Abnormalities of Electroencephalography Microstates in Drug-Naïve, First-Episode Schizophrenia

EEG Microstate Dynamics during Different Physiological Developmental Stages and the Effects of Medication in Schizophrenia

BACKGROUND

Schizophrenia (SCZ) is associated with abnormal neural activities and brain connectivity. Electroencephalography (EEG) microstate is a voltage topographical representation of temporary brain network activations. Most research on EEG microstates in SCZ has focused on differences between patients and healthy controls (HC). However, changes in EEG microstates among SCZ patients across various stages of physiological and cognitive development have not been thoroughly assessed. Consequently, we stratified patients with SCZ into four age-specific cohorts (20-29 years (brain maturation), 30-39 years (stabilization), 40-49 years (early aging), and 50-59 years (advanced aging)) to evaluate EEG microstate alterations. Additionally, we assessed changes in EEG microstates in first-episode psychosis (FEP) before and after an 8-week treatment period.

METHODS

We acquired 19-channel resting-state EEG from 140 chronic SCZ patients, aged 20 to 59 years, as well as from 19 FEP and 20 healthy controls. FEP patients underwent an 8-week inpatient follow-up. After pre-processing, EEG data from different groups were subjected to microstate analysis, and the K-Means clustering algorithm was applied to classify the data into 4 microstates. Subsequently, templates of these microstates were used to fit EEG signals from each patient, and the collected microstate parameters were analyzed.

RESULTS

Patients with SCZ aged 20 to 29 years demonstrated an increased time coverage of microstate class D compared to other age cohorts. In individuals aged 30-39 years, the parameters of microstate class B-specifically time coverage and occurrence-exhibited significant reductions relative to those in the 40-49 and 50-59 years age groups. Compared to healthy controls, microstates class A parameters were significantly reduced in SCZ patients, while microstates class C parameters were prolonged; after 8 weeks of treatment, microstates class A parameters increased and microstates class C parameters decreased.

CONCLUSIONS

Alterations in microstate dynamics were observed among SCZ patients across developmental stages, suggesting potential changes in brain activity patterns. Changes in microstates A and C may serve as potential biomarkers for evaluating treatment efficacy, establishing a foundation for personalized therapeutic approaches.

Multilayer network analysis reveals instability of brain dynamics in untreated first-episode schizophrenia

Although aberrant static functional brain network activity has been reported in schizophrenia, little is known about how the dynamics of neural function are altered in first-episode schizophrenia and are modulated by antipsychotic treatment. The baseline resting-state functional magnetic resonance imaging data were acquired from 122 first-episode drug-naïve schizophrenia patients and 128 healthy controls (HCs), and 44 patients were rescanned after 1-year of antipsychotic treatment. Multilayer network analysis was applied to calculate the network switching rates between brain states. Compared to HCs, schizophrenia patients at baseline showed significantly increased network switching rates. This effect was observed mainly in the sensorimotor (SMN) and dorsal attention networks (DAN), and in temporal and parietal regions at the nodal level. Switching rates were reduced after 1-year of antipsychotic treatment at the global level and in DAN. Switching rates at baseline at the global level and in the inferior parietal lobule were correlated with the treatment-related reduction of negative symptoms. These findings suggest that instability of functional network activity plays an important role in the pathophysiology of acute psychosis in early-stage schizophrenia. The normalization of network stability after antipsychotic medication suggests that this effect may represent a systems-level mechanism for their therapeutic efficacy.

Microstate D as a Biomarker in Schizophrenia: Insights from Brain State Transitions

Objectives. There is a significant correlation between EEG microstate and the neurophysiological basis of mental illness, brain state, and cognitive function. Given that the unclear relationship between network dynamics and different microstates, this paper utilized microstate, brain network, and control theories to understand the microstate characteristics of short-term memory task, aiming to mechanistically explain the most influential microstates and brain regions driving the abnormal changes in brain state transitions in patients with schizophrenia. Methods. We identified each microstate and analyzed the microstate abnormalities in schizophrenia patients during short-term memory tasks. Subsequently, the network dynamics underlying the primary microstates were studied to reveal the relationships between network dynamics and microstates. Finally, using control theory, we confirmed that the abnormal changes in brain state transitions in schizophrenia patients are driven by specific microstates and brain regions. Results. The frontal-occipital lobes activity of microstate D decreased significantly, but the left frontal lobe of microstate B increased significantly in schizophrenia, when the brain was moving toward the easy-to-reach states. However, the frontal-occipital lobes activity of microstate D decreased significantly in schizophrenia, when the brain was moving toward the hard-to-reach states. Microstate D showed that the right-frontal activity had a higher priority than the left-frontal, but microstate B showed that the left-frontal priority decreased significantly in schizophrenia, when changes occur in the synchronization state of the brain. Conclusions. In conclusion, microstate D may be a biomarker candidate of brain abnormal activity during the states transitions in schizophrenia, and microstate B may represent a compensatory mechanism that maintains brain function and exchanges information with other brain regions. Microstate and brain network provide complementary perspectives on the neurodynamics, offering potential insights into brain function in health and disease.

