What does the broken brain say to the neuroscientist? Oscillations and connectivity in schizophrenia, Alzheimer's disease, and bipolar disorder

Schizotypal traits and anomalous perceptual experiences are associated with greater visual temporal acuity

One of the main tasks of the human visual system is to organize the temporal flow of visual events into meaningful patterns. It has been suggested that segregation/integration of continuous visual stimuli relies on temporal windows that are phase-locked to brain oscillations in the alpha frequency range (~10 Hz). From a behavioral point of view, the balance between integration and segregation is reflected in visual temporal acuity: the ability to perceive a small temporal gap between two identical stimuli. Disruption of this balance may lead to impairment of perceptual organization processes. Notably, schizophrenia, a condition characterized by unusual perceptual experiences, has been associated with abnormal temporal processing of sensory stimuli and aberrant oscillations. We asked a large cohort of healthy participants to complete an online version of the two-flash fusion task and two questionnaires for schizotypal personality traits to investigate individual differences in the temporal resolution of perception, particularly its relationship with anomalous perceptual experiences. We found that two-flash discrimination acuity declines with age and that schizotypal traits are associated with better performances. Although this association was strong for perceptual and cognitive subscales, we found that this result could not be attributed to response biases (e.g., hallucination of two flashes). While these results appear to contrast with findings of slower alpha rhythms and sensory processing in schizotypy, we propose that a faster visual rate could be the consequence of an oscillopathy or a disconnection between different sensory modalities and their physiological pacemaker.

Socioeconomic Inequalities Affect Brain Responses of Infants Growing Up in Germany

Developmental changes in functional neural networks are sensitive to environmental influences. This EEG study investigated how infant brain responses relate to the social context that their families live in. Event-related potentials of 255 healthy, awake infants between six and fourteen months were measured during a passive auditory oddball paradigm. Infants were presented with 200 standard tones and 48 randomly distributed deviants. All infants are part of a longitudinal study focusing on families with socioeconomic and/or cultural challenges (Bremen Initiative to Foster Early Childhood Development; BRISE; Germany). As part of their familial socioeconomic status (SES), parental level of education and infant's migration background were assessed with questionnaires. For 30.6% of the infants both parents had a low level of education (≤10 years of schooling) and for 43.1% of the infants at least one parent was born abroad. The N2-P3a complex is associated with unintentional directing of attention to deviant stimuli and was analysed in frontocentral brain regions. Age was utilised as a control variable. Our results show that tone deviations in infants trigger an immature N2-P3a complex. Contrary to studies with older children or adults, the N2 amplitude was more positive for deviants than for standards. This may be related to an immature superposition of the N2 with the P3a. For infants whose parents had no high-school degree and were born abroad, this tendency was increased, indicating that facing multiple challenges as a young family impacts on the infant's early neural development. As such, attending to unexpected stimulus changes may be important for early learning processes. Variations of the infant N2-P3a complex may, thus, relate to early changes in attentional capacity and learning experiences due to familial challenges. This points towards the importance of early prevention programs.

Closing the loop in psychiatric deep brain stimulation: physiology, psychometrics, and plasticity

Deep brain stimulation (DBS) is an invasive approach to precise modulation of psychiatrically relevant circuits. Although it has impressive results in open-label psychiatric trials, DBS has also struggled to scale to and pass through multi-center randomized trials. This contrasts with Parkinson disease, where DBS is an established therapy treating thousands of patients annually. The core difference between these clinical applications is the difficulty of proving target engagement, and of leveraging the wide range of possible settings (parameters) that can be programmed in a given patient's DBS. In Parkinson's, patients' symptoms change rapidly and visibly when the stimulator is tuned to the correct parameters. In psychiatry, those same changes take days to weeks, limiting a clinician's ability to explore parameter space and identify patient-specific optimal settings. I review new approaches to psychiatric target engagement, with an emphasis on major depressive disorder (MDD). Specifically, I argue that better engagement may come by focusing on the root causes of psychiatric illness: dysfunction in specific, measurable cognitive functions and in the connectivity and synchrony of distributed brain circuits. I overview recent progress in both those domains, and how it may relate to other technologies discussed in companion articles in this issue.

40-Hz optogenetic stimulation rescues functional synaptic plasticity after stroke

Evoked brain oscillations in the gamma range have been shown to assist in stroke recovery. However, the causal relationship between evoked oscillations and neuroprotection is not well understood. We have used optogenetic stimulation to investigate how evoked gamma oscillations modulate cortical dynamics in the acute phase after stroke. Our results reveal that stimulation at 40 Hz drives activity in interneurons at the stimulation frequency and phase-locked activity in principal neurons at a lower frequency, leading to increased cross-frequency coupling. In addition, 40-Hz stimulation after stroke enhances interregional communication. These effects are observed up to 24 h after stimulation. Our stimulation protocol also rescues functional synaptic plasticity 24 h after stroke and leads to an upregulation of plasticity genes and a downregulation of cell death genes. Together these results suggest that restoration of cortical dynamics may confer neuroprotection after stroke.

Multiplexity of human brain oscillations as a personal brain signature

Human individuality is likely underpinned by the constitution of functional brain networks that ensure consistency of each person's cognitive and behavioral profile. These functional networks should, in principle, be detectable by noninvasive neurophysiology. We use a method that enables the detection of dominant frequencies of the interaction between every pair of brain areas at every temporal segment of the recording period, the dominant coupling modes (DoCM). We apply this method to brain oscillations, measured with magnetoencephalography (MEG) at rest in two independent datasets, and show that the spatiotemporal evolution of DoCMs constitutes an individualized brain fingerprint. Based on this successful fingerprinting we suggest that DoCMs are important targets for the investigation of neural correlates of individual psychological parameters and can provide mechanistic insight into the underlying neurophysiological processes, as well as their disturbance in brain diseases.

