1
|
Chen YC, Chang WP, Liang KJ, Chen CL, Chen HY, Chen SP, Chan PYS. The effects of neurofeedback training for children with cerebral palsy and co-occurring attention deficits: A pilot study. Child Care Health Dev 2024; 50:e13231. [PMID: 38465844 DOI: 10.1111/cch.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Limited research exists regarding the effectiveness of electroencephalogram (EEG) neurofeedback training for children with cerebral palsy (CP) and co-occurring attention deficits (ADs), despite the increasing prevalence of these dual conditions. This study aimed to fill this gap by examining the impact of neurofeedback training on the attention levels of children with CP and AD. METHODS Nineteen children with both CP and co-occurring ADs were randomly assigned to either a neurofeedback or control group. The neurofeedback group received 20 sessions of training, lasting approximately 1 h per day, twice a week. Theta/beta ratios of the quantitative electroencephalography (QEEG) recordings were measured pre-training and post-training in the resting state. The Continuous Performance Test (CPT), the Test of Visual Perceptual Skills-3rd Version (TVPS-3) and the Conners' Parent Rating Scale (CPRS) were measured at pre- and post-training. RESULTS The neurofeedback group showed both decreased theta/beta ratios compared with control group (p = 0.04) at post-training and a within-group improvement during training (p = 0.02). Additionally, the neurofeedback group had a trend of decreased omission rates of the CPT (p = 0.08) and the visual sequential memory and the visual closure subscores in the TVPS-3, compared with the control group (p = 0.02 and p = 0.01, respectively). CONCLUSIONS The results suggested that children with CP and co-occurring AD may benefit from neurofeedback training in their attention level. Further research is needed to explore long-term effects and expand its application in this population.
Collapse
Affiliation(s)
- Yuh-Chuan Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Pin Chang
- Department of Occupational Therapy, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Kai-Jie Liang
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsin-Yung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Ping Chen
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Pei-Ying S Chan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
2
|
Liang KJ, Cheng CH, Liu CY, Hsu SC, von Leupoldt A, Jelinčić V, Chan PYS. Neural oscillations underlying the neural gating of respiratory sensations in generalized anxiety disorder. Respir Physiol Neurobiol 2024; 321:104215. [PMID: 38211904 DOI: 10.1016/j.resp.2024.104215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
Individuals with generalized anxiety disorder (GAD) have been shown to have altered neural gating of respiratory sensations (NGRS) using respiratory-related evoked potentials (RREP); however, corresponding neural oscillatory activities remain unexplored. The present study aimed to investigate altered NGRS in individuals with GAD using both time and time-frequency analysis. Nineteen individuals with GAD and 28 healthy controls were recruited. Paired inspiratory occlusions were delivered to elicit cortical neural activations measured from electroencephalography. The GAD group showed smaller N1 amplitudes to the first stimulus (S1), lower evoked gamma and larger evoked beta oscillations compared to controls. Both groups showed larger N1, P3, beta power and theta power in response to S1 compared to S2, suggesting a neural gating phenomenon. These findings suggest that N1, gamma and beta frequency oscillations may be indicators for altered respiratory sensation in GAD populations and that the N1, P3, beta and theta oscillations can reflect the neural gating of respiratory sensations.
Collapse
Affiliation(s)
- Kai-Jie Liang
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan; Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan; Department of Psychiatry, New Taipei City Municipal Tucheng Hospital
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan; Department of Psychiatry, New Taipei City Municipal Tucheng Hospital
| | | | | | - Pei-Ying S Chan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan.
