Changes in EEG complexity with electroconvulsive therapy in a patient with autism spectrum disorders: a multiscale entropy approach

Machine learning-based differentiation of schizophrenia and bipolar disorder using multiscale fuzzy entropy and relative power from resting-state EEG

Schizophrenia (SZ) and bipolar disorder (BD) pose diagnostic challenges due to overlapping clinical symptoms and genetic factors, often resulting in misdiagnosis and suboptimal treatment outcomes. This study aimed to identify EEG-based biomarkers that can differentiate SZ from BD using multiscale fuzzy entropy (MFE) and relative power (RP) analyses and to evaluate their diagnostic utility using machine learning. EEG data were collected from 65 patients with SZ and 49 patients with BD under resting-state conditions. The MFE and RP were calculated for the bilateral frontal, central, and parietal regions using 30 s EEG segments. For MFE, the band-scale fuzzy entropy (FuzzyEn) was determined across the theta, alpha, beta, and gamma bands based on simulation results demonstrating an inverse relationship between scale factors and frequency components. RP was derived by segmenting the EEG data into 2 s intervals with a 500 ms moving window. A support vector machine (SVM) was used to differentiate between patients with SZ and BD based on band-scale FuzzyEn and RP. The SVM classifier achieved an accuracy of 78.94%, a sensitivity of 81.53%, and a specificity of 75.51%. Patients with SZ showed higher theta-scale FuzzyEn in the right frontal, left central, and bilateral parietal regions; higher alpha-scale FuzzyEn in the right parietal region; and increased theta power in the bilateral frontal, central, and right parietal regions. These differences remained robust after controlling for medication effects. These findings demonstrate the potential of combining MFE, RP, and machine learning to differentiate between SZ and BD, contributing to improved diagnostic precision in psychiatric disorders.

EEG Complexity Analysis of Brain States, Tasks and ASD Risk

Autism spectrum disorder is an increasingly prevalent and debilitating neurodevelopmental condition and an electroencephalogram (EEG) diagnostic challenge. Despite large amounts of electrophysiological research over many decades, an EEG biomarker for autism spectrum disorder (ASD) has not been found. We hypothesized that reductions in complex dynamical system behaviour in the human central nervous system as part of the macroscale neuronal function during cognitive processes might be detectable in whole EEG for higher-risk ASD adults. In three studies, we compared the medians of correlation dimension, largest Lyapunov exponent, Higuchi's fractal dimension, multiscale entropy, multifractal detrended fluctuation analysis and Kolmogorov complexity during resting, cognitive and social skill tasks in 20 EEG channels of 39 adults over a range of ASD risk. We found heterogeneous complexity distribution with clusters of hierarchical sequences pointing to potential cognitive processing differences, but no clear distinction based on ASD risk. We suggest that there is indication of statistically significant differences between complexity measures of brain states and tasks. Though replication of our studies is needed with a larger sample, we believe that our electrophysiological and analytic approach has potential as a biomarker for earlier ASD diagnosis.

Modulation of Resting-State Brain Complexity After Bilateral Cerebellar Anodal Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorders: a Randomized Controlled Trial Study

BACKGROUND

Autism spectrum disorders (ASD) are heterogeneous neurodevelopmental disorders characterized by aberrant neural networks. Cerebellum is best known for its role in controlling motor behaviors; however, recently, there have been significant reports showed that dysfunction in cerebellar-cerebral networks contributes significantly to many of the clinical features of ASD. Hereby, this is a randomized controlled trial (RCT) study examining the potential modulating effects of bilateral anodal tDCS stimulation over cerebellar hemispheres on the resting-state brain complexity in children with ASD.

METHODS

Thirty-six children with ASD (aged 4-14) years old were divided equally and randomly into a tDCS treatment group, which underwent 10 sessions (20-min duration, five sessions/per week) of bilateral anodal tDCS stimulation applied over left and right cerebellar hemispheres, and control group underwent the same procedures, but with sham tDCS stimulation. Resting-state brain complexity was evaluated through recording and calculating the approximate entropy (ApxEnt) values of the resting-state electroencephalograph (EEG) data obtained from a 64-channel EEG system before and after the interventions.

