Efficacy of Original Neurofeedback Treatment Method for Brain Fog From COVID-19: A Case Report

Brain fog is one of the most well-known sequelae of long COVID. It causes cognitive problems, mostly short-term memory disturbances, attention impairments, and problems with concentration. Although trials for treatment methods for brain fog have been carried out worldwide, effective methods have not yet been reported. Neurofeedback is effective for several common disorders and symptoms, including anxiety, depression, headaches, and pain. Neurofeedback is also reported to improve cognitive functions, such as processing speed and executive functions, including attention, planning, organization, problem-solving, and performance. Furthermore, neurofeedback is effective for "chemofog" and "chemobrain," which occur after chemotherapy and cause cognitive impairments in a similar manner to brain fog. However, there have been no reports of neurofeedback treatments for brain fog. Therefore, we have started to develop an original neurofeedback treatment method for brain fog using a Z-score neurofeedback technique. In this study, we present the first case report of a patient who has successfully recovered from brain fog via neurofeedback. Pain and psychological assessments revealed that the patient's pain improved and that the patient recovered from anxiety. Electroencephalograph data revealed several noble findings. C4 was thought to be the most affected site by brain fog, and this improved after treatment. The percentage increase at alpha wavelengths increased at almost all sites, and beta 1, beta 2, beta 3, and Hi beta decreased at almost all sites. The increased values at theta and alpha wavelengths after the 1st and 2nd sessions and the decreased values at higher beta wavelengths, such as beta 3 and Hi beta, were shown at all sessions.

Therapeutic Time Window With DWI-ADC (Diffusion-Weighted Imaging-Apparent Diffusion Coefficient) Match and Periodic Discharges for Status Epilepticus

A man in his 70s with alcoholic dementia was admitted for acute, prolonged impaired consciousness. Blood and cerebrospinal fluid findings were unremarkable. Brain MRI revealed multiple high-signal cortical regions. Following diazepam and levetiracetam administration, electroencephalography (EEG) revealed <1 Hz lateralized periodic discharges, indicating that the seizures were ceasing. The periodic discharges had disappeared during the gradual recovery process by day 10; however, cortical arterial spin labeling findings persisted only in regions exhibiting cytotoxic edema. Without additional anti-seizure medication, no seizure recurred, but cognitive dysfunction remained. He was transferred to a rehabilitation hospital with the continued oral administration of levetiracetam at 1,000 mg/day. DWI-ADC (diffusion-weighted imaging-apparent diffusion coefficient) match may suggest an indication of a missed suitable treatment window for seizures.

Efficacy of Melatonin as a Sleep Inducer in EEG Procedures in the Pediatric Population: A Cross-Sectional Study

Introduction Melatonin has been used as an alternative to sleep deprivation for EEG sleep induction in the pediatric population. Our study aims to describe the efficacy of the currently used doses of melatonin for sleep induction among the pediatric age group. Methods A retrospective cross-sectional study included all patients who underwent an EEG after receiving melatonin over the period of one year. A total of 126 patients have been included in the study. Patients aged one year to three years received oral melatonin in doses between 2 mg and 6 mg. Patients in the age of three years and above received 10 mg of melatonin. Patients' success rate in achieving sleep and the exact time required for the patients to fall asleep were obtained using the readings of their EEG. The percentage of patients who have achieved sleep and the time required for those patients to sleep were calculated and correlated with the patient's gender, the presence of any associated neurobehavioral disorders, and their use of antiepileptic drugs (AED). Results Successful sleep was achieved in 84.9% (n:107) of the patients, with a mean time of 24 minutes to fall asleep (SD = 14.36). Patients with neurobehavioral disorders were 20% less likely to fall asleep when compared to other patients without neurobehavioral disorders (p: 0.003). However, there was not a statistically significant difference among different genders and among patients who received AED. Conclusion Melatonin is an effective sleep inducer for patients undergoing EEG procedures. It should be considered in the majority of patients. However, in patients with neurobehavioral disorders, a lower success rate is expected.

Localizing EEG Recordings Associated With a Balance Threat During Unexpected Postural Translations in Young and Elderly Adults

Balance perturbations are accompanied by global cortical activation that increases in magnitude when postural perturbations are unexpected, potentially due to the addition of a startle response. A specific site for best recording the response to unexpected destabilization has not been identified. We hypothesize that a single sensor located near to subcortical brainstem mechanisms could serve as a marker for the response to unpredictable postural events. Twenty healthy young (20.8 ± 2.9 yrs) and 20 healthy elder (71.7 ± 4.2 yrs) adults stood upright on a dynamic platform with eyes open. Platform translations (20 cm at 100 cm/s) were delivered in the posterior (29 trials) and anterior (5 catch trials) directions. Active EEG electrodes were located at Fz and Cz and bilaterally on the mastoids. Following platform acceleration onset, 300 ms of EEG activity from each trial was detrended, baseline-corrected, and normalized to the first trial. Average Root-Mean-Square (RMS) values across "unpredictable" and "predictable" events were computed for each channel. EEG RMS responses were significantly greater with unpredictable than predictable disturbances: Cz ( [Formula: see text]), Fz ( [Formula: see text]), and mastoid ( [Formula: see text]). EEG RMS responses were also significantly greater in elderly than young adults at Cz ( [Formula: see text]) and mastoid ( [Formula: see text]). A significant effect of sex in the responses at the mastoid sensors ( [Formula: see text]) revealed that elderly male adults were principally responsible for the age effect. These results confirm that the cortical activity resulting from an unexpected postural disturbance could be portrayed by a single sensor located over the mastoid bone in both young and elderly adults.