| |
Collapse
|
3
|
Chang WP, Liang KJ, Cheng CH, Liu CY, von Leupoldt A, Chan PYS. Age-related changes in the neural gating of respiratory sensations in humans. ERJ Open Res 2024; 10:00821-2023. [PMID: 38333646 PMCID: PMC10851943 DOI: 10.1183/23120541.00821-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024] Open
Abstract
Background Neural gating of respiratory sensations (NGRS) characterises the brain's ability to filter out repetitive respiratory sensory stimuli. This mechanism plays a crucial role in the neural processing of respiratory stimuli. However, whether ageing affects NGRS in healthy adults is still unclear. Therefore, we aimed to measure the effect of age on NGRS as well as the corresponding S1 and S2 components of the respiratory-related evoked potentials (RREPs). Methods Three age groups of healthy adults participated in this study: a young group (YG; age 20-39 years), a middle-aged group (MG; age 40-59 years) and an old group (OG; age ≥60 years). NGRS was measured by the RREPs in the electroencephalogram in response to short-paired respiratory occlusion stimuli (S1 and S2). The S2/S1 ratio of the RREP N1 amplitude (the negative deflection of the RREP at ∼85-135 ms) was used to characterise NGRS. Results The results showed a significantly smaller N1 S2/S1 ratio in the YG than in the MG (p=0.01) and OG (p=0.03). Further analysis showed that the S1 N1 amplitude was larger for the YG compared with the MG (p=0.03) and OG (p=0.007). Moreover, age was significantly correlated with the N1 S2/S1 ratio (r=0.43), with higher age relating to higher N1 S2/S1 ratios. Conclusions The greater N1 S2/S1 ratios observed in older adults suggest that ageing has a negative impact on the NGRS. This might contribute to increased experiences of respiratory sensations such as dyspnoea in ageing adults.
Collapse
Affiliation(s)
- Wen-Pin Chang
- Department of Occupational Therapy, University of Texas Rio Grande Valley, Edinburg, TX, USA
- Department of Psychiatry, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Kai-Jie Liang
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
- These authors contributed equally
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan
- Brain Imaging and Neural Dynamics Laboratory, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan
- Department of Psychiatry, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan
| | - Andreas von Leupoldt
- Brain Imaging and Neural Dynamics Laboratory, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Ying S. Chan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkuo, Taoyuan, Taiwan
| |
Collapse
|
4
|
Chan PYS, Chang WP, Cheng CH, Liu CY, von Leupoldt A, Hsu AL, Wu CW. The impact of emotional context on neural substrates of respiratory sensory gating. Front Neurosci 2022; 16:1004271. [PMID: 36389230 PMCID: PMC9650924 DOI: 10.3389/fnins.2022.1004271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/21/2022] [Indexed: 12/04/2022] Open
Abstract
Psychological challenges have been found to impact respiratory symptom perception in healthy individuals as well as in patients with various neurological disorders. Human respiratory sensory gating is an objective measure to examine respiratory sensory information processing of repetitive respiratory mechanical stimuli in the central nervous system. With this electrophysiological method, patients with higher anxiety levels showed reduced respiratory sensory gating function in the cortex, and increased symptom perception. In addition, positive emotional contexts were found to increase the respiratory sensory gating function using RREPs. However, neural substrates related to emotional impacts on respiratory sensory gating remain still unclear. In the present study, we examined the emotion processing of respiratory sensory gating using functional magnetic resonance imaging. We hypothesized that positive compared with neutral stimuli would result in reduced brain activations in cortical areas with the paired occlusion paradigm. Thirty-five healthy adults participated in this event-designed fMRI experiment. Paired inspiratory occlusions (two transient occlusions with a 500 ms inter-stimulus-interval are delivered during one inspiration) were provided using an external trigger outside of the scanner. At least 40 paired inspiratory occlusions were collected for each trial. The experiment contained three runs during which participants underwent 12 min for the paired inspiratory occlusion paradigm while watching a fixation cross (the control condition), neutral and positive emotional picture series. The order of emotional picture series was randomized across the participants. Our results revealed an overall trend of reduction of brain activity from the neutral (minus fixation) condition, to the pleasant (minus fixation) condition. For bilateral thalamus and primary visual cortices, there was no significant difference in neural activation between the two contrasts of pleasant (ContrastP–F) and neutral condition (ContrastN–F). The activation of the mid-cingulate and the orbitofrontal cortex was lower in ContrastP–F compared to ContrastN–F. In conclusion, our results suggest that emotional context, especially positive valence, modulates neural correlates in middle cingulate cortex and orbitofrontal cortex in terms of respiratory sensory gating. Future studies are recommended to test emotional impacts on respiratory sensations in patients with neurological disorders.
