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Ozaki T, Toyomaki A, Hashimoto N, Kusumi I. Quantitative Resting State Electroencephalography in Patients with Schizophrenia Spectrum Disorders Treated with Strict Monotherapy Using Atypical Antipsychotics. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2021; 19:313-322. [PMID: 33888660 PMCID: PMC8077067 DOI: 10.9758/cpn.2021.19.2.313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The effect of antipsychotic drugs on quantitative electroencephalography (EEG) has been mainly examined by the administration of a single test dose or among patients using combinations of other psychotropic drugs. We therefore investigated the effects of strict monotherapy with antipsychotic drugs on quantitative EEG among schizophrenia patients. METHODS Data from 2,364 medical reports with EEG results from psychiatric patients admitted to the Hokkaido University Hospital were used. We extracted EEG records of patients who were diagnosed with schizophrenia spectrum disorders and who were either undergoing strict antipsychotic monotherapy or were completely free of psychotropic drugs. The spectral power was compared between drug-free patients and patients using antipsychotic drugs. We also performed multiple regression analysis to evaluate the relationship between spectral power and the chlorpromazine equivalent daily dose of antipsychotics in all the patients. RESULTS We included 31 monotherapy and 20 drug-free patients. Compared with drug-free patients, patients receiving antipsychotic drugs demonstrated significant increases in theta, alpha and beta power. When patients taking different types of antipsychotics were compared with drug-free patients, we found no significant change in any spectrum power for the aripiprazole or blonanserin groups. Patients taking risperidone demonstrated significant increases in alpha and beta power. Patients taking clozapine and olanzapine demonstrated significant slow wave increases. Multiple regression analysis revealed that the chlorpromazine equivalent dose was positively associated with theta power. CONCLUSION Use of any antipsychotic drug by patients was associated with a dose-dependent increase in theta power. However, each type of antipsychotic demonstrated different spectral power changes.
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Affiliation(s)
- Takashi Ozaki
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Psychiatry, Hokkaido Prefectural Koyogaoka Hospital, Sapporo, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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2
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Howells FM, Temmingh HS, Hsieh JH, van Dijen AV, Baldwin DS, Stein DJ. Electroencephalographic delta/alpha frequency activity differentiates psychotic disorders: a study of schizophrenia, bipolar disorder and methamphetamine-induced psychotic disorder. Transl Psychiatry 2018; 8:75. [PMID: 29643331 PMCID: PMC5895848 DOI: 10.1038/s41398-018-0105-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/29/2017] [Accepted: 12/13/2017] [Indexed: 11/17/2022] Open
Abstract
Electroencephalography (EEG) has been proposed as a neurophysiological biomarker to delineate psychotic disorders. It is known that increased delta and decreased alpha, which are apparent in psychosis, are indicative of inappropriate arousal state, which leads to reduced ability to attend to relevant information. On this premise, we investigated delta/alpha frequency activity, as this ratio of frequency activity may serve as an effective neurophysiological biomarker. The current study investigated differences in delta/alpha frequency activity, in schizophrenia (SCZ), bipolar I disorder with psychotic features and methamphetamine-induced psychosis. One hundred and nine participants, including individuals with SCZ (n = 28), bipolar I disorder with psychotic features (n = 28), methamphetamine-induced psychotic disorder (MPD) (n = 24) and healthy controls (CON, n = 29). Diagnosis was ascertained with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition disorders and current medication was recorded. EEG was undertaken in three testing conditions: resting eyes open, resting eyes closed and during completion of a simple cognitive task (visual continuous performance task). EEG delta/alpha frequency activity was investigated across these conditions. First, delta/alpha frequency activity during resting eyes closed was higher in SCZ and MPD globally, when compared to CON, then lower for bipolar disorder (BPD) than MPD for right hemisphere. Second, delta/alpha frequency activity during resting eyes open was higher in SCZ, BPD and MPD for all electrodes, except left frontal, when compared to CON. Third, delta/alpha frequency activity during the cognitive task was higher in BPD and MPD for all electrodes, except left frontal, when compared to CON. Assessment of EEG delta/alpha frequency activity supports the delineation of underlying neurophysiological mechanisms present in psychotic disorders, which are likely related to dysfunctional thalamo-cortical connectivity. Delta/alpha frequency activity may provide a useful neurophysiological biomarker to delineate psychotic disorders.