Event-related Oscillations to Emotional Faces are Related to a History of Internalizing Disorders

Event-related oscillations (EROs) may represent sensitive biomarkers or endophenotypes for disorders that underlie risk behaviors such as suicidal thoughts and actions. In this study, young adults of American Indian (AI) (n = 821) and Mexican American (MA) (n = 721) ancestry (age 18-30 yrs) were clinically assessed for internalizing and externalizing disorders, and an internalizing scale was generated by extracting core diagnostic items from 6 lifetime DSM5-compatible diagnoses (social phobia, panic disorder, agoraphobia, obsessive compulsive disorder, post-traumatic stress disorder, major depressive episode) and symptoms of suicidality. EROs were generated to sad, happy and neutral faces, and energy and phase locking of delta ERO oscillations were assessed in frontal areas. An increase in delta ERO energy was found in the frontal lead (FZ) following presentation of the sad facial expressions in those with a history of 10 or more internalizing symptoms compared to those with no symptoms. Increases in delta ERO energy in FZ were also associated with a diagnosis of major depressive disorder (MDD), but not with anxiety disorders or antisocial personality disorder/conduct disorders (ASP). Major depression was also associated with increases in cross-cortical phase-locking (FZ-PZ). A decrease in the percentage of correctly identified neutral faces also was seen among those with 10 or more internalizing symptoms compared to those without internalizing symptoms, and in those with anxiety disorders, but not in those with ASP or MDD as compared to their controls. These findings suggest ERO measures may represent important potential biomarkers of depressive disorders as well as risk indicators for suicidal behaviors.

Electrophysiological and Behavioral Effects of Alpha-Band Sensory Entrainment: Neural Mechanisms and Clinical Applications

Alpha-band (7-13 Hz) activity has been linked to visuo-attentional performance in healthy participants and to impaired functionality of the visual system in a variety of clinical populations including patients with acquired posterior brain lesion and neurodevelopmental and psychiatric disorders. Crucially, several studies suggested that short uni- and multi-sensory rhythmic stimulation (i.e., visual, auditory and audio-visual) administered in the alpha-band effectively induces transient changes in alpha oscillatory activity and improvements in visuo-attentional performance by synchronizing the intrinsic brain oscillations to the external stimulation (neural entrainment). The present review aims to address the current state of the art on the alpha-band sensory entrainment, outlining its potential functional effects and current limitations. Indeed, the results of the alpha-band entrainment studies are currently mixed, possibly due to the different stimulation modalities, task features and behavioral and physiological measures employed in the various paradigms. Furthermore, it is still unknown whether prolonged alpha-band sensory entrainment might lead to long-lasting effects at a neural and behavioral level. Overall, despite the limitations emerging from the current literature, alpha-band sensory entrainment may represent a promising and valuable tool, inducing functionally relevant changes in oscillatory activity, with potential rehabilitative applications in individuals characterized by impaired alpha activity.

The Role of Alpha Oscillations among the Main Neuropsychiatric Disorders in the Adult and Developing Human Brain: Evidence from the Last 10 Years of Research

Alpha oscillations (7-13 Hz) are the dominant rhythm in both the resting and active brain. Accordingly, translational research has provided evidence for the involvement of aberrant alpha activity in the onset of symptomatological features underlying syndromes such as autism, schizophrenia, major depression, and Attention Deficit and Hyperactivity Disorder (ADHD). However, findings on the matter are difficult to reconcile due to the variety of paradigms, analyses, and clinical phenotypes at play, not to mention recent technical and methodological advances in this domain. Herein, we seek to address this issue by reviewing the literature gathered on this topic over the last ten years. For each neuropsychiatric disorder, a dedicated section will be provided, containing a concise account of the current models proposing characteristic alterations of alpha rhythms as a core mechanism to trigger the associated symptomatology, as well as a summary of the most relevant studies and scientific contributions issued throughout the last decade. We conclude with some advice and recommendations that might improve future inquiries within this field.

Oscillatory Activities in Multiple Frequency Bands in Patients with Schizophrenia During Motion Perception

Patients with schizophrenia show impairment in binding stimulus features into coherent objects, which are reflected in disturbed oscillatory activities. This study aimed to identify disturbances in multiple oscillatory bands during perceptual organization of motion perception in patients with schizophrenia. EEG was recorded from healthy controls and patients with schizophrenia during continuous presentation of a motion stimulus which induces reversals between two exogenously generated perceptions. This stimulus was used to investigate differences in motion binding processes between healthy controls and patients with schizophrenia. EEG signals were transformed into frequency components by means of the Morlet wavelet transformation in order to analyse inter-trial coherences (ITC) in the delta (1-4 Hz), theta (4-7 Hz), alpha (8-12 Hz), and gamma (28-48 Hz) frequency bands during exogenous motion binding. Patients showed decreased delta-ITC in occipital and theta-ITC in central and parietal areas, while no significant differences were found for neither alpha nor gamma-ITCs. The present study provides one of the first insights on the oscillatory synchronizations related with the motion perception in schizophrenia. The ITC differences revealed alterations in the consistency of large-scale integration and transfer functions in patients with schizophrenia.

The Role of Aberrant Neural Oscillations in the Hippocampal-Medial Prefrontal Cortex Circuit in Neurodevelopmental and Neurological Disorders

The hippocampus (HPC) and medial prefrontal cortex (mPFC) have well-established roles in cognition, emotion, and sensory processing. In recent years, interests have shifted towards developing a deeper understanding of the mechanisms underlying interactions between the HPC and mPFC in achieving these functions. Considerable research supports the idea that synchronized activity between the HPC and the mPFC is a general mechanism by which brain functions are regulated. In this review, we summarize current knowledge on the hippocampal-medial prefrontal cortex (HPC-mPFC) circuit in normal brain function with a focus on oscillations and highlight several neurodevelopmental and neurological disorders associated with aberrant HPC-mPFC circuitry. We further discuss oscillatory dynamics across the HPC-mPFC circuit as potentially useful biomarkers to assess interventions for neurodevelopmental and neurological disorders. Finally, advancements in brain stimulation, gene therapy and pharmacotherapy are explored as promising therapies for disorders with aberrant HPC-mPFC circuit dynamics.

