P50 sensory gating in panic disorder

Influence of GABAA and GABAB receptor activation on auditory sensory gating and its association with anxiety in healthy volunteers

BACKGROUND

Dysfunctional sensory gating in anxiety disorders, indexed by the failure to inhibit the P50 event-related potential (ERP) to repeated stimuli, has been linked to deficits in the major inhibitory neurotransmitter γ-aminobutyric acid (GABA).

AIMS/METHODS

This study, conducted in 30 healthy volunteers, examined the acute effects of GABAA (lorazepam: 1 mg) and GABAB receptor (baclofen: 10 mg) agonists on P50 measures of auditory sensory gating within a paired-stimulus (S1-S2) paradigm and assessed changes in gating in relation to self-ratings of anxiety.

RESULTS

Compared to placebo, lorazepam reduced ERP indices of sensory gating by attenuating response to S1. Although not directly impacting P50 inhibition, baclofen-induced changes in gating (relative to placebo) were negatively correlated with trait but not state anxiety.

CONCLUSIONS

These preliminary findings support the involvement of GABA in sensory gating and tentatively suggest a role for GABAB receptor signaling in anxiety-associated gating dysregulation.

Neural oscillations underlying the neural gating of respiratory sensations in generalized anxiety disorder

Individuals with generalized anxiety disorder (GAD) have been shown to have altered neural gating of respiratory sensations (NGRS) using respiratory-related evoked potentials (RREP); however, corresponding neural oscillatory activities remain unexplored. The present study aimed to investigate altered NGRS in individuals with GAD using both time and time-frequency analysis. Nineteen individuals with GAD and 28 healthy controls were recruited. Paired inspiratory occlusions were delivered to elicit cortical neural activations measured from electroencephalography. The GAD group showed smaller N1 amplitudes to the first stimulus (S1), lower evoked gamma and larger evoked beta oscillations compared to controls. Both groups showed larger N1, P3, beta power and theta power in response to S1 compared to S2, suggesting a neural gating phenomenon. These findings suggest that N1, gamma and beta frequency oscillations may be indicators for altered respiratory sensation in GAD populations and that the N1, P3, beta and theta oscillations can reflect the neural gating of respiratory sensations.

Trait and State Anxiety Effects on Mismatch Negativity and Sensory Gating Event-Related Potentials

We used the auditory roving oddball to investigate whether individual differences in self-reported anxiety influence event-related potential (ERP) activity related to sensory gating and mismatch negativity (MMN). The state-trait anxiety inventory (STAI) was used to assess the effects of anxiety on the ERPs for auditory change detection and information filtering in a sample of thirty-six healthy participants. The roving oddball paradigm involves presentation of stimulus trains of auditory tones with certain frequencies followed by trains of tones with different frequencies. Enhanced negative mid-latency response (130-230 ms post-stimulus) was marked at the deviant (first tone) and the standard (six or more repetitions) tone at Fz, indicating successful mismatch negativity (MMN). In turn, the first and second tone in a stimulus train were subject to sensory gating at the Cz electrode site as a response to the second stimulus was suppressed at an earlier latency (40-80 ms). We used partial correlations and analyses of covariance to investigate the influence of state and trait anxiety on these two processes. Higher trait anxiety exhibited enhanced MMN amplitude (more negative) (F(1,33) = 14.259, p = 6.323 × 10-6, ηp2 = 0.302), whereas state anxiety reduced sensory gating (F(1,30) = 13.117, p = 0.001, ηp2 = 0.304). Our findings suggest that high trait-anxious participants demonstrate hypervigilant change detection to deviant tones that appear more salient, whereas increased state anxiety associates with failure to filter out irrelevant stimuli.

Investigation of auditory P50 sensory gating with sexual visual stimuli in patients with vaginismus

OBJECTIVES

The aim of the study was to investigate sensory information processing induced by visual sexual stimuli and to assess its relationship with sexual behaviors and symptoms in patients with vaginismus.

METHODS

Twenty-one patients with vaginismus and 20 controls were included in the study. The sociodemographic information and sexual life history of the patients with vaginismus and controls were examined and electrophysiological measurements related to auditory P50 sensory gating were obtained using a double click paradigm during by sexual/horror visual stimulation, which was thought to be related to the pathophysiology of the disease.

RESULTS

P50 suppression ratios during visual sexual stimuli were lower in vaginismus group compared to the control group. There was no difference in P50 suppression ratios during visual horror stimuli when the two groups were compared. The P50 suppression of the vaginismus group with visual sexual stimuli was found to be lower than P50 suppression with visual horror stimuli. A positive moderate correlation was found between the duration of foreplay and P50 suppression ratio during visual sexual stimuli in vaginismus group.

CONCLUSION

Our study revealed that patients with vaginismus had sensory gating impairment during visual sexual stimuli. Increase in the duration of foreplay in vaginismus patients may improve sensory gating impairment by affecting sensory gating functions.