Collapse
Affiliation(s)
- Pei-Ying S. Chan
- Department of Occupational Therapy, College of Medicine, and Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Pin Chang
- Department of Occupational Therapy, Rocky Mountain University of Health Professions, Provo, UT, United States
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy, College of Medicine, and Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | | | - Ai-Ling Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Ai-Ling Hsu,
| | - Changwei W. Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Brain and Consciousness Research Center, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Changwei W. Wu,
| |
Collapse
|
5
|
Chan PYS, Cheng CH, Liu CY, Davenport PW. Cortical Sources of Respiratory Mechanosensation, Laterality, and Emotion: An MEG Study. Brain Sci 2022; 12:brainsci12020249. [PMID: 35204012 PMCID: PMC8870097 DOI: 10.3390/brainsci12020249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 12/04/2022] Open
Abstract
Airway obstruction activates mechanoreceptors that project to the cerebral cortices in humans, as evidenced by scalp encephalography recordings of cortical neuronal activation, i.e., respiratory-related evoked potential (RREP). However, neural evidence of both high spatial and temporal resolution of occlusion-elicited cortical activation in healthy individuals is lacking. In the present study, we tested our hypothesis that inspiratory mechanical stimuli elicit neural activation in cortical structures that can be recorded using magnetoencephalography (MEG). We further examined the relationship between depression and respiratory symptoms and hemispheric dominance in terms of emotional states. A total of 14 healthy nonsmoking participants completed a respiratory symptom questionnaire and a depression symptom questionnaire, followed by MEG and RREP recordings of inspiratory occlusion. Transient inspiratory occlusion of 300 ms was provided randomly every 2 to 4 breaths, and approximately 80 occlusions were collected in every study participant. Participants were required to press a button for detection when they sensed occlusion. Respiratory-related evoked fields (RREFs) and RREP peaks were identified in terms of latencies and amplitudes in the right and left hemispheres. The Wilcoxon signed-rank test was further used to examine differences in peak amplitudes between the right and left hemispheres. Our results showed that inspiratory occlusion elicited RREF M1 peaks between 80 and 100 ms after triggering. Corresponding neuromagnetic responses peaked in the sensorimotor cortex, insular cortex, lateral frontal cortex, and middle frontal cortex. Overall, the RREF M1 peak amplitude in the right insula was significantly higher than that in the left insula (p = 0.038). The RREP data also showed a trend of higher N1 peak amplitudes in the right hemisphere compared to the left (p = 0.064, one-tailed). Subgroup analysis revealed that the laterality index of sensorimotor cortex activation was significantly different between higher- and lower-depressed individuals (−0.33 vs. −0.02, respectively; p = 0.028). For subjective ratings, a significant relationship was found between an individual’s depression level and their respiratory symptoms (Spearman’s rho = 0.54, p = 0.028, one-tailed). In summary, our results demonstrated that the inspiratory occlusion paradigm is feasible to elicit an RREF M1 peak with MEG. Our imaging results showed that cortical neurons were activated in the sensorimotor, frontal, middle temporal, and insular cortices for the M1 peak. Respiratory occlusion elicited higher cortical neuronal activation in the right insula compared to the left, with a higher tendency for right laterality in the sensorimotor cortex for higher-depressed rather than lower-depressed individuals. Higher levels of depression were associated with higher levels of respiratory symptoms. Future research with a larger sample size is recommended to investigate the role of emotion and laterality in cerebral neural processing of respiratory sensation.
Collapse
Affiliation(s)
- Pei-Ying S. Chan
- Department of Occupational Therapy and Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
- Correspondence: (P.-Y.S.C.); (C.-H.C.); Tel.: +886-3-2118800 (ext. 5441) (P.-Y.S.C.); +886-3-2118800 (ext. 3854) (C.-H.C.)
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy and Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
- BIND Lab, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: (P.-Y.S.C.); (C.-H.C.); Tel.: +886-3-2118800 (ext. 5441) (P.-Y.S.C.); +886-3-2118800 (ext. 3854) (C.-H.C.)