Impact of Listening to Indian Classical Music, or Rāgas, on the Electroencephalogram: A Meta-Analysis

Ancient Indian classical music (ICM) has long been lauded and recognized for influencing emotional responses by influencing the human body's resonance. A meta-analysis of prospective case studies published in the last ten years on the effect of ancient Indian music rāgas on brain waves is investigated. This meta-analysis aimed to analyze published prospective studies investigating the effect of ancient Indian rāgas on EEG in healthy subjects. The present study included prospective studies published since 2012. Studies were obtained by searching four databases, such as PsychINFO, PubMed, Google Scholar, and JSTOR, and searching related journals. Eligibility criteria included studies assessing the impact of listening to Indian classical music on the EEG. Primary outcomes were changes in the brain waves, frequency, and power and their relationship to activity-related arousal, attention, and mental tasks. The studies were analyzed according to the PRISMA guidelines. There were a total of five included studies with 71 participants in the age range of 19-30, and the conditions for the test groups were generally similar except for varying types of rāgas used and time of day. Analysis of the data collected from 71 participants revealed that music interventions had statistically significant effects on increasing alpha activity and attention scores. Fractal analysis was sensitive enough to detect EEG brainwave changes while and after listening to the rāga musical intervention. Rāgas stimulate arousal in different areas of the brain, depending on the emotions they are designed to evoke. However, the synchronized studies together could not highlight a significant relationship between rāgas and EEG fractal dimension values. Although the meta-analysis failed to reproduce the same results from the individual studies, potentially due to the small sample size and study variation, the meta-analysis opens doors to the potential of rāgas to elicit distinct emotions and serve as robust predictors of emotional response. Future studies can explore the therapeutic potential of various rāgas in the clinical setting, such as in the management of cognitive disorders and stress or in modulating heart rate variability and cognitive performance.

Understanding Focal Seizures in Adults: A Comprehensive Review

Focal or partial seizures are a common neurological disorder affecting adults. This review aims to provide an in-depth understanding of focal seizures in adults, including their classification, clinical presentation, etiology, diagnosis, and management. This article seeks to enhance awareness and knowledge among medical professionals and the general public by exploring the latest research and clinical insights. Standard electroencephalography (EEG) and recordings in presurgical electrode depth in humans provide a clear definition of patterns similar to focal seizures. Models of animals with partial seizures and epilepsy mimic seizure patterns with comparable characteristics. However, the network factors supporting interictal spikes, as well as the start, development, and end of seizures remain obscure. According to recent research, inhibitory networks are heavily implicated at the beginning of seizures, and extracellular potassium alterations help start and maintain seizure continuation. An increase in network synchronization, which may be caused by both excitatory and inhibitory pathways, is correlated with the cessation of a partial seizure. Recent research on temporal lobe focal seizures in human and animal models leads to the hypothesis that the active blocking of subcortical arousal processes brings on unconsciousness. Brainstem, basal forebrain, and thalamic arousal networks' neuronal firing is diminished during focal limbic seizures, and cortical arousal can be recovered when subcortical arousal circuits are engaged. These results suggest that thalamic neurostimulation may be therapeutic to restore arousal and consciousness during and after seizures. Targeted subcortical stimulation may increase arousal and consciousness when current treatments cannot halt seizures, enhancing safety and psychosocial function for epileptic patients. We embark on an investigation into adult focal seizures in this thorough review that goes beyond a cursory knowledge of their clinical symptoms.

Delayed Diagnosis of an Invisible Seizure: Cefepime-Induced Non-convulsive Status Epilepticus

Cefepime-induced non-convulsive status epilepticus (NCSE) is a recognized adverse event of cefepime. Risk factors for this adverse event include older age, underlying renal dysfunction, previous brain injury, diabetes, and severe infection. We present a case of a 79-year-old woman with no prior seizure history, who was admitted for Pseudomonas aeruginosa surgical wound infection for which she was on cefepime. She developed acute encephalopathy with associated, occasional, right-sided myoclonic facial twitches 11 days into her admission. Electroencephalogram (EEG) confirmed NCSE as evident by epileptiform activity described as generalized periodic discharges with predominantly triphasic morphology. Cefepime was substituted with piperacillin-tazobactam> 24 hours after symptom onset. NCSE completely resolved two days after the discontinuation of cefepime. This case highlights the fact that NCSE can occur even when precautions such as renal dosing of cefepime are observed. Clinicians need to have a high index of suspicion for the condition when taking care of at-risk patients on cefepime, as delayed diagnosis correlates with potentially fatal outcomes.

Exacerbation of Repetitive Falls Due to Atonic Seizures Following Perampanel Administration

A 47-year-old man presented with tonic-clonic seizures characterized by convulsions. He repeatedly exhibited seizures despite treatment with four anti-seizure medications. During the titration process of perampanel (PER), the seizures paradoxically increased in intensity and frequency, resulting in trauma. Video electroencephalogram monitoring revealed interictal rapid rhythms and generalized spikes and documented atonic seizures. Thus, the patient was diagnosed with Lennox-Gastaut syndrome. Upon discontinuation of PER, the patient's atonic seizures with falls improved, probably suggesting a paradoxical effect of PER. A non-competitive antagonist selective for AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors may have caused the weakness and delayed recovery from prolonged atonia that caused injuries.

Duplex perception reveals brainstem auditory representations are modulated by listeners' ongoing percept for speech

So-called duplex speech stimuli with perceptually ambiguous spectral cues to one ear and isolated low- vs. high-frequency third formant "chirp" to the opposite ear yield a coherent percept supporting their phonetic categorization. Critically, such dichotic sounds are only perceived categorically upon binaural integration. Here, we used frequency-following responses (FFRs), scalp-recorded potentials reflecting phase-locked subcortical activity, to investigate brainstem responses to fused speech percepts and to determine whether FFRs reflect binaurally integrated category-level representations. We recorded FFRs to diotic and dichotic stop-consonants (/da/, /ga/) that either did or did not require binaural fusion to properly label along with perceptually ambiguous sounds without clear phonetic identity. Behaviorally, listeners showed clear categorization of dichotic speech tokens confirming they were heard with a fused, phonetic percept. Neurally, we found FFRs were stronger for categorically perceived speech relative to category-ambiguous tokens but also differentiated phonetic categories for both diotically and dichotically presented speech sounds. Correlations between neural and behavioral data further showed FFR latency predicted the degree to which listeners labeled tokens as "da" vs. "ga". The presence of binaurally integrated, category-level information in FFRs suggests human brainstem processing reflects a surprisingly abstract level of the speech code typically circumscribed to much later cortical processing.

