White-matter lesions along the cholinergic tracts are related to cortical sources of EEG rhythms in amnesic mild cognitive impairment

Individual posterior alpha rhythms and cognitive reserve as possible early prognostic markers in people with subjective memory complaints

Subjective memory complaints (SMCs) are a memory disorder that often precedes mild cognitive impairment (MCI) or Alzheimer's disease (AD). Both individual alpha rhythms and cognitive reserve (CR) represent key features of SMCs and provide useful tools to characterize and predict the course of the disorder. We studied whether older people with SMCs may also present some abnormal resting state electroencephalogram (rsEEG) alpha rhythms, and whether alpha rhythms are associated with CR. To do this, eyes-closed rsEEG were recorded in 68 older people with and without SMCs. The individual alpha indexes alpha/theta transition frequency (TF) and individual alpha frequency peak (IAFp) were computed. TF and IAFp were also used to determine the alpha1, alpha2, and alpha3 power frequency. Results indicated no differences in TF or IAFp between older people with SMCs and controls. The SMCs group showed a reduction in alpha3 power in comparison with controls. Specifically, women with SMCs were characterized by a significant decrease in alpha3 power compared to control women. Furthermore, only in SMCs group, greater CR was associated with slow IAFp. In sum, these results suggest that TF and IAFp are two stable indexes that are not influenced by the presence of SMCs. However, the reduction in alpha3, as observed in women with SMCs, shows an abnormal posterior rsEEG at alpha power. Finally, the compensatory mechanisms of CR appear to interact with the neurophysiological mechanisms that underlie the regulation of alpha rhythms.

Resting state electroencephalographic alpha rhythms are sensitive to Alzheimer's disease mild cognitive impairment progression at a 6-month follow-up

Are posterior resting-state electroencephalographic (rsEEG) alpha rhythms sensitive to the Alzheimer's disease mild cognitive impairment (ADMCI) progression at a 6-month follow-up? Clinical, cerebrospinal, neuroimaging, and rsEEG datasets in 52 ADMCI and 60 Healthy old seniors (equivalent groups for demographic features) were available from an international archive (www.pdwaves.eu). The ADMCI patients were arbitrarily divided into two groups: REACTIVE and UNREACTIVE, based on the reduction (reactivity) in the posterior rsEEG alpha eLORETA source activities from the eyes-closed to eyes-open condition at ≥ -10% and -10%, respectively. 75% of the ADMCI patients were REACTIVE. Compared to the UNREACTIVE group, the REACTIVE group showed (1) less abnormal posterior rsEEG source activity during the eyes-closed condition and (2) a decrease in that activity at the 6-month follow-up. These effects could not be explained by neuroimaging and neuropsychological biomarkers of AD. Such a biomarker might reflect abnormalities in cortical arousal in quiet wakefulness to be used for clinical studies in ADMCI patients using 6-month follow-ups.

The effects of different acetylcholinesterase inhibitors on EEG patterns in patients with Alzheimer's disease: A systematic review

OBJECTIVE

Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the most common type of dementia. The early diagnosis of AD is an important factor for the control of AD progression. Electroencephalography (EEG) can be used for early diagnosis of AD. Acetylcholinesterase inhibitors (AChEIs) are also used for the amelioration of AD symptoms. In this systematic review, we reviewed the effect of different AChEIs including donepezil, rivastigmine, tacrine, physostigmine, and galantamine on EEG patterns in patients with AD.

METHODS

PubMed electronic database was searched and 122 articles were found. After removal of unrelated articles, 24 articles were selected for the present study.

RESULTS

AChEIs can decrease beta, theta, and delta frequency bands in patients with AD. However, conflicting results were found for alpha band. Some studies have shown increased alpha frequency, while others have shown decreased alpha frequency following treatment with AChEIs. The only difference was the type of drug.

CONCLUSIONS

We found that studies reporting the decreased alpha frequency used donepezil and galantamine, while studies reporting the increased alpha frequency used rivastigmine and tacrine. It was suggested that future studies should focus on the effect of different AChEIs on EEG bands, especially alpha frequency in patients with AD, to compare their effects and find the reason for their different influence on EEG patterns. Also, differences between the effects of AChEIs on oligodendrocyte differentiation and myelination may be another important factor. This is the first article investigating the effect of different AChEIs on EEG patterns in patients with AD.

Early dementia diagnosis, MCI-to-dementia risk prediction, and the role of machine learning methods for feature extraction from integrated biomarkers, in particular for EEG signal analysis

INTRODUCTION

Dementia in its various forms represents one of the most frightening emergencies for the aging population. Cognitive decline-including Alzheimer's disease (AD) dementia-does not develop in few days; disease mechanisms act progressively for several years before clinical evidence.

METHODS

A preclinical stage, characterized by measurable cognitive impairment, but not overt dementia, is represented by mild cognitive impairment (MCI), which progresses to-or, more accurately, is already in a prodromal form of-AD in about half cases; people with MCI are therefore considered the population at risk for AD deserving special attention for validating screening methods.

RESULTS

Graph analysis tools, combined with machine learning methods, represent an interesting probe to identify the distinctive features of physiological/pathological brain aging focusing on functional connectivity networks evaluated on electroencephalographic data and neuropsychological/imaging/genetic/metabolic/cerebrospinal fluid/blood biomarkers.

DISCUSSION

On clinical data, this innovative approach for early diagnosis might provide more insight into pathophysiological processes underlying degenerative changes, as well as toward a personalized risk evaluation for pharmacological, nonpharmacological, and rehabilitation treatments.