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;
| | - Paul W. Davenport
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32611, USA;
| |
Collapse
|
6
|
Herzog M, Sucec J, Jelinčić V, Van Diest I, Van den Bergh O, Chan PYS, Davenport P, von Leupoldt A. The test-retest reliability of the respiratory-related evoked potential. Biol Psychol 2021; 163:108133. [PMID: 34118356 DOI: 10.1016/j.biopsycho.2021.108133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 06/05/2021] [Accepted: 06/06/2021] [Indexed: 12/30/2022]
Abstract
The respiratory-related evoked potential (RREP) is an established technique to study the neural processing of respiratory sensations. We examined the test-retest reliability of the RREP during an unloaded baseline condition (no dyspnea) and an inspiratory resistive loaded breathing condition (dyspnea) over a one-week period. RREPs were evoked by short inspiratory occlusions (150 ms) while EEG was continuously measured. The mean amplitudes of the RREP components Nf, P1, N1, P2, and P3 were studied. For the no dyspnea condition, moderate test-retest reliability for Nf (intraclass correlation coefficient ICC: 0.73) and P1 (ICC: 0.74), good test-retest reliability for N1 (ICC: 0.89) and P3 (ICC: 0.76), and excellent test-retest reliability for P2 (ICC: 0.92) was demonstrated. For the dyspnea condition, moderate test-retest reliability was found for Nf (ICC: 0.69) and P1 (ICC: 0.57) and good test-retest reliability for N1 (ICC: 0.77), P2 (ICC: 0.84), and P3 (ICC: 0.77). This indicates that the RREP components Nf, P1, N1, P2, and P3, elicited by inspiratory occlusions, show adequate reliability in a test-retest study design with or without parallel sustained resistive load-induced dyspnea.
Collapse
Affiliation(s)
| | - Josef Sucec
- Health Psychology, University of Leuven, Leuven, Belgium
| | | | - Ilse Van Diest
- Health Psychology, University of Leuven, Leuven, Belgium
| | | | - Pei-Ying S Chan
- Department of Occupational Therapy and Healthy Aging Research Centre, Chang Gung University, Taoyuan, Taiwan
| | - Paul Davenport
- Department of Physiological Sciences, University of Florida, Gainesville, USA
| | | |
Collapse
|
7
|
Chen TC, Hsieh MH, Lin YT, Chan PYS, Cheng CH. Mismatch negativity to different deviant changes in autism spectrum disorders: A meta-analysis. Clin Neurophysiol 2020; 131:766-777. [DOI: 10.1016/j.clinph.2019.10.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/29/2019] [Accepted: 10/23/2019] [Indexed: 11/29/2022]
|
8
|
Cheng CH, Chan PYS, Hsu SC, Liu CY. Abnormal frontal generator during auditory sensory gating in panic disorder: An MEG study. Psychiatry Res Neuroimaging 2019; 288:60-66. [PMID: 31014913 DOI: 10.1016/j.pscychresns.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 01/08/2023]
Abstract
Patients with panic disorder (PD) exhibit abnormalities in early-stage information processing, even for the nonthreatening stimuli. A previous event-related potential study reported that PD patients show a deficit in sensory gating (SG), a protective mechanism of the brain to filter out irrelevant sensory inputs. However, there is no clear understanding about the neural correlates of SG deficits in PD. Moreover, whether SG deficits, if any, are associated with clinical manifestations remain unknown. In this study, 18 patients with PD and 20 age- and gender-matched healthy controls were recruited to perform auditory paired-stimulus paradigm using magnetoencephalographic (MEG) recordings. Results showed that PD patients demonstrated significantly higher M50 SG ratios in the right inferior frontal gyrus (RIFG) and higher M100 SG ratios in both RIFG and right superior temporal gyrus (RSTG) than those of the control group. It was important to note that in the RIFG, the M50 SG ratios correlated significantly with the scores of Body Sensation Questionnaire (BSQ) and Distractibility scale of Sensory Gating Inventory among patients with PD. In conclusion, this study suggests that PD patients exhibited a deficient ability to filter out irrelevant information, and such a defect might lead to cognitive misinterpretation of somatic sensations and distractibility.