EEG Techniques with Brain Activity Localization, Specifically LORETA, and Its Applicability in Monitoring Schizophrenia

Background/Objectives: Electroencephalography (EEG) is considered a standard but powerful tool for the diagnosis of neurological and psychiatric diseases. With modern imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and magnetoencephalography (MEG), source localization can be improved, especially with low-resolution brain electromagnetic tomography (LORETA). The aim of this review is to explore the variety of modern techniques with emphasis on the efficacy of LORETA in detecting brain activity patterns in schizophrenia. The study's novelty lies in the comprehensive survey of EEG methods and detailed exploration of LORETA in schizophrenia research. This evaluation aligns with clinical objectives and has been performed for the first time. Methods: The study is split into two sections. Part I examines different EEG methodologies and adjuncts to detail brain activity in deep layers in articles published between 2018 and 2023 in PubMed. Part II focuses on the role of LORETA in investigating structural and functional changes in schizophrenia in studies published between 1999 and 2024 in PubMed. Results: Combining imaging techniques and EEG provides opportunities for mapping brain activity. Using LORETA, studies of schizophrenia have identified hemispheric asymmetry, especially increased activity in the left hemisphere. Cognitive deficits were associated with decreased activity in the dorsolateral prefrontal cortex and other areas. Comparison of the first episode of schizophrenia and a chronic one may help to classify structural change as a cause or as a consequence of the disorder. Antipsychotic drugs such as olanzapine or clozapine showed a change in P300 source density and increased activity in the delta and theta bands. Conclusions: Given the relatively low spatial resolution of LORETA, the method offers benefits such as accessibility, high temporal resolution, and the ability to map depth layers, emphasizing the potential of LORETA in monitoring the progression and treatment response in schizophrenia.

Shared and distinct electroencephalogram microstate abnormalities across schizophrenia, bipolar disorder, and depression

BACKGROUND

Microstates of an electroencephalogram (EEG) are canonical voltage topographies that remain quasi-stable for 90 ms, serving as the foundational elements of brain dynamics. Different changes in EEG microstates can be observed in psychiatric disorders like schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD). However, the similarities and disparatenesses in whole-brain dynamics on a subsecond timescale among individuals diagnosed with SCZ, BD, and MDD are unclear.

METHODS

This study included 1112 participants (380 individuals diagnosed with SCZ, 330 with BD, 212 with MDD, and 190 demographically matched healthy controls [HCs]). We assembled resting-state EEG data and completed a microstate analysis of all participants using a cross-sectional design.

RESULTS

Our research indicates that SCZ, BD, and MDD exhibit distinct patterns of transition among the four EEG microstate states (A, B, C, and D). The analysis of transition probabilities showed a higher frequency of switching from microstates A to B and from B to A in each patient group compared to the HC group, and less frequent transitions from microstates A to C and from C to A in the SCZ and MDD groups compared to the HC group. And the probability of the microstate switching from C to D and D to C in the SCZ group significantly increased compared to those in the patient and HC groups.

CONCLUSIONS

Our findings provide crucial insights into the abnormalities involved in distributing neural assets and enabling proper transitions between different microstates in patients with major psychiatric disorders.

Abnormalities in Electroencephalographic Microstates in Patients with Late-Life Depression

Background

Late-life depression (LLD) is characterized by disrupted brain networks. Resting-state networks in the brain are composed of both stable and transient topological structures known as microstates, which reflect the dynamics of the neural activities. However, the specific pattern of EEG microstate in LLD remains unclear.