A Comparative Study of Functional Connectivity Measures for Brain Network Analysis in the Context of AD Detection with EEG

This work addresses brain network analysis considering different clinical severity stages of cognitive dysfunction, based on resting-state electroencephalography (EEG). We use a cohort acquired in real-life clinical conditions, which contains EEG data of subjective cognitive impairment (SCI) patients, mild cognitive impairment (MCI) patients, and Alzheimer’s disease (AD) patients. We propose to exploit an epoch-based entropy measure to quantify the connectivity links in the networks. This entropy measure relies on a refined statistical modeling of EEG signals with Hidden Markov Models, which allow a better estimation of the spatiotemporal characteristics of EEG signals. We also propose to conduct a comparative study by considering three other measures largely used in the literature: phase lag index, coherence, and mutual information. We calculated such measures at different frequency bands and computed different local graph parameters considering different proportional threshold values for a binary network analysis. After applying a feature selection procedure to determine the most relevant features for classification performance with a linear Support Vector Machine algorithm, our study demonstrates the effectiveness of the statistical entropy measure for analyzing the brain network in patients with different stages of cognitive dysfunction.

Relationship between regional white matter hyperintensities and alpha oscillations in older adults

Aging is associated with increased white matter hyperintensities (WMHs) and with alterations of alpha oscillations (7-13 Hz). However, a crucial question remains, whether changes in alpha oscillations relate to aging per se or whether this relationship is mediated by age-related neuropathology like WMHs. Using a large cohort of cognitively healthy older adults (N = 907, 60-80 years), we assessed relative alpha power, alpha peak frequency, and long-range temporal correlations from resting-state EEG. We further associated these parameters with voxel-wise WMHs from 3T MRI. We found that a higher prevalence of WMHs in the superior and posterior corona radiata as well as in the thalamic radiation was related to elevated alpha power, with the strongest association in the bilateral occipital cortex. In contrast, we observed no significant relation of the WMHs probability with alpha peak frequency and long-range temporal correlations. Finally, higher age was associated with elevated alpha power via total WMH volume. We suggest that an elevated alpha power is a consequence of WMHs affecting a spatial organization of alpha sources.

Electroencephalography, Magnetoencephalography, and Cognitive Reserve: A Systematic Review

OBJECTIVE

Cognitive reserve (CR) is the capacity to adapt to (future) brain damage without any or only minimal clinical symptoms. The underlying neuroplastic mechanisms remain unclear. Electrocorticography (ECOG), electroencephalography (EEG), and magnetoencephalography (MEG) may help elucidate the brain mechanisms underlying CR, as CR is thought to be related to efficient utilization of remaining brain resources. The purpose of this systematic review is to collect, evaluate, and synthesize the findings on neural correlates of CR estimates using ECOG, EEG, and MEG.

METHOD

We examined articles that were published from the first standardized definition of CR. Eleven EEG and five MEG cross-sectional studies met the inclusion criteria: They concerned original research, analyzed (M)EEG in humans, used a validated CR estimate, and related (M)EEG to CR. Quality assessment was conducted using an adapted form of the Newcastle-Ottawa scale. No ECOG study met the inclusion criteria.

RESULTS

A total of 1383 participants from heterogeneous patient, young and older healthy groups were divided into three categories by (M)EEG methodology: Eight (M)EEG studies employed event-related fields or potentials, six studies analyzed brain oscillations at rest (of which one also analyzed a cognitive task), and three studies analyzed brain connectivity. Various CR estimates were employed and all studies compared different (M)EEG measures and CR estimates. Several associations between (M)EEG measures and CR estimates were observed.

CONCLUSION

Our findings support that (M)EEG measures are related to CR estimates, particularly in healthy individuals. However, the character of this relationship is dependent on the population and task studied, warranting further studies.

Resting State Alpha Electroencephalographic Rhythms Are Affected by Sex in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment: A Retrospective and Exploratory Study

In the present retrospective and exploratory study, we tested the hypothesis that sex may affect cortical sources of resting state eyes-closed electroencephalographic (rsEEG) rhythms recorded in normal elderly (Nold) seniors and patients with Alzheimer's disease and mild cognitive impairment (ADMCI). Datasets in 69 ADMCI and 57 Nold individuals were taken from an international archive. The rsEEG rhythms were investigated at individual delta, theta, and alpha frequency bands and fixed beta (14-30 Hz) and gamma (30-40 Hz) bands. Each group was stratified into matched females and males. The sex factor affected the magnitude of rsEEG source activities in the Nold seniors. Compared with the males, the females were characterized by greater alpha source activities in all cortical regions. Similarly, the parietal, temporal, and occipital alpha source activities were greater in the ADMCI-females than the males. Notably, the present sex effects did not depend on core genetic (APOE4), neuropathological (Aβ42/phospho-tau ratio in the cerebrospinal fluid), structural neurodegenerative and cerebrovascular (MRI) variables characterizing sporadic AD-related processes in ADMCI seniors. These results suggest the sex factor may significantly affect neurophysiological brain neural oscillatory synchronization mechanisms underpinning the generation of dominant rsEEG alpha rhythms to regulate cortical arousal during quiet vigilance.

Resting State Alpha Electroencephalographic Rhythms Are Differently Related to Aging in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment

BACKGROUND

In relaxed adults, staying in quiet wakefulness at eyes closed is related to the so-called resting state electroencephalographic (rsEEG) rhythms, showing the highest amplitude in posterior areas at alpha frequencies (8-13 Hz).

OBJECTIVE

Here we tested the hypothesis that age may affect rsEEG alpha (8-12 Hz) rhythms recorded in normal elderly (Nold) seniors and patients with mild cognitive impairment due to Alzheimer's disease (ADMCI).

METHODS

Clinical and rsEEG datasets in 63 ADMCI and 60 Nold individuals (matched for demography, education, and gender) were taken from an international archive. The rsEEG rhythms were investigated at individual delta, theta, and alpha frequency bands, as well as fixed beta (14-30 Hz) and gamma (30-40 Hz) bands. Each group was stratified into three subgroups based on age ranges (i.e., tertiles).

RESULTS

As compared to the younger Nold subgroups, the older one showed greater reductions in the rsEEG alpha rhythms with major topographical effects in posterior regions. On the contrary, in relation to the younger ADMCI subgroups, the older one displayed a lesser reduction in those rhythms. Notably, the ADMCI subgroups pointed to similar cerebrospinal fluid AD diagnostic biomarkers, gray and white matter brain lesions revealed by neuroimaging, and clinical and neuropsychological scores.

