, thereby demonstrating the causal link between the two. Here, we review findings about the physiological mechanism of tACS and studies that have used tACS to modulate basic motor and sensory processes as well as higher cognitive processes like memory, ambiguous perception, and decision making.

Event-related oscillations reflect functional asymmetry in children with attention deficit/hyperactivity disorder

Previous studies have found that event-related theta and gamma oscillations elicited in an auditory selective attention task are deviant in children with attention deficit/hyperactivity disorder (ADHD). It has been suggested that these deviations are associated with deficient motor inhibition in ADHD, which may lead to increased excitability of not only the motor generation networks but also the networks involved in sensory and cognitive processing of the stimulus requiring motor response. Within this suggestion, the present study used the same experimental database to compare the motor cortical activation of healthy controls and children with ADHD during the performance of the auditory selective attention task. Electroencephalography mu (8-12 Hz) activity at C3 and C4 electrodes was used as a measure of motor cortical activation. Mu power was analyzed for four stimulus conditions of the task (attended target, unattended target, attended nontarget, and unattended nontarget). It was found that motor cortical activation as reflected by mu power suppression was not overall greater in ADHD than healthy children. However, stimuli that possessed only partial target features and did not require motor responding (unattended target and attended nontarget) produced a significant reduction of mu activity in ADHD patients. These results suggest that motor cortical excitability is not generally increased in ADHD children. Rather, the co-existence of conflict features in complex stimuli induces task-irrelevant motor activation in these children. The deficient inhibition of motor cortical networks contralateral to the response may therefore be responsible for the functional asymmetry in stimulus processing in ADHD.

Amphetamines modulate prefrontal γ oscillations during attention processing

Amphetamine-based medications robustly suppress symptoms of attention-deficit/hyperactivity disorder (ADHD), but their exact mechanisms remain poorly understood. Recent hemodynamic imaging studies have suggested that amphetamines may modulate the prefrontal and anterior cingulate brain regions, although few studies have been published and the results have not been entirely consistent. Meanwhile, several electrophysiological studies have shown that abnormal fast oscillations (in the γ range) may be closely linked to inattention and other cardinal symptoms of ADHD. In this study, we utilized magnetoencephalography to examine how amphetamines modulate high-frequency brain activity in adults with ADHD. Participants performed an auditory attention task, which required sustained attention in one block and passive listening in a separate block. Participants completed the task twice in the on-medication and off-medication states. All data were analyzed using beamforming techniques to resolve cortical regions showing event-related synchronizations and desynchronizations. Our primary findings indicated that oral administration of amphetamine decreased γ-band event-related desynchronization activity significantly in the medial prefrontal area and decreased event-related synchronization in bilateral superior parietal areas, left inferior parietal, and the left inferior frontal gyrus. These results suggest that psychostimulants strongly modulate γ activity in frontal and parietal cortical areas, which are known to be central to the brain's core attentional networks.

Ten years on: a follow-up review of ERP research in attention-deficit/hyperactivity disorder

This article reviews the event-related potential (ERP) literature in relation to attention-deficit/hyperactivity disorder (AD/HD) over the years 2002-2012. ERP studies exploring various aspects of brain functioning in children and adolescents with AD/HD are reviewed, with a focus on group effects and interpretations in the domains of attention, inhibitory control, performance monitoring, non-pharmacological treatments, and ERP/energetics interactions. There has been a distinct shift in research intensity over the past 10 years, with a large increase in ERP studies conducted in the areas of inhibitory control and performance monitoring. Overall, the research has identified a substantial number of ERP correlates of AD/HD. Robust differences from healthy controls have been reported in early orienting, inhibitory control, and error-processing components. These data offer potential to improve our understanding of the specific brain dysfunction(s) which contribute to the disorder. The literature would benefit from a more rigorous approach to clinical group composition and consideration of age effects, as well as increased emphasis on replication and extension studies using exacting participant, task, and analysis parameters.

