The P1 component of the middle latency auditory evoked potential predicts a practice effect during clinical trials in Alzheimer's disease

Middle latency auditory-evoked potentials in myotonic dystrophy: relation to the size of the CTG trinucleotide repeat and intelligent quotient

OBJECTIVE

Major components of MLAEPs are thought to originate in the temporal lobe. Absence of the Pb potential has been demonstrated in MLAEPs in Alzheimer's disease and demented Parkinson's disease patients. To validate usefulness of middle latency auditory-evoked potentials (MLAEPs) in evaluating the central nervous system (CNS) involvement of myotonic dystrophy (MyD).

METHODS

MLAEPs were recorded in eight patients with MyD and nine normal control subjects. In the patient group, the size of the CTG triplet repeat expansion within the dystrophia myotonica protein kinase (DMPK) gene and the revised Wechsler Adult Intelligence Scale (WAIS-R) were also assessed.

RESULTS

The latency of the Nb potential showed a significant correlation with the size of the CTG repeat expansion (r=0.734, P=0.036). The Pb latency also tended to prolong according to CTG amplification (r=0.644, P=0.087). The amplitudes of Na and Pa significantly increased compared with those of normal control subjects (P=0.024 and 0.016, respectively). However, they did not correlate with IQ or CTG amplification.

CONCLUSIONS

Abnormal MLAEPs may indicate CNS involvement in MyD. Although the precise generating mechanisms of Nb are unclear, the correlation of Nb latency with CTG amplification suggests that MLAEPs can reflect the extent of genetic abnormality.

Auditory sensory memory and the cholinergic system: implications for Alzheimer's disease

Auditory sensory memory represents one of the simplest types of short-term memory that can be studied electrophysiologically with mismatch negativity (MMN); a specific auditory event-related potential indexing automatic comparison of incoming stimuli to an existing memory trace. Previous results suggest that auditory sensory memory deteriorates in aging and especially in Alzheimer's disease (AD). It has remained unsettled, however, whether MMN is regulated by the cholinergic system, which is deteriorated in AD contributing to cognitive impairments. We recorded cortical auditory responses with a magnetometer from 13 healthy subjects after intravenous injection of scopolamine, centrally acting cholinergic antagonist, or glycopyrrolate, a drug with a peripheral anticholinergic properties without penetrating the blood-brain barrier, using a double-blind protocol. Scopolamine reduced MMNm amplitude in response to frequency, but not duration, change, increased P50m amplitude, and delayed N100m latency. These findings suggest that the cholinergic system regulates the frequency-specific comparison of incoming stimuli to existing memory trace and modulates the preattentive processing related to stimulus detection. Further, neural mechanisms responsible for cortical frequency- and duration-specific discrimination appear to have different sensitivities to cholinergic modulation. Auditory evoked potentials might be suitable to monitor cholinergic activity in AD.

Review of outcome measurement instruments in Alzheimer's disease drug trials: introduction

This article introduces a four-part series on outcome scales used in Alzheimer's disease drug trials. First, it discusses the division of scales into four domains: cognition, functional ability/quality of life, behavior/mood, and global. Within each domain, the shortcomings of existing literature reviews are outlined, and the need for a more coherent view of the psychometric properties of the scales is emphasized. Second, the key concepts of reliability, validity, and responsiveness to change are defined and explained. This explanation also provides an overview of the statistical techniques used to assess measurement properties. Finally, the methods used to select the scales for review in the subsequent articles are explained, and each article is briefly introduced.

Reduced sensory gating of the P1 potential in rape victims and combat veterans with posttraumatic stress disorder

The P1 midlatency auditory evoked potential was studied in female rape victims with Posttraumatic Stress Disorder (PTSD) and compared to an age-matched female control group; and in male combat veterans with PTSD and compared to three groups of age-matched male control subjects. Sensory gating of the P1 potential was determined using a paired click stimulus paradigm in which the stimuli were presented at 250, 500 and 1000 msec interstimulus intervals (ISI). Results showed that sensory gating of the P1 potential was significantly decreased at the 250 msec ISI, and that there was a numerical, but not a statistically significant, decrease in sensory gating at the other intervals tested in both male and female PTSD subjects compared to all control groups. Since the P1 potential may be generated, at least in part, by the reticular activating system, dysregulation of sensory processing by elements of this system may be present in PTSD.

Auditory P50 obtained with a repetitive stimulus paradigm shows suppression to high-intensity tones

We manipulated stimulus intensity and number of frequency bands in auditory stimuli in order to investigate the nature of P50 in human auditory evoked potentials. Pure-tone and mixed-tone conditions were examined. For each condition, four stimulus intensities were used: 55, 70, 85 and 100 dB sound pressure level (SPL). The P50s were obtained at Cz using a repetitive stimulus paradigm. P50 amplitudes increased as stimulus intensities increased up to 85 dB; with 100 dB stimulation amplitudes decreased. The number of frequency bands in the stimulus did not affect P50 amplitude. Considered in terms of P50 suppression under a conditioning/testing paradigm, the results suggest that the P50 wave reflects activity of the sensory gating mechanism in humans.

Decreased habituation of midlatency auditory evoked responses in Parkinson's disease

The P1 midlatency auditory evoked potential was studied in patients with Parkinson's disease and compared to that in age-matched controls. Habituation of the potential was determined by using a two-click stimulus paradigm in which the stimuli were presented at 250-, 500-, and 1,000-ms interstimulus intervals. Results showed that habituation of the P1 potential had a statistically significant decrease at the 250-ms and 500-ms interstimulus intervals in patients with Parkinson's disease compared to normal controls. The degree of decreased habituation was found to increase with severity of the disease such that stage 5 patients showed greater decreases in habituation compared to stage 4, as did stage 4 compared to stage 3. These findings may be explained by the presence of a dysregulation of sensory processing, possibly by elements of the reticular activating system, including the pedunculopontine nucleus, in Parkinson's disease.