CONCLUSION

The present results suggest that age may represent a deranging factor for dominant rsEEG alpha rhythms in Nold seniors, while rsEEG alpha rhythms in ADMCI patients may be more affected by the disease variants related to earlier versus later onset of the AD.

Reduced Resting-State Cortical Alpha Connectivity Reflects Distinct Functional Brain Dysconnectivity in Alzheimer's Disease and Mild Cognitive Impairment

Background: Emerging evidence suggests distinct abnormal activity patterns during resting state in intrinsic functional brain networks in patients with neurodegenerative diseases, including Alzheimer's disease (AD) and mild cognitive impairment (MCI). This study aimed to identify the changes in the resting-state intracortical lagged phase synchronization derived from dense array electroencephalography (EEG) in AD and MCI. Methods: Resting-state current source density (CSD) and lagged phase synchronization between 84 regions of interest defined by Brodmann areas (BAs) for seven EEG frequency bands were investigated between the study groups (AD, MCI, and age-matched controls) using 128-channel EEG. Results: Reduced CSD and connectivity (large effect size, Cohen's d > 0.8) were found in AD and MCI compared with controls at alpha frequency. However, a positive correlation (r = 0.433; p = 0.044) of mini-mental state examination scores was found with BA 32-33 connectivity values in AD only. Conclusion: Reduced resting-state alpha 1 source connectivity in patient groups and correlation between attenuation of resting-state alpha 1 connectivity with cognitive decline in AD could indicate the disruption of inhibitory function of alpha rhythm leading to tonic unselective cortical excitation that affects attention and controlled access to stored information.

The Preponderant Role of Fusiform Face Area for the Facial Expression Confusion Effect: An MEG Study

Although the recognition of facial expressions seems automatic and effortless, discrimination of expressions can still be error prone. Common errors are often due to visual similarities between some expressions (e.g., fear and surprise). However, little is known about the neural mechanisms underlying such a confusion effect. To address this question, we recorded the magnetoencephalography (MEG) while participants judged facial expressions that were either easily confused with or easily distinguished from other expressions. The results showed that the fusiform face area (FFA), rather than the posterior superior temporal sulcus (pSTS), played a preponderant role in discriminating confusable facial expressions. No difference between high confusion and low confusion conditions was observed on the M170 component in either the FFA or the pSTS, whilst a difference between two conditions started to emerge in the late positive potential (LPP), with the low confusion condition eliciting a larger LPP amplitude in the FFA. In addition, the power of delta was stronger in the time window of LPP component. This confusion effect was reflected in the FFA, which might be associated with the perceptual-to-conceptual shift.

Cortical auditory evoked potentials in mild cognitive impairment: Evidence from a temporal-spatial principal component analysis

Mild cognitive impairment (MCI) is considered an intermediate transitional stage for the development of dementia, especially Alzheimer's disease. The identification of neurophysiological biomarkers for MCI will allow improvement in detecting and tracking the progression of cognitive impairment. The primary objective of this study was to compare cortical auditory evoked potentials between older adults with and without probable MCI to identify potential neurophysiological indicators of cognitive impairment. We applied a temporal-spatial principal component analysis to the evoked potentials achieved during the processing of pure tones and speech sounds, to facilitate the separation of the components of the P1-N1-P2 complex. The probable MCI group showed a significant amplitude increase in a factor modeling N1b for speech sounds (Cohen's d = .84) and a decrease in a factor around the P2 time interval, especially for pure tones (Cohen's d = 1.17). Moreover, both factors showed a fair discrimination value between groups (area under the curve [AUC] = .698 for N1b in speech condition; AUC = .746 for P2 in tone condition), with high sensitivity to detect MCI cases (86% and 91%, respectively). The results for N1b suggest that MCI participants may suffer from a deficit to inhibit irrelevant speech information, and the decrease of P2 amplitude could be a signal of cholinergic hypoactivation. Therefore, both components could be proposed as early biomarkers of cognitive impairment.

Attention-Related Brain Activation Is Altered in Older Adults With White Matter Hyperintensities Using Multi-Echo fMRI

Cognitive decline is often undetectable in the early stages of accelerated vascular aging. Attentional processes are particularly affected in older adults with white matter hyperintensities (WMH), although specific neurovascular mechanisms have not been elucidated. We aimed to identify differences in attention-related neurofunctional activation and behavior between adults with and without WMH. Older adults with moderate to severe WMH (n = 18, mean age = 70 years), age-matched adults (n = 28, mean age = 72), and healthy younger adults (n = 19, mean age = 25) performed a modified flanker task during multi-echo blood oxygenation level dependent functional magnetic resonance imaging. Task-related activation was assessed using a weighted-echo approach. Healthy older adults had more widespread response and higher amplitude of activation compared to WMH adults in fronto-temporal and parietal cortices. Activation associated with processing speed was absent in the WMH group, suggesting attention-related activation deficits that may be a consequence of cerebral small vessel disease. WMH adults had greater executive contrast activation in the precuneous and posterior cingulate gyrus compared to HYA, despite no performance benefits, reinforcing the network dysfunction theory in WMH.

Diagnosis of Alzheimer's disease with Electroencephalography in a differential framework

This study addresses the problem of Alzheimer’s disease (AD) diagnosis with Electroencephalography (EEG). The use of EEG as a tool for AD diagnosis has been widely studied by comparing EEG signals of AD patients only to those of healthy subjects. By contrast, we perform automated EEG diagnosis in a differential diagnosis context using a new database, acquired in clinical conditions, which contains EEG data of 169 patients: subjective cognitive impairment (SCI) patients, mild cognitive impairment (MCI) patients, possible Alzheimer’s disease (AD) patients, and patients with other pathologies. We show that two EEG features, namely epoch-based entropy (a measure of signal complexity) and bump modeling (a measure of synchrony) are sufficient for efficient discrimination between these groups. We studied the performance of our methodology for the automatic discrimination of possible AD patients from SCI patients and from patients with MCI or other pathologies. A classification accuracy of 91.6% (specificity = 100%, sensitivity = 87.8%) was obtained when discriminating SCI patients from possible AD patients and 81.8% to 88.8% accuracy was obtained for the 3-class classification of SCI, possible AD and other patients.