RESULTS

Repeated measures of ANOVA showed that tDCS had significant effects on the treatment group (Wilks' Lambda = 0.29, F (15, 16) = 2.67, p = 0.03) compared with the control group. Analyzed data showed a significant increase in the averaged ApxEnt values in the right frontal cortical region (F (1, 16) = 10.46, p = 0.005) after the bilateral cerebellar anodal tDCS stimulation. Besides, the Cohen's d effect size showed a large effect size (0.70-0.92) of bilateral cerebellar anodal tDCS on the ApxEnt values increases in the left and right frontal cortical regions, the right central cortical region, and left parietal cortical region. However, there were no any significant differences or increases in the brain complexity before and after the sham tDCS stimulation of the control group.

CONCLUSION

Bilateral cerebellar anodal tDCS modulated and increased the brain complexity in children with ASD with no any reported adverse effect. Hereby, cerebellum and cerebellar-cerebral circuitry would serve as a promising target for non-invasive brain stimulation and neuro-modulation as a therapeutic intervention.

Targeting gut microbiota and immune crosstalk: potential mechanisms of natural products in the treatment of atherosclerosis

Atherosclerosis (AS) is a chronic inflammatory reaction that primarily affects large and medium-sized arteries. It is a major cause of cardiovascular disease and peripheral arterial occlusive disease. The pathogenesis of AS involves specific structural and functional alterations in various populations of vascular cells at different stages of the disease. The immune response is involved throughout the entire developmental stage of AS, and targeting immune cells presents a promising avenue for its treatment. Over the past 2 decades, studies have shown that gut microbiota (GM) and its metabolites, such as trimethylamine-N-oxide, have a significant impact on the progression of AS. Interestingly, it has also been reported that there are complex mechanisms of action between GM and their metabolites, immune responses, and natural products that can have an impact on AS. GM and its metabolites regulate the functional expression of immune cells and have potential impacts on AS. Natural products have a wide range of health properties, and researchers are increasingly focusing on their role in AS. Now, there is compelling evidence that natural products provide an alternative approach to improving immune function in the AS microenvironment by modulating the GM. Natural product metabolites such as resveratrol, berberine, curcumin, and quercetin may improve the intestinal microenvironment by modulating the relative abundance of GM, which in turn influences the accumulation of GM metabolites. Natural products can delay the progression of AS by regulating the metabolism of GM, inhibiting the migration of monocytes and macrophages, promoting the polarization of the M2 phenotype of macrophages, down-regulating the level of inflammatory factors, regulating the balance of Treg/Th17, and inhibiting the formation of foam cells. Based on the above, we describe recent advances in the use of natural products that target GM and immune cells crosstalk to treat AS, which may bring some insights to guide the treatment of AS.

Systematic Review on EEG Analysis to Diagnose and Treat Autism by Evaluating Functional Connectivity and Spectral Power

An abnormality in neural connectivity is linked to autism spectrum disorder (ASD). There is no way to test the concept of neural connectivity empirically. According to recent network theory and time series analysis findings, electroencephalography (EEG) can assess neural network architecture, a sign of activity in the brain. This systematic review aims to evaluate functional connectivity and spectral power using EEG signals. EEG records the brain activity of an individual by displaying wavy lines that depict brain cells' communication through electrical impulses. EEG can diagnose various brain disorders, including epilepsy and related seizure illness, brain dysfunction, tumors, and damage. We found 21 studies using two of the most common EEG analysis methods: functional connectivity and spectral power. ASD and non-ASD individuals were found to differ significantly in all selected papers. Due to high heterogeneity in the outcomes, generalizations cannot be drawn, and no single method is currently beneficial as a diagnostic tool. For ASD subtype delineation, the lack of research prevented the evaluation of these techniques as diagnostic tools. These findings confirm the presence of abnormalities in the EEG in ASD, but they are insufficient to diagnose. Our study suggests that EEG is useful in diagnosing ASD by evaluating entropy in the brain. Researchers may be able to develop new diagnostic methods for ASD which focuses on particular stimuli and brainwaves if they conduct more extensive studies with higher numbers and more rigorous study designs.