Extracorporeal Membrane Oxygenation for Neonates With Congenital Diaphragmatic Hernia: Prevalence of Seizures and Outcomes

OBJECTIVES

We aimed to determine the prevalence of electrographic seizures and associated odds of adverse outcomes of electrographic seizures in neonates with congenital diaphragmatic hernia (CDH) receiving extracorporeal membrane oxygenation (ECMO).

DESIGN

Retrospective, descriptive case series.

SETTING

Neonatal ICU (NICU) in a quaternary care institution.

PATIENTS

All neonates with CDH receiving ECMO undergoing continuous electroencephalographic monitoring (CEEG) and follow-up between January 2012 and December 2019.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

All eligible neonates with CDH receiving ECMO underwent CEEG (n = 75). Electrographic seizures occurred in 14 of 75 (19%): they were exclusively electrographic-only in nine of 14, both electrographic-only and electroclinical in three of 14, and electroclinical only in two of 14. Two neonates developed status epilepticus. We identified an association between presence of seizures, rather than not, and longer duration of initial session of CEEG monitoring (55.7 hr [48.2-87.3 hr] vs 48.0 hr [43.0-48.3 hr]; p = 0.001). We also found an association between presence of seizures, rather than not, and greater odds of use of a second CEEG monitoring (12/14 vs 21/61; odds ratio [OR], 11.43 [95% CI, 2.34-55.90; p = 0.0026). Most neonates with seizures (10/14), experienced their onset of seizures more than 96 hours after the start of ECMO. Overall, the presence of electrographic seizures, compared with not, was associated with lower odds of survival to NICU discharge (4/14 vs 49/61; OR 0.10 [95% CI 0.03 to 0.37], p = 0.0006). Also, the presence of seizures-rather than not-was associated with greater odds of a composite of death and all abnormal outcomes on follow-up (13/14 vs 26/61; OR, 17.5; 95% CI, 2.15-142.39; p = 0.0074).

CONCLUSIONS

Nearly one in five neonates with CDH receiving ECMO developed seizures during the ECMO course. Seizures were predominantly electrographic-only and when present were associated with great odds of adverse outcomes. The current study provides evidence to support standardized CEEG in this population.

A Rare Case of Lance-Adams Syndrome: Status Post-Successful Cardiopulmonary Resuscitation

Lance-Adams syndrome (LAS), also known as chronic post-hypoxic myoclonus (PHM), is a rare condition that may present with intention myoclonus in a patient who has regained consciousness after cardiorespiratory arrest. This case report describes a patient who received successful cardiopulmonary resuscitation (CPR) after going into cardiac arrest. And regaining consciousness, the patient developed myoclonic jerks diagnosed as LAS. The patient responded well to treatment with clonazepam and physical rehabilitation.

Neurophysiological Markers of Internet Gaming Disorder: A Literature Review of Electroencephalography Studies

Pathological online gaming is a relatively newer psychiatric disorder. It is the second behavioral addiction (after internet gambling disorder) included in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM), 5^th edition as “Internet Gaming Disorder” (IGD). Recent research is showing high morbidity associated with IGD, thus encouraging researchers to find valid and reliable biomarkers of IGD. So that, early diagnosis and proper treatment could limit the high disability level accompanying excessive online gaming. As electroencephalography (EEG) is a non-invasive and relatively easily available diagnostic technique, we aimed at collecting EEG studies that investigated EEG changes associated with IGD, with a specific focus on finding diagnostic and predictive neurophysiological biomarkers of IGD. We searched PubMed and Google Scholar for EEG studies of IGD. We eliminated those EEG studies that were not focused on finding biomarkers. Scale for the Assessment of Narrative Review Articles (SANRA) is followed in the writing of this review article. Our results showed that increased slow-wave resting-state activity and reduced P300 and N100 can serve as useful IGD diagnostic markers of IGD. Moreover, increased resting-state theta activity can be a predictive biomarker of IGD. Lastly, increased late low potentials (LLPs) can be specific trait markers of cue-induced cravings in IGD.

Head Over Heart: An Atypical Presentation of Temporal Lobe Epilepsy

Ictal asystole is a long-documented medical condition that causes pauses during epileptic episodes. This condition has garnered attention due to resulting accidents. The mechanism of action and treatment guidelines are not well established. We present a case of a 39-year-old male truck driver who presented with dizziness, lightheadedness, confusion, and amnesia with a history of two motor vehicle accidents within one week. During his second hospitalization he underwent pacemaker placement due to presumed sinus node dysfunction. The patient returned with recurrent symptoms and was found to have epileptic focus of the left anterior temporal lobe on electroencephalogram and was thought to have ictal asystole. In this report, we focus on the importance of evaluating for neurogenic cause of cardiac arrythmias.

Magnetic Resonance Imaging Findings and Their Association with Electroencephalogram Data in Children with Partial Epilepsy

Background

It is important to identify the neuroimaging features that are associated with partial epilepsy in children. Advances in technology have recently been made to localize focal epileptogenic lesions, especially high-resolution structural imaging with magnetic resonance imaging (MRI). The recommendation that electroencephalography (EEG) should be the gold standard and that MRI should be optional has been questioned. The present study aims to evaluate the efficacy of MRI in children with partial epilepsy and to compare the diagnostic yields of MRI and EEG data.

Methods

The present study was conducted among one hundred twelve 1- to 6-year-old children with partial epilepsy. All patients underwent EEG and brain MRI. The epileptogenic lesions were identified on the basis of the signal intensities and morphological abnormalities seen on MRI. The correlation between MRI and EEG abnormal findings was analyzed using a chi-square test.