The electrophysiology of neuroHIV: A systematic review of EEG and MEG studies in people with HIV infection since the advent of highly-active antiretroviral therapy

OBJECTIVE

The Human Immunodeficiency Virus (HIV) has an impact on the brain, even when the infection is well-controlled with modern highly-active antiretroviral therapy (HAART). While dementia is rare in those on HAART, milder cognitive impairment is common. The causes, patterns, and evolution of brain dysfunction in people living with HIV remain uncertain. We evaluate whether electrophysiological methods provide informative measures of brain dysfunction in this population.

METHODS

A systematic literature search identified studies that used EEG or MEG to evaluate persons living with HIV published between 1996 (when HAART became available) and 2016.

RESULTS

Twenty-eight studies were identified. Most involved small samples, and all but four were cross-sectional. Reduced amplitude of Event Related Potentials and decreased power in the alpha band at rest were the most frequent differences between people with and without HIV infection. Of the 16 studies that also assessed cognitive ability, 13 found a significant relationship between cognition and electrophysiological changes in the HIV+ groups. Five of those studies also reported a significant relationship with current immunosuppression, suggesting a direct effect of HIV on the brain. There were few longitudinal studies; whether these electrophysiological changes progress over time, or respond to treatment, remains unclear.

CONCLUSIONS

EEG and MEG can provide useful information about brain dysfunction in people with HIV infection, but more consistent assessments of both cognition and EEG patterns, as well as longitudinal studies with larger, better characterized samples are needed.

SIGNIFICANCE

This is the first systematic review of electrophysiological findings in HIV since the availability of HAART. EEG and MEG measures are sensitive to brain dysfunction in this population, and could complement other approaches in improving the assessment, understanding and treatment of neurocognitive disorders in HIV.

Gender-Specific Hippocampal Dysrhythmia and Aberrant Hippocampal and Cortical Excitability in the APPswePS1dE9 Model of Alzheimer's Disease

Alzheimer's disease (AD) is a multifactorial disorder leading to progressive memory loss and eventually death. In this study an APPswePS1dE9 AD mouse model has been analyzed using implantable video-EEG radiotelemetry to perform long-term EEG recordings from the primary motor cortex M1 and the hippocampal CA1 region in both genders. Besides motor activity, EEG recordings were analyzed for electroencephalographic seizure activity and frequency characteristics using a Fast Fourier Transformation (FFT) based approach. Automatic seizure detection revealed severe electroencephalographic seizure activity in both M1 and CA1 deflection in APPswePS1dE9 mice with gender-specific characteristics. Frequency analysis of both surface and deep EEG recordings elicited complex age, gender, and activity dependent alterations in the theta and gamma range. Females displayed an antithetic decrease in theta (θ) and increase in gamma (γ) power at 18-19 weeks of age whereas related changes in males occurred earlier at 14 weeks of age. In females, theta (θ) and gamma (γ) power alterations predominated in the inactive state suggesting a reduction in atropine-sensitive type II theta in APPswePS1dE9 animals. Gender-specific central dysrhythmia and network alterations in APPswePS1dE9 point to a functional role in behavioral and cognitive deficits and might serve as early biomarkers for AD in the future.

Reduced prefrontal MEG alpha-band power in mild traumatic brain injury with associated posttraumatic stress disorder symptoms

OBJECTIVE

To determine if changes in cortical alpha-band power in patients with mild traumatic brain injury (mTBI) are associated with the severity of their post-traumatic stress disorder (PTSD) symptoms, and if injury severity and level of exposure to psychologically traumatic events are predictors of these electrophysiological changes.

METHODS

Resting-state magnetoencephalographic recordings were analyzed in 32 patients with mTBI. Alpha-band power was estimated for each patient in 68 cortical regions and was compared between groups of patients with low versus high PTSD symptoms severity.

RESULTS

Participants with high PTSD symptom severity showed reduced alpha-band power bilaterally in the superior and middle frontal gyri and frontal poles, and in the left inferior frontal gyrus. Alpha-band power in bilateral middle frontal gyri and frontal poles was negatively correlated with scores reflecting symptoms of emotional numbing. Loss of consciousness (LOC) associated with mTBI and level of exposure to psychologically traumatic events were predictors of decreased prefrontal alpha-band power in some of these regions.

CONCLUSION

Altered prefrontal alpha-band activity, shown to be partly explained by mTBI-related LOC, is associated with PTSD symptoms severity.

SIGNIFICANCE

Our findings will guide future studies addressing the electrophysiological mechanisms underlying a higher incidence of PTSD in patients with mTBI.

Cognitive Correlates of Basal Forebrain Atrophy and Associated Cortical Hypometabolism in Mild Cognitive Impairment

Degeneration of basal forebrain (BF) cholinergic nuclei is associated with cognitive decline, and this effect is believed to be mediated by neuronal dysfunction in the denervated cortical areas. MRI-based measurements of BF atrophy are increasingly being used as in vivo surrogate markers for cholinergic degeneration, but the functional implications of reductions in BF volume are not well understood. We used high-resolution MRI, fluorodeoxyglucose-positron emission tomography (PET), and neuropsychological test data of 132 subjects with mild cognitive impairment (MCI) and 177 cognitively normal controls to determine associations between BF atrophy, cortical hypometabolism, and cognitive deficits. BF atrophy in MCI correlated with both impaired memory function and attentional control deficits, whereas hippocampus volume was more specifically associated with memory deficits. BF atrophy was also associated with widespread cortical hypometabolism, and path analytic models indicated that hypometabolism in domain-specific cortical networks mediated the association between BF volume and cognitive dysfunction. The presence of cortical amyloid pathology, as assessed using AV45-PET, did not significantly interact with the observed associations. These data underline the potential of multimodal imaging markers to study structure-function-cognition relationships in the living human brain and provide important in vivo evidence for an involvement of the human BF in cortical activity and cognitive function.