Methods

Resting-state EEG were recorded for 31 patients with episodic LLD (eLLD), 20 patients with remitted LLD (rLLD) and 32 healthy controls (HCs) using a 64-channel cap. The clinical data of the patients were collected and the 17-Item Hamilton Rating Scale for Depression (HAMD) was used for symptom assessment. Duration, occurrence, time coverage and syntax of the four microstate classes (A-D) were calculated. Group differences in EEG microstates and the relationship between microstates parameters and clinical features were analyzed.

Results

Compared with NC and patients with rLLD, patients with eLLD showed increased duration and time coverage of microstate class D. Besides, a decrease in occurrence of microstate C and transition probability between microstate B and C was observed. In addition, the time coverage of microstate D was positively correlated with the total score of HAMD, core symptoms, and miscellaneous items.

Conclusion

These findings suggest that disrupted EEG microstates may be associated with the pathophysiology of LLD and may serve as potential state markers for the monitoring of the disease.

Normative Temporal Dynamics of Resting EEG Microstates

The large-scale electrophysiological events known as electroencephalographic microstates provide an important window into the intrinsic activity of whole-brain neuronal networks. The spontaneous activity of coordinated brain networks, including the ongoing temporal dynamics expressed by microstates, are thought to reflect individuals' neurocognitive functioning, and predict development, disease progression, and psychological differences among varied populations. A comprehensive understanding of human brain function therefore requires characterizing typical and atypical patterns in the temporal dynamics of microstates. But population-level estimates of normative microstate temporal dynamics are still unknown. To address this gap, I conducted a systematic search of the literature and accompanying meta-analysis of the average dynamics of microstates obtained from studies investigating spontaneous brain activity in individuals during periods of eyes-closed and eyes-open rest. Meta-analyses provided estimates of the average temporal dynamics of microstates across 93 studies totaling 6583 unique individual participants drawn from diverse populations. Results quantified the expected range of plausible estimates of average microstate dynamics across study samples, as well as characterized heterogeneity resulting from sampling variability and systematic differences in development, clinical diagnoses, or other study methodological factors. Specifically, microstate dynamics significantly differed for samples with specific developmental differences or clinical diagnoses, relative to healthy, typically developing samples. This research supports the notion that microstates and their dynamics reflect functionally relevant properties of large-scale brain networks, encoding typical and atypical neurocognitive functioning.

Changes in oscillatory patterns of microstate sequence in patients with first-episode psychosis

We aimed to utilize chaos game representation (CGR) for the investigation of microstate sequences and explore its potential as neurobiomarkers for psychiatric disorders. We applied our proposed method to a public dataset including 82 patients with first-episode psychosis (FEP) and 61 control subjects. Two time series were constructed: one using the microstate spacing distance in CGR and the other using complex numbers representing the microstate coordinates in CGR. Power spectral features of both time series and frequency matrix CGR (FCGR) were compared between groups and employed in a machine learning application. The four canonical microstates (A, B, C, and D) were identified using both shared and separate templates. Our results showed the microstate oscillatory pattern exhibited alterations in the FEP group. Using oscillatory features improved machine learning performance compared with classical features and FCGR. This study opens up new avenues for exploring the use of CGR in analyzing EEG microstate sequences. Features derived from microstate sequence CGR offer fine-grained neurobiomarkers for psychiatric disorders.

EEG microstate quantifiers and state space descriptors during anaesthesia in patients with postoperative delirium: a descriptive analysis

