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Aeberli T, Müller M, Theodoridou A, Hagenmuller F, Seifritz E, Walitza S, Rössler W, Kawohl W, Heekeren K. Mismatch negativity generation in subjects at risk for psychosis: source analysis is more sensitive than surface electrodes in risk prediction. Front Psychiatry 2023; 14:1130809. [PMID: 37539328 PMCID: PMC10394234 DOI: 10.3389/fpsyt.2023.1130809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/30/2023] [Indexed: 08/05/2023] Open
Abstract
Background Deficits of mismatch negativity (MMN) in patients with schizophrenia have been demonstrated many times and there is growing evidence that alterations of MMN already exist in individuals at risk for psychosis. The present study examines differences in MMN between subjects fulfilling ultra-high risk (UHR) or only basic symptoms criteria and it addresses the question, if MMN source analysis can improve prediction of transition to psychosis. Methods The MMN to duration, frequency, and intensity deviants was recorded in 50 healthy controls and 161 individuals at risk for psychosis classified into three subgroups: only basic symptoms (n = 74), only ultra-high risk (n = 13) and persons who fulfill both risk criteria (n = 74). Based on a three-source model of MMN generation, we conducted an MMN source analysis and compared the amplitudes of surface electrodes and sources among the three groups. Results Significant differences in MMN generation among the four groups were revealed at surface electrodes Cz and C4 (p < 0.05) and at the frontal source (p < 0.001) for duration deviant stimuli. The 15 subjects from the risk groups who subsequently developed a manifest psychosis had a significantly lower MMN amplitude at frontal source (p = 0.019) without showing significant differences at surface electrodes. Low activity at frontal MMN source increased the risk of transition to manifest disease by the factor 3.12 in UHR subjects. Conclusion MMN activity differed significantly between subjects presenting only basic symptoms and subjects which additionally meet UHR criteria. The largest differences between groups as well as between individuals with and without transition were observed at the frontal source. The present results suggest that source analysis is more sensitive than surface electrodes in psychosis risk prediction by MMN.
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Affiliation(s)
- Tina Aeberli
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
| | - Florence Hagenmuller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
- Clienia Schlössli AG, Oetwil am See, Zurich, Switzerland
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Karsten Heekeren
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy I, LVR-Hospital Cologne, Cologne, Germany
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Roach BJ, Carrión RE, Hamilton HK, Bachman P, Belger A, Duncan E, Johannesen J, Light GA, Niznikiewicz M, Addington J, Bearden CE, S Cadenhead K, Cannon TD, A Cornblatt B, McGlashan TH, Perkins DO, Seidman L, Tsuang M, Walker EF, Woods SW, Mathalon DH. Reliability of mismatch negativity event-related potentials in a multisite, traveling subjects study. Clin Neurophysiol 2020; 131:2899-2909. [PMID: 33160266 DOI: 10.1016/j.clinph.2020.09.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 08/25/2020] [Accepted: 09/11/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine the optimal methods for measuring mismatch negativity (MMN), an auditory event-related potential (ERP), and quantify sources of MMN variance in a multisite setting. METHODS Reliability of frequency, duration, and double (frequency + duration) MMN was determined from eight traveling subjects, tested on two occasions at eight laboratory sites. Deviant-specific variance components were estimated for MMN peak amplitude and latency measures using different ERP processing methods. Generalizability (G) coefficients were calculated using two-facet (site and occasion), fully-crossed models and single-facet (occasion) models within each laboratory to assess MMN reliability. RESULTS G-coefficients calculated from two-facet models indicated fair (0.4 < G<=0.6) duration MMN reliability at electrode Fz, but poor (G < 0.4) double and frequency MMN reliability. Single-facet G-coefficients averaged across laboratory resulted in improved reliability (G > 0.5). MMN amplitude reliability was greater than latency reliability, and reliability with mastoid referencing significantly outperformed nose-referencing. CONCLUSIONS EEG preprocessing methods have an impact on the reliability of MMN amplitude. Within site MMN reliability can be excellent, consistent with prior single site studies. SIGNIFICANCE With standardized data collection and ERP processing, MMN can be reliably obtained in multisite studies, providing larger samples sizeswithin rare patient groups.