Quantitative EEG of Rapid-Eye-Movement Sleep: A Marker of Amnestic Mild Cognitive Impairment

The basal forebrain cholinergic system, which is impaired in early Alzheimer's disease, is more crucial for the activation of rapid-eye-movement (REM) sleep electroencephalogram (EEG) than it is for wakefulness. Quantitative EEG from REM sleep might thus provide an earlier and more accurate marker of the development of Alzheimer's disease in subjects with mild cognitive impairment (MCI) subjects than that from wakefulness. To assess the superiority of the REM sleep EEG as a screening tool for preclinical Alzheimer's disease, 22 subjects with amnestic MCI (a-MCI; 63.9±7.7 years), 10 subjects with nonamnestic MCI (na-MCI; 64.1±4.5 years) and 32 controls (63.7±6.6 years) participated in the study. Spectral analyses of the waking EEG and REM sleep EEG were performed and the [(delta+theta)/(alpha+beta)] ratio was used to assess between-group differences in EEG slowing. The a-MCI subgroup showed EEG slowing in frontal lateral regions compared to both na-MCI and control groups. This EEG slowing was present in wakefulness (compared to controls) but was much more prominent in REM sleep. Moreover, the comparison between amnestic and nonamnestic subjects was found significant only for the REM sleep EEG. There was no difference in EEG power ratio between na-MCI and controls for any of the 7 cortical regions studied. These findings demonstrate the superiority of the REM sleep EEG in the discrimination between a-MCI and both na-MCI and control subjects.

Measuring Cortical Connectivity in Alzheimer's Disease as a Brain Neural Network Pathology: Toward Clinical Applications

OBJECTIVES

The objective was to review the literature on diffusion tensor imaging as well as resting-state functional magnetic resonance imaging and electroencephalography (EEG) to unveil neuroanatomical and neurophysiological substrates of Alzheimer's disease (AD) as a brain neural network pathology affecting structural and functional cortical connectivity underlying human cognition.

METHODS

We reviewed papers registered in PubMed and other scientific repositories on the use of these techniques in amnesic mild cognitive impairment (MCI) and clinically mild AD dementia patients compared to cognitively intact elderly individuals (Controls).

RESULTS

Hundreds of peer-reviewed (cross-sectional and longitudinal) papers have shown in patients with MCI and mild AD compared to Controls (1) impairment of callosal (splenium), thalamic, and anterior-posterior white matter bundles; (2) reduced correlation of resting state blood oxygen level-dependent activity across several intrinsic brain circuits including default mode and attention-related networks; and (3) abnormal power and functional coupling of resting state cortical EEG rhythms. Clinical applications of these measures are still limited.

CONCLUSIONS

Structural and functional (in vivo) cortical connectivity measures represent a reliable marker of cerebral reserve capacity and should be used to predict and monitor the evolution of AD and its relative impact on cognitive domains in pre-clinical, prodromal, and dementia stages of AD.

Resting-state EEG coupling analysis of amnestic mild cognitive impairment with type 2 diabetes mellitus by using permutation conditional mutual information

OBJECTIVE

This study was meant to explore whether the coupling strength and direction of resting-state electroencephalogram (rsEEG) could be used as an indicator to distinguish the patients of type 2 diabetes mellitus (T2DM) with or without amnestic mild cognitive impairment (aMCI).

METHODS

Permutation conditional mutual information (PCMI) was used to calculate the coupling strength and direction of rsEEG signals between different brain areas of 19 aMCI and 20 normal control (NC) with T2DM on 7 frequency bands: Delta, Theta, Alpha1, Alpha2, Beta1, Beta2 and Gamma. The difference in coupling strength or direction of rsEEG between two groups was calculated. The correlation between coupling strength or direction of rsEEG and score of different neuropsychology scales were also calculated.

RESULTS

We have demonstrated that PCMI can calculate effectively the coupling strength and directionality of EEG signals between different brain regions. The significant difference in coupling strength and directionality of EEG signals was found between the patients of aMCI and NC with T2DM on different brain regions. There also existed significant correlation between sex or age and coupling strength or coupling directionality of EEG signals between a few different brain regions from all subjects.

CONCLUSIONS

The coupling strength or directionality of EEG signals calculated by PCMI are significantly different between aMCI and NC with T2DM.

SIGNIFICANCE

These results showed that the coupling strength or directionality of EEG signals calculated by PCMI might be used as a biomarker in distinguishing the aMCI from NC with T2DM.

Occipital sources of resting-state alpha rhythms are related to local gray matter density in subjects with amnesic mild cognitive impairment and Alzheimer's disease

Occipital sources of resting-state electroencephalographic (EEG) alpha rhythms are abnormal, at the group level, in patients with amnesic mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here, we evaluated the hypothesis that amplitude of these occipital sources is related to neurodegeneration in occipital lobe as measured by magnetic resonance imaging. Resting-state eyes-closed EEG rhythms were recorded in 45 healthy elderly (Nold), 100 MCI, and 90 AD subjects. Neurodegeneration of occipital lobe was indexed by weighted averages of gray matter density, estimated from structural MRIs. EEG rhythms of interest were alpha 1 (8-10.5 Hz) and alpha 2 (10.5-13 Hz). EEG cortical sources were estimated by low-resolution brain electromagnetic tomography. Results showed a positive correlation between occipital gray matter density and amplitude of occipital alpha 1 sources in Nold, MCI, and AD subjects as a whole group (r = 0.3, p = 0.000004, N = 235). Furthermore, there was a positive correlation between the amplitude of occipital alpha 1 sources and cognitive status as revealed by Mini Mental State Examination score across all subjects (r = 0.38, p = 0.000001, N = 235). Finally, amplitude of occipital alpha 1 sources allowed a moderate classification of individual Nold and AD subjects (sensitivity: 87.8%; specificity: 66.7%; area under the receiver operating characteristic curve: 0.81). These results suggest that the amplitude of occipital sources of resting-state alpha rhythms is related to AD neurodegeneration in occipital lobe along pathologic aging.