Sensorimotor and sensory gating in depression, anxiety, and their comorbidity

OBJECTIVES

Abnormal attentional and cognitive processes are thought to increase the risk for depression and anxiety. To improve understanding of brain mechanisms of anxiety and depressive disorders and condition of their comorbidity, the study of early attentional processes was provided.

METHODS

Participants were patients with depressive (80 s.), anxiety (69 s.), and comorbid (41 s.) disorders, and healthy volunteers (50 s.). Acoustic startle response (ASR) and P50 component of the auditory event-related potential were recorded.

RESULTS

In the ASR model decreased startle response amplitude at the left eye in patients with comorbid disorder was found, and ASR latency was lengthened in all clinical groups. Deficit of prepulse inhibition was unique for comorbid disorder, and might be considered as risk of evolution to more serious condition. Reduced prepulse facilitation was revealed in patients with comorbid and anxiety disorders. In P50 suppression paradigm decreased S1 response amplitude was revealed in all clinical groups, P50 latency was prolonged in depressive and comorbid patients, and P50 suppression deficit was observed in depression and anxiety groups.

CONCLUSIONS

The obtained results might be useful for development of integrative neural models of comorbidity of anxiety and depression, and elaboration of diagnostic and therapeutic approaches.

Dysfunctional frontal activation of mismatch negativity in panic disorder: A magnetoencephalographic study

BACKGROUND

Mismatch negativity (MMN) or its magnetic counterpart (MMNm) is a neurophysiological signal to reflect the automatic change-detection ability. However, MMN studies in patients with panic disorder (PD) showed contrasting results using electroencephalographic (EEG) recordings. The present study attempted to overcome the limitations of EEG methodology by means of a whole-head magnetoencephalography (MEG) combined with the depth-weighted minimum norm estimate method to conduct an in-depth investigation on the MMNm at the cortical level in patients with PD.

METHODS

We recruited 22 healthy controls (HC) and 20 patients with PD to perform auditory oddball paradigm during MEG recordings. The cortical MMNm amplitudes and latencies in the superior temporal gyrus, inferior parietal lobule, and inferior frontal gyrus (IFG) were compared between the HC and PD groups. The correlations between MMNm responses and clinical measurement were also examined.

RESULTS

Compared with the HC group, the PD group demonstrated significantly reduced MMNm amplitudes in the IFG. Furthermore, higher trait scores of the State-Trait Anxiety Inventory were associated with lower MMNm amplitudes of the right IFG among patients with PD.

LIMITATIONS

Generalization of the current results to other settings or samples should be made cautiously due to the use of different medication regimens and presence of comorbidities in our patients.

CONCLUSIONS

Our data suggest dysfunctional pre-attentive change-detection ability in patients with PD, particularly in the IFG.

Reduced coupling of somatosensory gating and gamma oscillation in panic disorder

Previous studies have reported that patients with panic disorder (PD) exhibited an aberrant level of GABA concentration, an inhibitory neurotransmitter in the human brain. However, it remains substantially unclear whether the inhibitory function regarding the neurophysiological characteristics is altered in this disease. Sensory gating (SG) is considered as an automatic inhibitory function in the sensory cortex. In addition, brain's gamma oscillation within the sensory cortex is another index to reflect inhibitory function. Here we aimed to investigate whether the patients with PD showed altered inhibitory function in the somatosensory system, including the primary (SI) and secondary (SII) somatosensory cortices. A total of 20 healthy controls and 21 patients with PD underwent magnetoencephalographic recordings. Paired-pulse and single-pulse paradigms were used to study SG and gamma oscillations, respectively. There were no significant between-group differences in the SG function in the SI and SII. However, patients with PD demonstrated a reduced gamma power in the SI. Among the healthy individuals, strong associations between SG ratios and gamma frequency values were observed in the SI. However, such a functional relationship disappeared among the patients with PD. We suggested the reduced coupling of SG and gamma oscillation as one of the neural signatures in PD.

Cross-modal relationships of neural gating with the subjective perception of respiratory and somatosensory sensations