Collapse
Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan.
| | - Pei-Ying S Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
9
|
Chan PYS, Cheng CH, Wu YT, Wu CW, Liu HLA, Shaw FZ, Liu CY, Davenport PW. Cortical and Subcortical Neural Correlates for Respiratory Sensation in Response to Transient Inspiratory Occlusions in Humans. Front Physiol 2018; 9:1804. [PMID: 30618816 PMCID: PMC6305490 DOI: 10.3389/fphys.2018.01804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/29/2018] [Indexed: 11/26/2022] Open
Abstract
Cortical and subcortical mechanosensation of breathing can be measured by short respiratory occlusions. However, the corresponding neural substrates involved in the respiratory sensation elicited by a respiratory mechanical stimulus remained unclear. Therefore, we applied the functional magnetic resonance imaging (fMRI) technique to study cortical activations of respiratory mechanosensation. We hypothesized that thalamus, frontal cortex, somatosensory cortex, and inferior parietal cortex would be significantly activated in response to respiratory mechanical stimuli. We recruited 23 healthy adults to participate in our event-designed fMRI experiment. During the 12-min scan, participants breathed with a specialized face-mask. Single respiratory occlusions of 150 ms were delivered every 2–4 breaths. At least 32 successful occlusions were collected for data analysis. The results showed significant neural activations in the thalamus, supramarginal gyrus, middle frontal gyrus, inferior frontal triangularis, and caudate (AlphaSim corrected p < 0.05). In addition, subjective ratings of breathlessness were significantly correlated with the levels of neural activations in bilateral thalamus, right caudate, right supramarginal gyrus, left middle frontal gyrus, left inferior triangularis. Our results demonstrated cortical sources of respiratory sensations elicited by the inspiratory occlusion paradigm in healthy adults were located in the thalamus, supramarginal gyrus, and the middle frontal cortex, inferior frontal triangularis, suggesting subcortical, and cortical neural sources of the respiratory mechanosensation are thalamo-cortical based, especially the connections to the premotor area, middle and ventro-lateral prefrontal cortex, as well as the somatosensory association cortex. Finally, level of neural activation in thalamus is associated with the subjective rating of breathlessness, suggesting respiratory sensory information is gated at the thalamic level.
Collapse
Affiliation(s)
- Pei-Ying S Chan
- Department of Occupational Therapy and Healthy Aging Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy and Healthy Aging Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ting Wu
- Department of Occupational Therapy and Healthy Aging Center, Chang Gung University, Taoyuan, Taiwan
| | - Changwei W Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.,Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Ho-Ling A Liu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Fu-Zen Shaw
- Department of Psychology, National Cheng-Kung University, Tainan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Paul W Davenport
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| |
Collapse
|
10
|
Cheng CH, Chan PYS, Hsu SC, Liu CY. Meta-analysis of sensorimotor gating in patients with autism spectrum disorders. Psychiatry Res 2018; 262:413-419. [PMID: 28918862 DOI: 10.1016/j.psychres.2017.09.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 01/24/2023]
Abstract
Prepulse inhibition (PPI) of startle response is a well-established neurophysiological marker of sensorimotor gating ability in psychiatric patients including those with autism spectrum disorders (ASD). PPI has been utilized as an indicator of the central inhibitory function and is potentially linked to the clinical features of this disease. However, it remains inconclusive whether ASD patients exhibit PPI deficits compared with healthy controls. The present meta-analysis aimed to explore the pooled effect sizes of PPI in ASD patients. We searched major electronic databases from 1990 to January 2017. Seven studies, consisting of 21 individual investigations with 135 healthy controls and 99 ASD patients, were obtained. The effect size, calculated as Hedges's g and 95% confidence interval, were estimated. Overall, we found ASD patients exhibited an impaired PPI compared with healthy controls (p = 0.008). Specifically, significant PPI deficits were observed among ASD children/adolescents, compared with their healthy counterparts (p = 0.019). However, differences in PPI responses were not observed among adults. Conclusively, our results reconciled the previous studies and showed that ASD children/adolescents, but not adults, exhibit reduced sensorimotor gating function compared to healthy controls. We also suggest that the parameters of PPI are particularly important and the results should be interpreted with cautions.