Association between abnormal brain oscillations and cognitive performance in patients with bipolar disorder; Molecular mechanisms and clinical evidence

Brain oscillations have gained great attention in neuroscience during recent decades as functional building blocks of cognitive-sensory processes. Research has shown that oscillations in "alpha," "beta," "gamma," "delta," and "theta" frequency windows are highly modified in brain pathology, including in patients with cognitive impairment like bipolar disorder (BD). The study of changes in brain oscillations can provide fundamental knowledge for exploring neurophysiological biomarkers in cognitive impairment. The present article reviews findings from the role and molecular basis of abnormal neural oscillation and synchronization in the symptoms of patients with BD. An overview of the results clearly demonstrates that, in cognitive-sensory processes, resting and evoked/event-related electroencephalogram (EEG) spectra in the delta, theta, alpha, beta, and gamma bands are abnormally changed in patients with BD showing psychotic features. Abnormal oscillations have been found to be associated with several neural dysfunctions and abnormalities contributing to BD, including abnormal GABAergic neurotransmission signaling, hippocampal cell discharge, abnormal hippocampal neurogenesis, impaired cadherin and synaptic contact-based cell adhesion processes, extended lateral ventricles, decreased prefrontal cortical gray matter, and decreased hippocampal volume. Mechanistically, impairment in calcium voltage-gated channel subunit alpha1 I, neurotrophic tyrosine receptor kinase proteins, genes involved in brain neurogenesis and synaptogenesis like WNT3 and ACTG2, genes involved in the cell adhesion process like CDH12 and DISC1, and gamma-aminobutyric acid (GABA) signaling have been reported as the main molecular contributors to the abnormalities in resting-state low-frequency oscillations in BD patients. Findings also showed the association of impaired synaptic connections and disrupted membrane potential with abnormal beta/gamma oscillatory activity in patients with BD. Of note, the synaptic GABA neurotransmitter has been found to be a fundamental requirement for the occurrence of long-distance synchronous gamma oscillations necessary for coordinating the activity of neural networks between various brain regions. This article is protected by copyright. All rights reserved.

Auditory driven gamma synchrony is associated with cortical thickness in widespread cortical areas

OBJECTIVE

Gamma synchrony is a fundamental functional property of the cerebral cortex, impaired in multiple neuropsychiatric conditions (i.e. schizophrenia, Alzheimer's disease, stroke etc.). Auditory stimulation in the gamma range allows to drive gamma synchrony of the entire cortical mantle and to estimate the efficiency of the mechanisms sustaining it. As gamma synchrony depends strongly on the interplay between parvalbumin-positive interneurons and pyramidal neurons, we hypothesize an association between cortical thickness and gamma synchrony. To test this hypothesis, we employed a combined magnetoencephalography (MEG) - Magnetic Resonance Imaging (MRI) study.

METHODS

Cortical thickness was estimated from anatomical MRI scans. MEG measurements related to exposure of 40 Hz amplitude modulated tones were projected onto the cortical surface. Two measures of cortical synchrony were considered: (a) inter-trial phase consistency at 40 Hz, providing a vertex-wise estimation of gamma synchronization, and (b) phase-locking values between primary auditory cortices and whole cortical mantle, providing a measure of long-range cortical synchrony. A correlation between cortical thickness and synchronization measures was then calculated for 72 MRI-MEG scans.

RESULTS

Both inter-trial phase consistency and phase locking values showed a significant positive correlation with cortical thickness. For inter-trial phase consistency, clusters of strong associations were found in the temporal and frontal lobes, especially in the bilateral auditory and pre-motor cortices. Higher phase-locking values corresponded to higher cortical thickness in the frontal, temporal, occipital and parietal lobes.

DISCUSSION AND CONCLUSIONS

In healthy subjects, a thicker cortex corresponds to higher gamma synchrony and connectivity in the primary auditory cortex and beyond, likely reflecting underlying cell density involved in gamma circuitries. This result hints towards an involvement of gamma synchrony together with underlying brain structure in brain areas for higher order cognitive functions. This study contributes to the understanding of inherent cortical functional and structural brain properties, which might in turn constitute the basis for the definition of useful biomarkers in patients showing aberrant gamma synchronization.

Decreased frontal gamma activity in Alzheimer's disease patients

Objective

In Alzheimer disease (AD) animal models, synaptic dysfunction has recently been linked to a disorder of high‐frequency neuronal activity. In patients, a clear relation between AD and oscillatory activity remains elusive. Here, we attempt to shed light on this relation by using a novel approach combining transcranial magnetic stimulation and electroencephalography (TMS‐EEG) to probe oscillatory activity in specific hubs of the frontoparietal network in a sample of 60 mild‐to‐moderate AD patients.

Methods

Sixty mild‐to‐moderate AD patients and 21 age‐matched healthy volunteers (HVs) underwent 3 TMS‐EEG sessions to assess cortical oscillations over the left dorsolateral prefrontal cortex, the precuneus, and the left posterior parietal cortex. To investigate the relations between oscillatory activity, cortical plasticity, and cognitive decline, AD patients underwent a TMS‐based neurophysiological characterization and a cognitive evaluation at baseline. The latter was repeated after 24 weeks to monitor clinical evolution.

Results

AD patients showed a significant reduction of frontal gamma activity as compared to age‐matched HVs. In addition, AD patients with a more prominent decrease of frontal gamma activity showed a stronger impairment of long‐term potentiation–like plasticity and a more pronounced cognitive decline at subsequent follow‐up evaluation at 24 weeks.

Interpretation

Our data provide novel evidence that frontal lobe gamma activity is dampened in AD patients. The current results point to the TMS‐EEG approach as a promising technique to measure individual frontal gamma activity in patients with AD. This index could represent a useful biomarker to predict disease progression and to evaluate response to novel pharmacological therapies. ANN NEUROL 2022;92:464–475

Abnormalities of Electroencephalography Microstates in Drug-Naïve, First-Episode Schizophrenia

OBJECTIVE

Microstate analysis is a powerful tool to probe the brain functions, and changes in microstates under electroencephalography (EEG) have been repeatedly reported in patients with schizophrenia. This study aimed to investigate the dynamics of EEG microstates in drug-naïve, first-episode schizophrenia (FE-SCH) and to test the relationship between EEG microstates and clinical symptoms.

METHODS

Resting-state EEG were recorded for 23 patients with FE-SCH and 23 healthy controls using a 64-channel cap. Three parameters, i.e., contribution, duration, and occurrence, of the four microstate classes were calculated. Group differences in EEG microstates and their clinical symptoms [assessed using the Positive and Negative Syndrome Scale (PANSS)] were analyzed.

RESULTS

Compared with healthy controls, patients with FE-SCH showed increased duration, occurrence and contribution of microstate class C and decreased contribution and occurrence of microstate class D. In addition, the score of positive symptoms in PANSS was negatively correlated with the occurrence of microstate D.

CONCLUSION

Our findings showed abnormal patterns of EEG microstates in drug-naïve, first-episode schizophrenia, which might help distinguish individuals with schizophrenia in the early stage and develop early intervention strategies.