The EEG as an index of neuromodulator balance in memory and mental illness

There is a strong correlation between signature EEG frequency patterns and the relative levels of distinct neuromodulators. These associations become particularly evident during the sleep-wake cycle. The monoamine-acetylcholine balance hypothesis is a theory of neurophysiological markers of the EEG and a detailed description of the findings that support this proposal are presented in this paper. According to this model alpha rhythm reflects the relative predominance of cholinergic muscarinic signals and delta rhythm that of monoaminergic receptor effects. Both high voltage synchronized rhythms are likely mediated by inhibitory Gαi/o-mediated transduction of inhibitory interneurons. Cognitively, alpha and delta EEG measures are proposed to indicate automatic and flexible strategies, respectively. Sleep is associated with marked changes in relative neuromodulator levels corresponding to EEG markers of distinct stages. Sleep studies on memory consolidation present some of the strongest evidence yet for the respective roles of monoaminergic and cholinergic projections in declarative and non-declarative memory processes, a key theoretical premise for understanding the data. Affective dysregulation is reflected in altered EEG patterns during sleep.

Cortical sources of resting state electroencephalographic alpha rhythms deteriorate across time in subjects with amnesic mild cognitive impairment

Cortical sources of resting state electroencephalographic (EEG) rhythms are abnormal in subjects with mild cognitive impairment (MCI). Here, we tested the hypothesis that these sources in amnesic MCI subjects further deteriorate over 1 year. To this aim, the resting state eyes-closed EEG data were recorded in 54 MCI subjects at baseline (Mini Mental State Examination I = 26.9; standard error [SE], 0.2) and at approximately 1-year follow-up (13.8 months; SE, 0.5; Mini Mental State Examination II = 25.8; SE, 0.2). As a control, EEG recordings were also performed in 45 normal elderly and in 50 mild Alzheimer's disease subjects. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), and beta2 (20-30 Hz). Cortical EEG sources were estimated using low-resolution brain electromagnetic tomography. Compared with the normal elderly and mild Alzheimer's disease subjects, the MCI subjects were characterized by an intermediate power of posterior alpha1 sources. In the MCI subjects, the follow-up EEG recordings showed a decreased power of posterior alpha1 and alpha2 sources. These results suggest that the resting state EEG alpha sources were sensitive-at least at the group level-to the cognitive decline occurring in the amnesic MCI group over 1 year, and might represent cost-effective, noninvasive and widely available markers to follow amnesic MCI populations in large clinical trials.

Amyloid Beta peptides differentially affect hippocampal theta rhythms in vitro

Soluble amyloid beta peptide (A β ) is responsible for the early cognitive dysfunction observed in Alzheimer's disease. Both cholinergically and glutamatergically induced hippocampal theta rhythms are related to learning and memory, spatial navigation, and spatial memory. However, these two types of theta rhythms are not identical; they are associated with different behaviors and can be differentially modulated by diverse experimental conditions. Therefore, in this study, we aimed to investigate whether or not application of soluble A β alters the two types of theta frequency oscillatory network activity generated in rat hippocampal slices by application of the cholinergic and glutamatergic agonists carbachol or DHPG, respectively. Due to previous evidence that oscillatory activity can be differentially affected by different A β peptides, we also compared Aβ 25-35 and Aβ 1-42 for their effects on theta rhythms in vitro at similar concentrations (0.5 to 1.0  μ M). We found that Aβ 25-35 reduces, with less potency than Aβ 1-42, carbachol-induced population theta oscillatory activity. In contrast, DHPG-induced oscillatory activity was not affected by a high concentration of Aβ 25-35 but was reduced by Aβ 1-42. Our results support the idea that different amyloid peptides might alter specific cellular mechanisms related to the generation of specific neuronal network activities, instead of exerting a generalized inhibitory effect on neuronal network function.

Peak individual alpha frequency qualifies as a stable neurophysiological trait marker in healthy younger and older adults

The individual alpha frequency (IAF) of the human EEG reflects systemic properties of the brain, is highly heritable, and relates to cognitive functioning. Not much is known about the modifiability of IAF by cognitive interventions. We report analyses of resting EEG from a large-scale training study in which healthy younger (20-31 years, N = 30) and older (65-80 years, N = 28) adults practiced 12 cognitive tasks for ∼100 1-h sessions. EEG was recorded before and after the cognitive training intervention. In both age groups, IAF (and, in a control analysis, alpha amplitude) did not change, despite large gains in cognitive performance. As within-session reliability and test-retest stability were high for both age groups, imprecise measurements cannot account for the findings. In sum, IAF is highly stable in healthy adults up to 80 years, not easily modifiable by cognitive interventions alone, and thus qualifies as a stable neurophysiological trait marker.

Abnormal corticospinal excitability in patients with disorders of consciousness

BACKGROUND

Transcranial magnetic stimulation (TMS) has been frequently used to explore changes in the human motor cortex in different conditions, while the extent of motor cortex reorganization in patients in vegetative state (VS) (now known as unresponsive wakefulness syndrome, UWS) and minimally conscious (MCS) states due to severe brain damage remains largely unknown.

OBJECTIVE/HYPOTHESIS

It was hypothesized that cortical motor excitability would be decreased and would correlate to the level of consciousness in patients with disorders of consciousness.

METHODS

Corticospinal excitability was assessed in 47 patients (24 VS/UWS and 23 MCS) and 14 healthy controls. The test parameters included maximal peak-to-peak M-wave (Mmax), F-wave persistence, peripheral and central motor conduction times, sensory (SEP) and motor evoked (MEP) potential latencies and amplitudes, resting motor threshold (RMT), stimulus/response curves, and short latency afferent inhibition (SAI). TMS measurements were correlated to the level of consciousness (assessed using the Coma Recovery Scale-Revised).