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Affiliation(s)
- Fleur M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - Hendrik S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jennifer H Hsieh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Andrea V van Dijen
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - David S Baldwin
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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3
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Grin-Yatsenko VA, Ponomarev VA, Pronina MV, Poliakov YI, Plotnikova IV, Kropotov JD. Local and Widely Distributed EEG Activity in Schizophrenia With Prevalence of Negative Symptoms. Clin EEG Neurosci 2017; 48:307-315. [PMID: 28056537 DOI: 10.1177/1550059416683283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated EEG frequency abnormalities in resting state (eyes closed and eyes open) EEG in a group of chronic schizophrenia patients as compared with healthy subjects. The study included 3 methods of analysis of deviation of EEG characteristics: genuine EEG, current source density (CSD), and group independent component (gIC). All 3 methods have shown that the EEG in schizophrenia patients is characterized by enhanced low-frequency (delta and theta) and high-frequency (beta) activity in comparison with the control group. However, the spatial pattern of differences was dependent on the type of method used. Comparative analysis has shown that increased EEG power in schizophrenia patients apparently concerns both widely spatially distributed components and local components of signal. Furthermore, the observed differences in the delta and theta range can be described mainly by the local components, and those in the beta range mostly by spatially widely distributed ones. The possible nature of the widely distributed activity is discussed.
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Affiliation(s)
- Vera A Grin-Yatsenko
- 1 Laboratory of Neurobiology of Action Programming, N.P. Bechtereva Institute of the Human Brain of the Russian Academy of Sciences, St Petersburg, Russia
| | - Valery A Ponomarev
- 1 Laboratory of Neurobiology of Action Programming, N.P. Bechtereva Institute of the Human Brain of the Russian Academy of Sciences, St Petersburg, Russia
| | - Marina V Pronina
- 1 Laboratory of Neurobiology of Action Programming, N.P. Bechtereva Institute of the Human Brain of the Russian Academy of Sciences, St Petersburg, Russia
| | - Yury I Poliakov
- 1 Laboratory of Neurobiology of Action Programming, N.P. Bechtereva Institute of the Human Brain of the Russian Academy of Sciences, St Petersburg, Russia
| | - Irina V Plotnikova
- 1 Laboratory of Neurobiology of Action Programming, N.P. Bechtereva Institute of the Human Brain of the Russian Academy of Sciences, St Petersburg, Russia
| | - Juri D Kropotov
- 1 Laboratory of Neurobiology of Action Programming, N.P. Bechtereva Institute of the Human Brain of the Russian Academy of Sciences, St Petersburg, Russia.,2 Institute of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,3 Department of Neuropsychology, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
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4
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Aiyer R, Novakovic V, Barkin RL. A systematic review on the impact of psychotropic drugs on electroencephalogram waveforms in psychiatry. Postgrad Med 2016; 128:656-64. [DOI: 10.1080/00325481.2016.1218261] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Rohit Aiyer
- Department of Psychiatry, Hofstra Northwell Health, Staten Island University Hospital, Staten Island, NY, USA
| | - Vladan Novakovic
- Department of Psychiatry, Hofstra Northwell Health, Staten Island University Hospital, Staten Island, NY, USA
| | - Robert L. Barkin
- Department of Anesthesiology, Family Medicine & Pharmacology, Rush Medical College, North Shore University Health System Evanston and Skokie Hospital, Chicago, IL, USA
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Schulz S, Bolz M, Bär KJ, Voss A. Central- and autonomic nervous system coupling in schizophrenia. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2016; 374:rsta.2015.0178. [PMID: 27044986 PMCID: PMC4822441 DOI: 10.1098/rsta.2015.0178] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 05/03/2023]
Abstract
The autonomic nervous system (ANS) dysfunction has been well described in schizophrenia (SZ), a severe mental disorder. Nevertheless, the coupling between the ANS and central brain activity has been not addressed until now in SZ. The interactions between the central nervous system (CNS) and ANS need to be considered as a feedback-feed-forward system that supports flexible and adaptive responses to specific demands. For the first time, to the best of our knowledge, this study investigates central-autonomic couplings (CAC) studying heart rate, blood pressure and electroencephalogram in paranoid schizophrenic patients, comparing them with age-gender-matched healthy subjects (CO). The emphasis is to determine how these couplings are composed by the different regulatory aspects of the CNS-ANS. We found that CAC were bidirectional, and that the causal influence of central activity towards systolic blood pressure was more strongly pronounced than such causal influence towards heart rate in paranoid schizophrenic patients when compared with CO. In paranoid schizophrenic patients, the central activity was a much stronger variable, being more random and having fewer rhythmic oscillatory components. This study provides a more in-depth understanding of the interplay of neuronal and autonomic regulatory processes in SZ and most likely greater insights into the complex relationship between psychotic stages and autonomic activity.
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Affiliation(s)
- Steffen Schulz
- Institute of Innovative Health Technologies, University of Applied Sciences, Jena, Germany
| | - Mathias Bolz
- Department of Child and Adolescent Psychiatry, Pain and Autonomics-Integrative Research, University Hospital, Jena, Germany
| | - Karl-Jürgen Bär
- Department of Psychiatry and Psychotherapy, Pain and Autonomics-Integrative Research, University Hospital, Jena, Germany
| | - Andreas Voss
- Institute of Innovative Health Technologies, University of Applied Sciences, Jena, Germany
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6
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Howells FM, Baldwin DS, Kingdon DG. Can cognitive behaviour therapy beneficially influence arousal mechanisms in psychosis? Hum Psychopharmacol 2016; 31:64-9. [PMID: 26270489 DOI: 10.1002/hup.2499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 07/02/2015] [Accepted: 07/04/2015] [Indexed: 11/07/2022]
Abstract
Cognitive behavioural therapy for psychosis (CBTp) is an approved adjunct therapy for patients with psychotic disorders; however, we do not fully understand the neurobiological effects that this therapy may exert. Arousal, as measured by electroencephalography (EEG), provides a useful electrophysiological marker for assessing psychotic disorders. EEG studies may therefore serve as a useful measure for assessing the underlying effects of CBTp in psychotic disorders.