The automated preprocessing pipe-line for the estimation of scale-wise entropy from EEG data (APPLESEED): Development and validation for use in pediatric populations

It is increasingly understood that moment-to-moment brain signal variability - traditionally modeled out of analyses as mere "noise" - serves a valuable functional role related to development, cognitive processing, and psychopathology. Multiscale entropy (MSE) - a measure of signal irregularity across temporal scales - is an increasingly popular analytic technique in human neuroscience calculated from time series such as electroencephalography (EEG) signals. MSE provides insight into the time-structure and (non)linearity of fluctuations in neural activity and network dynamics, capturing the brain's moment-to-moment complexity as it operates on multiple time scales. MSE is emerging as a powerful predictor of developmental processes and outcomes. However, differences in data preprocessing and MSE computation make it challenging to compare results across studies. Here, we (1) provide an introduction to MSE for developmental researchers, (2) demonstrate the effect of preprocessing procedures on scale-wise entropy estimates, and (3) establish a standardized EEG preprocessing and entropy estimation pipeline that adapts a critical modification to the original MSE algorithm, and generates reliable scale-wise entropy estimates capable of differentiating developmental stages and cognitive states. This novel pipeline - the Automated Preprocessing Pipe-Line for the Estimation of Scale-wise Entropy from EEG Data (APPLESEED) is fully automated, customizable, and freely available for download from https://github.com/mhpuglia/APPLESEED.

EMD-based analysis of complexity with dissociated EEG amplitude and frequency information: a data-driven robust tool -for Autism diagnosis- compared to multi-scale entropy approach

OBJECTIVE

Autism spectrum disorder (ASD) is usually characterised by altered social skills, repetitive behaviours, and difficulties in verbal/nonverbal communication. It has been reported that electroencephalograms (EEGs) in ASD are characterised by atypical complexity. The most commonly applied method in studies of ASD EEG complexity is multiscale entropy (MSE), where the sample entropy is evaluated across several scales. However, the accuracy of MSE-based classifications between ASD and neurotypical EEG activities is poor owing to several shortcomings in scale extraction and length, the overlap between amplitude and frequency information, and sensitivity to frequency. The present study proposes a novel, nonlinear, non-stationary, adaptive, data-driven, and accurate method for the classification of ASD and neurotypical groups based on EEG complexity and entropy without the shortcomings of MSE.

APPROACH

The proposed method is as follows: (a) each ASD and neurotypical EEG (122 subjects × 64 channels) is decomposed using empirical mode decomposition (EMD) to obtain the intrinsic components (intrinsic mode functions). (b) The extracted components are normalised through the direct quadrature procedure. (c) The Hilbert transforms of the components are computed. (d) The analytic counterparts of components (and normalised components) are found. (e) The instantaneous frequency function of each analytic normalised component is calculated. (f) The instantaneous amplitude function of each analytic component is calculated. (g) The Shannon entropy values of the instantaneous frequency and amplitude vectors are computed. (h) The entropy values are classified using a neural network (NN). (i) The achieved accuracy is compared to that obtained with MSE-based classification. (j) The consistency of the results of entropy 3D mapping with clinical data is assessed.

MAIN RESULTS

The results demonstrate that the proposed method outperforms MSE (accuracy: 66.4%), with an accuracy of 93.5%. Moreover, the entropy 3D mapping results are more consistent with the available clinical data regarding brain topography in ASD.

SIGNIFICANCE

This study presents a more robust alternative to MSE, which can be used for accurate classification of ASD/neurotypical as well as for the examination of EEG entropy across brain zones in ASD.

Signal complexity indicators of health status in clinical EEG

Brain signal variability changes across the lifespan in both health and disease, likely reflecting changes in information processing capacity related to development, aging and neurological disorders. While signal complexity, and multiscale entropy (MSE) in particular, has been proposed as a biomarker for neurological disorders, most observations of altered signal complexity have come from studies comparing patients with few to no comorbidities against healthy controls. In this study, we examined whether MSE of brain signals was distinguishable across patient groups in a large and heterogeneous set of clinical-EEG data. Using a multivariate analysis, we found unique timescale-dependent differences in MSE across various neurological disorders. We also found MSE to differentiate individuals with non-brain comorbidities, suggesting that MSE is sensitive to brain signal changes brought about by metabolic and other non-brain disorders. Such changes were not detectable in the spectral power density of brain signals. Our findings suggest that brain signal complexity may offer complementary information to spectral power about an individual's health status and is a promising avenue for clinical biomarker development.