Collapse
Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Pei-Ying S Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
11
|
Cheng CH, Chan PYS, Liu CY, Hsu SC. Auditory sensory gating in patients with bipolar disorders: A meta-analysis. J Affect Disord 2016; 203:199-203. [PMID: 27295376 DOI: 10.1016/j.jad.2016.06.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 05/29/2016] [Accepted: 06/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sensory gating (SG) refers to the attenuation of neural response to the second identical stimulus and is conceptualized as an automatic process to inhibit redundant information. Although its deficit in schizophrenia has been well-documented, the degree to which SG is modulated by bipolar disorders (BD) remains elusive. Thus, the present meta-analysis study aimed to explore the pooled effect sizes of SG ability in BD patients. METHODS Ten studies consisting of 14 individual investigations were included, consisting of 699 healthy controls and 568 BD patients. The effect sizes, calculated as Cohen's d, were estimated individually for S2/S1 ratio and S1-S2 difference. Additionally, S2/S1 ratio was examined in two conditions: BD with and without a history of psychosis. RESULTS We found that BD patients with (d=0.847, p<0.001) or without (d=0.589, p<0.001) a psychotic history exhibited an impaired SG ability compared to the healthy controls. Furthermore, both S1-S2 difference score and S2/S1 ratio, at a group level, can differentiate BD patients from healthy controls. LIMITATIONS We were not able to divide patients with BD into different subtypes, and thus our data should be interpreted with cautions. CONCLUSION These findings suggest BD itself impairs SG ability, which worsens with a psychotic history. The current understanding invites future research to ascertain the role of SG in subtypes of BD.
Collapse
Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Pei-Ying S Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
12
|
Chan PYS, Cheng CH, Jhu YJ, Chen CL, von Leupoldt A. Being Anxious, Thinking Positively: The Effect of Emotional Context on Respiratory Sensory Gating. Front Physiol 2016; 7:19. [PMID: 26909040 PMCID: PMC4754425 DOI: 10.3389/fphys.2016.00019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/14/2016] [Indexed: 12/27/2022] Open
Abstract
Respiratory sensory gating function has been found decreased by induced negative emotion in healthy adults. The increased ratio of the respiratory-related evoked potential (RREP) N1 peak amplitude for the second occlusion (S2) vs. the first occlusion (S1), S2/S1, is indicative of such decreased respiratory sensory gating. In this study, we tested the hypothesis that a positive emotional context would enhance respiratory sensory gating function in healthy individuals. In addition, we tested the modulating role of individual anxiety levels. We compared respiratory sensory gating in 40 healthy individuals by the paired inspiratory occlusion paradigm in a positive and neutral emotional context induced by emotional picture viewing. The results showed that the group averaged RREP N1 peak amplitudes S2/S1 ratios were significantly smaller in the positive compared to neutral context (0.49 vs. 0.64; p < 0.01). Further, analysis showed that the ratio decrease was due to a reduced response to the S2 and an enhanced response to S1 in the positive emotional context (p < 0.05). The subgroup analyses showed that in the positive emotional context, both individuals with low-moderate anxiety levels and those with no anxiety demonstrated a significant decrease of their S2/S1 ratio, but only those with low-moderate anxiety levels showed reduced S2 amplitudes compared to the neutral context (p < 0.01). In conclusion, our results suggest that a positive emotional context is related to better brain inhibitory mechanisms by filtering out repetitive respiratory stimuli in healthy individuals, especially in the presence of low-moderate anxiety levels. Further, investigation on how positive emotional contexts might contribute to improved respiratory sensory gating ability in clinical populations is necessary.