Results

Abnormal MRI findings were present in 34.8% (n = 39) of the sample. The EEG and MRI data agreed with respect to classifications into abnormal or normal in 48.2% of the sample (n = 54). Of the 27 patients with normal EEG findings, six (22.2%) had abnormal MRI findings. Inter-rater agreement showed the compatibility between EEG and MRI not significant (weighted Kappa = 0.105).

Conclusion

A number of MRI abnormalities were found in our study of otherwise normal children, although the correlation between these results was not clear. The follow-up of these children will help us identify the important abnormalities. Despite the small sample size, our results showed that normal EEG findings do not predict normal brain MRI data in children with partial epilepsy.

Use of longitudinal EEG measures in estimating language development in infants with and without familial risk for autism spectrum disorder

Language development in children with autism spectrum disorder (ASD) varies greatly among affected individuals and is a strong predictor of later outcomes. Younger siblings of children with ASD have increased risk of ASD, but also language delay. Identifying neural markers of language outcomes in infant siblings could facilitate earlier intervention and improved outcomes. This study aimed to determine whether EEG measures from the first 2-years of life can explain heterogeneity in language development in children at low- and high-risk for ASD, and to determine whether associations between EEG measures and language development are different depending on ASD risk status or later ASD diagnosis. In this prospective longitudinal study EEG measures collected between 3-24 months were used in a multivariate linear regression model to estimate participants' 24-month language development. Individual baseline longitudinal EEG measures included (1) the slope of EEG power across 3-12 months or 3-24 months of life for 6 canonical frequency bands, (2) estimated EEG power at age 6-months for the same frequency bands, and (3) terms representing the interaction between ASD risk status and EEG power measures. Modeled 24-month language scores using EEG data from either the first 2-years (Pearson R = 0.70, 95% CI 0.595-0.783, P=1x10^-18) or the first year of life (Pearson R=0.66, 95% CI 0.540-0.761, P=2.5x10^-14) were highly correlated with observed scores. All models included significant interaction effects of risk on EEG measures, suggesting that EEG-language associations are different depending on risk status, and that different brain mechanisms effect language development in low-versus high-risk infants.

An Algorithm for Automated, Noninvasive Detection of Cortical Spreading Depolarizations Based on EEG Simulations

OBJECTIVE

We present a novel signal processing algorithm for automated, noninvasive detection of cortical spreading depolarizations (CSDs) using electroencephalography (EEG) signals and validate the algorithm on simulated EEG signals. CSDs are waves of neurochemical changes that suppress the neuronal activity as they propagate across the brain's cortical surface. CSDs are believed to mediate secondary brain damage after brain trauma and cerebrovascular diseases like stroke. We address the following two key challenges in detecting CSDs from EEG signals: i) attenuation and loss of high spatial resolution information; and ii) cortical folds, which complicate tracking CSD waves.

METHODS

Our algorithm detects and tracks "wavefronts" of a CSD wave, and stitch together data across space and time to make a detection. To test our algorithm, we provide different models of CSD waves, including different widths of CSD suppressions and different patterns, and use them to simulate scalp EEG signals using head models of four subjects.

RESULTS AND CONCLUSION

Our results suggest that low-density EEG grids (40 electrodes) can detect CSD widths of 1.1 cm on average, while higher density EEG grids (340 electrodes) can detect CSD patterns as thin as 0.43 cm (less than minimum widths reported in prior works), among which single-gyrus CSDs are the hardest to detect because of their small suppression area.

SIGNIFICANCE

The proposed algorithm is a first step toward noninvasive, automated detection of CSDs, which can help in reducing secondary brain damages.

Current Understanding of Religion, Spirituality, and Their Neurobiological Correlates

Religion and spirituality (R/S) have been prominent aspects of most human cultures through the ages; however, scientific inquiry into this phenomenon has been limited. We conducted a systematic literature review of research on the neurobiological correlates of R/S, which resulted in 25 reports studying primarily R/S with electroencephalography, structural neuroimaging (MRI), and functional neuroimaging (fMRI, PET). These studies investigated a wide range of religions (e.g., Christianity, Buddhism, Islam) and R/S states and behaviors (e.g., resting state, prayer, judgments) and employed a wide range of methodologies, some of which (e.g., no control group, varying measures of religiosity, small sample sizes) raise concerns about the validity of the results. Despite these limitations, the findings of these studies collectively suggest that the experience of R/S has specific neurobiological correlates and that these correlates are distinct from non-R/S counterparts. The findings implicate several brain regions potentially associated with R/S development and behavior, including the medial frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network, and caudate. This research may suggest future clinical applications and interventions related to R/S and various disorders, including mood, anxiety, psychotic, pain, and vertiginous disorders. Further studies with more rigorous study designs are warranted to elucidate the neurobiological mechanisms of R/S and their potential clinical applications.