Postoperative delirium is a serious sequela of surgery and surgery-related anaesthesia. One recommended method to prevent postoperative delirium is using bi-frontal EEG recording. The single, processed index of depth of anaesthesia allows the anaesthetist to avoid episodes of suppression EEG and excessively deep anaesthesia. The study data presented here were based on multichannel (19 channels) EEG recordings during anaesthesia. This enabled the analysis of various parameters of global electrical brain activity. These parameters were used to compare microstate topographies under anaesthesia with those in healthy volunteers and to analyse changes in microstate quantifiers and EEG global state space descriptors with increasing exposure to anaesthesia. Seventy-three patients from the Surgery Depth of Anaesthesia and Cognitive Outcome study (SRCTN 36437985) received intraoperative multichannel EEG recordings. Altogether, 720 min of artefact-free EEG data, including 210 min (29.2%) of suppression EEG, were analysed. EEG microstate topographies, microstate quantifiers (duration, frequency of occurrence and global field power) and the state space descriptors sigma (overall EEG power), phi (generalized frequency) and omega (number of uncorrelated brain processes) were evaluated as a function of duration of exposure to anaesthesia, suppression EEG and subsequent development of postoperative delirium. The major analyses involved covariate-adjusted linear mixed-effects models. The older (71 ± 7 years), predominantly male (60%) patients received a median exposure of 210 (range: 75-675) min of anaesthesia. During seven postoperative days, 21 patients (29%) developed postoperative delirium. Microstate topographies under anaesthesia resembled topographies from healthy and much younger awake persons. With increasing duration of exposure to anaesthesia, single microstate quantifiers progressed differently in suppression or non-suppression EEG and in patients with or without subsequent postoperative delirium. The most pronounced changes occurred during enduring suppression EEG in patients with subsequent postoperative delirium: duration and frequency of occurrence of microstates C and D progressed in opposite directions, and the state space descriptors showed a pattern of declining uncorrelated brain processes (omega) combined with increasing EEG variance (sigma). With increasing exposure to general anaesthesia, multiple changes in the dynamics of microstates and global EEG parameters occurred. These changes varied partly between suppression and non-suppression EEG and between patients with or without subsequent postoperative delirium. Ongoing suppression EEG in patients with subsequent postoperative delirium was associated with reduced network complexity in combination with increased overall EEG power. Additionally, marked changes in quantifiers in microstate C and in microstate D occurred. These putatively adverse intraoperative trajectories in global electrical brain activity may be seen as preceding and ultimately predicting postoperative delirium.

EEG microstate changes during hyperbaric oxygen therapy in patients with chronic disorders of consciousness

Hyperbaric oxygen (HBO) therapy is an effective treatment for patients with disorders of consciousness (DOC). In this study, real-time electroencephalogram (EEG) recordings were obtained from patients with DOC during HBO therapy. EEG microstate indicators including mean microstate duration (MMD), ratio of total time covered (RTT), global explained variance (GEV), transition probability, mean occurrence, and mean global field power (GFP) were compared before and during HBO therapy. The results showed that the duration of microstate C in all patients with DOC increased after 20 min of HBO therapy (p < 0.05). Further statistical analysis found that the duration of microstate C was longer in the higher CRS-R group (≥8, 17 cases) than in the lower group (<8, 24 cases) during HBO treatment. In the higher CRS-R group, the transition probabilities from microstate A to microstate C and from microstate C to microstate A also increased significantly compared with the probability before treatment (p < 0.05). Microstate C is generally considered to be related to a salience network; an increase in the transition probability between microstate A and microstate C indicates increased information exchange between the auditory network and the salience network. The results of this study show that HBO therapy has a specific activating effect on attention and cognitive control in patients and causes increased activity in the primary sensory cortex (temporal lobe and occipital lobe). This study demonstrates that real-time EEG detection and analysis during HBO is a clinically feasible method for assessing brain function in patients with DOC. During HBO therapy, some EEG microstate indicators show significant changes related to the state of consciousness in patients with chronic DOC. This will be complementary to important electrophysiological indicators for assessing consciousness and may also provide an objective foundation for the precise treatment of patients with DOC.

Altered Microstate Dynamics and Spatial Complexity in Late-Life Schizophrenia

BACKGROUND

Resting-state EEG microstate and omega complexity analyses have been widely used to explore deviant brain function in various neuropsychiatric disorders. This study aimed to investigate the features of microstate dynamics and spatial complexity in patients with late-life schizophrenia (LLS).

METHOD

Microstate and omega complexity analyses were performed on resting-state EEG data from 39 in patients with LLS and compared with 40 elderly normal controls (NCs).

RESULT

The duration of microstate classes A and D were significantly higher in patients with LLS compared with NCs. The occurrence of microstate classes A, B, and C was significantly lower in patients with LLS compared with NCs. LLS patients have a lower time coverage of microstate class A and a higher time coverage of class D than NCs. Transition probabilities from microstate class A to B and from class A to C were significantly lower in patients with LLS compared with NCs. Transition probabilities between microstate class B and D were significantly higher in patients with LLS compared with NCs. Global omega complexity and anterior omega complexity were significantly higher in patients with LLS compared with NCs.

CONCLUSION

This study revealed an altered pattern of microstate dynamics and omega complexity in patients with LLS. This may reflect the disturbed neural basis underlying LLS and enhance the understanding of the pathophysiology of LLS.