Accurate assessment of low-function autistic children based on EEG feature fusion

Autism spectrum disorder (ASD) is a very serious neurodevelopmental disorder and diagnosis mainly depends on the clinical scale, which has a certain degree of subjectivity. It is necessary to make accurate evaluation by objective indicators. In this study, we enrolled 96 children aged from 3 to 6 years: 48 low-function autistic children (38 males and 10 females; mean±SD age: 4.9±1.1 years) and 48 typically developing (TD) children (38 males and 10 females; mean±SD age: 4.9 ± 1.2 years) to participate in our experiment. We investigated to fuse multi-features (entropy, relative power, coherence and bicoherence) to distinguish low-function autistic children and TD children accurately. Minimum redundancy maximum correlation algorithm was used to choose the features and support vector machine was used for classification. Ten-fold cross validation was used to test the accuracy of the model. Better classification result was obtained. We tried to provide a reliable basis for clinical evaluation and diagnosis for ASD.

Identification of attention-deficit hyperactivity disorder based on the complexity and symmetricity of pupil diameter

Adult attention-deficit/hyperactivity disorder (ADHD) frequently leads to psychological/social dysfunction if unaddressed. Identifying a reliable biomarker would assist the diagnosis of adult ADHD and ensure that adults with ADHD receive treatment. Pupil diameter can reflect inherent neural activity and deficits of attention or arousal characteristic of ADHD. Furthermore, distinct profiles of the complexity and symmetricity of neural activity are associated with some psychiatric disorders. We hypothesized that analysing the relationship between the size, complexity of temporal patterns, and asymmetricity of pupil diameters will help characterize the nervous systems of adults with ADHD and that an identification method combining these features would ease the diagnosis of adult ADHD. To validate this hypothesis, we evaluated the resting state hippus in adult participants with or without ADHD by examining the pupil diameter and its temporal complexity using sample entropy and the asymmetricity of the left and right pupils using transfer entropy. We found that large pupil diameters and low temporal complexity and symmetry were associated with ADHD. Moreover, the combination of these factors by the classifier enhanced the accuracy of ADHD identification. These findings may contribute to the development of tools to diagnose adult ADHD.

Electroencephalography complexity in infantile spasms and its association with treatment response

OBJECTIVE

To investigate the potential of EEG multiscale entropy and complexity as biomarkers in infantile spasms.

METHODS

We collected EEG data retrospectively from 16 newly diagnosed patients, 16 age- and gender-matched healthy controls, and 15 drug-resistant patients. The multiscale entropy (MSE) and total EEG complexity before anti-epileptic drug (AED) treatment, before adrenocorticotropic hormone (ACTH) treatment, 14 days after ACTH therapy, and after 6 months of follow-up were calculated.

RESULTS

The total EEG complexity of 16 newly diagnosed infantile spasms patients was lower than the 16 healthy controls (median [IQR]: 351.5 [323.1-388.1] vs 461.6 [407.7-583.4]). The total EEG complexity before treatment was higher in the six patients with good response to AED than the 10 patients without response (median [IQR]: 410.0 [388.1-475.0] vs 344.5 [319.6-352.0]). The total EEG complexity before and after 14-days of ACTH therapy was not different between 13 ACTH therapy responders and nine non-responders. After 6-months follow-up, the total EEG complexity of ACTH therapy responders were higher than non-responders (median [IQR]: 598.5 [517.4-623.3] vs 448.6 [347.1-536.3]).

CONCLUSIONS

The total EEG complexity before AED and 6 months after ACTH are associated with spasm-freedom.

SIGNIFICANCE

The total EEG complexity is a potential biomarker to predict and monitor the treatment effect in infantile spasms.