Driving Oscillatory Dynamics: Neuromodulation for Recovery After Stroke

Stroke is a leading cause of death and disability worldwide, with limited treatments being available. However, advances in optic methods in neuroscience are providing new insights into the damaged brain and potential avenues for recovery. Direct brain stimulation has revealed close associations between mental states and neuroprotective processes in health and disease, and activity-dependent calcium indicators are being used to decode brain dynamics to understand the mechanisms underlying these associations. Evoked neural oscillations have recently shown the ability to restore and maintain intrinsic homeostatic processes in the brain and could be rapidly deployed during emergency care or shortly after admission into the clinic, making them a promising, non-invasive therapeutic option. We present an overview of the most relevant descriptions of brain injury after stroke, with a focus on disruptions to neural oscillations. We discuss the optical technologies that are currently used and lay out a roadmap for future studies needed to inform the next generation of strategies to promote functional recovery after stroke.

EEG measures for clinical research in major vascular cognitive impairment: recommendations by an expert panel

Vascular contribution to cognitive impairment (VCI) and dementia is related to etiologies that may affect the neurophysiological mechanisms regulating brain arousal and generating electroencephalographic (EEG) activity. A multidisciplinary expert panel reviewed the clinical literature and reached consensus about the EEG measures consistently found as abnormal in VCI patients with dementia. As compared to cognitively unimpaired individuals, those VCI patients showed (1) smaller amplitude of resting state alpha (8-12 Hz) rhythms dominant in posterior regions; (2) widespread increases in amplitude of delta (< 4 Hz) and theta (4-8 Hz) rhythms; and (3) delayed N200/P300 peak latencies in averaged event-related potentials, especially during the detection of auditory rare target stimuli requiring participants' responses in "oddball" paradigms. The expert panel formulated the following recommendations: (1) the above EEG measures are not specific for VCI and should not be used for its diagnosis; (2) they may be considered as "neural synchronization" biomarkers to enlighten the relationships between features of the VCI-related cerebrovascular lesions and abnormalities in neurophysiological brain mechanisms; and (3) they may be tested in future clinical trials as prognostic biomarkers and endpoints of interventions aimed at normalizing background brain excitability and vigilance in wakefulness.

Harmonic cross-correlation decomposition for multivariate time series

We introduce harmonic cross-correlation decomposition (HCD) as a tool to detect and visualize features in the frequency structure of multivariate time series. HCD decomposes multivariate time series into spatiotemporal harmonic modes with the leading modes representing dominant oscillatory patterns in the data. HCD is closely related to data-adaptive harmonic decomposition (DAHD) [Chekroun and Kondrashov, Chaos 27, 093110 (2017)10.1063/1.4989400] in that it performs an eigendecomposition of a grand matrix containing lagged cross-correlations. As for DAHD, each HCD mode is uniquely associated with a Fourier frequency, which allows for the definition of multidimensional power and phase spectra. Unlike in DAHD, however, HCD does not exhibit a systematic dependency on the ordering of the channels within the grand matrix. Further, HCD phase spectra can be related to the phase relations in the data in an intuitive way. We compare HCD with DAHD and multivariate singular spectrum analysis, a third related correlation-based decomposition, and we give illustrative applications to a simple traveling wave, as well as to simulations of three coupled Stuart-Landau oscillators and to human EEG recordings.

Classification of Schizophrenia by Combination of Brain Effective and Functional Connectivity

At present, lots of studies have tried to apply machine learning to different electroencephalography (EEG) measures for diagnosing schizophrenia (SZ) patients. However, most EEG measures previously used are either a univariate measure or a single type of brain connectivity, which may not fully capture the abnormal brain changes of SZ patients. In this paper, event-related potentials were collected from 45 SZ patients and 30 healthy controls (HCs) during a learning task, and then a combination of partial directed coherence (PDC) effective and phase lag index (PLI) functional connectivity were used as features to train a support vector machine classifier with leave-one-out cross-validation for classification of SZ from HCs. Our results indicated that an excellent classification performance (accuracy = 95.16%, specificity = 94.44%, and sensitivity = 96.15%) was obtained when the combination of functional and effective connectivity features was used, and the corresponding optimal feature number was 15, which included 12 PDC and three PLI connectivity features. The selected effective connectivity features were mainly located between the frontal/temporal/central and visual/parietal lobes, and the selected functional connectivity features were mainly located between the frontal/temporal and visual cortexes of the right hemisphere. In addition, most of the selected effective connectivity abnormally enhanced in SZ patients compared with HCs, whereas all the selected functional connectivity features decreased in SZ patients. The above results showed that our proposed method has great potential to become a tool for the auxiliary diagnosis of SZ.

A Transient Survival Model of Alteration of Electrophysiological Properties Due to Amyloid Beta Toxicity Based on SH-SY5Y Cell Line

BACKGROUND

Accumulation of toxic strands of amyloid beta (AB), which cause neurofibrillary tangles and, ultimately, cell death, is suspected to be the main culprit behind clinical symptoms of Alzheimer's disease. Although the mechanism of cell death due to AB accumulation is well known, the intermediate phase between the start of accumulation and cell death is less known and investigated, partially due to technical challenges in identifying partially affected cells.

OBJECTIVE

First, we aimed to establish an in vitro model that would show resilience against AB toxicity. Then we used morphological, molecular and electrophysiological assays to investigate how the characteristics of the surviving cells changed after AB toxicity.

METHODS

To investigate this phase, we used differentiation of SH-SY5Y neuroblastoma stem cells by Retinoic Acid (RA) and Brain Derived Neurotrophic Factor (BDNF) to establish an in vitro model which would be able to demonstrate various levels of resistance to AB toxicity. We utilized fluorescent microscopy and whole cell patch clamp recordings to investigate behavior of the model.

RESULTS

We observed significantly higher morphological resilience against AB toxicity in cells which were differentiated by both Retinoic Acid and Brain Derived Neurotrophic Factor compared to Retinoic Acid only. However, the electrophysiological properties of the Retinoic Acid + Brain-Derived Neurotrophic Factor differentiated cells were significantly altered after AB treatment.

CONCLUSION

We established a transient survival model for AB toxicity and observed the effects of AB on transmembrane currents of differentiated neurons.