Gamma oscillatory activity in relation to memory ability in older adults

Human gamma-band activity (GBA) is widely reported to reflect memory processing. Recent studies suggest that GBA is associated with behavioral performance in memory tasks, but it is not clear whether gamma oscillations are related to individual differences in memory ability. To examine this issue, we recruited participants with low memory ability (mild cognitive impairment, or MCI; n=16) as well as age-, education-, and sex-matched controls (n=19) for a study involving a spatial delayed match to sample (DMTS) task. We recorded EEG during task performance and analyzed gamma oscillation changes during the memory maintenance phase of the task. Gamma event-related desynchronization was stronger in the control group than in the MCI group in the mid-frontal area, and mean GBA in this area correlated with clinical memory measures as well as behavioral performance on the DMTS task. These findings suggest that gamma oscillations not only reflect brain activity related to memory processes, but also vary with the memory ability of individuals.

Gamma-frequency neuronal activity is diminished in adults with attention-deficit/hyperactivity disorder: a pharmaco-MEG study

Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder affecting approximately 4-7% of children and persisting in 2-5% of adults. The core symptoms include pervasive inattention and inappropriate levels of hyperactivity-impulsivity. High-frequency gamma activity has been implicated in the temporal binding of stimulus properties across cortical areas, and is known to be crucial for complex information processing and attentional processes in particular. Thus, we evaluated the amplitude of gamma-frequency neural responses in adults with and those without ADHD, and tested whether stimulant medications, the most common treatment for ADHD, modulate gamma activity in affected adults. Participants underwent two sessions (~75 min apart) of auditory stimulation using stimuli known to elicit 40 Hz gamma-band responses as magnetoencephalography data were acquired. Between sessions, the ADHD group (who were in maintenance therapy) were administered their daily stimulant medication and both groups were told to relax. The primary results indicated that gamma activity was weaker in the ADHD group during session one (pre-drug), but not session two (post-drug), and that gamma activity significantly increased following stimulant administration in adults with ADHD. These results suggest that ADHD is associated with reduced cortical gamma activity and that stimulants may ameliorate this abnormality.

INDUCED EEG GAMMA OSCILLATION ALIGNMENT IMPROVES DIFFERENTIATION BETWEEN AUTISM AND ADHD GROUP RESPONSES IN A FACIAL CATEGORIZATION TASK

INTRODUCTION: Children diagnosed with an autism spectrum disorder (ASD) often lack the ability to recognize and properly respond to emotional stimuli. Emotional deficits also characterize children with attention deficit/hyperactivity disorder (ADHD), in addition to exhibiting limited attention span. These abnormalities may effect a difference in the induced EEG gamma wave burst (35-45 Hz) peaked approximately 300-400 milliseconds following an emotional stimulus. Because induced gamma oscillations are not fixed at a definite point in time post-stimulus, analysis of averaged EEG data with traditional methods may result in an attenuated gamma burst power. METHODS: We used a data alignment technique to improve the averaged data, making it a better representation of the individual induced EEG gamma oscillations. A study was designed to test the response of a subject to emotional stimuli, presented in the form of emotional facial expression images. In a four part experiment, the subjects were instructed to identify gender in the first two blocks of the test, followed by differentiating between basic emotions in the final two blocks (i.e. anger vs. disgust). EEG data was collected from ASD (n=10), ADHD (n=9), and control (n=11) subjects via a 128 channel EGI system, and processed through a continuous wavelet transform and bandpass filter to isolate the gamma frequencies. A custom MATLAB code was used to align the data from individual trials between 200-600 ms post-stimulus, EEG site, and condition by maximizing the Pearson product-moment correlation coefficient between trials. The gamma power for the 400 ms window of maximum induced gamma burst was then calculated and compared between subject groups. RESULTS AND CONCLUSION: Condition (anger/disgust recognition, gender recognition) × Alignment × Group (ADHD, ASD, Controls) interaction was significant at most of parietal topographies (e.g., P3-P4, P7-P8). These interactions were better manifested in the aligned data set. Our results show that alignment of the induced gamma oscillations improves sensitivity of this measure in differentiation of EEG responses to emotional facial stimuli in ADHD and ASD.