Neural gating is a phenomenon whereby the response to a stimulus in the electroencephalogram (EEG) is attenuated when preceded by an identical stimulus. Attenuation of paired auditory clicks has repeatedly been shown to be affected in mental disorders, for example, schizophrenia. Neural gating has also been measured for respiratory and somatosensory sensations, however the attenuation of bodily relevant stimuli has not yet been systematically related to the subjective perception of bodily sensations. This research direction is potentially relevant to explaining disease trajectories in psychosomatic conditions characterized by chronic breathlessness and/or pain. In the present study, we recorded high-density EEG from 85 healthy young adults while they experienced brief paired respiratory occlusions and brief paired electrocutaneous stimulation of the wrist. The event-related potential N1 was measured centro-laterally in response to the second relative to the first stimulus to quantify neural gating in both sensory domains. Participants experienced resistive loaded breaths and electrocutaneous stimuli of various intensities, rated their perceived intensity and unpleasantness, and performed magnitude estimation. Relationships of respiratory and somatosensory neural gating to the subjective intensity and unpleasantness of sensations, as well as the ability to discriminate sensations of varying intensities, were investigated intra-modally and cross-modally. We report significant relationships of the somatosensory neural gating to perceived intensity and unpleasantness of respiratory and somatosensory sensations, with the stronger neural gating relating to a stronger subjective intensity and unpleasantness. We discuss these unexpected findings through the lens of individual differences and different theoretical accounts on the origins of cortical attenuation of repetitive stimuli.

P50, N100, and P200 Sensory Gating in Panic Disorder

Panic disorder (PD) has been linked to abnormalities in information processing. However, only little evidence has been published for sensory gating in PD. Sensory gating describes the brain's ability to exclude stimuli of low relevance from higher level information processing, thereby sustaining efficient cognitive processing. Deficits in sensory gating have been associated with various psychiatric conditions, most prominently schizophrenia. In this case-control event-related potential study, we tested 32 patients with PD and 39 healthy controls in a double click paradigm. Both groups were compared with regard to pre-attentive (P50), early-attentive (N100), and late-attentive (P200) sensory gating indices. Contrary to a hypothesized deficit, PD patients and healthy controls showed no differences in P50, N100 and P200 values. These results suggest that sensory gating seems to be functional across the pre-attentive, early-attentive, and late-attentive time span in this clinical population. Given this consistency across auditory sensory gating indices, further research aiming to clarify information processing deficits in PD should focus on other neurophysiological markers to investigate information processing deficits in PD (eg, P300, error-related negativity or mismatch negativity).

Meta-analysis of auditory P50 sensory gating in schizophrenia and bipolar disorder

The ability of the brain to reduce the amount of trivial or redundant sensory inputs is called gating function. Dysfunction of sensory gating may lead to cognitive fragmentation and poor real-world functioning. The auditory dual-click paradigm is a pertinent neurophysiological measure of sensory gating function. This meta-analysis aimed to examine the subcomponents of abnormal P50 waveforms in bipolar disorder and schizophrenia to assess P50 sensory gating deficits and examine effects of diagnoses, illness states (first-episode psychosis vs. schizophrenia, remission vs. episodes in bipolar disorder), and treatment status (medication-free vs. medicated). Literature search of PubMed between Jan 1st 1980 and March 31st 2019 identified 2091 records for schizophrenia, 362 for bipolar disorder. 115 studies in schizophrenia (4932 patients), 16 in bipolar disorder (975 patients) and 10 in first-degree relatives (848 subjects) met the inclusion criteria. P50 sensory gating ratio (S2/S1) and S1-S2 difference were significantly altered in schizophrenia, bipolar disorder and their first-degree relatives. First-episode psychosis did not differ from schizophrenia, however episodes altered P50 sensory gating in bipolar disorder. Medications improve P50 sensory gating alterations in schizophrenia significantly and at trend level in bipolar disorder. Future studies should examine longitudinal course of P50 sensory gating in schizophrenia and bipolar disorder.

Abnormal frontal generator during auditory sensory gating in panic disorder: An MEG study

Patients with panic disorder (PD) exhibit abnormalities in early-stage information processing, even for the nonthreatening stimuli. A previous event-related potential study reported that PD patients show a deficit in sensory gating (SG), a protective mechanism of the brain to filter out irrelevant sensory inputs. However, there is no clear understanding about the neural correlates of SG deficits in PD. Moreover, whether SG deficits, if any, are associated with clinical manifestations remain unknown. In this study, 18 patients with PD and 20 age- and gender-matched healthy controls were recruited to perform auditory paired-stimulus paradigm using magnetoencephalographic (MEG) recordings. Results showed that PD patients demonstrated significantly higher M50 SG ratios in the right inferior frontal gyrus (RIFG) and higher M100 SG ratios in both RIFG and right superior temporal gyrus (RSTG) than those of the control group. It was important to note that in the RIFG, the M50 SG ratios correlated significantly with the scores of Body Sensation Questionnaire (BSQ) and Distractibility scale of Sensory Gating Inventory among patients with PD. In conclusion, this study suggests that PD patients exhibited a deficient ability to filter out irrelevant information, and such a defect might lead to cognitive misinterpretation of somatic sensations and distractibility.