EEG-Based Measures in At-Risk Mental State and Early Stages of Schizophrenia: A Systematic Review

Introduction: Electrophysiological (EEG) abnormalities in subjects with schizophrenia have been largely reported. In the last decades, research has shifted to the identification of electrophysiological alterations in the prodromal and early phases of the disorder, focusing on the prediction of clinical and functional outcome. The identification of neuronal aberrations in subjects with a first episode of psychosis (FEP) and in those at ultra high-risk (UHR) or clinical high-risk (CHR) to develop a psychosis is crucial to implement adequate interventions, reduce the rate of transition to psychosis, as well as the risk of irreversible functioning impairment. The aim of the review is to provide an up-to-date synthesis of the electrophysiological findings in the at-risk mental state and early stages of schizophrenia. Methods: A systematic review of English articles using Pubmed, Scopus, and PsychINFO was undertaken in July 2020. Additional studies were identified by hand-search. Electrophysiological studies that included at least one group of FEP or subjects at risk to develop psychosis, compared to healthy controls (HCs), were considered. The heterogeneity of the studies prevented a quantitative synthesis. Results: Out of 319 records screened, 133 studies were included in a final qualitative synthesis. Included studies were mainly carried out using frequency analysis, microstates and event-related potentials. The most common findings included an increase in delta and gamma power, an impairment in sensory gating assessed through P50 and N100 and a reduction of Mismatch Negativity and P300 amplitude in at-risk mental state and early stages of schizophrenia. Progressive changes in some of these electrophysiological measures were associated with transition to psychosis and disease course. Heterogeneous data have been reported for indices evaluating synchrony, connectivity, and evoked-responses in different frequency bands. Conclusions: Multiple EEG-indices were altered during at-risk mental state and early stages of schizophrenia, supporting the hypothesis that cerebral network dysfunctions appear already before the onset of the disorder. Some of these alterations demonstrated association with transition to psychosis or poor functional outcome. However, heterogeneity in subjects' inclusion criteria, clinical measures and electrophysiological methods prevents drawing solid conclusions. Large prospective studies are needed to consolidate findings concerning electrophysiological markers of clinical and functional outcome.

Potential targets for the treatment of ADHD using transcranial electrical current stimulation

Attention deficit hyperactivity disorder (ADHD) is a psychiatric disease with a prevalence of 2%-7.5% among the population. It is characterized by three core symptoms: hyperactivity, impulsivity, and inattention. Although the majority of ADHD patients respond to a combination of psychotherapy and standard pharmacotherapy with Methylphenidate, there is a significant minority of patients that do not respond to these substances. Additionally, the treatment with Methylphenidate can cause a variety of side effects like insomnia, headache, decreased appetite, and xerostomia. It would be favorable to have an alternative treatment-option that could circumnavigate the shortcomings of traditional pharmacological treatments. Recent results show that transcranial electrical stimulation (tES) might offer a promising approach. Since research has shown that ADHD is associated with various alterations in brain activity, brain stimulation methods targeting different facets of neuronal functions are currently under investigation. In this article, we briefly review different tES techniques like transcranial random noise stimulation (tRNS), transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) and explain the modes of action of these brain stimulations. We will specifically focus on transcranial alternating current stimulation (tACS) as a potential method of treating ADHD.

Disrupted resting-state brain functional network in methamphetamine abusers: A brain source space study by EEG

This study aimed to examine the effects of chronic methamphetamine use on the topological organization of whole-brain functional connectivity network (FCN) by reconstruction of neural-activity time series at resting-state. The EEG of 36 individuals with methamphetamine use disorder (IWMUD) and 24 normal controls (NCs) were recorded, pre-processed and source-reconstructed using standardized low-resolution tomography (sLORETA). The brain FCNs of participants were constructed and between-group differences in network topological properties were investigated using graph theoretical analysis. IWMUD showed decreased characteristic path length, increased clustering coefficient and small-world index at delta and gamma frequency bands compared to NCs. Moreover, abnormal changes in inter-regional connectivity and network hubs were observed in all the frequency bands. The results suggest that the IWMUD and NCs have distinct FCNs at all the frequency bands, particularly at the delta and gamma bands, in which deviated small-world brain topology was found in IWMUD.

Staging model in psychiatry: Review of the evolution of electroencephalography abnormalities in major psychiatric disorders

AIM

Clinical staging in psychiatry aims to classify patients according to the severity of their symptoms, from stage 0 (increased risk, asymptomatic) to stage 4 (severe illness), enabling adapted treatment at each stage of the illness. The staging model would gain specificity if one or more quantifiable biological markers could be identified. Several biomarkers reflecting possible causal mechanisms and/or consequences of the pathophysiology are candidates for integration into the clinical staging model of psychiatric illnesses.

METHODS

This review covers the evolution (from stage 0 to stage 4) of the most important brain functioning impairments as measured with electroencephalography (EEG), in psychosis spectrum and in severe mood disorders.

RESULTS

The present review of the literature demonstrates that it is currently not possible to draw any conclusion with regard to the state or trait character of any of the EEG impairments in both major depressive disorder and bipolar disorder. As for schizophrenia, the most promising markers of the stage of the illness are the pitch mismatch negativity as well as the p300 event-related potentials, as these components seem to deteriorate with increasing severity of the illness.

CONCLUSIONS

Given the complexity of major psychiatric disorders, and that not a single impairment can be observed in all patients, future research should most likely consider combinations of markers in the quest for a better identification of the stages of the psychiatric illnesses.

Neural oscillations during cognitive processes in an App knock-in mouse model of Alzheimer's disease pathology

Multiple animal models have been created to gain insight into Alzheimer's disease (AD) pathology. Among the most commonly used models are transgenic mice overexpressing human amyloid precursor protein (APP) with mutations linked to familial AD, resulting in the formation of amyloid β plaques, one of the pathological hallmarks observed in AD patients. However, recent evidence suggests that the overexpression of APP by itself can confound some of the reported observations. Therefore, we investigated in the present study the AppNL-G-Fmodel, an App knock-in (App-KI) mouse model that develops amyloidosis in the absence of APP-overexpression. Our findings at the behavioral, electrophysiological, and histopathological level confirmed an age-dependent increase in Aβ1-42 levels and plaque deposition in these mice in accordance with previous reports. This had apparently no consequences on cognitive performance in a visual discrimination (VD) task, which was largely unaffected in AppNL-G-F mice at the ages tested. Additionally, we investigated neurophysiological functioning of several brain areas by phase-amplitude coupling (PAC) analysis, a measure associated with adequate cognitive functioning, during the VD task (starting at 4.5 months) and the exploration of home environment (at 5 and 8 months of age). While we did not detect age-dependent changes in PAC during home environment exploration for both the wild-type and the AppNL-G-F mice, we did observe subtle changes in PAC in the wild-type mice that were not present in the AppNL-G-F mice.