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Affiliation(s)
- Fleur M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - David S Baldwin
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Department of Psychiatry, University of Southampton, Southampton, UK
| | - David G Kingdon
- Department of Psychiatry, University of Southampton, Southampton, UK
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7
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Bochkarev VK, Kirenskaya AV, Tkachenko AA, Samylkin DV, Novototsky-Vlasov VY, Kovaleva ME. [EEG frequency and regional properties in patients with paranoid schizophrenia: effects of positive and negative symptomatology prevalence]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:66-74. [PMID: 25909792 DOI: 10.17116/jnevro20151151166-74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE EEG changes in schizophrenic patients are caused by a multitude of factors related to clinical heterogeneity of the disease, current state of patients, and conducted therapy. EEG spectral analysis remains an actual methodical approach for the investigation of the neurophysiological mechanisms of the disease. The goal of the investigation was the study of frequency and regional EEG correlating with the intensity of productive and negative disorders. MATERIAL AND METHODS Models of summary prevalence of positive/negative disorders and evidence of concrete clinical indices of the PANSS scale were used. Spectral characteristics of background EEG in the frequency range of 1-60 Hz were studied in 35 patients with paranoid schizophrenia free from psychoactive medication and in 19 healthy volunteers. RESULTS It was established that the main index of negative symptomatology in summary assessment was diffuse increase of spectral power of gamma and delta ranges. Deficient states with the predominance of volitional disorders were characterized by a lateralized increase of spectral power of beta-gamma ranges in the left hemisphere, and of delta range - in frontal areas of this hemisphere. Positive symptomatology was noticeably less reflected in EEG changes than negative ones. CONCLUSION An analysis of psychopathological symptom complexes revealed the significance of spatially structured EEG patterns in the beta range: for the delusion disturbances with psychic automatism phenomena - in frontal areas of the left hemisphere, and for the paranoid syndrome with primary interpretative delusion - in cortical areas of the right hemisphere.
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Affiliation(s)
- V K Bochkarev
- Serbsky National Research Centre for Social and Forensic Psychiatry, Moscow, Russia
| | - A V Kirenskaya
- Serbsky National Research Centre for Social and Forensic Psychiatry, Moscow, Russia
| | - A A Tkachenko
- Serbsky National Research Centre for Social and Forensic Psychiatry, Moscow, Russia
| | - D V Samylkin
- Serbsky National Research Centre for Social and Forensic Psychiatry, Moscow, Russia
| | | | - M E Kovaleva
- Serbsky National Research Centre for Social and Forensic Psychiatry, Moscow, Russia
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Wix-Ramos R, Moreno X, Capote E, González G, Uribe E, Eblen-Zajjur A. Drug Treated Schizophrenia, Schizoaffective and Bipolar Disorder Patients Evaluated by qEEG Absolute Spectral Power and Mean Frequency Analysis. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:48-53. [PMID: 24851121 PMCID: PMC4022766 DOI: 10.9758/cpn.2014.12.1.48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/25/2013] [Accepted: 11/25/2013] [Indexed: 12/04/2022]
Abstract
Objective Research of electroencephalograph (EEG) power spectrum and mean frequency has shown inconsistent results in patients with schizophrenic, schizoaffective and bipolar disorders during medication when compared to normal subjects thus; the characterization of these parameters is an important task. Methods We applied quantitative EEG (qEEG) to investigate 38 control, 15 schizophrenic, 7 schizoaffective and 11 bipolar disorder subjects which remaine under the administration of psychotropic drugs (except control group). Absolute spectral power (ASP), mean frequency and hemispheric electrical asymmetry were measured by 19 derivation qEEG. Group mean values were compared with non parametrical Mann-Whitney test and spectral EEG maps with z-score method at p < 0.05. Results Most frequent drug treatments for schizophrenic patients were neuroleptic+antiepileptic (40% of cases) or 2 neuroleptics (33.3%). Schizoaffective patients received neuroleptic+benzodiazepine (71.4%) and for bipolar disorder patients neuroleptic+antiepileptic (81.8%). Schizophrenic (at all derivations except for Fp1, Fp2, F8 and T6) and schizoaffective (only at C3) show higher values of ASP (+57.7% and +86.1% respectively) compared to control group. ASP of bipolar disorder patients did not show differences against control group. The mean frequency was higher at Fp1 (+14.2%) and Fp2 (+17.4%) in bipolar disorder patients than control group, but no differences were found in frequencies between schizophrenic or schizoaffective patients against the control group. Majority of spectral differences were found at the left hemisphere in schizophrenic and schizoaffective but not in bipolar disorder subjects. Conclusion The present report contributes to characterize quantitatively the qEEG in drug treated schizophrenic, schizoaffective or bipolar disorder patients.