Characterization of EEG signals revealing covert cognition in the injured brain

See Boly and Laureys (doi:10.1093/brain/awy080) for a scientific commentary on this article.Patients with severe brain injury are difficult to assess and frequently subject to misdiagnosis. 'Cognitive motor dissociation' is a term used to describe a subset of such patients with preserved cognition as detected with neuroimaging methods but not evident in behavioural assessments. Unlike the locked-in state, cognitive motor dissociation after severe brain injury is prominently marked by concomitant injuries across the cerebrum in addition to limited or no motoric function. In the present study, we sought to characterize the EEG signals used as indicators of cognition in patients with disorders of consciousness and examine their reliability for potential future use to re-establish communication. We compared EEG-based assessments to the results of using similar methods with functional MRI. Using power spectral density analysis to detect EEG evidence of task performance (Two Group Test, P ≤ 0.05, with false discovery rate correction), we found evidence of the capacity to follow commands in 21 of 28 patients with severe brain injury and all 15 healthy individuals studied. We found substantial variability in the temporal and spatial characteristics of significant EEG signals among the patients in contrast to only modest variation in these domains across healthy controls; the majority of healthy controls showed suppression of either 8-12 Hz 'alpha' or 13-40 Hz 'beta' power during task performance, or both. Nine of the 21 patients with EEG evidence of command-following also demonstrated functional MRI evidence of command-following. Nine of the patients with command-following capacity demonstrated by EEG showed no behavioural evidence of a communication channel as detected by a standardized behavioural assessment, the Coma Recovery Scale - Revised. We further examined the potential contributions of fluctuations in arousal that appeared to co-vary with some patients' ability to reliably generate EEG signals in response to command. Five of nine patients with statistically indeterminate responses to one task tested showed a positive response after accounting for variations in overall background state (as visualized in the qualitative shape of the power spectrum) and grouping of trial runs with similar background state characteristics. Our findings reveal signal variations of EEG responses in patients with severe brain injuries and provide insight into the underlying physiology of cognitive motor dissociation. These results can help guide future efforts aimed at re-establishment of communication in such patients who will need customization for brain-computer interfaces.

Enhancing Detection of SSVEPs for a High-Speed Brain Speller Using Task-Related Component Analysis

OBJECTIVE

This study proposes and evaluates a novel data-driven spatial filtering approach for enhancing steady-state visual evoked potentials (SSVEPs) detection toward a high-speed brain-computer interface (BCI) speller.

METHODS

Task-related component analysis (TRCA), which can enhance reproducibility of SSVEPs across multiple trials, was employed to improve the signal-to-noise ratio (SNR) of SSVEP signals by removing background electroencephalographic (EEG) activities. An ensemble method was further developed to integrate TRCA filters corresponding to multiple stimulation frequencies. This study conducted a comparison of BCI performance between the proposed TRCA-based method and an extended canonical correlation analysis (CCA)-based method using a 40-class SSVEP dataset recorded from 12 subjects. An online BCI speller was further implemented using a cue-guided target selection task with 20 subjects and a free-spelling task with 10 of the subjects.

RESULTS

The offline comparison results indicate that the proposed TRCA-based approach can significantly improve the classification accuracy compared with the extended CCA-based method. Furthermore, the online BCI speller achieved averaged information transfer rates (ITRs) of 325.33 ± 38.17 bits/min with the cue-guided task and 198.67 ± 50.48 bits/min with the free-spelling task.

CONCLUSION

This study validated the efficiency of the proposed TRCA-based method in implementing a high-speed SSVEP-based BCI.

SIGNIFICANCE

The high-speed SSVEP-based BCIs using the TRCA method have great potential for various applications in communication and control.

Electrographic Seizures in Children and Neonates Undergoing Extracorporeal Membrane Oxygenation

OBJECTIVE

We aimed to determine the prevalence and risk factors for electrographic seizures in neonates and children requiring extracorporeal membrane oxygenation support.

DESIGN

Prospective quality improvement project.

SETTING

Quaternary care pediatric institution.

PATIENTS

Consistent with American Clinical Neurophysiology Society electroencephalographic monitoring recommendations, neonates and children requiring extracorporeal membrane oxygenation support underwent clinically indicated electroencephalographic monitoring.

INTERVENTIONS

We performed a 2-year quality improvement study from July 2013 to June 2015 evaluating electrographic seizure prevalence and risk factors.

MAIN RESULTS

Ninety-nine of 112 patients (88%) requiring extracorporeal membrane oxygenation support underwent electroencephalographic monitoring. Electrographic seizures occurred in 18 patients (18%), of whom 11 patients (61%) had electrographic status epilepticus and 15 patients (83%) had exclusively electrographic-only seizures. Electrographic seizures were more common in patients with low cardiac output syndrome (p = 0.03). Patients with electrographic seizures were more likely to die prior to discharge (72% vs 30%; p = 0.01) and have unfavorable outcomes (54% vs 17%; p = 0.004) than those without electrographic seizures.

CONCLUSIONS

Electrographic seizures occurred in 18% of neonates and children requiring extracorporeal membrane oxygenation support, often constituted electrographic status epilepticus, and were often electrographic-only thereby requiring electroencephalographic monitoring for identification. Low cardiac output syndrome was associated with an increased risk for electrographic seizures. Electrographic seizures were associated with higher mortality and unfavorable outcomes. Further investigation is needed to determine whether electrographic seizures identification and management improves outcomes.

Functional development of the brain's face-processing system

In the first 20 years of life, the human brain undergoes tremendous growth in size, weight, and synaptic connectedness. Over the same time period, a person achieves remarkable transformations in perception, thought, and behavior. One important area of development is face processing ability, or the ability to quickly and accurately extract extensive information about a person's identity, emotional state, attractiveness, intention, and numerous other types of information that are crucial to everyday social interaction and communication. Associating particular brain changes with specific behavioral and intellectual developments has historically been a serious challenge for researchers. Fortunately, modern neuroimaging is dramatically advancing our ability to make associations between morphological and behavioral developments. In this article, we demonstrate how neuroimaging has revolutionized our understanding of the development of face processing ability to show that this essential perceptual and cognitive skill matures consistently yet slowly over the first two decades of life. In this manner, face processing is a model system of many areas of complex cognitive development. WIREs Cogn Sci 2017, 8:e1423. doi: 10.1002/wcs.1423 For further resources related to this article, please visit the WIREs website.

Early and late effects of objecthood and spatial frequency on event-related potentials and gamma band activity

BACKGROUND

The visual system may process spatial frequency information in a low-to-high, coarse-to-fine sequence. In particular, low and high spatial frequency information may be processed via different pathways during object recognition, with LSF information projected rapidly to frontal areas and HSF processed later in visual ventral areas. In an electroencephalographic study, we examined the time course of information processing for images filtered to contain different ranges of spatial frequencies. Participants viewed either high spatial frequency (HSF), low spatial frequency (LSF), or unfiltered, broadband (BB) images of objects or non-object textures, classifying them as showing either man-made or natural objects, or non-objects. Event-related potentials (ERPs) and evoked and total gamma band activity (eGBA and tGBA) recorded using the electroencephalogram were compared for object and non-object images across the different spatial frequency ranges.