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Affiliation(s)
- Brian J Roach
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA, United States
| | - Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, United States; Center For PsychiatricNeuroscience, Feinstein Institute for Medical Research, North Shore-Long Island JewishHealth System, Manhasset, NY, United States; Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, United States
| | - Holly K Hamilton
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA, United States; Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Peter Bachman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Aysenil Belger
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Erica Duncan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States; Atlanta VeteransAffairs Medical Center, Decatur, GA, United States
| | - Jason Johannesen
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; Veterans Affairs San Diego Healthcare System, La Jolla, CA, United States
| | - Margaret Niznikiewicz
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscienceand Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, School of Medicine, New Haven, CT, United States
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, United States; Center For PsychiatricNeuroscience, Feinstein Institute for Medical Research, North Shore-Long Island JewishHealth System, Manhasset, NY, United States; Department of Psychiatry, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, United States; Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, United States
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Larry Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States
| | - Ming Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
| | - Daniel H Mathalon
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA, United States; Department of Psychiatry, University of California, San Francisco, CA, United States.
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McMackin R, Dukic S, Broderick M, Iyer PM, Pinto-Grau M, Mohr K, Chipika R, Coffey A, Buxo T, Schuster C, Gavin B, Heverin M, Bede P, Pender N, Lalor EC, Muthuraman M, Hardiman O, Nasseroleslami B. Dysfunction of attention switching networks in amyotrophic lateral sclerosis. Neuroimage Clin 2019; 22:101707. [PMID: 30735860 PMCID: PMC6365983 DOI: 10.1016/j.nicl.2019.101707] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/28/2019] [Accepted: 01/31/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To localise and characterise changes in cognitive networks in Amyotrophic Lateral Sclerosis (ALS) using source analysis of mismatch negativity (MMN) waveforms. RATIONALE The MMN waveform has an increased average delay in ALS. MMN has been attributed to change detection and involuntary attention switching. This therefore indicates pathological impairment of the neural network components which generate these functions. Source localisation can mitigate the poor spatial resolution of sensor-level EEG analysis by associating the sensor-level signals to the contributing brain sources. The functional activity in each generating source can therefore be individually measured and investigated as a quantitative biomarker of impairment in ALS or its sub-phenotypes. METHODS MMN responses from 128-channel electroencephalography (EEG) recordings in 58 ALS patients and 39 healthy controls were localised to source by three separate localisation methods, including beamforming, dipole fitting and exact low resolution brain electromagnetic tomography. RESULTS Compared with controls, ALS patients showed significant increase in power of the left posterior parietal, central and dorsolateral prefrontal cortices (false discovery rate = 0.1). This change correlated with impaired cognitive flexibility (rho = 0.45, 0.45, 0.47, p = .042, .055, .031 respectively). ALS patients also exhibited a decrease in the power of dipoles representing activity in the inferior frontal (left: p = 5.16 × 10-6, right: p = 1.07 × 10-5) and left superior temporal gyri (p = 9.30 × 10-6). These patterns were detected across three source localisation methods. Decrease in right inferior frontal gyrus activity was a good discriminator of ALS patients from controls (AUROC = 0.77) and an excellent discriminator of C9ORF72 expansion-positive patients from controls (AUROC = 0.95). INTERPRETATION Source localization of evoked potentials can reliably discriminate patterns of functional network impairment in ALS and ALS subgroups during involuntary attention switching. The discriminative ability of the detected cognitive changes in specific brain regions are comparable to those of functional magnetic resonance imaging (fMRI). Source analysis of high-density EEG patterns has excellent potential to provide non-invasive, data-driven quantitative biomarkers of network disruption that could be harnessed as novel neurophysiology-based outcome measures in clinical trials.
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Affiliation(s)
- Roisin McMackin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland.
| | - Stefan Dukic
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland.
| | - Michael Broderick
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Trinity Centre for Bioengineering, Trinity College Dublin, The University of Dublin, Ireland.
| | - Parameswaran M Iyer
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Beaumont Hospital Dublin, Department of Neurology, Dublin, Ireland.