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Affiliation(s)
- Richard Wix-Ramos
- Dr. José Ortega Durán Psychiatric Hospital, INSALUD, Valencia, Venezuela
| | - Xiomara Moreno
- Dr. José Ortega Durán Psychiatric Hospital, INSALUD, Valencia, Venezuela
| | - Eduardo Capote
- Faculty of Political and Juridical Sciences, Carabobo University, Barbula, Valencia, Venezuela
| | - Gilbert González
- Dr. José Ortega Durán Psychiatric Hospital, INSALUD, Valencia, Venezuela
| | - Ezequiel Uribe
- Dr. José Ortega Durán Psychiatric Hospital, INSALUD, Valencia, Venezuela
| | - Antonio Eblen-Zajjur
- Laboratory of Neurophysiology, Faculty of Health Sciences, Carabobo University, Bárbula, Valencia, Venezuela
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9
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Galderisi S, Mucci A, Volpe U, Boutros N. Evidence-based medicine and electrophysiology in schizophrenia. Clin EEG Neurosci 2009; 40:62-77. [PMID: 19534300 DOI: 10.1177/155005940904000206] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In research on schizophrenia electrophysiological measures have been investigated to identify biomarkers of the disorder, indices enabling differential diagnosis among psychotic disorders, prognostic indicators or endophenotypes. The present systematic review will focus on the most largely studied electrophysiological indices, i.e., qualitative or quantitative (limited to spectral analysis) EEG and the P300 event-related potential. The PubMed clinical query was used with research methodology filters for each of the following categories: diagnosis/prognosis/ aetiology and a broad sensitive search strategy. The key-words: SCHIZOPHRENIA AND EEG/P3/P300 were used. The search results were then narrowed by including the terms "human" and "English language", and cross-referenced. Systematic reviews and meta-analyses, when available, were also used for cross-referencing. Case reports and studies irrelevant to the topics and methodologies under examination were excluded. The remaining papers were screened to verify the eligibility for this systematic review. Inclusion criteria were: a) a diagnosis of schizophrenia confirmed by DSM-III/ICD-9 criteria (or later editions of the same classification systems); b) the inclusion of both a schizophrenia study group and an healthy control group (when appropriate, i.e., for P300 and quantitative EEG); c) qualitative or spectral EEG findings and amplitude measures for P300. The included studies were then reviewed to verify homogeneity of the results, as well as the presence of the information needed for the present systematic review and meta-analysis. Previous reviews and studies meeting the above requirements (n = 22 for qualitative EEG; n = 45 for spectral EEG and n = 132 for P300) were classified according to the Oxford Centre for Evidence-based Medicine (EBM) levels of evidence criteria. For qualitative EEG as a diagnostic test, the majority of studies predated the introduction of DSM-III and were excluded from the review. Few post DSM-III studies investigated the usefulness of qualitative EEG in the differential diagnosis between schizophrenia and psychosis due to general medical condition. None of them was Oxford CEBM level 3b (non-consecutive-study or cohort-study without consistently-applied reference standard) or better (exploratory or validating cohort-study). No meta-analysis could be conducted due to the lack of reliable quantification methods in the reviewed studies. For spectral EEG as a diagnostic test, most studies qualified as level 4 (case-control study with poor reference standard), and only 24% as level 3b or better. An increase of slow activity in patients is reported by most of these studies. As to meta-analyses examining 29 studies, with 32 independent samples for the delta band and 35 for the theta band, a moderate effect size was found and only 1 study yielded findings in the opposite direction for both measures. There was no identified source for the discrepancy. The analysis of moderator factors included medication, band frequency limits, spectral parameters and disease stage. The medication status was significant for the theta band but the effect was unclear as findings for drug-naïve and drug-free patients were in a different direction. Chronicity had a significant effect on both delta and theta bands, with slow activity increase larger in chronic than in first episode patients. For P3 amplitude reduction as a diagnostic index, 63% of the studies qualified as level 3b or better. Meta-analysis (52 studies, 60 independent samples) results demonstrated a large effect size. None of the studies reported opposite findings. The analysis of moderator factors, including medication status and disease stage, revealed no significant effect on data heterogeneity. In conclusion, the examined indices are good candidates but are not ready yet for clinical applications aimed to improve present diagnostic standards for schizophrenia. Further research carried out according to adequate methodological standards and based on large scale multi-center studies is mandatory.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, University of Naples SUN, Largo Madonna Grazie, Naples, Italy.