RESULTS

The visual P1 showed independent modulations by object and spatial frequency, while for the N1 these factors interacted. The P1 showed more positive amplitudes for objects than non-objects, and more positive amplitudes for BB than for HSF images, which in turn evoked more positive amplitudes than LSF images. The peak-to-peak N1 showed that the N1 was much reduced for BB non-objects relative to all other images, while HSF and LSF non-objects still elicited as negative an N1 as objects. In contrast, eGBA was influenced by spatial frequency and not objecthood, while tGBA showed a stronger response to objects than non-objects.

CONCLUSIONS

Different pathways are involved in the processing of low and high spatial frequencies during object recognition, as reflected in interactions between objecthood and spatial frequency in the visual N1 component. Total gamma band seems to be related to a late, probably high-level representational process.

An energy efficient compressed sensing framework for the compression of electroencephalogram signals

The use of wireless body sensor networks is gaining popularity in monitoring and communicating information about a person's health. In such applications, the amount of data transmitted by the sensor node should be minimized. This is because the energy available in these battery powered sensors is limited. In this paper, we study the wireless transmission of electroencephalogram (EEG) signals. We propose the use of a compressed sensing (CS) framework to efficiently compress these signals at the sensor node. Our framework exploits both the temporal correlation within EEG signals and the spatial correlations amongst the EEG channels. We show that our framework is up to eight times more energy efficient than the typical wavelet compression method in terms of compression and encoding computations and wireless transmission. We also show that for a fixed compression ratio, our method achieves a better reconstruction quality than the CS-based state-of-the art method. We finally demonstrate that our method is robust to measurement noise and to packet loss and that it is applicable to a wide range of EEG signal types.

Electrophysiological evidence for ventral stream deficits in schizophrenia patients

Schizophrenic patients suffer from many deficits including visual, attentional, and cognitive ones. Visual deficits are of particular interest because they are at the fore-end of information processing and can provide clear examples of interactions between sensory, perceptual, and higher cognitive functions. Visual deficits in schizophrenic patients are often attributed to impairments in the dorsal (where) rather than the ventral (what) stream of visual processing. We used a visual-masking paradigm in which patients and matched controls discriminated small vernier offsets. We analyzed the evoked electroencephalography (EEG) responses and applied distributed electrical source imaging techniques to estimate activity differences between conditions and groups throughout the brain. Compared with controls, patients showed strongly reduced discrimination accuracy, confirming previous work. The behavioral deficits corresponded to pronounced decreases in the evoked EEG response at around 200 ms after stimulus onset. At this latency, patients showed decreased activity for targets in left parietal cortex (dorsal stream), but the decrease was most pronounced in lateral occipital cortex (in the ventral stream). These deficiencies occurred at latencies that reflect object processing and fine shape discriminations. We relate the reduced ventral stream activity to deficient top-down processing of target stimuli and provide a framework for relating the commonly observed dorsal stream deficiencies with the currently observed ventral stream deficiencies.

Neural connectivity abnormalities in autism: insights from the Tuberous Sclerosis model

Autism Spectrum Disorder (ASD) is a behavioral syndrome caused by complex genetic and non-genetic risk factors. It has been proposed that these risk factors lead to alterations in the development and 'wiring' of brain circuits and hence, the emergence of ASD. Although several lines of research lend support to this theory, etiological and clinical heterogeneity, methodological issues and inconsistent findings have led to significant doubts. One of the best established, albeit rare, causes of ASD is the genetic condition Tuberous Sclerosis Complex (TSC), where 40% of individuals develop ASD. A recent study by Peters and Taquet et al. analyzed electroencephalography (EEG) data using graph theory to model neural 'connectivity' in individuals with TSC with and without ASD and cases with 'idiopathic' ASD. TSC cases exhibited global under-connectivity and abnormal network topology, whereas individuals with TSC + ASD demonstrated similar connectivity patterns to those seen in individuals with idiopathic ASD: decreased long- over short-range connectivity. The similarity in connectivity abnormalities in TSC + ASD and ASD suggest a common final pathway and provide further support for 'mis-wired' neural circuitry in ASD. The origins of the connectivity changes, and their role in mediating between the neural and the cognitive/behavioral manifestations, will require further study.Please see related research article here http://www.biomedcentral.com/1741-7015/11/54.

Slow brain activity (ISA/DC) detected by MEG

Infraslow activity (ISA), direct coupled (DC), and direct current (DC) are the terms used to describe brain activity that occurs in frequencies below 0.1 Hz. Infraslow activity amplitude increase is also associated with epilepsy, traumatic brain injuries, strokes, tumors, and migraines and has been studied since the early 90s at the Henry Ford Hospital MEG Laboratory. We have used a DC-based magnetoencephalography (MEG) system to validate and characterize the ISA from animal models of cortical spreading depression thought to be the underlying mechanism of migraine and other cortical spreading depression-like events seen during ischemia, anoxia, and epilepsy. Magnetoencephalography characterizes these slow shifts easier than electroencephalography because there is no attenuation of these signals by the skull. In the current study, we report on ISA MEG signals of 12 patients with epilepsy in the preictal and postictal states. In the minutes just before the onset of a seizure, large-amplitude ISA MEG waveforms were detected, signaling the onset of the seizure. It is suggested that MEG assessment of ISA, in addition to activity in the conventional frequency band, can at times be useful in the lateralization of epileptic seizures.