Collapse
Affiliation(s)
- Pei-Ying S Chan
- Department of Occupational Therapy, College of Medicine, and Healthy Ageing Research Center, Chang Gung UniversityTaoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at LinkouTaoyuan, Taiwan
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy, College of Medicine, and Healthy Ageing Research Center, Chang Gung UniversityTaoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at LinkouTaoyuan, Taiwan
| | - Ya-Jhih Jhu
- Department of Occupational Therapy, College of Medicine, and Healthy Ageing Research Center, Chang Gung UniversityTaoyuan, Taiwan; Division of Psychiatry, Taipei Veterans General Hospital at Yuan ShanYilan County, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial hospital at LinkouTaoyuan, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | | |
Collapse
|
13
|
Cheng CH, Chan PYS, Niddam DM, Tsai SY, Hsu SC, Liu CY. Sensory gating, inhibition control and gamma oscillations in the human somatosensory cortex. Sci Rep 2016; 6:20437. [PMID: 26843358 PMCID: PMC4740805 DOI: 10.1038/srep20437] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/04/2016] [Indexed: 11/09/2022] Open
Abstract
Inhibiting the responses to irrelevant stimuli is an essential component of human cognitive function. Pre-attentive auditory sensory gating (SG), an attenuated neural activation to the second identical stimulus, has been found to be related to the performance of higher-hierarchical brain function. However, it remains unclear whether other cortical regions, such as somatosensory cortex, also possess similar characteristics, or if such a relationship is modality-specific. This study used magnetoencephalography to record neuromagnetic responses to paired-pulse electrical stimulation to median nerve in 22 healthy participants. Somatosensory SG ratio and cortical brain oscillations were obtained and compared with the behavioral performance of inhibition control, as evaluated by somatosensory and auditory Go-Nogo tasks. The results showed that somatosensory P35m SG ratio correlated with behavioral performance of inhibition control. Such relationship was also established in relation to the auditory Go-Nogo task. Finally, a higher frequency value of evoked gamma oscillations was found to relate to a better somatosensory SG ability. In conclusion, our data provided an empirical link between automatic cortical inhibition and behavioral performance of attentive inhibition control. This study invites further research on the relationships among gamma oscillations, neurophysiological indices, and behavioral performance in clinical populations in terms of SG or cortical inhibition.
Collapse
Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Pei-Ying S Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - David M Niddam
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shang-Yueh Tsai
- Graduate Institute of Applied Physics, National Chengchi University, Taipei, Taiwan.,Mind, Brain and Learning Center, National Chengchi University, Taipei, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
14
|
Chan PYS, Cheng CH, Hsu SC, Liu CY, Davenport PW, von Leupoldt A. Respiratory sensory gating measured by respiratory-related evoked potentials in generalized anxiety disorder. Front Psychol 2015. [PMID: 26217278 PMCID: PMC4496549 DOI: 10.3389/fpsyg.2015.00957] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The perception of respiratory sensations plays an important role both in respiratory diseases and in anxiety disorders. However, little is known about the neural processes underlying respiratory sensory perception, especially in patient groups. Therefore, the present study examined whether patients with generalized anxiety disorder (GAD) would demonstrate altered respiratory sensory gating compared to a healthy control group. Respiratory-related evoked potentials (RREP) were measured in a paired inspiratory occlusion paradigm presenting two brief occlusion stimuli (S1 and S2) within one inspiration. The results showed a significantly greater S2/S1 ratio for the N1 component of the RREP in the GAD group compared to the control group. Our findings suggest altered respiratory sensory processing in patients with GAD, which might contribute to altered perception of respiratory sensations in these patients.
