The 40-Hz auditory steady-state response in bipolar disorder: A meta-analysis

Examining the role of novelty detection in 20- and 40-Hz auditory steady-state responses

An auditory steady-state response (ASSR) is an electrophysiological response to periodic stimuli that reflects the synchronization of endogenous oscillations. The 40-Hz ASSR is reduced in patients with schizophrenia, bipolar disorder, and autism spectrum disorder, making it a candidate biomarker for these psychiatric disorders. Previous studies have revealed that experimental conditions such as stimulus duration and inter-stimulus interval tend to affect ASSR, suggesting that novelty detection may play an important role in determining the magnitude of ASSR. The present study is the first to investigate the effect of novelty detection on 20- and 40-Hz ASSRs in healthy individuals. Magnetoencephalography recordings were obtained from 30 healthy adults exposed to auditory stimuli at 20 and 40 Hz. The stimuli were presented in three paradigms: 20- and 40-Hz repetitive presentations and random presentation, the latter being categorized by whether the preceding stimulus was the same (S trials) or different (D trials). The ASSR amplitude and inter-trial phase coherence (ITPC) were assessed via time-frequency analysis. The results revealed that the 20-Hz ASSR was suppressed with increased novelty, with the highest amplitude and ITPC observed during repetitive presentation. In contrast, the 40-Hz ASSR was enhanced by increased novelty, with the greatest measures observed during the D trials. These findings show that novelty detection modulates 20- and 40-Hz ASSRs in opposite directions, highlighting its critical role in shaping stimulus-induced oscillatory responses. This frequency-specific modulation pattern may provide a novel perspective for understanding ASSR abnormalities in psychiatric disorders.

Effect of the magnitude of abrupt change in sound pressure on the magnitude and phase synchrony of 40-Hz auditory steady state response

A periodic sound with a fixed inter-stimulus interval elicits an auditory steady-state response (ASSR). An abrupt change in a continuous sound is known to affect the brain's ongoing neural oscillatory activity, but the underlying mechanism has not been fully clarified. We investigated whether and how an abrupt change in sound intensity affects the ASSR. The control stimulus was a train of 1-ms clicks with a sound pressure level (SPL) of 70 dB at 40 Hz for 1000 ms. In addition to the control stimulus, we applied six stimuli with changes consisting of a 500-ms train at 70 dB followed by a 500-ms similar train with louder clicks of 75, 80, or 85 dB or weaker clicks of 55, 60, or 65 dB. We obtained the magnetoencephalographic responses from 15 healthy subjects while presenting the seven stimuli randomly. The two-dipole model obtained for the 40-Hz ASSR in the control condition was applied to all of the stimulus conditions for each subject, and then the time-frequency analysis was conducted. We observed that both the amplitude and the inter-trial phase coherence of the 40-Hz ASSR transiently decreased and returned to the steady state after the change onset, i.e., the desynchronization of 40-Hz ASSR. The degree of desynchronization depended on the magnitude of the change regardless of whether the sound intensity increased or decreased, which might be a novel neurophysiological index of cerebral response driven by a change in the sensory environment.

Individualized EEG-Based Neurofeedback Targeting Auditory Steady-State Responses: A Proof-of-Concept Study

Gamma-band (> 30 Hz) brain oscillatory activity is linked with sensory and cognitive processes and exhibits abnormalities in neuropsychiatric disorders. Therefore, neuromodulation techniques targeting gamma activity are being developed. One promising approach is neurofeedback (NFB) which is based on the alteration of brain responses via online feedback. However, the existing gamma-based NFB systems lack individualized approach. In the present work, we developed and tested an individualized EEG-NFB system. 46 healthy volunteers participated in three sessions on separate days. Before NFB training, individual gamma frequency (IGF) was estimated using chirp-modulated auditory stimulation (30-60 Hz). Participants were subjected to IGF-increase (if IGF was ≤ 45 Hz) or IGF-decrease conditions (if IGF was > 45 Hz). Gamma-band responses were targeted during NFB training, in which participants received auditory steady-state stimulation at frequency slightly above or below IGF and were instructed to try to increase their response while receiving real-time visual feedback. Each time a pre-defined response goal was reached, stimulation frequency was either increased or decreased. After training, IGF was reassessed. Experimental group participants were divided into equal groups based on the median success rate during NFB training. The results showed that high-responders had a significantly higher IGF modulation compared to control group, while low-responders did not differ from controls. No differences in IGF modulation were found between sessions and between NFB repetitions in all participant groups. The initial evaluation of the proposed EEG-NFB system showed potential to modulate IGF. Future studies could investigate longer-lasting electrophysiological and behavioural effects of the application of ASSR/IGF-based NFB system in clinical populations.