Translating long-term potentiation from animals to humans: a novel method for noninvasive assessment of cortical plasticity

Long-term potentiation (LTP) is a synaptic mechanism underlying learning and memory that has been studied extensively in laboratory animals. The study of LTP recently has been extended into humans with repetitive sensory stimulation to induce cortical LTP. In this review article, we will discuss past results from our group demonstrating that repetitive sensory stimulation (visual or auditory) induces LTP within the sensory cortex (visual/auditory, respectively) and can be measured noninvasively with electroencephalography or functional magnetic resonance imaging. We will discuss a number of studies that indicate that this form of LTP shares several characteristics with the synaptic LTP described in animals: it is frequency dependent, long-lasting (> 1 hour), input-specific, depotentiates with low-frequency stimulation, and is blocked by N-methyl-D-aspartate receptor blockers in rats. In this review, we also present new data with regard to the behavioral significance of human sensory LTP. These advances will permit enquiry into the functional significance of LTP that has been hindered by the absence of a human model. The ability to elicit LTP with a natural sensory stimulus noninvasively will provide a model system allowing the detailed examination of synaptic plasticity in normal subjects and might have future clinical applications in the diagnosis and assessment of neuropsychiatric and neurocognitive disorders.

Impaired early visual response modulations to spatial information in chronic schizophrenia

Early visual processing stages have been demonstrated to be impaired in schizophrenia patients and their first-degree relatives. The amplitude and topography of the P1 component of the visual evoked potential (VEP) are both affected; the latter of which indicates alterations in active brain networks between populations. At least two issues remain unresolved. First, the specificity of this deficit (and suitability as an endophenotype) has yet to be established, with evidence for impaired P1 responses in other clinical populations. Second, it remains unknown whether schizophrenia patients exhibit intact functional modulation of the P1 VEP component; an aspect that may assist in distinguishing effects specific to schizophrenia. We applied electrical neuroimaging analyses to VEPs from chronic schizophrenia patients and healthy controls in response to variation in the parafoveal spatial extent of stimuli. Healthy controls demonstrated robust modulation of the VEP strength and topography as a function of the spatial extent of stimuli during the P1 component. By contrast, no such modulations were evident at early latencies in the responses from patients with schizophrenia. Source estimations localized these deficits to the left precuneus and medial inferior parietal cortex. These findings provide insights on potential underlying low-level impairments in schizophrenia.

Effects of reverberation on brainstem representation of speech in musicians and non-musicians

Perceptual and neurophysiological enhancements in linguistic processing in musicians suggest that domain specific experience may enhance neural resources recruited for language specific behaviors. In everyday situations, listeners are faced with extracting speech signals in degraded listening conditions. Here, we examine whether musical training provides resilience to the degradative effects of reverberation on subcortical representations of pitch and formant-related harmonic information of speech. Brainstem frequency-following responses (FFRs) were recorded from musicians and non-musician controls in response to the vowel /i/ in four different levels of reverberation and analyzed based on their spectro-temporal composition. For both groups, reverberation had little effect on the neural encoding of pitch but significantly degraded neural encoding of formant-related harmonics (i.e., vowel quality) suggesting a differential impact on the source-filter components of speech. However, in quiet and across nearly all reverberation conditions, musicians showed more robust responses than non-musicians. Neurophysiologic results were confirmed behaviorally by comparing brainstem spectral magnitudes with perceptual measures of fundamental (F0) and first formant (F1) frequency difference limens (DLs). For both types of discrimination, musicians obtained DLs which were 2-4 times better than non-musicians. Results suggest that musicians' enhanced neural encoding of acoustic features, an experience-dependent effect, is more resistant to reverberation degradation which may explain their enhanced perceptual ability on behaviorally relevant speech and/or music tasks in adverse listening conditions.

Occipital gamma activation during Vipassana meditation

Long-term Vipassana meditators sat in meditation vs. a control rest (mind-wandering) state for 21 min in a counterbalanced design with spontaneous EEG recorded. Meditation state dynamics were measured with spectral decomposition of the last 6 min of the eyes-closed silent meditation compared to control state. Meditation was associated with a decrease in frontal delta (1-4 Hz) power, especially pronounced in those participants not reporting drowsiness during meditation. Relative increase in frontal theta (4-8 Hz) power was observed during meditation, as well as significantly increased parieto-occipital gamma (35-45 Hz) power, but no other state effects were found for the theta (4-8 Hz), alpha (8-12 Hz), or beta (12-25 Hz) bands. Alpha power was sensitive to condition order, and more experienced meditators exhibited no tendency toward enhanced alpha during meditation relative to the control task. All participants tended to exhibit decreased alpha in association with reported drowsiness. Cross-experimental session occipital gamma power was the greatest in meditators with a daily practice of 10+ years, and the meditation-related gamma power increase was similarly the strongest in such advanced practitioners. The findings suggest that long-term Vipassana meditation contributes to increased occipital gamma power related to long-term meditational expertise and enhanced sensory awareness.

Classifying EEG signals preceding right hand, left hand, tongue, and right foot movements and motor imageries

OBJECTIVE

To use the neural signals preceding movement and motor imagery to predict which of the four movements/motor imageries is about to occur, and to access this utility for brain-computer interface (BCI) applications.

METHODS

Eight naïve subjects performed or kinesthetically imagined four movements while electroencephalogram (EEG) was recorded from 29 channels over sensorimotor areas. The task was instructed with a specific stimulus (S1) and performed at a second stimulus (S2). A classifier was trained and tested offline at differentiating the EEG signals from movement/imagery preparation (the 1.5-s preceding movement/imagery execution).

RESULTS

Accuracy of movement/imagery preparation classification varied between subjects. The system preferentially selected event-related (de)synchronization (ERD/ERS) signals for classification, and high accuracies were associated with classifications that relied heavily on the ERD/ERS to discriminate movement/imagery planning.

CONCLUSIONS

The ERD/ERS preceding movement and motor imagery can be used to predict which of the four movements/imageries is about to occur. Prediction accuracy depends on this signal's accessibility.

SIGNIFICANCE

The ERD/ERS is the most specific pre-movement/imagery signal to the movement/imagery about to be performed.