Reduced Sensitivity to Non-Fear-Related Stimulus Changes in Panic Disorder

Panic disorder (PD) is associated with increased body vigilance and reduced cognitive resources directed at non-fear-related stimuli, particularly in the absence of stimulus-rich environments. To date, only few studies have investigated whether this deficit in PD is reflected in reduced mismatch negativity (MMN), an event-related potential indexing preattentive sensitivity to unexpected stimulus changes. We tested 35 patients affected by PD and 42 matched healthy controls in an oddball paradigm, using frequency and duration deviant stimuli to measure auditory MMN. PD patients displayed reduced duration MMN amplitudes in comparison to healthy controls. No group differences were detected for duration MMN latency, as well as frequency MMN indices. Results support the notion of reduced processing of non-fear-related stimuli in PD patients, particularly with regard to the preattentive processing of sound duration deviants. Additionally, our findings are in line with clinical studies reporting divergent deficits in preattentive processing of frequency and duration deviants.

Long-latency suppression of auditory and somatosensory change-related cortical responses

Sensory suppression is a mechanism that attenuates selective information. As for long-latency suppression in auditory and somatosensory systems, paired-pulse suppression, observed as 2 identical stimuli spaced by approximately 500 ms, is widely known, though its mechanism remains to be elucidated. In the present study, we investigated the relationship between auditory and somatosensory long-latency suppression of change-related cortical responses using magnetoencephalography. Somatosensory change-related responses were evoked by an abrupt increase in stimulus strength in a train of current-constant square wave pulses at 100 Hz to the left median nerve at the wrist. Furthermore, auditory change-related responses were elicited by an increase in sound pressure by 15 dB in a continuous sound composed of a train of 25-ms pure tones. Binaural stimulation was used in Experiment 1, while monaural stimulation was used in Experiment 2. For both somatosensory and auditory stimuli, the conditioning and test stimuli were identical, and inserted at 2400 and 3000 ms, respectively. The results showed clear suppression of the test response in the bilateral parisylvian region, but not in the postcentral gyrus of the contralateral hemisphere in the somatosensory system. Similarly, the test response in the bilateral supratemporal plane (N100m) was suppressed in the auditory system. Furthermore, there was a significant correlation between suppression of right N100m and right parisylvian activity, suggesting that similar mechanisms are involved in both. Finally, a high test-retest reliability for suppression was seen with both modalities. Suppression revealed in the present study is considered to reflect sensory inhibition ability in individual subjects.

New paradigm for auditory paired pulse suppression

Sensory gating is a mechanism of sensory processing used to prevent an overflow of irrelevant information, with some indexes, such as prepulse inhibition (PPI) and P50 suppression, often utilized for its evaluation. In addition, those are clinically important for diseases such as schizophrenia. In the present study, we investigated long-latency paired-pulse suppression of change-related cortical responses using magnetoencephalography. The test change-related response was evoked by an abrupt increase in sound pressure by 15 dB in a continuous sound composed of a train of 25-ms pure tones at 65 dB. By inserting a leading change stimulus (prepulse), we observed suppression of the test response. In Experiment 1, we examined the effects of conditioning-test intervals (CTI) using a 25-ms pure tone at 80 dB as both the test and prepulse. Our results showed clear suppression of the test response peaking at a CTI of 600 ms, while maximum inhibition was approximately 30%. In Experiment 2, the effects of sound pressure on prepulse were examined by inserting prepulses 600 ms prior to the test stimulus. We found that a paired-pulse suppression greater than 25% was obtained by prepulses larger than 77 dB, i.e., 12 dB louder than the background, suggesting that long latency suppression requires a relatively strong prepulse to obtain adequate suppression, different than short-latency paired-pulse suppression reported in previous studies. In Experiment 3, we confirmed similar levels of suppression using electroencephalography. These results suggested that two identical change stimuli spaced by 600 ms were appropriate for observing the long-latency inhibition. The present method requires only a short inspection time and is non-invasive.

Diminished Infant P50 Sensory Gating Predicts Increased 40-Month-Old Attention, Anxiety/Depression, and Externalizing Symptoms

OBJECTIVE

When behavioral problems resulting from attentional difficulties present, often in preschool, it is unknown whether these problems represent preexisting altered brain development or new brain changes. This study examines whether infant sensory gating of auditory evoked potentials predicts parent-reported behavior at 40 months.

METHOD

P50 sensory gating, an auditory evoked potential measure reflective of inhibitory processes in the brain, was measured in 50 infants around 70 days old. Parents, using the Child Behavior Checklist, reported on the child's behavior at 40 months.

RESULTS

Controlling for gender, infants with diminished sensory gating had more problems later with externalizing behavior ( F = 4.17, ndf = 1, ddf = 46, p = .047), attentional problems ( F = 5.23, ndf = 1, ddf = 46, p = .027), and anxious/depressed symptoms ( F = 5.36, ndf = 1, ddf = 46, p = .025).

CONCLUSION

Diminished infant P50 sensory gating predicts attention symptoms 3 years later. These results support the hypothesis that preschool attentional dysfunction may relate to altered brain development that is detectable years prior to symptom onset.