Abnormal resting-state EEG phase dynamics distinguishes major depressive disorder and bipolar disorder

Changes in EEG have been reported in both major depressive disorder (MDD) and bipolar disorder (BD). Specifically, power changes in EEG alpha and theta frequency bands during rest and task are known in both disorders. This leaves open whether there are changes in yet another component of the electrophysiological EEG signal, namely phase-related processes that may allow for distinguishing MDD and BD. For that purpose, we investigate EEG-based spontaneous phase in the resting state of MDD, BD and healthy controls. Our main findings show: (i) decreased spontaneous phase variability in frontal theta of both MDD and BD compared to HC; (ii) decreased spontaneous phase variability in central-parietal alpha in MDD compared to both BD and HC; (iii) increased delays or lags of alpha phase cycles in MDD (but not in BD), which (iv) correlate with the decreased phase variability in MDD. Together, we show similar (decreased frontal theta variability) and distinct (decreased central-parietal alpha variability with increased lags or delays) findings in the spontaneous phase dynamics of MDD and BD. This suggests potential relevance of theta and alpha phase dynamics in distinguishing MDD and BD in clinical differential-diagnosis.

Dysfunctional Parvalbumin Neurons in Schizophrenia and the Pathway to the Clinical Application of Kv3 Channel Modulators

Based on the pathophysiological changes observed in schizophrenia, the gamma-aminobutyric acid (GABA) hypothesis may facilitate the development of targeted treatments for this disease. This hypothesis, mainly derived from postmortem brain results, postulates dysfunctions in a subset of GABAergic neurons, particularly parvalbumin-containing interneurons. In the cerebral cortex, the fast spike firing of parvalbumin-positive GABAergic interneurons is regulated by the Kv3.1 and Kv3.2 channels, which belong to a potassium channel subfamily. Decreased Kv3.1 levels have been observed in the prefrontal cortex of patients with schizophrenia, prompting the investigation of Kv3 channel modulators for the treatment of schizophrenia. However, biomarkers that capture the dysfunction of parvalbumin neurons are required for these modulators to be effective in the pharmacotherapy of schizophrenia. Electroencephalography and magnetoencephalography studies have demonstrated impairments in evoked gamma oscillations in patients with schizophrenia, which may reflect the dysfunction of cortical parvalbumin neurons. This review summarizes these topics and provides an overview of how the development of therapeutics that incorporate biomarkers could innovate the treatment of schizophrenia and potentially change the targets of pharmacotherapy.

Atypical brain responses to 40-Hz click trains in girls with Rett syndrome: Auditory steady-state response and sustained wave

AIM

The current study aimed to infer neurophysiological mechanisms of auditory processing in children with Rett syndrome (RTT)-rare neurodevelopmental disorders caused by MECP2 mutations. We examined two brain responses elicited by 40-Hz click trains: auditory steady-state response (ASSR), which reflects fine temporal analysis of auditory input, and sustained wave (SW), which is associated with integral processing of the auditory signal.

METHODS

We recorded electroencephalogram findings in 43 patients with RTT (aged 2.92-17.1 years) and 43 typically developing children of the same age during 40-Hz click train auditory stimulation, which lasted for 500 ms and was presented with interstimulus intervals of 500 to 800 ms. Mixed-model ancova with age as a covariate was used to compare amplitude of ASSR and SW between groups, taking into account the temporal dynamics and topography of the responses.