Borderline Personality and Bipolar Disorders Cannot Be Differentiated Electrophysiologically

Objectives. Certain studies have claimed that borderline personality disorder (BPD) could be evaluated as a subtype of bipolar disorder (BD), whereas others have argued that BPD should be regarded as an independent disorder because of its distinct clinical features. The aim of this study was to investigate if there was a difference between these 2 disorders biologically based on EEG recordings. Methods. A total of 111 subjects (11 healthy, 25 BPD, 75 BD) who had resting EEG recordings were included. The EEGs were analyzed to compute absolute power values. Results. One-way analysis of variance results revealed statistically significant differences among the 3 groups on 55 out of 229 EEG variables. However, post hoc analysis indicated that all of the significant changes were between healthy and patient groups and no significant differences were found between 2 clinical groups. Conclusion. The findings suggested that these 2 clinical entities are biologically similar; however, further research should be performed to explain the basis clinical differences between the 2 disorders.

A statistical framework to assess cross-frequency coupling while accounting for confounding analysis effects

Cross frequency coupling (CFC) is emerging as a fundamental feature of brain activity, correlated with brain function and dysfunction. Many different types of CFC have been identified through application of numerous data analysis methods, each developed to characterize a specific CFC type. Choosing an inappropriate method weakens statistical power and introduces opportunities for confounding effects. To address this, we propose a statistical modeling framework to estimate high frequency amplitude as a function of both the low frequency amplitude and low frequency phase; the result is a measure of phase-amplitude coupling that accounts for changes in the low frequency amplitude. We show in simulations that the proposed method successfully detects CFC between the low frequency phase or amplitude and the high frequency amplitude, and outperforms an existing method in biologically-motivated examples. Applying the method to in vivo data, we illustrate examples of CFC during a seizure and in response to electrical stimuli.

Abnormalities of Alpha Activity in Frontocentral Region of the Brain as a Biomarker to Diagnose Adolescents With Bipolar Disorder

Objectives. To investigate brain abnormalities in adolescents with new-onset bipolar disorder (BD) during acute hypomanic and depressive episodes using electroencephalogram (EEG) analysis and to derive a computer-based method for diagnosis of the disorder. Methods. EEG spectral power and entropy of 21 adolescents with BD (included 11 patients in the hypomanic episode and 10 patients in the depressive episode) and 18 healthy adolescents were compared. Moreover, using significant differences and K-nearest-neighbors (KNN) classifier, it was attempted to distinguish the BD adolescents from normal ones. Results. The BD adolescents had higher values of spectral power in all frequency bands, particularly in the frontocentral, mid-temporal, and right parietal regions. Also, spectral entropy had significantly increased in delta, alpha, and gamma frequency bands for BD. A high accuracy of 95.8% was achieved by all significant differences in the alpha band in discriminating adolescents with BD. The depressive state showed higher values of spectral power and entropy in low-frequency bands (delta and theta) compared to the hypomanic state. Conclusion. Based on BD symptoms, especially inattention, increased alpha power is a rational finding which is associated with thalamus dysfunction. Thus, it seems that EEG alpha oscillation is the main source of abnormality in BD. Furthermore, EEG slowing in the depressive episode is related to inhibition of electrical activity and reduced cognitive functions.

Disparate Effects of Lithium and a GSK-3 Inhibitor on Neuronal Oscillatory Activity in Prefrontal Cortex and Hippocampus

Glycogen synthase kinase-3 (GSK-3) plays a critical role in cognitive dysfunction associated with Alzheimer’s disease (AD), yet the mechanism by which GSK-3 alters cognitive processes in other disorders, such as schizophrenia, remains unknown. In the present study, we demonstrated a role for GSK-3 in the direct regulation of neuronal oscillations in hippocampus (HIP) and prelimbic cortex (PL). A comparison of the GSK-3 inhibitors SB 216763 and lithium demonstrated disparate effects of the drugs on spatial memory and neural oscillatory activity in HIP and PL. SB 216763 administration improved spatial memory whereas lithium treatment had no effect. Analysis of neuronal local field potentials in anesthetized animals revealed that whereas both repeated SB 216763 (2.5 mg/kg) and lithium (100 mg/kg) induced a theta frequency spike in HIP at approximately 10 Hz, only SB 216763 treatment induced an overall increase in theta power (4–12 Hz) compared to vehicle. Acute administration of either drug suppressed slow (32–59 Hz) and fast (61–100 Hz) gamma power. In PL, both drugs induced an increase in theta power. Repeated SB 216763 increased HIP–PL coherence across all frequencies except delta, whereas lithium selectively suppressed delta coherence. These findings demonstrate that GSK-3 plays a direct role in the regulation of theta oscillations in regions critically involved in cognition, and highlight a potential mechanism by which GSK-3 may contribute to cognitive decline in disorders of cognitive dysfunction.

Too Fast or Too Slow? Time and Neuronal Variability in Bipolar Disorder-A Combined Theoretical and Empirical Investigation

Time is an essential feature in bipolar disorder (BP). Manic and depressed BP patients perceive the speed of time as either too fast or too slow. The present article combines theoretical and empirical approaches to integrate phenomenological, psychological, and neuroscientific accounts of abnormal time perception in BP. Phenomenology distinguishes between perception of inner time, ie, self-time, and outer time, ie, world-time, that desynchronize or dissociate from each other in BP: inner time speed is abnormally slow (as in depression) or fast (as in mania) and, by taking on the role as default-mode function, impacts and modulates the perception of outer time speed in an opposite way, ie, as too fast in depression and too slow in mania. Complementing, psychological investigation show opposite results in time perception, ie, time estimation and reproduction, in manic and depressed BP. Neuronally, time speed can be indexed by neuronal variability, ie, SD. Our own empirical data show opposite changes in manic and depressed BP (and major depressive disorder [MDD]) with abnormal SD balance, ie, SD ratio, between somatomotor and sensory networks that can be associated with inner and outer time. Taken together, our combined theoretical-empirical approach demonstrates that desynchronization or dissociation between inner and outer time in BP can be traced to opposite neuronal variability patterns in somatomotor and sensory networks. This opens the door for individualized therapeutic "normalization" of neuronal variability pattern in somatomotor and sensory networks by stimulation with TMS and/or tDCS.