Endophenotypes in Schizophrenia for the Perinatal Period: Criteria for Validation

Endophenotypes are disease-associated phenotypes that are thought to reflect the neurobiological or other mechanisms that underlie the more overt symptoms of a psychiatric illness. Endophenotypes have been critical in understanding the genetics, neurobiology, and treatment of schizophrenia. Because psychiatric illnesses have multiple causes, including both genetic and nongenetic risk factors, an endophenotype linked to one of the mechanisms may be expressed more frequently than the disease itself. However, in schizophrenia research, endophenotypes have almost exclusively been studied in older adolescents or adults who have entered or passed through the age of risk for the disorder. Yet, schizophrenia is a neurodevelopmental disorder where prenatal development starts a cascade of brain changes across the lifespan. Endophenotypes have only minimally been utilized to explore the perinatal development of vulnerability. One major impediment to the development of perinatally-useful endophenotypes has been the established validity criteria. For example, the criterion that the endophenotype be more frequently present in those with disease than those without is difficult to demonstrate when there can be a decades-long period between endophenotype measurement and the age of greatest risk for onset of the disorder. This article proposes changes to the endophenotype validity criteria appropriate to perinatal research and reviews how application of these modified criteria helped identify a perinatally-usable phenotype of risk for schizophrenia, P50 sensory gating, which was then used to propose a novel perinatal primary prevention intervention.

Mismatch negativity indices of enhanced preattentive automatic processing in panic disorder as measured by a multi-feature paradigm

Panic disorder (PD) is a mental disorder characterized by recurrent panic attacks and worrying about having subsequent attacks. Mismatch negativity (MMN) has been established as a correlate of preattentive automatic processing. The aim of the present study is to investigate the preattentive automatic information processing in PD patients as measured by MMN. Subjects included 15 medication-free patients with a DSM-IV diagnosis of PD and 15 age-matched healthy volunteers. MMN was investigated using event-related potentials. The protocol used a multi-feature paradigm. Mean amplitudes and peak latencies were subjected to repeated-measures ANOVAs. PD patients showed a significantly increased MMN of sound intensity and location compared with healthy participants. The correlation between the amplitudes of intensity-MMN and disease severity was also significant. These data provide evidence of anomalous preattentive automatic information processing in PD patients. In particular, the abnormality may be specific for PD.

An auditory-neuroscience perspective on the development of selective mutism

Selective mutism (SM) is a relatively rare psychiatric disorder of childhood characterized by consistent inability to speak in specific social situations despite the ability to speak normally in others. SM typically involves severe impairments in social and academic functioning. Common complications include school failure, social difficulties in the peer group, and aggravated intra-familial relationships. Although SM has been described in the medical and psychological literatures for many years, the potential underlying neural basis of the disorder has only recently been explored. Here we explore the potential role of specific auditory neural mechanisms in the psychopathology of SM and discuss possible implications for treatment.

Stability of P50 auditory sensory gating during sleep from infancy to 4 years of age

The stability of cerebral inhibition was assessed across early childhood using a paired-click auditory sensory gating paradigm. The P50 ERP was measured during REM (or its infant analogue, active sleep) and NREM sleep in 14 children at approximately 3 months of age and again at approximately 4 years of age. Evoked response amplitudes, latencies, and the S2/S1 ratio of the amplitudes of the evoked responses were compared between the two visits. Significant reliability was found for the S2/S1 ratio (r = .73, p = .003) during REM but not non REM sleep (r = -.05, p = .88). A significant stimulus number by sleep stage interaction (F(1,12) = 17.1, p = .001) demonstrated that the response to the second stimulus decreased during REM but not NREM sleep. These findings suggest that this measure is stable during REM sleep across early childhood, is not affected by age, and is sleep-state dependent. P50 sensory gating is a biomarker which, if used properly, may provide a mechanism to further explore changes in the developing brain or may help with early screening for psychiatric illness vulnerability.

The Effects of Vigilance and Visual Distraction on the P50 Mid-Latency Auditory Evoked Potential

Sensory gating function has been investigated through measurement of the P50 evoked potential. However, the susceptibility of auditory P50 sensory gating to attentional modulation remains unclear. We sought to investigate the effects of vigilance (sustaining alertness across multiple recording blocks) and visual distraction (watching a muted movie versus a static fixation cross). We specifically chose a movie as the distracting stimulus because investigators sometimes show muted movies during P50 paradigms and the effects of this method were previously unknown. We recorded evoked potentials in a standard paired-click paradigm from groups watching a movie or static fixation cross; both groups completed four identical blocks of recording. Ratings of fatigue were recorded throughout the experiment. P50 and N100 amplitude showed signs of habituation, although N100’s amplitude reduction was more prominent than P50. P50 suppression did not change over the course of the recording session, despite increasing fatigue ratings. P50 suppression was significantly stronger for the participants who watched a movie during the recording. When comparing P50 gating results across studies, care should be taken to consider differing methodologies.