Resting EEG deficits in accused murderers with schizophrenia

Empirical evidence continues to suggest a biologically distinct violent subtype of schizophrenia. The present study examined whether murderers with schizophrenia would demonstrate resting EEG deficits distinguishing them from both non-violent schizophrenia patients and murderers without schizophrenia. Resting EEG data were collected from five diagnostic groups (normal controls, non-murderers with schizophrenia, murderers with schizophrenia, murderers without schizophrenia, and murderers with psychiatric conditions other than schizophrenia) at a brain hospital in Nanjing, China. Murderers with schizophrenia were characterized by increased left-hemispheric fast-wave EEG activity relative to non-violent schizophrenia patients, while non-violent schizophrenia patients instead demonstrated increased diffuse slow-wave activity compared to all other groups. Results are discussed within the framework of a proposed left-hemispheric over-processing hypothesis specific to violent individuals with schizophrenia, involving left hemispheric hyperarousal deficits, which may lead to a homicidally violent schizophrenia outcome.

Relationships between pre-stimulus γ power and subsequent P300 and reaction time breakdown in schizophrenia

INTRODUCTION

Little is known about the relationship between gamma-band oscillations prior to the arrival of a target stimulus and subsequent sensory processing and response execution. Although schizophrenia has been associated with abnormalities in gamma-band oscillations, P300, and reaction time (RT), few studies have examined the possible correspondence between these three neurobiological and behavioral markers in schizophrenia. To characterize the relationship between preparatory processes, information processing, and subsequent behavioral performance in schizophrenia, the present study investigated the relationships between pre-stimulus gamma-band power, RT and P300 amplitude.

METHODS

EEG and behavioral data were collected from 18 schizophrenia patients and 21 healthy controls during a conventional auditory oddball task.

RESULTS

In controls, single-trial pre-stimulus gamma power was positively correlated with RT, and average P300 amplitude was positively correlated with average pre-stimulus gamma power.

DISCUSSION

We interpret these findings as evidence that gamma power enhancement reflects a state of greater pre-stimulus preparation resulting in fuller evaluation of the target stimulus and therefore slower RT, as proposed by Jokeit and Makeig (1994). Consistent with previous research, schizophrenia patients exhibited RT slowing and P300 amplitude reductions relative to controls. Importantly, neither RT nor P300 amplitude was related to pre-stimulus gamma power in schizophrenia, suggesting a breakdown in the preparatory brain state critical for stimulus processing and later motor execution. The present findings underscore the behavioral significance of gamma-band responses, and provide an additional link between gamma-band oscillations and information processing abnormalities in schizophrenia.

Neurofeedback Effects on Evoked and Induced EEG Gamma Band Reactivity to Drug-related Cues in Cocaine Addiction