Deterministic characteristics of spontaneous activity detected by multi-fractal analysis in a spiking neural network with long-tailed distributions of synaptic weights

Cortical neural networks maintain autonomous electrical activity called spontaneous activity that represents the brain's dynamic internal state even in the absence of sensory stimuli. The spatio-temporal complexity of spontaneous activity is strongly related to perceptual, learning, and cognitive brain functions; multi-fractal analysis can be utilized to evaluate the complexity of spontaneous activity. Recent studies have shown that the deterministic dynamic behavior of spontaneous activity especially reflects the topological neural network characteristics and changes of neural network structures. However, it remains unclear whether multi-fractal analysis, recently widely utilized for neural activity, is effective for detecting the complexity of the deterministic dynamic process. To verify this point, we focused on the log-normal distribution of excitatory postsynaptic potentials (EPSPs) to evaluate the multi-fractality of spontaneous activity in a spiking neural network with a log-normal distribution of EPSPs. We found that the spiking activities exhibited multi-fractal characteristics. Moreover, to investigate the presence of a deterministic process in the spiking activity, we conducted a surrogate data analysis against the time-series of spiking activity. The results showed that the spontaneous spiking activity included the deterministic dynamic behavior. Overall, the combination of multi-fractal analysis and surrogate data analysis can detect deterministic complex neural activity. The multi-fractal analysis of neural activity used in this study could be widely utilized for brain modeling and evaluation methods for signals obtained by neuroimaging modalities.

Individual Cortical Entropy Profile: Test-Retest Reliability, Predictive Power for Cognitive Ability, and Neuroanatomical Foundation

The entropy profiles of cortical activity have become novel perspectives to investigate individual differences in behavior. However, previous studies have neglected foundational aspects of individual entropy profiles, that is, the test-retest reliability, the predictive power for cognitive ability in out-of-sample data, and the underlying neuroanatomical basis. We explored these issues in a large young healthy adult dataset (Human Connectome Project, N = 998). We showed the whole cortical entropy profile from resting-state functional magnetic resonance imaging is a robust personalized measure, while subsystem profiles exhibited heterogeneous reliabilities. The limbic network exhibited lowest reliability. We tested the out-of-sample predictive power for general and specific cognitive abilities based on reliable cortical entropy profiles. The default mode and visual networks are most crucial when predicting general cognitive ability. We investigated the anatomical features underlying cross-region and cross-individual variations in cortical entropy profiles. Cortical thickness and structural connectivity explained spatial variations in the group-averaged entropy profile. Cortical folding and myelination in the attention and frontoparietal networks determined predominantly individual cortical entropy profile. This study lays foundations for brain-entropy-based studies on individual differences to understand cognitive ability and related pathologies. These findings broaden our understanding of the associations between neural structures, functional dynamics, and cognitive ability.

Two Sides of the Same Coin: A Case Report of First-Episode Catatonic Syndrome in a High-Functioning Autism Patient

Background: Catatonic phenomena such as stupor, mutism, stereotypy, echolalia, echopraxia, affective flattening, psychomotor deficits, and social withdrawal are characteristic symptoms of both schizophrenia and autism spectrum disorders (ASD), suggesting overlapping pathophysiological similarities such as altered glutamatergic and dopaminergic synaptic transmission and common genetic mutations. In daily clinical practice, ASD can be masked by manifest catatonic or psychotic symptoms and represent a diagnostic challenge, especially in patients with unknown or empty medical history. Unclear diagnosis is one of the main factors for delayed treatment. However, we are still missing diagnostic recommendations when dealing with ASD patients suffering from catatonic syndrome. Case presentation: A 31-year-old male patient without history of psychiatric disease presented with a severe catatonic syndrome and was admitted to our closed psychiatric ward. After the treatment with high-dose lorazepam and intramuscular olanzapine, catatonic symptoms largely remitted, but autistic traits persisted. Following a detailed anamnesis and a thorough neuropsychological testing, we diagnosed the patient with high-functioning autism and catatonic schizophrenia. The patient was discharged in a remitted state with long-acting injectable olanzapine. Conclusion: This case represents an example of diagnostic and therapeutic challenges of catatonic schizophrenia in high-functioning autism due to clinical and neurobiological overlaps of these conditions. We discuss clinical features together with pathophysiological concepts of both conditions. Furthermore, we tackle social and legal hurdles in Germany that naturally arise in these patients. Finally, we present diagnostic "red flags" that can be used to rationally select and conduct current recommended diagnostic assessments if there is a suspicion of ASD in patients with catatonic syndrome in order to provide them with the most appropriate treatment.