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10
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REM sleep EEG spectral analysis in patients with first-episode schizophrenia. J Psychiatr Res 2008; 42:1086-93. [PMID: 18280502 DOI: 10.1016/j.jpsychires.2008.01.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Revised: 12/24/2007] [Accepted: 01/02/2008] [Indexed: 11/23/2022]
Abstract
The pathophysiology of schizophrenia includes abnormalities in subcortical-cortical transfer of information that can be studied using REM sleep EEG spectral analysis, a measure that reflects spontaneous and endogenous thalamocortical activity. We recorded 10 patients with first-episode schizophrenia and 30 healthy controls for two consecutive nights in a sleep laboratory, using a 10-electrode EEG montage. Sixty seconds of REM sleep EEG without artifact were analyzed using FFT spectral analysis. Absolute and relative spectral amplitudes of five frequency bands (delta, theta, alpha, beta1 and beta2) were extracted and compared between the two groups. Frequency bands with significant differences were correlated with BPRS positive and negative symptoms scores. Patients with schizophrenia showed lower relative alpha and higher relative beta2 spectral amplitudes compared to healthy controls over the averaged total scalp. Analysis using cortical regions showed lower relative alpha over frontal, central and temporal regions and higher relative beta2 over the occipital region. Absolute spectral amplitude was not different between groups for any given EEG band. However, absolute alpha activity correlated negatively with BPRS positive symptoms scores and correlated positively with negative symptoms scores. Since similar results have been reported following EEG spectral analysis during the waking state, we conclude that abnormalities of subcortical-cortical transfer of information in schizophrenia could be generated by mechanisms common to REM sleep and waking.
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11
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The status of spectral EEG abnormality as a diagnostic test for schizophrenia. Schizophr Res 2008; 99:225-37. [PMID: 18160260 PMCID: PMC2288752 DOI: 10.1016/j.schres.2007.11.020] [Citation(s) in RCA: 207] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 11/08/2007] [Accepted: 11/14/2007] [Indexed: 11/20/2022]
Abstract
OBJECTIVE A literature review was conducted to ascertain whether or not EEG spectral abnormalities are consistent enough to warrant additional effort towards developing them into a clinical diagnostic test for schizophrenia. METHODS Fifty three papers met criteria for inclusion into the review and 15 were included in a meta-analysis of the degree of significance of EEG deviations as compared to healthy controls. Studies were classified based on a 4-step approach based on guidelines for evaluating the clinical usefulness of a diagnostic test. RESULTS Our review and meta-analysis revealed that most of the abnormalities are replicated in the expected directions with the most consistent results related to the increased preponderance of slow rhythms in schizophrenia patients. This effect remained consistent in un-medicated patients. Only a small number of studies provided data on the sensitivity and specificity of the findings in differentiating among the psychiatric disorders that frequently appear on the same differential diagnostic list as schizophrenia (Step 3 studies). No multicenter studies using standardized assessment criteria were found (Step 4 studies). CONCLUSIONS Additional Step 3 and Step 4 studies are needed to draw conclusions on the usefulness of EEG spectral abnormalities as a diagnostic test for schizophrenia.
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Kikuchi M, Wada Y, Higashima M, Nagasawa T, Takeda T, Koshino Y. Individual analysis of EEG band power and clinical drug response in schizophrenia. Neuropsychobiology 2005; 51:183-90. [PMID: 15870508 DOI: 10.1159/000085593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The main purpose of this study was to investigate the relationship between short-term clinical outcome and changes in electroencephalogram (EEG) power after drug treatment in patients with schizophrenia, and also to compare two different methods for quantitative EEG analysis. EEG power analysis was performed by both conventional fixed frequency band and adjusted frequency band based on individual alpha frequency (IAF) in 16 drug-naive patients before and after drug administration. In the theta bands determined by both conventional fixed band and IAF methods, the EEG power after treatment was larger than that before treatment. In addition, there was a correlation between EEG power and clinical drug response evaluated by changes in BPRS score. With regard to this correlation, IAF methods showed no apparent advantage over methods using conventional fixed frequency bands. Conventional quantitative EEG analysis can still serve as a useful tool for the assessment of short-term outcome of drug treatment.
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Affiliation(s)
- Mitsuru Kikuchi
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
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13
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Cerdán LF, Guevara MA, Sanz A, Amezcua C, Ramos-Loyo J. Brain electrical activity changes in treatment refractory schizophrenics after olanzapine treatment. Int J Psychophysiol 2005; 56:237-47. [PMID: 15866327 DOI: 10.1016/j.ijpsycho.2004.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2004] [Revised: 12/14/2004] [Accepted: 12/17/2004] [Indexed: 10/25/2022]
Abstract
The aim of the present study was to identify brain electrical activity changes generated by olanzapine (OLZ) in treatment refractory schizophrenics (TRS). 14 paranoid TRS (31.5+/-8.39 years old) were evaluated before and after 8 weeks of OLZ treatment. Psychopathology was evaluated by means of total BPRS and PANSS scores. Resting EEG was recorded in the pre (under typical neuroleptics) and post (under OLZ) sessions. A good response to OLZ was observed in 57% of TRS. A significant reduction in positive and negative symptoms scales of PANSS was found. Absolute power of theta1, theta2, alpha1 bands increased after treatment, while beta2 power showed a decrease. Intrahemispheric correlation increased between different zones of the frontal areas and between frontal and posterior areas, while interhemispheric correlation decreased in theta2. EEG changes were more evident in those patients who had a better response to OLZ. OLZ showed to be effective in TRS, improving psychiatric symptoms and increasing activity synchronization between different areas within each hemisphere that may indicate a functional reorganization, particularly in good responders.