Electroencephalographic findings in panic disorder

Some studies have reported the importance of electroencephalography (EEG) as a method for investigating abnormal parameters in psychiatric disorders. Different findings in time and frequency domain analysis with regard to central nervous system arousal during acute panic states have already been obtained. This study aimed to systematically review the EEG findings in panic disorder (PD), discuss them having a currently accepted neuroanatomical hypothesis for this pathology as a basis, and identify limitations in the selected studies. Literature search was conducted in the databases PubMed and ISI Web of Knowledge, using the keywords electroencephalography and panic disorder; 16 articles were selected. Despite the inconsistency of EEG findings in PD, the major conclusions about the absolute power of alpha and beta bands point to a decreased alpha power, while beta power tends to increase. Different asymmetry patterns were found between studies. Coherence studies pointed to a lower degree of inter-hemispheric functional connectivity at the frontal region and intra-hemispheric at the bilateral temporal region. Studies on possible related events showed changes in memory processing in PD patients when exposed to aversive stimuli. It was noticed that most findings reflect the current neurobiological hypothesis of PD, where inhibitory deficits of the prefrontal cortex related to the modulation of amygdala activity, and the subsequent activation of subcortical regions, may be responsible to trigger anxiety responses. We approached some important issues that need to be considered in further researches, especially the use of different methods for analyzing EEG signals.

The neuropsychological and neurophysiological profile of women with pseudoseizure

OBJECTIVE

Our aim in this study was to compare the assessments of neuropsychological tests and the p50 neurophysiological test of patients with seizure diagnosed as conversion disorder and healthy control subjects, and to investigate the neurological status in conversion disorder with pseudoseizure.

METHODS

A total of 22 female conversion disorder patients with convulsions diagnosed according to SCID-I/CV and 22 healthy women were included in the assessment. The participants were administered WMS-R, the cancellation test, and the Stroop test as neuropsychological tests and p50 was assessed as a neurophysiological test.

RESULTS

The patient's results for the neuropsychological tests were found to be significantly low compared to the control group. The p50 sensory gating ratios of the patient group were statistically significantly lower than the controls. There was no significant correlation between the neuropsychological test scores and gating ratios of the patient and control groups.

CONCLUSIONS

This study is the first to check sensory gating in conversion disorder patients with pseudoseizure and its most important result is finding reduced p50 sensory gating in patients. Our results suggest that these patients have a neurological tendency to this disease due to functional neurophysiological features.

EEG microstate analysis in drug-naive patients with panic disorder

Patients with panic disorder (PD) have a bias to respond to normal stimuli in a fearful way. This may be due to the preactivation of fear-associated networks prior to stimulus perception. Based on EEG, we investigated the difference between patients with PD and normal controls in resting state activity using features of transiently stable brain states (microstates). EEGs from 18 drug-naive patients and 18 healthy controls were analyzed. Microstate analysis showed that one class of microstates (with a right-anterior to left-posterior orientation of the mapped field) displayed longer durations and covered more of the total time in the patients than controls. Another microstate class (with a symmetric, anterior-posterior orientation) was observed less frequently in the patients compared to controls. The observation that selected microstate classes differ between patients with PD and controls suggests that specific brain functions are altered already during resting condition. The altered resting state may be the starting point of the observed dysfunctional processing of phobic stimuli.

Probing the relative contribution of the first and second responses to sensory gating indices: a meta-analysis

Sensory gating deficit in schizophrenia patients has been well-documented. However, a central conceptual issue, regarding whether the gating deficit results from an abnormal initial response (S1) or difficulty in attenuating the response to the repeating stimulus (S2), raise doubts about the validity and utility of the S2/S1 ratio as a measure of sensory gating. This meta-analysis study, therefore, sought to determine the consistency and relative magnitude of the effect of the two essential components (S1 and S2) and the ratio. The results of weighted random effects meta-analysis revealed that the overall effect sizes for the S1 amplitude, S2 amplitude, and P50 S2/S1 ratio were -0.19 (small), 0.65 (medium to large), and 0.93 (large), respectively. These results confirm that the S2/S1 ratio and the repeating (S2) stimulus differ robustly between schizophrenia patients and healthy controls in contrast to the consistent but smaller effect size for the S1 amplitude. These findings are more likely to reflect defective inhibition of repeating redundant input rather than an abnormal response to novel stimuli.