Graph-based analysis of brain connectivity in schizophrenia

The present study evaluated brain connectivity using electroencephalography (EEG) data from 14 patients with schizophrenia and 14 healthy controls. Phase-Locking Value (PLV), Phase-Lag Index (PLI) and Directed Transfer Function (DTF) were calculated for the original EEG data and following current source density (CSD) transformation, re-referencing using the average reference electrode (AVERAGE) and reference electrode standardization techniques (REST). The statistical analysis of adjacency matrices was carried out using indices based on graph theory. Both CSD and REST reduced the influence of volume conducted currents. The largest group differences in connectivity were observed for the alpha band. Schizophrenic patients showed reduced connectivity strength, as well as a lower clustering coefficient and shorter characteristic path length for both measures of phase synchronization following CSD transformation or REST re-referencing. Reduced synchronization was accompanied by increased directional flow from the occipital region for the alpha band. Following the REST re-referencing, the sources of alpha activity were located at parietal rather than occipital derivations. The results of PLV and DTF demonstrated group differences in fronto-posterior asymmetry following CSD transformation, while for PLI the differences were significant only using REST. The only analysis that identified group differences in inter-hemispheric asymmetry was DTF calculated for REST. Our results suggest that a comparison of different connectivity measures using graph-based indices for each frequency band, separately, may be a useful tool in the study of disconnectivity disorders such as schizophrenia.

Graph-based analysis of brain connectivity in schizophrenia

The present study evaluated brain connectivity using electroencephalography (EEG) data from 14 patients with schizophrenia and 14 healthy controls. Phase-Locking Value (PLV), Phase-Lag Index (PLI) and Directed Transfer Function (DTF) were calculated for the original EEG data and following current source density (CSD) transformation, re-referencing using the average reference electrode (AVERAGE) and reference electrode standardization techniques (REST). The statistical analysis of adjacency matrices was carried out using indices based on graph theory. Both CSD and REST reduced the influence of volume conducted currents. The largest group differences in connectivity were observed for the alpha band. Schizophrenic patients showed reduced connectivity strength, as well as a lower clustering coefficient and shorter characteristic path length for both measures of phase synchronization following CSD transformation or REST re-referencing. Reduced synchronization was accompanied by increased directional flow from the occipital region for the alpha band. Following the REST re-referencing, the sources of alpha activity were located at parietal rather than occipital derivations. The results of PLV and DTF demonstrated group differences in fronto-posterior asymmetry following CSD transformation, while for PLI the differences were significant only using REST. The only analysis that identified group differences in inter-hemispheric asymmetry was DTF calculated for REST. Our results suggest that a comparison of different connectivity measures using graph-based indices for each frequency band, separately, may be a useful tool in the study of disconnectivity disorders such as schizophrenia.

Decrease of Delta Oscillatory Responses in Cognitively Normal Parkinson's Disease

Parkinson's disease (PD) is a common progressive neurodegenerative disorder. This study aims to compare sensory-evoked oscillations (SEOs) and event-related oscillations (EROs) of visual modality in cognitively normal PD patients and healthy controls. Sixteen PD and 16 age-, gender-, and education-matched healthy controls participated in the study. A simple flashlight was used for SEO and a classical visual oddball paradigm was used for target ERO. Oscillatory responses in the delta frequency range (0.5-3.5 Hz) were examined. Significantly lower delta ERO and SEO responses were found in PD patients than healthy controls. Delta ERO responses were decreased at all frontal, central and parietal locations, whereas delta SEO responses were decreased over mid and right central locations in PD. According to the notion that SEO reflects the activity of sensory networks and ERO reflects cognitive networks, these findings indicate that PD patients have impairments in both cognitive and sensory networks of visual modality. Decreased delta ERO responses indicate that the subliminal cognitive changes in PD can be detected by electrophysiological methods. These results demonstrate that brain oscillatory responses have the potential to be studied as a biomarker for visual cognitive and sensory networks in PD.

The atypical dopamine receptor agonist SKF 83959 enhances hippocampal and prefrontal cortical neuronal network activity in a rat model of cognitive dysfunction

Deficits in neuronal network synchrony in hippocampus and prefrontal cortex have been widely demonstrated in disorders of cognitive dysfunction, including schizophrenia and Alzheimer's disease. The atypical dopamine agonist SKF 83959 has been shown to increase brain-derived neurotrophic factor signalling and suppress activity of glycogen synthase kinase-3 in PFC, two processes important to learning and memory. The purpose of this study was to therefore evaluate the impact of SKF 83959 on oscillatory deficits in methylazoxymethanol acetate (MAM) rat model of schizophrenia. To achieve this, local field potentials were recorded simultaneously from the hippocampus and prefrontal cortex of anesthetized rats at 15 and 90 min following both acute and repeated administration of SKF 83959 (0.4 mg/kg). In MAM rats, but not controls, repeated SKF 83959 treatment increased signal amplitude in hippocampus and enhanced the spectral power of low frequency delta and theta oscillations in this region. In PFC, SKF 83959 increased delta, theta and gamma spectral power. Increased HIP-PFC theta coherence was also evident following acute and repeated SKF 83959. In apparent contradiction to these oscillatory effects, in MAM rats, SKF 83959 inhibited spatial learning and induced a significant increase in thigmotactic behaviour. These findings have uncovered a previously unknown role for SKF 83959 in the positive regulation of hippocampal-prefrontal cortical oscillatory network activity. As SKF 83959 is known to have affinity for a number of receptors, delineating the receptor mechanisms that mediate the positive drug effects on neuronal oscillations could have significant future implications in disorders associated with cognitive dysfunction.

Whole genome sequence association and ancestry-informed polygenic profile of EEG alpha in a Native American population

EEG alpha activity is the dominant oscillation in most adult humans, is highly heritable, and has been associated with a number of cognitive functions. Two EEG phenotypes, low- and high-voltage alpha (LVA & HVA), have been demonstrated to have high heritabilities. They have different prevalence depending on a population's ancestral origins. In the present study we assessed the influence of ancestry admixture on EEG alpha power, and conducted a whole genome sequencing association analysis and an ancestry-informed polygenic study on those phenotypes in a Native American (NA) population that has a high prevalence of LVA. Seven common variants, in LD with each other upstream from gene ASIC2, reached genome-wide significance (p = 2 × 10-8 ) having a positive association with alpha voltage. They had lower minor allele frequencies in the NAs than in a global population sample. Overall correlations between lower degrees of NA (higher degree European) ancestry and HVA, and higher degrees of NA and LVA were also found. Additionally a rare-variant gene-based study identified gene TIA1 being negatively associated with LVA. Approximately 3% of SNPs exhibited a 15-fold enrichment that explained nearly half of the total SNP-heritability for EEG alpha. These regions showed the most significant anti-correlations between NA ancestry and alpha voltage, and were enriched for genes and pathways mediating cognitive functions. Our findings suggested that these regions likely harbor causal variants for HVA, and lacking of such variants could explain the high prevalence of LVA in this NA population, possibly illuminating the ancestral origin and genetic basis for EEG alpha.