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Affiliation(s)
- Luis F Cerdán
- Centro Comunitario de Salud Mental No. 1, Instituto Mexicano del Seguro Social, Mexico
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14
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Abstract
Quantitative electroencephalogram (qEEG) plays a significant role in EEG-based clinical diagnosis and studies of brain function. In past decades, various qEEG methods have been extensively studied. This article provides a detailed review of the advances in this field. qEEG methods are generally classified into linear and nonlinear approaches. The traditional qEEG approach is based on spectrum analysis, which hypothesizes that the EEG is a stationary process. EEG signals are nonstationary and nonlinear, especially in some pathological conditions. Various time-frequency representations and time-dependent measures have been proposed to address those transient and irregular events in EEG. With regard to the nonlinearity of EEG, higher order statistics and chaotic measures have been put forward. In characterizing the interactions across the cerebral cortex, an information theory-based measure such as mutual information is applied. To improve the spatial resolution, qEEG analysis has also been combined with medical imaging technology (e.g., CT, MR, and PET). With these advances, qEEG plays a very important role in basic research and clinical studies of brain injury, neurological disorders, epilepsy, sleep studies and consciousness, and brain function.
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Affiliation(s)
- Nitish V Thakor
- Biomedical Engineering Department, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
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Amann BL, Pogarell O, Mergl R, Juckel G, Grunze H, Mulert C, Hegerl U. EEG abnormalities associated with antipsychotics: a comparison of quetiapine, olanzapine, haloperidol and healthy subjects. Hum Psychopharmacol 2003; 18:641-6. [PMID: 14696024 DOI: 10.1002/hup.537] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this study the effects of the atypical antipsychotics quetiapine and olanzapine, and the typical antipsychotic haloperidol on EEG patterns were retrospectively investigated in 81 patients under stable monotherapy with either drug (quetiapine: n=22, olanzapine: n=37, haloperidol: n=22). These three subgroups were compared with a control group of healthy subjects (n=30) which were matched regarding sex and age. Diagnoses of patients were schizophrenia (DSM-IV 295.xx, n=61), brief psychotic disorder (DSM-IV 298.8, n=9), schizoaffective disorder (DSM-IV 295.70, n=8) and delusional disorder (DSM-IV 297.1, n=3). There were no statistically significant differences regarding demographic characteristics between the groups. Digital EEG recordings were retrieved from a database and visually assessed by two independent investigators, and one blinded regarding medication. One patient from the quetiapine group (5%), 13 olanzapine patients (35%), five of the haloperidol patients (23%) and two subjects of the control group (7%) had an abnormal EEG. Epileptiform activity was observed in four patients (11%) of the olanzapine group, and none in the others. EEG abnormalities were statistically significantly increased with dose in the olanzapine group, in contrast to patients treated with haloperidol, quetiapine or healthy subjects. In conclusion, EEG abnormalities seem to occur rarely in patients treated with quetiapine comparable to the control group, but significantly more often with haloperidol and olanzapine, possibly due to different receptor profiles of these substances. To our knowledge, this is the first electrophysiological investigation comparing the new atypical antipsychotics quetiapine, haloperidol, olanzapine with healthy subjects.
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Affiliation(s)
- Benedikt L Amann
- Department of Psychiatry, Section of Clinical Neurophysiology, University of Munich, Germany.
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16
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Ramos J, Cerdán LF, Guevara MA, Amezcua C, Sanz A. Abnormal EEG patterns in treatment-resistant schizophrenic patients. Int J Neurosci 2001; 109:47-59. [PMID: 11699340 DOI: 10.3109/00207450108986524] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was conducted in order to compare the EEG patterns of schizophrenics who do not respond to typical neuroleptics with those who do respond under typical neuroleptic medication and a group of controls. Absolute (AP) and relative power (RP), and inter- and intrahemispheric correlations were calculated. Nonresistant schizophrenics showed lower delta RP, higher alpha 1 AP and RP and higher correlation between prefrontal areas than the resistant ones and controls. Resistant schizophrenics showed lower alpha 2 RP, lower beta 1 and beta 2 in temporal but higher beta 2 AP and RP in occipital derivations, and higher intrahemispheric correlation between Fp2 and F4 and lower between F8 and T4 than the nonresistant and controls. The resistants also showed a higher antero-posterior beta 1 and beta 2 index than the controls. We concluded that the EEG pattern showed by the nonresistants may be associated with their good neuroleptic response that was not present in the resistant schizophrenics.
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Affiliation(s)
- J Ramos
- Instituto de Neurociencias de la Universidad de Guadalajara, Jalisco Mexico.