P50 suppression in children with selective mutism: a preliminary report

Evidence suggests that children with selective mutism (SM) display significant aberrations in auditory efferent activity at the brainstem level that may underlie inefficient auditory processing during vocalization, and lead to speech avoidance. The objective of the present study was to explore auditory filtering processes at the cortical level in children with SM. The classic paired-click paradigm was utilized to assess suppression of the P50 event-related potential to the second, of two sequentially-presented clicks, in ten children with SM and 10 control children. A significant suppression of P50 to the second click was evident in the SM group, whereas no suppression effect was observed in controls. Suppression was evident in 90% of the SM group and in 40% of controls, whereas augmentation was found in 10% and 60%, respectively, yielding a significant association between group and suppression of P50. P50 to the first click was comparable in children with SM and controls. The adult-like, mature P50 suppression effect exhibited by children with SM may reflect a cortical mechanism of compensatory inhibition of irrelevant repetitive information that was not properly suppressed at lower levels of their auditory system. The current data extends our previous findings suggesting that differential auditory processing may be involved in speech selectivity in SM.

Impaired P50 suppression in fear extinction in obsessive-compulsive disorder

The processes of fear conditioning and extinction are thought to be related to the pathophysiology of anxiety disorders including obsessive-compulsive disorder (OCD). We have reported alterations of auditory P50 suppression in human fear conditioning and extinction in healthy control subjects (Kurayama et al., 2009). In the study, P50 suppression was impaired transiently in the course of fear acquisition and extinction. In this study, we investigated the changes of P50 suppression with OCD patients in the course of the same experimental paradigm. 39 patients with OCD and 21 healthy control subjects were recruited. In the acquisition phase of classical fear conditioning, 10 pairings of the conditioned stimulus (CS; the visual stimulus from a light-emitting diode) and the unconditioned stimulus (US; the electrical stimulus to the wrist) were administered, and in the extinction phase, 10 CS without US were administered. P50 auditory evoked potentials were measured as the first stimulus sound (S1) and the second stimulus sound (S2) in double-click paradigm with a 500 ms interval. P50 S2/S1 ratio was used to evaluate P50 suppression. The mean P50 S2/S1 ratio in patients with OCD significantly elevated from baseline level during the fear acquisition as that in healthy controls, but the elevated S2/S1 ratio did not recover to baseline level. The S2/S1 ratio in the extinction phase was significantly higher in the OCD patient group than in the healthy control group. In conclusion, our data suggested that P50 sensory gating in fear extinction was impaired in patients with OCD.

P50 sensory gating is related to performance on select tasks of cognitive inhibition

P50 suppression deficits have been documented in clinical and nonclinical populations, but the behavioral correlates of impaired auditory sensory gating remain poorly understood. In the present study, we examined the relationship between P50 gating and healthy adults' performance on cognitive inhibition tasks. On the basis of load theory (Lavie, Hirst, de Fockert, & Viding, 2004), we predicted that a high perceptual load, a possible consequence of poor auditory P50 sensory gating, would have differential (i.e., positive vs. negative) effects on performance of cognitive inhibition tasks. A dissociation was observed such that P50 gating was negatively related to interference resolution on a Stroop task and positively related to response inhibition on a go/no-go task. Our findings support the idea that a high perceptual load may be beneficial to Stroop performance because of the reduced processing of distractors but detrimental to performance on the go/no-go task because of interference with stimulus discrimination.

P50, N100, and P200 sensory gating: relationships with behavioral inhibition, attention, and working memory

P50, N100, and P200 auditory sensory gating could reflect mechanisms involved in protecting higher-order cognitive functions, suggesting relationships between sensory gating and cognition. This hypothesis was tested in 56 healthy adults who were administered the paired-click paradigm and two adaptations of the continuous performance test (Immediate/Delayed Memory Task, IMT/DMT). Stronger P50 gating correlated with fewer commission errors and prolonged reaction times on the DMT. Stronger N100 and P200 gating correlated with better discriminability on the DMT. Finally, prolonged P200 latency related to better discriminability on the IMT. These findings suggest that P50, N100, and P200 gating could be involved in protecting cognition by affecting response bias, behavioral inhibition, working memory, or attention.

Alterations of auditory p50 suppression in human fear conditioning and extinction

BACKGROUND

Auditory P50 suppression, assessed by using a paired auditory stimulus (S1 and S2) paradigm to record P50 mid-latency evoked potential, is assumed to reflect sensory gating. Recently, P50 suppression deficits were found in patients with anxiety disorders, including panic disorder, obsessive compulsive disorder, and posttraumatic stress disorder. The processes of fear conditioning are thought to play roles in pathophysiology of anxiety disorders. Our aim was to investigate whether sensory gating would be physiologically altered by fear conditioning.

METHODS

To clarify the relationship between classical fear conditioning and the sensory gating mechanism, we measured changes of P50 and N100 suppression of 21 healthy volunteers in control (baseline) phase, in fear acquisition phase, and in fear extinction phase.

RESULTS

The mean P50 S2/S1 ratio in fear acquisition phase was significantly elevated in comparison with that in control phase, and it recovered into basal level in extinction phase. In contrast, the mean N100 S2/S1 ratio showed no changes through all phases from fear acquisition to extinction.