INTRODUCTION: Preoccupation with drug and drug-related items is a typical characteristic of cocaine addicted individuals. It has been shown in multiple accounts that prolonged drug use has a profound effect on the EEG recordings of drug addicts when compared to controls during cue reactivity tests. Cue reactivity refers to a phenomenon in which individuals with a history of drug abuse exhibit excessive psychophysiological responses to cues associated with their drug of choice. One of the aims of this pilot study was to determine the presence of an attentional bias to preferentially process drug-related cues using evoked and induced gamma reactivity measures in cocaine addicts before and after biobehavioral treatment based on neurofeedback. Another aim was to show that central SMR amplitude increase and frontal theta control is possible in an experimental outpatient drug users group over 12 neurofeedback sessions. METHOD: Ten current cocaine abusers participated in this pilot research study using neurofeedback combined with Motivational Interviewing sessions. Eight of them completed all planned pre- and post -neurofeedback cue reactivity tests with event-related EEG recording and clinical evaluations. Cue reactivity test represented a visual oddball task with images from the International Affective Picture System and drug-related pictures. Evoked and induced gamma responses to target and non-target drug cues were analyzed using wavelet analysis. RESULTS: Outpatient subjects with cocaine addiction completed the biobehavioral intervention and successfully increased SMR while keeping theta practically unchanged in 12 sessions of neurofeedback training. The addition of Motivational Interviewing helped retain patients in the study. Clinical evaluations immediately after completion of the treatment showed decreased self-reports on depression and stress scores, and urine tests collaborated reports of decreased use of cocaine and marijuana. Effects of neurofeedback resulted in a lower EEG gamma reactivity to drug-related images in a post-neurofeedback cue reactivity test. In particular, evoked gamma showed decreases in power to non-target and to a lesser extent target drug-related cues at all topographies (left, right, frontal, parietal, medial, inferior); while induced gamma power decreased globally to both target and non-target drug cues. Our findings supported our hypothesis that gamma band cue reactivity measures are sufficiently sensitive functional outcomes of neurofeedback treatment. Both evoked and induced gamma measures were found capable to detect changes in responsiveness to both target and non-target drug cues. CONCLUSION: Our study emphasizes the utility of cognitive neuroscience methods based on EEG gamma band measures for the assessment of the functional outcomes of neurofeedback-based biobehavioral interventions for cocaine use disorders. This approach may have significant potential for identifying both physiological and clinical markers of treatment progress. The results confirmed our prediction that EEG changes achieved with neurofeedback training will be accompanied by positive EEG outcomes in a cue reactivity and clinical improvements.

Altered evoked gamma-band responses reveal impaired early visual processing in ADHD children

Neurophysiological studies yield contrary results whether attentional problems of patients with attention-deficit/hyperactivity disorder (ADHD) are related to early visual processing deficits or not. Evoked gamma-band responses (GBRs), being among the first cortical responses occurring as early as 90ms after visual stimulation in human EEG, have been assigned a pivotal role in early visual processing. In particular, they are involved in memory matching processes and are enhanced when known stimuli are processed. The current study examined whether evoked GBR patterns during early memory matching processes could be indicative of an early visual processing deficit in ADHD patients. EEG was recorded from 13 young ADHD patients as well as 13 age-matched healthy participants. Both groups performed a simple forced choice reaction task employing line drawings of either known real-world items with representations in long-term memory or physically similar unknown items without such representations. Evoked GBRs of ADHD patients did not differentiate between known and unknown items. However, in healthy children, evoked GBRs were enhanced when stimuli matched a representation stored in memory. This finding indicates disadvantages at early visual processing stages in ADHD patients: In contrast to healthy participants, ADHD children lack an early memory based classification, possibly resulting in an impaired ability to rapidly reallocate attentional resources to relevant stimuli. These findings suggest that impaired early automatic stimulus classification in ADHD patients could be involved in deficits of selective and sustained attention.

Human gamma-band activity: a review on cognitive and behavioral correlates and network models

Gamma-band oscillations (roughly 30-100 Hz) in human and animal EEG have received considerable attention in the past due to their correlations with cognitive processes. Here, we want to sketch how some of the higher cognitive functions can be explained by memory processes which are known to modulate gamma activity. Especially, the function of binding together the multiple features of a perceived object requires a comparison with contents stored in memory. In addition, we review recent findings about the actual behavioral relevance of human gamma-band activity. Interestingly, rather simple models of spiking neurons are not only able to generate oscillatory activity within the gamma-band range, but even show modulations of these oscillations in line with findings from human experiments.

A review of brain oscillations in cognitive disorders and the role of neurotransmitters

The analysis of the functional correlates of "brain oscillations" has become an important branch of neuroscience. Although research on the functional correlates of brain oscillation has progressed to a high level, studies on cognitive disorders are rare and mainly limited to schizophrenia patients. The present review includes the results of the changes in brain oscillations in patients with Alzheimer's, schizophrenia, bipolar disorders, mild cognitive impairment, attention-deficit hyperactivity disorder (ADHD), alcoholism and those with genetic disorders. Furthermore, the effects of pharmaca and the influence of neurotransmitters in patients with cognitive disorders are also reviewed. Following the review, a short synopsis is given related to the analysis of brain oscillations.