RESULTS

Amplitude of SW was atypically small in children with RTT starting from early childhood, with the difference from typically developing children decreasing with age. ASSR showed a different pattern of developmental changes: the between-group difference was negligible in early childhood but increased with age as ASSR increased in the typically developing group, but not in those with RTT. Moreover, ASSR was associated with expressive speech development in patients, so that children who could use words had more pronounced ASSR.

CONCLUSION

ASSR and SW show promise as noninvasive electrophysiological biomarkers of auditory processing that have clinical relevance and can shed light onto the link between genetic impairment and the RTT phenotype.

Auditory Biomarkers of Neuropsychiatric Disorders in Nonhuman Primates

Animal models of neuropsychiatric disorders with appropriate biomarkers can greatly inform the neurobiological basis of disorder-related deficits of cognitive and/or sensory processes. Given the genetic, physiologic, and behavioral similarities between humans and nonhuman primates (NHPs), NHP studies are monumentally important for preclinical translational research. Capitalizing on the NHP's similarities with human systems provides one of the best opportunities to gain detailed insight into the mechanisms underlying disorder-related symptoms and to accumulate a foundation of information for the development of therapeutic interventions. Here, we discuss how results from NHP studies have provided insight into the generation and modulation of select auditory biomarkers of schizophrenia including auditory steady-state responses and mismatch negativity. Since neuro-oscillatory activity has been shown to be relatively preserved across species, we highlight how incorporating the analysis of local and network-level oscillations from multiple nodes across different pathways involved in auditory processing has been used to further the precision of translational comparisons across species.

40-Hz Auditory Steady-State Responses in Schizophrenia: Toward a Mechanistic Biomarker for Circuit Dysfunctions and Early Detection and Diagnosis

There is converging evidence that 40-Hz auditory steady-state responses (ASSRs) are robustly impaired in schizophrenia and could constitute a potential biomarker for characterizing circuit dysfunctions as well as enable early detection and diagnosis. Here, we provide an overview of the mechanisms involved in 40-Hz ASSRs, drawing on computational, physiological, and pharmacological data with a focus on parameters modulating the balance between excitation and inhibition. We will then summarize findings from electro- and magnetoencephalographic studies in participants at clinical high risk for psychosis, patients with first-episode psychosis, and patients with schizophrenia to identify the pattern of deficits across illness stages, the relationship with clinical variables, and the prognostic potential. Finally, data on genetics and developmental modifications will be reviewed, highlighting the importance of late modifications of 40-Hz ASSRs during adolescence, which are closely related to the underlying changes in GABA (gamma-aminobutyric acid) interneurons. Together, our review suggests that 40-Hz ASSRs may constitute an informative electrophysiological approach to characterize circuit dysfunctions in psychosis that could be relevant for the development of mechanistic biomarkers.

Neurophysiological markers of depression detection and severity prediction in first-episode major depressive disorder

OBJECTIVE

Deviant γ auditory steady-state responses (γ-ASSRs) have been documented in some psychiatric disorders. Nevertheless, the role of γ-ASSR in drug-naïve first-episode major depressive disorder (FEMD) patients remains equivocal. This study aimed to examine whether γ-ASSRs are impaired in FEMD patients and predict depression severity.

METHODS

Cortical reactivity was assessed in a cohort of 28 FEMD patients relative to 30 healthy control (HC) subjects during an ASSR paradigm randomly presented at 40 and 60 Hz. Event-related spectral perturbation and inter-trial phase coherence (ITC) were calculated to quantify dynamic changes of the γ-ASSR. Receiver operating characteristic curve combined with binary logistic regression were then employed to summarize ASSR variables that maximally differentiated groups.

RESULTS

FEMD patients exhibited significantly inferior 40 Hz-ASSR-ITC in the right hemisphere versus HC subjects (p = 0.007), along with attenuated θ-ITC that reflected underlying impairments in θ responses during 60 Hz clicks (p < 0.05). Moreover, the 40 Hz-ASSR-ITC and θ-ITC in the right hemisphere can be used as a combinational marker to detect FEMD patients with 84.0 % sensitivity and 81.5 % specificity (area under the curve was 0.868, 95 % CI: 0.768-0.968). Pearson's correlations between the depression severity and ASSR variables were further conducted. The symptom severity of FEMD patients was negatively correlated with 60 Hz-ASSR-ITC in the midline and right hemisphere, possibly indicating that depression severity mediated high γ neural synchrony.