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17
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Knott V, Labelle A, Jones B, Mahoney C. Quantitative EEG in schizophrenia and in response to acute and chronic clozapine treatment. Schizophr Res 2001; 50:41-53. [PMID: 11378313 DOI: 10.1016/s0920-9964(00)00165-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Topographic quantitative electroencephalographic (EEG) power and frequency indices were collected in 17 treatment refractory, DSM-III diagnosed schizophrenic patients, before and after acute (single dose) and chronic (six weeks) clozapine treatment, as well as in 17 healthy volunteers. Prior to treatment, patients exhibited greater overall absolute theta power, slower mean alpha frequency and elevated absolute delta and total power in anterior regions. Acute dosing increased total spectrum power globally, slow wave power posteriorally, mean alpha frequency and beta power anteriorally and decreased alpha power posteriorally. Six weeks of clozapine treatment significantly reduced clinical ratings of positive and negative symptoms as well as symptoms of global psychopathology. Chronic treatment resulted in EEG slowing as shown by decreases in relative alpha power, mean beta/total spectrum frequency and by widespread increases in absolute total and delta/theta power. The preliminary findings suggest that brain electric profiling may be a promising tool for assessing and understanding the central impact of pharmacotherapeutic interventions in schizophrenia.
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Affiliation(s)
- V Knott
- Department of Psychiatry and Psychology, University of Ottawa and Institute of Mental Health Research, Royal Ottawa Hospital, 1145 Carling Avenue, Ottawa, Ont., Canada K1Z 7K4.
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18
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Begić D, Hotujac L, Jokić-Begić N. Quantitative EEG in schizophrenic patients before and during pharmacotherapy. Neuropsychobiology 2000; 41:166-70. [PMID: 10754432 DOI: 10.1159/000026650] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the study was to determine the possible differences in quantitative EEG parameters of schizophrenic patients before and during therapy with neuroleptics. First EEG recordings were obtained from schizophrenic patients (n = 50) who had not been taking any medicaments during the preceding 2 months. Second EEG recordings were obtained during the administration of neuroleptic therapy. Amplitude values of particular spectral segment, i.e. delta, theta, alpha 1, alpha 2, beta 1 and beta 2 (after fast Fourier transformation) were analyzed. The F3, F4, C3, C4, T3, T4, P3, P4, O1 and O2 regions were observed. The effect of pharmacotherapy manifested as a decrease in delta and beta 2 activities. The alterations of the delta spectrum were recorded in each patient subgroup (regardless of the neuroleptic used). The changes in beta 2 activity were registered in patients on haloperidol and fluphenazine.
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Affiliation(s)
- D Begić
- Department of Psychiatry, KBC Rebro, Zagreb, Croatia
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19
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Abstract
The clinical significance of electroencephalographic (EEG) changes in patients with functional psychoses is not yet clearly defined, particularly whether these changes are state indicators or trait indicators. In the present review, the EEG abnormalities in schizophrenia are discussed. In early EEG studies of schizophrenics, the various specific EEG patterns were suggested to be trait indicators, but those findings were not confirmed. The EEG patterns of some patients with catatonic schizophrenia, especially periodic catatonia, were thought to be episode or state indicators, and some of the patients diagnosed as having atypical psychoses in Japan were suggested to show state indicator EEG findings. As the computerized and spectral analyses of EEG have advanced, the contradictory findings of EEG in schizophrenia have been reported, interpreted as 'hyperstable' or 'hypernormal' EEG findings and 'hypofrontal' EEG findings (slow waves in the frontal region). However, no conclusion can be made as to whether these EEG findings are state or trait indicators. On the borderland of functional psychoses, the behavioral changes in temporal lobe epilepsy were described as a trait indicator, and the psychotic states in non-convulsive generalized status epilepticus and acute confusional states were suggested to be state indicators. Further studies of EEG abnormalities in schizophrenia are necessary from multi-dimensional perspectives, including in comparison with the symptomatic psychoses.
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Affiliation(s)
- A Sengoku
- Department of Psychiatry, Faculty of Medicine, Kyoto University, Japan
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20
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Harris A, Gordon E, Anderson J, Ritchie G, McLachlan C, Meares R. Change in quantified electroencephalography (QEEG) with medication and altered clinical state in the same subjects with schizophrenia. Schizophr Res 1997; 23:87-9. [PMID: 9050132 DOI: 10.1016/s0920-9964(96)00047-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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21
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Abstract
In this paper, major trends in the recent applications of Clinical Psychophysiology are summarized. These clinical applications pertain to neurosurgical interventions, and to neurological, psychiatric, pediatric, and ophthalmological diseases. Other applications of Clinical Psychophysiology include psychosomatic diseases such as cardiovascular, gastrointestinal, respiratory and sleep-related disorders. The International Organization of Psychophysiology based on its Constitution and By-Laws (IOP, 1981, 1982) is promoting high scientific standards in the applications of Clinical Psychophysiology to various medical conditions.