Interactions of BDNF Val66Met Polymorphism and Menstrual Pain on Brain Complexity

The irregularity and uncertainty of neurophysiologic signals across different time scales can be regarded as neural complexity, which is related to the adaptability of the nervous system and the information processing between neurons. We recently reported general loss of brain complexity, as measured by multiscale sample entropy (MSE), at pain-related regions in females with primary dysmenorrhea (PDM). However, it is unclear whether this loss of brain complexity is associated with inter-subject genetic variations. Brain-derived neurotrophic factor (BDNF) is a widely expressed neurotrophin in the brain and is crucial to neural plasticity. The BDNF Val66Met single-nucleotide polymorphism (SNP) is associated with mood, stress, and pain conditions. Therefore, we aimed to examine the interactions of BDNF Val66Met polymorphism and long-term menstrual pain experience on brain complexity. We genotyped BDNF Val66Met SNP in 80 PDM females (20 Val/Val, 31 Val/Met, 29 Met/Met) and 76 healthy female controls (25 Val/Val, 36 Val/Met, 15 Met/Met). MSE analysis was applied to neural source activity estimated from resting-state magnetoencephalography (MEG) signals during pain-free state. We found that brain complexity alterations were associated with the interactions of BDNF Val66Met polymorphism and menstrual pain experience. In healthy female controls, Met carriers (Val/Met and Met/Met) demonstrated lower brain complexity than Val/Val homozygotes in extensive brain regions, suggesting a possible protective role of Val/Val homozygosity in brain complexity. However, after experiencing long-term menstrual pain, the complexity differences between different genotypes in healthy controls were greatly diminished in PDM females, especially in the limbic system, including the hippocampus and amygdala. Our results suggest that pain experience preponderantly affects the effect of BDNF Val66Met polymorphism on brain complexity. The results of the present study also highlight the potential utilization of resting-state brain complexity for the development of new therapeutic strategies in patients with chronic pain.

Multiscale Entropy Analysis for Recognition of Visually Elicited Negative Stress From EEG Recordings

Automatic identification of negative stress is an unresolved challenge that has received great attention in the last few years. Many studies have analyzed electroencephalographic (EEG) recordings to gain new insights about how the brain reacts to both short- and long-term stressful stimuli. Although most of them have only considered linear methods, the heterogeneity and complexity of the brain has recently motivated an increasing use of nonlinear metrics. Nonetheless, brain dynamics reflected in EEG recordings often exhibit a multiscale nature and no study dealing with this aspect has been developed yet. Hence, in this work two nonlinear indices for quantifying regularity and predictability of time series from several time scales are studied for the first time to discern between visually elicited emotional states of calmness and negative stress. The obtained results have revealed the maximum discriminant ability of 86.35% for the second time scale, thus suggesting that brain dynamics triggered by negative stress can be more clearly assessed after removal of some fast temporal oscillations. Moreover, both metrics have also been able to report complementary information for some brain areas.

Transcranial Direct Current Stimulation (tDCS) Can Modulate EEG Complexity of Children With Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder which affects the developmental trajectory in several behavioral domains, including impairments of social communication, cognitive and language abilities. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, and it was used for modulating the brain disorders. In this paper, we enrolled 13 ASD children (11 males and 2 females; mean ± SD age: 6.5 ± 1.7 years) to participate in our trial. Each patient received 10 treatments over the dorsolateral prefrontal cortex (DLPFC) once every 2 days. Also, we enrolled 13 ASD children (11 males and 2 females; mean ± SD age: 6.3 ± 1.7 years) waiting to receive therapy as controls. A maximum entropy ratio (MER) method was adapted to measure the change of complexity of EEG series. It was found that the MER value significantly increased after tDCS. This study suggests that tDCS may be a helpful tool for the rehabilitation of children with ASD.