RESULTS

On average, the patient group had lower Mmax, lower MEP and SEP amplitudes, higher RMTs, narrower stimulus/response curves, and reduced SAI compared to the healthy controls (P < 0.05). The SAI alterations were correlated to the level of consciousness (P < 0.05).

CONCLUSIONS

The findings demonstrated the impairment of the cortical inhibitory circuits in patients with disorders of consciousness. Moreover, the significant relationship was found between cortical inhibition and clinical consciousness dysfunction.

Stability of clinical condition in mild cognitive impairment is related to cortical sources of alpha rhythms: an electroencephalographic study

Previous evidence has shown that resting eyes-closed cortical alpha rhythms are higher in amplitude in mild cognitive impairment (MCI) than Alzheimer's disease (AD) subjects (Babiloni et al. [2006a]: Human Brain Mapp 27:162-172; [2006b]: Clin Neurophysiol 117:252-268; [2006c]: Neuroimage 29:948-964; [2006d]: Ann Neurol 59:323-334; [2006e]: Clin Neurophysiol 117:1113-1129; [2006f]: Neuroimage 31:1650-1665). This study tested the hypothesis that, in amnesic MCI subjects, high amplitude of baseline cortical alpha rhythms is related to long-term stability of global cognition on clinical follow-up. Resting electroencephalographic (EEG) data were recorded in 100 amnesic MCI subjects during eyes-closed condition. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), and beta2 (20-30 Hz). Cortical EEG sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Global cognition was indexed by mini mental state evaluation (MMSE) score at the time of EEG recordings (baseline) and about after 1 year. Based on the MMSE percentage difference between baseline and 1-year follow-up (MMSEvar), the MCI subjects were retrospectively divided into three arbitrary groups: DECREASED (MMSEvar ≤ -4%; N = 43), STABLE (MMSEvar ≈ 0; N = 27), and INCREASED (MMSEvar ≥ +4%; N = 30). Subjects' age, education, individual alpha frequency, gender, and MMSE scores were used as covariates for statistical analysis. Baseline posterior cortical sources of alpha 1 rhythms were higher in amplitude in the STABLE than in the DECREASED and INCREASED groups. These results suggest that preserved resting cortical neural synchronization at alpha frequency is related to a long-term (1 year) stable cognitive function in MCI subjects. Future studies should use serial MMSE measurements to confirm and refine the present results.

Cognitive impairment and EEG background activity in adults with Down's syndrome: a topographic study

OBJECTIVE

Studies correlating electroencephalographic (EEG) data and cognitive performance in Down's syndrome (DS) showed conflicting results. The aims of this study were to investigate the sources of EEG rhythms in adults with DS at three dimensional representation of current source density (CSD) using exact/standard Low Resolution Electromagnetic Tomography (e/sLORETA), and their correlation with cognitive performance.

METHODS

Twenty-five adults with DS underwent a neuropsychological battery and 5 min of resting, eye-closed 29-channel EEG were recorded. After e/sLORETA analysis, data were compared with those from age and gender-matching control subjects as following: absolute and relative power in delta (1-3 Hz), theta (4-7 Hz), alpha1 (8-9 Hz), alpha2 (10-12 Hz), beta1 (13-18 Hz), beta2 (19-21 Hz), beta3 (22-30 Hz); alpha and theta bands adjusted to individual alpha peak frequency (IAF). Current source activities in DS group in regions showing significant differences compared with controls underwent correlation analysis with psychometric scores.

RESULTS

In DS, IAF was shifted to lower frequencies and correlated positively with Wechsler Adult Intelligence Scale and Mini-Mental State examination. Compared with controls, DS showed increased CSD in: theta, alpha-1, and beta1 classical bands and in IAF-adjusted bands, while relative alpha2 was decreased. A negative correlation between cognitive performance and theta/alpha CSD in the right frontal lobe and right posterior cingulate cortex was found. The relative alpha2 correlated positively with cognitive tests.

CONCLUSIONS

Increased CSD in DS, correlating with cognitive performance, for both slow and fast rhythms suggests involving of cortical and subcortical mechanisms. LORETA might be useful for objective measure of cognitive decline in DS.

Resting state cortical electroencephalographic rhythms in subjects with normal and abnormal body weight

It is well known that resting state regional cerebral blood flow is abnormal in obese when compared to normal-weight subjects but the underlying neurophysiological mechanisms are poorly known. To address this issue, we tested the hypothesis that amplitude of resting state cortical electroencephalographic (EEG) rhythms differ among underweight, normal-weight, and overweight/obese subjects as a reflection of the relationship between cortical neural synchronization and regulation of body weight. Eyes-closed resting state EEG data were recorded in 16 underweight subjects, 25 normal-weight subjects, and 18 overweight/obese subjects. All subjects were psychophysically healthy (no eating disorders or major psychopathologies). EEG rhythms of interest were delta (2-4Hz), theta (4-8Hz), alpha 1 (8-10.5Hz), alpha 2 (10.5-13Hz), beta 1 (13-20Hz), beta 2 (20-30Hz), and gamma (30-40Hz). EEG cortical sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Statistical results showed that parietal and temporal alpha 1 sources fitted the pattern underweight>normal-weight>overweight/obese (p<0.004), whereas occipital alpha 1 sources fitted the pattern normal-weight>underweight>overweight/obese (p<0.00003). Furthermore, amplitude of the parietal, occipital, and temporal alpha 2 sources was stronger in the normal-weight subjects than in the underweight and overweight/obese subjects (p<0.0007). These results suggest that abnormal weight in healthy overweight/obese subjects is related to abnormal cortical neural synchronization at the basis of resting state alpha rhythms and fluctuation of global brain arousal.