CONCLUSIONS

Our findings provide critical insight into the pathological mechanism of FEMD, suggesting first that 40 Hz-ASSR-ITC and θ-ITC in right hemisphere constitute potential neurophysiological markers for early depression detection, and second, that high γ entrainment deficits may contribute to underlying symptom severity in FEMD patients.

Temporal imprecision and phase instability in schizophrenia resting state EEG

Schizophrenia is characterized by temporal imprecision and irregularities on neuronal, psychological cognitive, and behavioral levels which are usually tested during task-related activity. This leaves open whether analogous temporal imprecision and irregularities can already be observed in the brain's spontaneous activity as measured during the resting state; this is the goal of our study. Building on recent task-related data, we, using EEG, aimed to investigate the temporal precision and regularity of phase coherence over time in healthy, schizophrenia, and bipolar disorder participants. To this end, we developed a novel methodology, nominal frequency phase stability (NFPS), that allows to measure stability over phase angles in selected frequencies. By applying sample entropy quantification to the time-series of the nominal frequency phase angle time series, we found increased irregularities in theta activity over a frontocentral electrode in schizophrenia but not in bipolar disorder. We therefore assume that temporal imprecision and irregularity already occur in the brain's spontaneous activity in schizophrenia.

Prolonged Intrinsic Neural Timescales Dissociate from Phase Coherence in Schizophrenia

Input processing in the brain is mediated by phase synchronization and intrinsic neural timescales, both of which have been implicated in schizophrenia. Their relationship remains unclear, though. Recruiting a schizophrenia EEG sample from the B-SNIP consortium dataset (n = 134, 70 schizophrenia patients, 64 controls), we investigate phase synchronization, as measured by intertrial phase coherence (ITPC), and intrinsic neural timescales, as measured by the autocorrelation window (ACW) during both the rest and oddball-task states. The main goal of our paper was to investigate whether reported shifts from shorter to longer timescales are related to decreased ITPC. Our findings show (i) decreases in both theta and alpha ITPC in response to both standard and deviant tones; and (iii) a negative correlation of ITPC and ACW in healthy subjects while such correlation is no longer present in SCZ participants. Together, we demonstrate evidence of abnormally long intrinsic neural timescales (ACW) in resting-state EEG of schizophrenia as well as their dissociation from phase synchronization (ITPC). Our data suggest that, during input processing, the resting state's abnormally long intrinsic neural timescales tilt the balance of temporal segregation and integration towards the latter. That results in temporal imprecision with decreased phase synchronization in response to inputs. Our findings provide further evidence for a basic temporal disturbance in schizophrenia on the different timescales (longer ACW and shorter ITPC), which, in the future, might be able to explain common symptoms related to the temporal experience in schizophrenia, for example temporal fragmentation.

Hybrid Genetic Algorithm for Clustering IC Topographies of EEGs

Clustering of independent component (IC) topographies of Electroencephalograms (EEG) is an effective way to find brain-generated IC processes associated with a population of interest, particularly for those cases where event-related potential features are not available. This paper proposes a novel algorithm for the clustering of these IC topographies and compares its results with the most currently used clustering algorithms. In this study, 32-electrode EEG signals were recorded at a sampling rate of 500 Hz for 48 participants. EEG signals were pre-processed and IC topographies computed using the AMICA algorithm. The algorithm implements a hybrid approach where genetic algorithms are used to compute more accurate versions of the centroids and the final clusters after a pre-clustering phase based on spectral clustering. The algorithm automatically selects the optimum number of clusters by using a fitness function that involves local-density along with compactness and separation criteria. Specific internal validation metrics adapted to the use of the absolute correlation coefficient as the similarity measure are defined for the benchmarking process. Assessed results across different ICA decompositions and groups of subjects show that the proposed clustering algorithm significantly outperforms the (baseline) clustering algorithms provided by the software EEGLAB, including CORRMAP.