From event-related potential to oscillations: genetic diathesis in brain (dys)function and alcohol dependence

Recording the brain's electrical activity using electrodes placed on the individual's scalp provides noninvasive sensitive measures of brain function in humans. Regardless of whether an individual receives sensory information or performs higher cognitive processes, the brain regions involved exhibit measurable electrical activity, and by recording this activity with numerous electrodes placed on different areas of the scalp, researchers can determine when and where in the brain information processing occurs. Two general approaches can be used to record these neuroelectric phenomena: The continuous electroencephalogram (EEG) records brain activity when the subject is at rest and not involved in a task. It reflects the sum of the random activity of thousands of neurons that have similar spatial orientation in the brain. This activity typically fluctuates in wave-like patterns, and depending on the frequency of these patterns, one distinguishes different brain waves called δ (frequency of 1 to 3 Hz), θ (frequency of 4 to 7 Hz), α (frequency of 8 to 12 Hz), β (frequency of 12 to 28 Hz), and γ (frequency of 28+ Hz) rhythms. Variations in the patterns of these brain waves can indicate the level of consciousness, psychological state, or presence of neurological disorders. Event-related potentials (ERPs) are recorded while the subject is performing a sensory or cognitive task. They reflect the summated activity of network ensembles active during the task and are characterized by a specific pattern called the waveform, which is composed of negative and positive deflections (i.e., waves). For example, a target stimulus detected amidst a series of other nontarget stimuli produces a positive wave around 300 milliseconds after the stimulus. This is known as the P300 or P3 response.

Treatment of neonatal seizures

Newborn babies with unusual movements thought to represent seizures are usually given a loading dose of phenobarbitone without electroencephalography being performed. Antiepileptic drugs (AEDs) are then continued, with the outcome determined by clinical observation alone. AED treatment, often involving multiple drugs for long periods, is undesirable at a time when the brain is developing rapidly and likely to be especially vulnerable to any toxic effects. Despite considerable advances in the pharmacology of AEDs, continuous EEG monitoring using compact digital systems with simultaneous videorecording allowing off-line analysis, automated seizure detection, neuroimaging, and basic science research on cellular mechanisms of brain injury, treatment of such babies has progressed little. A change in practice is long overdue to allow affected babies to benefit from the advances made.

Shifting of activation center in the brain during muscle fatigue: an explanation of minimal central fatigue?

Accumulating evidence suggests that the overall level of cortical activation controlling a voluntary motor task that leads to significant muscle fatigue does not decrease as much as the activation level of the motoneuron pool projecting to the muscle. One possible explanation for this "muscle fatigue>cortical fatigue" phenomenon is that the brain is an organ with built-in redundancies: it has multiple motor centers and parallel pathways, and the center of activation may shift from one location to another when neurons in the previous location become fatigued. This hypothesis was tested by estimating the changes of source locations of high-density (64 channels) scalp electroencephalographic (EEG) signals collected during both fatigue and non-fatigue motor tasks. A current dipole model was used to estimate the EEG sources. The fatigue motor task induced significant muscle fatigue, and the non-fatigue task did not. The EEG signal source that indicated the center of brain activation showed substantial location shifts during the fatigue motor task. The shifts could not be explained by variations of source locations caused by error estimated from the non-fatigue task EEG and simulated data. Compared to the non-fatigue condition, the weighted-center of the source locations for all the participants shifted toward the right hemisphere (ipsilateral to the muscle activation), anterior, and inferior cortical regions under the fatigue condition. Fatigue did not alter dipole (source-signal) strength or the overall level of brain activation. The brain may avoid fatigue by shifting neuron populations that participate in a fatiguing motor task.

Characterization of N200 and P300: selected studies of the Event-Related Potential

The Event-Related Potential (ERP) is a time-locked measure of electrical activity of the cerebral surface representing a distinct phase of cortical processing. Two components of the ERP which bear special importance to stimulus evaluation, selective attention, and conscious discrimination in humans are the P300 positivity and N200 negativity, appearing 300 ms and 200 ms post-stimulus, respectively. With the rapid proliferation of high-density EEG methods, and interdisciplinary interest in its application as a prognostic, diagnostic, and investigative tool, an understanding of the underpinnings of P300 and N200 physiology may support its application to both the basic neuroscience and clinical medical settings. The authors present a synthesis of current understanding of these two deflections in both normal and pathological states.

Transcranial direct current stimulation during sleep improves declarative memory

In humans, weak transcranial direct current stimulation (tDCS) modulates excitability in the motor, visual, and prefrontal cortex. Periods rich in slow-wave sleep (SWS) not only facilitate the consolidation of declarative memories, but in humans, SWS is also accompanied by a pronounced endogenous transcortical DC potential shift of negative polarity over frontocortical areas. To experimentally induce widespread extracellular negative DC potentials, we applied anodal tDCS (0.26 mA) [correction] repeatedly (over 30 min) bilaterally at frontocortical electrode sites during a retention period rich in SWS. Retention of declarative memories (word pairs) and also nondeclarative memories (mirror tracing skills) learned previously was tested after this period and compared with retention performance after placebo stimulation as well as after retention intervals of wakefulness. Compared with placebo stimulation, anodal tDCS during SWS-rich sleep distinctly increased the retention of word pairs (p < 0.005). When applied during the wake retention interval, tDCS did not affect declarative memory. Procedural memory was also not affected by tDCS. Mood was improved both after tDCS during sleep and during wake intervals. tDCS increased sleep depth toward the end of the stimulation period, whereas the average power in the faster frequency bands (,alpha, and beta) was reduced. Acutely, anodal tDCS increased slow oscillatory activity <3 Hz. We conclude that effects of tDCS involve enhanced generation of slow oscillatory EEG activity considered to facilitate processes of neuronal plasticity. Shifts in extracellular ionic concentration in frontocortical tissue (expressed as negative DC potentials during SWS) may facilitate sleep-dependent consolidation of declarative memories.