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Beaumont Hospital Dublin, Department of Psychology, Dublin, Ireland.
| | - Kieran Mohr
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland.
| | - Rangariroyashe Chipika
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Computational Neuroimaging Group, Trinity College Dublin, The University of Dublin, Ireland..
| | - Amina Coffey
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Beaumont Hospital Dublin, Department of Neurology, Dublin, Ireland.
| | - Teresa Buxo
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland.
| | - Christina Schuster
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Computational Neuroimaging Group, Trinity College Dublin, The University of Dublin, Ireland..
| | - Brighid Gavin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland.
| | - Peter Bede
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Computational Neuroimaging Group, Trinity College Dublin, The University of Dublin, Ireland..
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Beaumont Hospital Dublin, Department of Neurology, Dublin, Ireland
| | - Edmund C Lalor
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, The University of Dublin, Ireland.; Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA..
| | - Muthuraman Muthuraman
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Johannes-Gutenberg-University Hospital, Mainz, Germany.
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland; Beaumont Hospital Dublin, Department of Neurology, Dublin, Ireland; Computational Neuroimaging Group, Trinity College Dublin, The University of Dublin, Ireland..
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity College Dublin, The University of Dublin, Ireland.
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Yoshimura Y, Kikuchi M, Hiraishi H, Hasegawa C, Hirosawa T, Takahashi T, Munesue T, Kosaka H, Hiagashida H, Minabe Y. Longitudinal changes in the mismatch field evoked by an empathic voice reflect changes in the empathy quotient in autism spectrum disorder. Psychiatry Res Neuroimaging 2018; 281:117-122. [PMID: 30292077 DOI: 10.1016/j.pscychresns.2018.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/26/2018] [Accepted: 05/11/2018] [Indexed: 11/22/2022]
Abstract
Autism spectrum disorders (ASDs) are neurodevelopmental conditions with impairments in social communication and interaction. Empathy is the ability to understand and share another person's inner life, and it is an essential process in social cognition, which is deficient in ASD. The mismatch field (MMF) has been used as a neurophysiological marker for the automatic detection of changes in auditory stimuli. In the present study, we focused on long-term changes in MMF evoked by an empathic voice and changes in the empathy quotient (EQ) in ASD during an 8-week clinical trial using oxytocin (OT). Ten males with ASD without intellectual disability participated in this pilot study. The results demonstrated a significant positive correlation between the change in the MMF amplitude in the auditory cortex (i.e., right banks of the superior sulcus) and the change in the EQ score during the 8-week clinical trial, whereas no significant change was observed in the MMF amplitude or EQ score after the administration period of OT. Although we cannot conclude that the observed relationships were caused by OT's effect or by natural changes, our results suggest that MMF evoked by social voice can be a state-dependent marker of empathic abilities in male adults with ASD.
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Affiliation(s)
- Yuko Yoshimura
- Institute of Human and Social Sciences, Kanazawa University, Kanazawa, Japan; Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Mitsuru Kikuchi
- Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.
| | - Hirotoshi Hiraishi
- Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Chiaki Hasegawa
- Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Tetsu Hirosawa
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | | | - Toshio Munesue
- Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, Japan
| | - Haruhiro Hiagashida
- Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yoshio Minabe
- Research Center for Child Mental Development, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan; Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
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A cross-sectional survey of psychotic symptoms in the community: The GRANAD∑P psychosis study. EUROPEAN JOURNAL OF PSYCHIATRY 2018. [DOI: 10.1016/j.ejpsy.2017.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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6
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Yoshimura Y, Kikuchi M, Hayashi N, Hiraishi H, Hasegawa C, Takahashi T, Oi M, Remijn GB, Ikeda T, Saito DN, Kumazaki H, Minabe Y. Altered human voice processing in the frontal cortex and a developmental language delay in 3- to 5-year-old children with autism spectrum disorder. Sci Rep 2017; 7:17116. [PMID: 29215027 PMCID: PMC5719344 DOI: 10.1038/s41598-017-17058-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/15/2017] [Indexed: 11/21/2022] Open
Abstract
The inferior frontal and superior temporal areas in the left hemisphere are crucial for human language processing. In the present study, we investigated the magnetic mismatch field (MMF) evoked by voice stimuli in 3- to 5-year-old typically developing (TD) children and children with autism spectrum disorder (ASD) using child-customized magnetoencephalography (MEG). The children with ASD exhibited significantly decreased activation in the left superior temporal gyrus compared with the TD children for the MMF amplitude. If we classified the children with ASD according to the presence of a speech onset delay (ASD - SOD and ASD - NoSOD, respectively) and compared them with the TD children, both ASD groups exhibited decreased activation in the left superior temporal gyrus compared with the TD children. In contrast, the ASD - SOD group exhibited increased activity in the left frontal cortex (i.e., pars orbitalis) compared with the other groups. For all children with ASD, there was a significant negative correlation between the MMF amplitude in the left pars orbitalis and language performance. This investigation is the first to show a significant difference in two distinct MMF regions in ASD – SOD children compared with TD children.