CONCLUSIONS

These results suggest that the P50 but not N100 sensory gating mechanism might be physiologically associated with fear acquisition and extinction.

The right hemisphere fails to respond to temporal novelty in autism: evidence from an ERP study

OBJECTIVE

This study aimed to investigate electrophysiological correlates of initial attention orienting to temporally novel sound in children with autism (CWA).

METHODS

Twenty-one CWA (4-8 years) and 21 age-matched typically developing children (TDC) were presented with pairs of clicks separated by a 0.5s intra-pair interval, with longer (7-9s) intervals between pairs. Children watched a silent movie during click presentation. We assessed EEG perturbations and event-related potentials (ERP) in response to sounds of different temporal novelty - first (S1) and second (S2) clicks in the pair.

RESULTS

In TDC, the early attention-modulated midtemporal N1c wave evoked by S1 and corresponding EEG phase locking and power increase were right-lateralized and were bilaterally higher than those evoked by S2. CWA demonstrated abnormal S1 responses, characterized by reduced N1c amplitude and EEG phase locking in the right midtemporal region, reversed leftward lateralization of the phase locking, and diminished later frontal N2 wave. Their brain responses to S2 were essentially normal.

CONCLUSIONS

The impaired right hemispheric processing of temporary and contextually novel information and suboptimal lateralization of normally right-lateralized attention networks may be important features of autistic disorder.

SIGNIFICANCE

Results of this study contribute to the understanding of autism neurobiology.

The Role of Age, Gender, Education, and Intelligence in P50, N100, and P200 Auditory Sensory Gating

P50, N100, and P200 auditory sensory gating reflect distinct mechanisms involved in protecting the integrity of higher-order functions. They have been implicated in multiple psychiatric disorders. Recent studies showed the (limited) effects of age and gender on sensory gating in control subjects, suggesting there may be other sources of variance. Two potential sources may be education and intelligence (intellectual capability), variables that frequently differ across studies and across experimental groups. We explored potential effects of age, gender, education, and intelligence (Shipley intelligence scale) on P50, N100, and P200 sensory gating measured with the paired-click paradigm in 60 healthy subjects recruited from the general population. Increased intellectual capability related to stronger N100 and P200 gating and more pronounced N100 and P200 amplitudes. In addition, increased age related to weaker P200 gating and smaller P200 amplitudes. Gender had negligible effects. Intellectual capability or age could contribute to variation in N100 or P200 auditory sensory gating and should be controlled for when studying sensory gating in clinical and control groups.

P50 sensory gating ratios in schizophrenics and controls: a review and data analysis

Many studies have found that the P50 sensory gating ratio in a paired click task is smaller in normal control subjects than in patients with schizophrenia, indicating more effective sensory gating. However, a wide range of gating ratios has been reported in the literature for both groups. The purpose of this study was to compile these findings and to compare reported P50 gating ratios in controls and patients with schizophrenia. Current data collected from individual controls in eight studies from the University of California, Irvine (UCI), Indiana University (IU), and Yale University also are reported. The IU, UCI, and Yale data showed that approximately 40% of controls had P50 ratios within 1 S.D. below the mean of means for patients with schizophrenia. The meta-analysis rejected the null hypothesis that all studies showed no effect. The meta-analysis also showed that the differences were not the same across all studies. The mean ratios in 45 of the 46 group comparisons were smaller for controls than for patients, and the observed difference in means was significant for 35 of those studies. Reported gating ratios for controls from two laboratories whose findings were reported in the literature differed from all the other control groups. Variables affecting the gating ratio included band pass filter setting, rules regarding the inclusion of P30, sex, and age. Standards of P50 collection and measurement would help determine whether the gating ratio can be sufficiently reliable to be labeled an endophenotype, and suggestions are made toward this goal.

Deficits in auditory P50 inhibition in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is considered to involve abnormalities in inhibitory processes including gating systems. Auditory P50 inhibition, which is assessed by using a paired auditory stimulus paradigm to record P50 mid-latency evoked potential, is assumed to reflect sensory gating. In the present study, we investigated auditory P50 inhibition in subjects with OCD, and examined the relationship between P50 and clinical variables or neuropsychological performance. Twenty-six subjects with OCD and 26 age- and sex-matched healthy controls received P50 recording and neuropsychological tests. In the OCD subjects, we also evaluated clinical features including OC symptoms and subtypes of the disorder. P50 T/C ratios were significantly higher in OCD subjects than in control subjects (t=2.9, df=50, p=0.006). Compared to the controls, the OCD subjects performed significantly worse on the Symbol Digit Modalities Test (SDMT) and the Trail Making Test (TMT). There were no correlations between P50 T/C ratios and clinical variables or the results of neuropsychological tests. Our findings suggest that sensory gating deficits may be involved in the pathophysiology of OCD in a different way from clinical symptoms and executive attention dysfunction.