Collapse
Affiliation(s)
- Pei-Ying S Chan
- Department of Occupational Therapy, College of Medicine, Chang Gung University , Taoyuan, Taiwan ; Healthy Ageing Research Center, Chang Gung University , Taoyuan, Taiwan
| | - Chia-Hsiung Cheng
- Department of Occupational Therapy, College of Medicine, Chang Gung University , Taoyuan, Taiwan ; Healthy Ageing Research Center, Chang Gung University , Taoyuan, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital , Taoyuan, Taiwan ; Department of Medicine, Chang Gung University , Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital , Taoyuan, Taiwan ; Department of Traditional Chinese Medicine, Chang Gung University , Taoyuan, Taiwan
| | - Paul W Davenport
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida , Gainesville, FL, USA
| | - Andreas von Leupoldt
- Research Group on Health Psychology, University of Leuven , Leuven, Belgium ; Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf , Hamburg, Germany
| |
Collapse
|
15
|
Chan PYS, von Leupoldt A, Liu CY, Hsu SC. Respiratory perception measured by cortical neural activations in individuals with generalized anxiety disorder. Respir Physiol Neurobiol 2014; 204:36-40. [DOI: 10.1016/j.resp.2014.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 02/01/2023]
|
16
|
Chan PYS, von Leupoldt A, Bradley MM, Lang PJ, Davenport PW. The effect of anxiety on respiratory sensory gating measured by respiratory-related evoked potentials. Biol Psychol 2012; 91:185-9. [PMID: 22781313 PMCID: PMC3612944 DOI: 10.1016/j.biopsycho.2012.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 06/08/2012] [Accepted: 07/02/2012] [Indexed: 11/24/2022]
Abstract
Respiratory sensory gating is evidenced by decreased amplitudes of the respiratory-related evoked potentials (RREP) N1 peak for the second (S2) compared to the first occlusion (S1) when two paired occlusions are presented with a 500-millisecond (ms) inter-stimulus-interval during one inspiration. Because anxiety is prevalent in respiratory diseases and associated with altered respiratory perception, we tested whether anxiety can modulate individuals' respiratory neural gating mechanism. By using high-density EEG, RREPs were measured in a paired inspiratory occlusion paradigm in 11 low and 10 higher anxious individuals with normal lung function. The N1 peak gating S2/S1 ratio and the N1 S2 amplitudes were greater in higher compared to low anxious individuals (p's<0.05). In addition, higher anxiety levels were correlated with greater S2/S1 ratios (r=0.54, p<0.05) and S2 amplitudes (r=-0.49, p<0.05). The results demonstrate that anxiety is associated with reduced respiratory sensory gating which might underlie altered respiratory symptom perception in anxious individuals.
Collapse
Affiliation(s)
- Pei-Ying S Chan
- Department of Occupational Therapy, Chang Gung University, Taoyuan, Taiwan.
| | | | | | | | | |
Collapse
|
17
|
von Leupoldt A, Chan PYS, Bradley MM, Lang PJ, Davenport PW. The impact of anxiety on the neural processing of respiratory sensations. Neuroimage 2011; 55:247-52. [PMID: 21111831 PMCID: PMC3031667 DOI: 10.1016/j.neuroimage.2010.11.050] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 11/15/2010] [Indexed: 11/30/2022] Open
Abstract
Previous studies demonstrated that anxiety considerably impacts the reported perceptions of respiratory sensations. A novel feature of the current study is exploring the impact of anxiety on the neural processing of respiratory sensations elicited by short inspiratory occlusions during different affective contexts. Using high-density EEG, respiratory-related evoked potentials (RREP) were recorded in 23 low and 23 matched higher anxious individuals when viewing unpleasant or neutral picture series. Low anxious individuals showed the expected pattern of reduced magnitudes of later RREP components P2 and P3 during the unpleasant compared to the neutral affective context (p<0.05 and p<0.01). In contrast, higher anxious individuals showed greater magnitudes of P2 and P3 during the unpleasant compared to the neutral affective context (p's<0.05). Moreover, higher anxiety levels were correlated with greater magnitudes for P2 (r=0.44, p<0.01) and P3 (r=0.54, p<0.001) during the unpleasant relative to the neutral affective context. Earlier components of the RREP (Nf, P1, N1) were not affected by anxiety. This study demonstrates that anxiety affects the later, higher-order neural processing of respiratory sensations, but not its earlier, first-order sensory processing. These findings might represent a neural mechanism that underlies the increased perception of respiratory sensations in anxious individuals.
Collapse
Affiliation(s)
- Andreas von Leupoldt
- Department of Physiological Sciences, University of Florida, Gainesville, FL, USA.
| | | | | | | | | |
Collapse
|