Dynamic complexity measures and entropy paths for modelling and comparison of evolution of patients with drug resistant epileptic encephalopathy syndromes (DREES)

Epileptic encephalopathies (EE) is a term coined by the International League Against Epilepsy (ILAE) to refer to a group of epilepsies in which the ictal and interictal abnormalities may contribute to progressive cerebral dysfunction. Among them, two affect mainly children and are very difficult to deal with, Doose and Lennox-Gastaut syndromes, (DS and LGS, respectively). So far (Zavala-Yoe et al., J Integr Neurosci 15(2):205-223, 2015a and works of ours there), quantitative analysis of single case studies of EE have been performed. All of them are manifestations of drug resistant epileptic encephalopathies (DREES) and as known, such disorders require a lot of EEG studies through all patient's life. As a consequence, dozens of EEG records are stored by parents and neurologists as time goes by. However, taking into account all this massive information, our research questions (keeping colloquial wording by parents) arise: a) Which zone of the brain has been the most affected so far? b) On which year was the child better? c) How bad is our child with respect to others? We must reflect that despite clinical assessment of the EEG has undergone standardization by establishment of guidelines such as the recently published guidelines of the American Clinical Neurophysiology Society (Tsuchida et al., J Clin Neurophysiol 4(33):301-302, 2016), qualitative EEG will never be as objective as quantitative EEG, since it depends largely on the education and experience of the conducting neurophysiologist (Grant et al., Epilepsy Behav 2014(32):102-107, 2014, Rating, Z Epileptologie, Springer Med 27(2):139-142, 2014). We already answered quantitatively the above mentioned questions in the references of ours given above where we provided entropy curves and an entropy index which encompasses the complexity of bunches of EEG making possible to deal with massive data and to make objective comparisons among some patients simultaneously. However, we have refined that index here and we also offer another two measures which are spatial and dynamic. Moreover, from those indices we also provide what we call a temporal dynamic complexity path which shows in a standard 10-20 system head diagram the evolution of the lowest complexity per brain zone with respect to the EEG period. These results make it possible to compare quantitatively/graphically the progress of several patients at the same time, answering the questions posed above. The results obtained showed that we can associate low spatio-temporal entropy indices to multiple seizures events in several patients at the same time as well as tracking seizure progress in space and time with our entropy path, coinciding with neurophysiologists observations.

The Potential Application of Multiscale Entropy Analysis of Electroencephalography in Children with Neurological and Neuropsychiatric Disorders

Electroencephalography (EEG) is frequently used in functional neurological assessment of children with neurological and neuropsychiatric disorders. Multiscale entropy (MSE) can reveal complexity in both short and long time scales and is more feasible in the analysis of EEG. Entropy-based estimation of EEG complexity is a powerful tool in investigating the underlying disturbances of neural networks of the brain. Most neurological and neuropsychiatric disorders in childhood affect the early stage of brain development. The analysis of EEG complexity may show the influences of different neurological and neuropsychiatric disorders on different regions of the brain during development. This article aims to give a brief summary of current concepts of MSE analysis in pediatric neurological and neuropsychiatric disorders. Studies utilizing MSE or its modifications for investigating neurological and neuropsychiatric disorders in children were reviewed. Abnormal EEG complexity was shown in a variety of childhood neurological and neuropsychiatric diseases, including autism, attention deficit/hyperactivity disorder, Tourette syndrome, and epilepsy in infancy and childhood. MSE has been shown to be a powerful method for analyzing the non-linear anomaly of EEG in childhood neurological diseases. Further studies are needed to show its clinical implications on diagnosis, treatment, and outcome prediction.

How Useful Is Electroencephalography in the Diagnosis of Autism Spectrum Disorders and the Delineation of Subtypes: A Systematic Review

Autism spectrum disorders (ASD) are thought to be associated with abnormal neural connectivity. Presently, neural connectivity is a theoretical construct that cannot be easily measured. Research in network science and time series analysis suggests that neural network structure, a marker of neural activity, can be measured with electroencephalography (EEG). EEG can be quantified by different methods of analysis to potentially detect brain abnormalities. The aim of this review is to examine evidence for the utility of three methods of EEG signal analysis in the ASD diagnosis and subtype delineation. We conducted a review of literature in which 40 studies were identified and classified according to the principal method of EEG analysis in three categories: functional connectivity analysis, spectral power analysis, and information dynamics. All studies identified significant differences between ASD patients and non-ASD subjects. However, due to high heterogeneity in the results, generalizations could not be inferred and none of the methods alone are currently useful as a new diagnostic tool. The lack of studies prevented the analysis of these methods as tools for ASD subtypes delineation. These results confirm EEG abnormalities in ASD, but as yet not sufficient to help in the diagnosis. Future research with larger samples and more robust study designs could allow for higher sensitivity and consistency in characterizing ASD, paving the way for developing new means of diagnosis.