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Affiliation(s)
- Yuko Yoshimura
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Mitsuru Kikuchi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan.
| | - Norio Hayashi
- Gunma Prefectural College of Health Science, Maebashi, 371-0052, Japan
| | - Hirotoshi Hiraishi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Chiaki Hasegawa
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Tetsuya Takahashi
- Health Administration Center, University of Fukui, Fukui, 910-1193, Japan
| | - Manabu Oi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Gerard B Remijn
- International Education Center, Kyushu University, Fukuoka, 815-8540, Japan
| | - Takashi Ikeda
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Daisuke N Saito
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Hirokazu Kumazaki
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
| | - Yoshio Minabe
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, 920-8640, Japan
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Iyer PM, Mohr K, Broderick M, Gavin B, Burke T, Bede P, Pinto-Grau M, Pender NP, McLaughlin R, Vajda A, Heverin M, Lalor EC, Hardiman O, Nasseroleslami B. Mismatch Negativity as an Indicator of Cognitive Sub-Domain Dysfunction in Amyotrophic Lateral Sclerosis. Front Neurol 2017; 8:395. [PMID: 28861032 PMCID: PMC5559463 DOI: 10.3389/fneur.2017.00395] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/25/2017] [Indexed: 12/11/2022] Open
Abstract
Objective To evaluate the utility of mismatch negativity (MMN), a neurophysiologic marker of non-motor cognitive processing, in amyotrophic lateral sclerosis (ALS). Methods 89 patients, stratified into 4 different phenotypic presentations of ALS (67 spinal-onset, 15 bulbar-onset, 7 ALS-FTD, 7 C9ORF72 gene careers), and 19 matched controls underwent 128-channel EEG data recording. Subjects were presented with standard auditory tones interleaved with pitch-deviant tones in three recording blocks. The MMN response was quantified by peak amplitude, peak delay, average amplitude, and average delay, 100–300 ms after stimuli. 64 patients underwent cognitive screening using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS), and 38 participants underwent contemporaneous cognitive assessment using the Stroop Color–Word Interference test (CWIT), which measures attention shift, inhibitory control, and error monitoring. Results The MMN response was observed in frontal and frontocentral regions of patient and control groups. Compared to controls, waveforms were attenuated in early onset, and the average delay was significantly increased in all of the ALS subgroups, with no significant difference between subgroups. Comparing with the control response, the ALS MMN response clustered into four new subgroups characterized by differences in response latency. The increased average delay correlated with changes in the Stroop CWIT; however, it did not show a direct relationship with age, gender, traditional phenotypes, revised ALS Functional Rating Scale, or ECAS scores. Conclusion and significance The MMN response in ALS patients reflects the cognitive dysfunction in specific sub-domains, as the new patient subgroups, identified by cluster analysis, do not segregate with existing clinical or cognitive classifications. Event-related potentials can provide additional quantitative neurophysiologic measures of impairment in specific cognitive sub-domains from which it may be possible to generate novel biologically relevant subgroups of ALS.
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Affiliation(s)
- Parameswaran Mahadeva Iyer
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Kieran Mohr
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Michael Broderick
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Brighid Gavin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Tom Burke
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Peter Bede
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Marta Pinto-Grau
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Niall P Pender
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Russell McLaughlin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Alice Vajda
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Edmund C Lalor
- Trinity College Institute of Neuroscience, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, The University of Dublin, Dublin, Ireland.,Department of Biomedical Engineering and Department of Neuroscience, University of Rochester, Rochester, NY, United States
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Bahman Nasseroleslami
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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