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Affiliation(s)
- C A Mangina
- Montreal Research and Treatment Center, Quebec, Canada
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22
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Nagase Y, Okubo Y, Toru M. Electroencephalography in schizophrenic patients: comparison between neuroleptic-naive state and after treatment. Biol Psychiatry 1996; 40:452-6. [PMID: 8879464 DOI: 10.1016/0006-3223(96)00304-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Electroencephalography of 12 schizophrenic patients was recorded in a neuroleptic-naive state and after 6.2 +/- 1.1 months of treatment, when they were on medication and in partial remission. Compared with age- and sex-matched controls, the neuroleptic-naive schizophrenics had less alpha 2 power. In the medicated state, alpha 2 power and slow-wave power were reduced as compared with the neuroleptic-naive state. The reduction in alpha 2 power may occur from the early stage of the disease and progress even though the patients are medicated and clinically improved.
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Affiliation(s)
- Y Nagase
- Department of Neuropsychiatry, Tokyo Medical and Dental University, School of Medicine, Japan
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23
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Jin Y, Sandman CA, Wu JC, Bernat J, Potkin SG. Topographic analysis of EEG photic driving in normal and schizophrenic subjects. CLINICAL EEG (ELECTROENCEPHALOGRAPHY) 1995; 26:102-7. [PMID: 7781188 DOI: 10.1177/155005949502600207] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In a 19-channel EEG photic driving paradigm the steady-state evoked response was studied in schizophrenic patients and normal controls. Seventeen drug-free patients and 15 normal controls were compared. Schizophrenic patients had lower EEG photic driving in the alpha range, particularly in the high alpha frequency band (p = 0.08). Topographic analysis revealed that the group differences were primarily located in the mid-frontal, central and parietal areas (p < 0.05). Temporal and lateral frontal lobe alpha remained the same in the two groups. Separate analysis of eye movement (EM) showed an opposite effect on the alpha-frequency photic driving as compared to that on the resting alpha EEG. EM decreased the resting alpha EEG and increased the photic driving. This finding suggested that the lower EEG photic driving in the schizophrenic patients could not be explained by the eye movement artifact. We hypothesize that the 10 Hz range photic driving that reflects the intrinsic EEG spindle generation in the thalamus may play an important role in the psychophysiology of schizophrenia.
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Affiliation(s)
- Y Jin
- Department of Psychiatry and Human Behavior, University of California Irvine College of Medicine, Orange 92668, USA
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24
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Jones RD, Greufe NP. A quantitative electroencephalographic method for xenobiotic screening in the canine model. J Pharmacol Toxicol Methods 1994; 31:233-8. [PMID: 7949380 DOI: 10.1016/1056-8719(94)90008-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A method, using quantitative electroencephalography (qEEG), was developed for screening xenobiotics in conjunction with neurological examinations, for defining toxicodynamic profiles of certain drugs and chemicals in the dog. The standard 10-channel montage was used to evaluate normotonic, auditory, visual, and somatosensory cortical activity. Compressed spectral analysis and Fourier Transformation determined spectral edge frequencies, distribution of the total, fractional and absolute powers of delta, theta, alpha, and beta frequencies as parameters. The alpha 2-agonist, xylazine, was used to detect treatment-related differences, threshold effect levels, and qEEG-target parameters. An increase in theta and alpha activity, and a shift to lower spectral edge frequency were noted. Visual stimulation was the least sensitive test condition in detecting significant changes in measured parameters. Data derived by qEEG may make a reliable contribution to the physiologic interpretation, along with biochemical, clinical, and pathological data collected during a regulatory study.
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Affiliation(s)
- R D Jones
- Agriculture Division, Toxicology Miles, Inc., Stilwell, Kansas 66085-9104
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25
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Galderisi S, Maj M, Mucci A, Bucci P, Kemali D. QEEG alpha 1 changes after a single dose of high-potency neuroleptics as a predictor of short-term response to treatment in schizophrenic patients. Biol Psychiatry 1994; 35:367-74. [PMID: 8018782 DOI: 10.1016/0006-3223(94)90002-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Baseline quantitative electroencephalographic (QEEG) characteristics and their changes after a single test dose of either haloperidol or clopenthixol were investigated in a group of 29 schizophrenics as possible predictors of short-term response to those drugs. On baseline QEEG assessment, responders (R) to subsequent treatment showed fewer slow and more fast activities than nonresponders (NR). A large overlap between R and NR with respect to these measures was observed, however, revealing their practical inadequacy to predict short-term response in individual patients. On the contrary, changes in alpha 1, observed 6 hr after the administration of a single test dose of either haloperidol or clopenthixol, discriminated to a very large extent between R and NR, correctly identifying 17 out of 18 R and 8 out of 10 NR. The QEEG test dose procedure might be used in the selection of the most appropriate antipsychotic drug for individual schizophrenic patients.
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Affiliation(s)
- S Galderisi
- Department of Psychiatry, Medical School, Second University of Naples, Italy
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