An Information-Theoretic Framework to Map the Spatiotemporal Dynamics of the Scalp Electroencephalogram

We present the first application of the emerging framework of information dynamics to the characterization of the electroencephalography (EEG) activity. The framework provides entropy-based measures of information storage (self entropy, SE) and information transfer (joint transfer entropy (TE) and partial TE), which are applied here to detect complex dynamics of individual EEG sensors and causal interactions between different sensors. The measures are implemented according to a model-free and fully multivariate formulation of the framework, allowing the detection of nonlinear dynamics and direct links. Moreover, to deal with the issue of volume conduction, a compensation for instantaneous effects is introduced in the computation of joint and partial TE. The framework is applied to resting state EEG measured from healthy subjects in the eyes open (EO) and eyes closed (EC) conditions, evidencing condition-dependent patterns indicative of how information is distributed in the EEG sensor space. The SE was uniformly low during EO and significantly higher in the posterior areas during EC. The joint and partial TE were saturated by instantaneous effects, documenting how volume conduction blurs the detection of information flow in the EEG. However, the use of compensated TE measures led us to evidence meaningful patterns like the presence of local sinks of information flow and propagation motifs, and the emergence of prevalent front-to-back EEG propagation during EC. These findings support the feasibility of our information-theoretic approach to assess the spatiotemporal dynamics of the scalp EEG in different conditions.

Epigenetic Treatment of Neuropsychiatric Disorders: Autism and Schizophrenia

Neuropsychiatric disorders are a heterogeneous group of conditions that often share underlying mitochondrial dysfunction and biological pathways implicated in their pathogenesis, progression, and treatment. To date, these disorders have proven notoriously resistant to molecular-targeted therapies, and clinical options are relegated to interventional types, which do not address the core symptoms of the disease. In this review, we discuss emerging epigenetic-driven approaches using novel acylcarnitine esters (carnitinoids) that act on master regulators of antioxidant and cytoprotective genes and mitophagic pathways. These carnitinoids are actively transported, mitochondria-localizing, biomimetic coenzyme A surrogates of short-chain fatty acids, which inhibit histone deacetylase and may reinvigorate synaptic plasticity and protect against neuronal damage. We outline these neuroprotective effects in the context of treatment of neuropsychiatric disorders such as autism spectrum disorder and schizophrenia.

Enhanced brain signal variability in children with autism spectrum disorder during early childhood

Extensive evidence shows that a core neurobiological mechanism of autism spectrum disorder (ASD) involves aberrant neural connectivity. Recent advances in the investigation of brain signal variability have yielded important information about neural network mechanisms. That information has been applied fruitfully to the assessment of aging and mental disorders. Multiscale entropy (MSE) analysis can characterize the complexity inherent in brain signal dynamics over multiple temporal scales in the dynamics of neural networks. For this investigation, we sought to characterize the magnetoencephalography (MEG) signal variability during free watching of videos without sound using MSE in 43 children with ASD and 72 typically developing controls (TD), emphasizing early childhood to older childhood: a critical period of neural network maturation. Results revealed an age‐related increase of brain signal variability in a specific timescale in TD children, whereas atypical age‐related alteration was observed in the ASD group. Additionally, enhanced brain signal variability was observed in children with ASD, and was confirmed particularly for younger children. In the ASD group, symptom severity was associated region‐specifically and timescale‐specifically with reduced brain signal variability. These results agree well with a recently reported theory of increased brain signal variability during development and aberrant neural connectivity in ASD, especially during early childhood. Results of this study suggest that MSE analytic method might serve as a useful approach for characterizing neurophysiological mechanisms of typical‐developing and its alterations in ASD through the detection of MEG signal variability at multiple timescales. Hum Brain Mapp 37:1038–1050, 2016. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.