Extraction of Individual EEG Gamma Frequencies from the Responses to Click-Based Chirp-Modulated Sounds

Activity in the gamma range is related to many sensory and cognitive processes that are impaired in neuropsychiatric conditions. Therefore, individualized measures of gamma-band activity are considered to be potential markers that reflect the state of networks within the brain. Relatively little has been studied in respect of the individual gamma frequency (IGF) parameter. The methodology for determining the IGF is not well established. In the present work, we tested the extraction of IGFs from electroencephalogram (EEG) data in two datasets where subjects received auditory stimulation consisting of clicks with varying inter-click periods, covering a 30-60 Hz range: in 80 young subjects EEG was recorded with 64 gel-based electrodes; in 33 young subjects, EEG was recorded using three active dry electrodes. IGFs were extracted from either fifteen or three electrodes in frontocentral regions by estimating the individual-specific frequency that most consistently exhibited high phase locking during the stimulation. The method showed overall high reliability of extracted IGFs for all extraction approaches; however, averaging over channels resulted in somewhat higher reliability scores. This work demonstrates that the estimation of individual gamma frequency is possible using a limited number of both the gel and dry electrodes from responses to click-based chirp-modulated sounds.

The 40-Hz auditory steady-state response in bipolar disorder: A meta-analysis

OBJECTIVE

Bipolar disorder is characterized by aberrant neurophysiological responses as measured with electroencephalography (EEG) and magnetoencephalography (MEG), including the 40-Hz auditory steady-state response (ASSR). 40-Hz ASSR deficits are also found in patients with schizophrenia and may represent a transdiagnostic biomarker of neuronal circuit dysfunction. In this systematic review and meta-analysis, we summarize and evaluate the evidence for 40-Hz ASSR deficits in patients with bipolar disorder.

METHODS

We identified studies from PubMed, EMBASE, and SCOPUS. We assessed the risk of bias, calculated Hedges' g meta-level effect sizes, and investigated small-study effects using funnel plots and Egger regression.

RESULTS

Seven studies, comprising 396 patients with bipolar disorder and 404 healthy controls, were included in the meta-analysis. Studies displayed methodological heterogeneity and an overall high risk of bias. Patients with bipolar disorder showed consistent reductions in 40-Hz ASSR evoked power (Hedges' g = -0.49; 95% confidence intervals [-0.67, -0.31]) and inter-trial phase coherence (ITPC) (Hedges' g = -0.43; 95 %CI [-0.58, -0.29]) compared with healthy controls.

CONCLUSIONS

Our meta-analysis provides evidence that 40-Hz ASSRs are reduced in patients with bipolar disorder compared with healthy controls.

SIGNIFICANCE

Future large-scale studies are warranted to link 40-Hz ASSR deficits to clinical features and developmental trajectories.

Decreased BOLD signals elicited by 40-Hz auditory stimulation of the right primary auditory cortex in bipolar disorder: An fMRI study

BACKGROUND

A number studies have been conducted on abnormalities in the cortical circuitry of gamma oscillations, including deficit in auditory steady-state response (ASSR) to gamma-frequency (≧ 30-Hz) stimulation, in patients with bipolar disorder (BD). In the current study, we investigated neural responses during click stimulation by blood oxygen level-dependent (BOLD) signals. We focused on Broadman 41 and 42, the main sources of ASSR.

MATERIALS AND METHODS

We acquired BOLD responses elicited by click trains of 80-, 40-, 30- and 20-Hz frequencies from 25 patients with BD to 27 healthy controls (HC) with normal hearing between 22 and 59 years of age assessed via a standard general linear-model-based analysis. We extracted contrast values by identifying the primary auditory cortex and Brodmann areas 41 and 42 as regions of interest (ROI)s.

RESULTS

BD group showed significantly decreased ASSR-BOLD signals in response to 40-Hz stimuli compared to the HC group in the right Brodmann areas 41 and 42. We found significant negative correlations between the BOLD change in the right Brodmann areas 41 and 42 and Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) scores, also the BOLD change in the right Brodmann areas 41 and 42 and the Positive and Negative Syndrome Scale (PANSS)-Negative scores.

CONCLUSION

The observed decrease in BOLD signal patterns in the right primary auditory cortex during 40-Hz ASSR may be a potential biomarker option for bipolar disorder.