Differential contribution of right and left parietal cortex to the control of spatial attention: a simultaneous EEG-rTMS study

We have recently shown that interference with repetitive transcranial magnetic stimulation (rTMS) of right posterior intraparietal sulcus (IPS) cortex during the allocation of spatial attention leads to abnormal desynchronization of anticipatory (pretarget) electroencephalographic alpha rhythms (8-12 Hz) in occipital-parietal cortex and the detection of subsequently presented visual targets (Capotosto et al. 2009). Since lesion data suggest that lesions of the right frontoparietal cortices produce more severe and long-lasting deficits of visual spatial attention than lesions of the left hemisphere, here, we used the mentioned rTMS-electroencephalographic procedure to test if the control of anticipatory alpha rhythms by IPS is asymmetrically organized in the 2 hemispheres. Results showed that interference with either left or right IPS during covert spatial attention equally disrupted the normally lateralized anticipatory modulation of occipital visual cortex, with stronger alpha desynchronization contralaterally to the attended visual field. In contrast, only interference with right IPS induced a paradoxical pretarget synchronization of alpha rhythms and bilateral deficits of target identification. These results suggest that the control of spatial topography of anticipatory alpha rhythms in occipital-parietal cortex is shared between left and right IPS cortex, but that right IPS uniquely contributes to a bilateral prestimulus activation of occipital visual cortex.

Imaging the Alzheimer brain

This supplement to the Journal of Alzheimer's Disease contains more than half of the chapters from The Handbook of Imaging the Alzheimer Brain, which was first presented at the International Conference on Alzheimer's Disease in Paris, in July, 2011.

While the Handbook contains 27 chapters that are modified articles from 2009, 2010, and 2011 issues of the Journal of Alzheimer's Disease, this supplement contains the 31 new chapters of that book and an introductory article drawn from the introductions to each section of the book.

The Handbook was designed to provide a multilevel overview of the full field of brain imaging related to Alzheimer's disease (AD). The Handbook, as well as this supplement, contains both reviews of the basic concepts of imaging, the latest developments in imaging, and various discussions and perspectives of the problems of the field and promising directions.

The Handbook was designed to be useful for students and clinicians interested in AD as well as scientists studying the brain and pathology related to AD.

Resting state cortical rhythms in athletes: a high-resolution EEG study

The present electroencephalographic (EEG) study tested the working hypothesis that the amplitude of resting state cortical EEG rhythms (especially alpha, 8-12 Hz) was higher in elite athletes compared with amateur athletes and non-athletes, as a reflection of the efficiency of underlying back-ground neural synchronization mechanisms. Eyes closed resting state EEG data were recorded in 16 elite karate athletes, 20 amateur karate athletes, and 25 non-athletes. The EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). EEG cortical sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Statistical results showed that the amplitude of parietal and occipital alpha 1 sources was significantly higher in the elite karate athletes than in the non-athletes and karate amateur athletes. Similar results were observed in parietal and occipital delta sources as well as in occipital theta sources. Finally, a control confirmatory experiment showed that the amplitude of parietal and occipital delta and alpha 1 sources was stronger in 8 elite rhythmic gymnasts compared with 14 non-athletes. These results supported the hypothesis that cortical neural synchronization at the basis of eyes-closed resting state EEG rhythms is enhanced in elite athletes than in control subjects.

Resting state electroencephalographic correlates with red cell long-chain fatty acids, memory performance and age in adolescent boys with attention deficit hyperactivity disorder

Abnormal fatty acid status has been implicated in the aetiology of attention deficit hyperactivity disorder (ADHD). Delayed maturation in ADHD may result in raised frontal low frequency (theta) electroencephalographic activity (EEG) and a reduction in posterior high frequency (beta, alpha) activity. The current study used sequential linear regression to investigate the association between age, resting-state EEG and levels of long-chain polyunsaturated omega-3 and omega-6 fatty acids in red blood cells in 46 adolescent boys with ADHD symptoms. Docosahexaenoic acid (DHA) levels were positively associated with fast frequency activity: alpha during eyes-open and beta during eyes-closed conditions. Frontal theta activity during both eyes-open and eyes-closed conditions was inversely associated with age and positively associated with eicosapentaenoic acid (EPA) levels. Alpha activity correlated positively with performance on fluency for categories (semantic memory). Theta activity correlated inversely with performance on delayed (25 min) verbal memory (recall + recognition/2). No associations were observed between long-chain omega-6 and EEG measures. Results support differential associations for DHA and EPA with fast and slow EEG activity respectively. Results support EEG activity as an objective biomarker of neural function associated with long-chain omega-3 fatty acids in ADHD.

Global Functional Coupling of Resting EEG Rhythms is Abnormal in Mild Cognitive Impairment and Alzheimer’s Disease

Alzheimer’s disease (AD) is typically associated with an impairment of brain networks and global cognitive function in aging. In this vein, the present study tested the hypothesis that the functional coupling of resting cortical electroencephalographic (EEG) rhythms is progressively abnormal in amnesic mild cognitive impairment (MCI) and AD subjects. Eyes-closed resting EEG data were recorded (10–20 system) in 33 mild AD, 52 amnesic MCI, and 47 normal elderly subjects (Nold). EEG rhythms of interest were delta (2–4 Hz), theta (4–8 Hz), alpha1 (8–10 Hz), alpha2 (10–13 Hz), beta1 (13–20 Hz), beta2 (20–30 Hz), and gamma (30–40 Hz). The global functional coupling of the EEG rhythms was indexed by means of spectral coherence for all combinations of electrode pairs (i.e., total coherence). The main results showed that the total coherence of delta rhythms was higher in the AD than the MCI group. It was also higher in the MCI than the Nold group. Furthermore, the delta total coherence was negatively correlated with global cognition (Mini Mental State Examination score) across the Nold, MCI, and AD subjects. Finally, the alpha1 total coherence was lower in the AD group than in the MCI and Nold groups. These results suggest that in the AD process an impairment of brain networks and global cognition is associated with a frequency-specific modulation of the global functional coupling of resting EEG rhythms.