Graph Theory and Brain Connectivity in Alzheimer's Disease

This article presents a review of recent advances in neuroscience research in the specific area of brain connectivity as a potential biomarker of Alzheimer's disease with a focus on the application of graph theory. The review will begin with a brief overview of connectivity and graph theory. Then resent advances in connectivity as a biomarker for Alzheimer's disease will be presented and analyzed.

Increased long distance event-related gamma band connectivity in Alzheimer's disease

BACKGROUND

Brain oscillatory responses can be used for non-invasive analyses of cortico-cortical connectivity, local neuronal synchronization, and coherence of oscillations in many neuropsychiatric conditions including Alzheimer's disease (AD). In the present paper, we examine sensory-evoked and event-related gamma coherences elicited by visual stimuli in three sub-gamma bands in two sub-groups of patients with AD (i.e., acetylcholinesterase-inhibitor treated and untreated) and healthy controls.

METHODS

We studied a total of 39 patients with probable mild AD (according to NINCDS-ADRDA criteria) who had been sub-divided into untreated (n = 21) and treated (n = 18) (patients either on cholinergic monotherapy or combined therapy with memantine) AD groups, and 21 age-, gender-, and education-matched healthy elderly controls. A simple flash visual paradigm was applied for the acquisition of sensory-evoked coherences. Event-related coherences were elicited using a classical visual oddball paradigm. Both sensory-evoked and event-related gamma coherences were calculated for long-distance intrahemispheric pairs for three frequency ranges: 25-30 Hz, 30-35 Hz, and 40-48 Hz in post-stimulus 0-800 ms duration. The long-distance intrahemispheric pairs from both sides were fronto-parietal, fronto-temporal, fronto-temporoparietal, fronto-occipital, centro-occipital and parieto-occipital.

RESULTS

The sensory-evoked or event-related gamma coherences revealed that both treated and untreated AD patients had significantly increased values compared to healthy controls in all three sub-gamma bands. Moreover, the treated AD patients demonstrated significantly higher fronto-parietal gamma coherences during both sensory stimulation and oddball paradigm and lower occipito-parietal coherences during oddball paradigm in comparison to untreated AD patients.

CONCLUSION

The present study demonstrated that an increase of gamma coherences was present in response to both visual sensory and cognitive stimulation in AD patients in all gamma sub-bands. Therefore, gamma oscillatory activity seems to be fundamental in brain functions at both the sensory and cognitive levels. The increase of gamma coherence values was not due to cholinergic treatment to any significant extent, as both treated and untreated AD patients had increased gamma coherence values compared to healthy controls. The use of coherence values reflecting brain connectivity holds potential for neuroimaging of AD and understanding brain dynamics related to the effects of medication.

Acute Exposure to Pacific Ciguatoxin Reduces Electroencephalogram Activity and Disrupts Neurotransmitter Metabolic Pathways in Motor Cortex

Ciguatera fish poisoning (CFP) is a common human food poisoning caused by consumption of ciguatoxin (CTX)-contaminated fish affecting over 50,000 people worldwide each year. CTXs are classified depending on their origin from the Pacific (P-CTXs), Indian Ocean (I-CTXs), and Caribbean (C-CTXs). P-CTX-1 is the most toxic CTX known and the major source of CFP causing an array of neurological symptoms. Neurological symptoms in some CFP patients last for several months or years; however, the underlying electrophysiological properties of acute exposure to CTXs remain unknown. Here, we used CTX purified from ciguatera fish sourced in the Pacific Ocean (P-CTX-1). Delta and theta electroencephalography (EEG) activity was reduced remarkably in 2 h and returned to normal in 6 h after a single exposure. However, second exposure to P-CTX-1 induced not only a further reduction in EEG activities but also a 2-week delay in returning to baseline EEG values. Ciguatoxicity was detected in the brain hours after the first and second exposure by mouse neuroblastoma assay. The spontaneous firing rate of single motor cortex neuron was reduced significantly measured by single-unit recording with high spatial resolution. Expression profile study of neurotransmitters using targeted profiling approach based on liquid chromatography-tandem mass spectrometry revealed an imbalance between excitatory and inhibitory neurotransmitters in the motor cortex. Our study provides a possible link between the brain oscillations and neurotransmitter release after acute exposure to P-CTX-1. Identification of EEG signatures and major metabolic pathways affected by P-CTX-1 provides new insight into potential biomarker development and therapeutic interventions.

Small-World Characteristics of Cortical Connectivity Changes in Acute Stroke

Background After cerebral ischemia, disruption and subsequent reorganization of functional connections occur both locally and remote to the lesion. Recently, complexity of brain connectivity has been described using graph theory, a mathematical approach that depicts important properties of complex systems by quantifying topologies of network representations. Functional and dynamic changes of brain connectivity can be reliably analyzed via electroencephalography (EEG) recordings even when they are not yet reflected in structural changes of connections. Objective We tested whether and how ischemic stroke in the acute stage may determine changes in small-worldness of cortical networks as measured by cortical sources of EEG. Methods Graph characteristics of EEG of 30 consecutive stroke patients in acute stage (no more than 5 days after the event) were examined. Connectivity analysis was performed using eLORETA in both hemispheres. Results Network rearrangements were mainly detected in delta, theta, and alpha bands when patients were compared with healthy subjects. In delta and alpha bands similar findings were observed in both hemispheres regardless of the side of ischemic lesion: bilaterally decreased small-worldness in the delta band and bilaterally increased small-worldness in the alpha2 band. In the theta band, bilaterally decreased small-worldness was observed only in patients with stroke in the left hemisphere. Conclusions After an acute stroke, brain cortex rearranges its network connections diffusely, in a frequency-dependent modality probably in order to face the new anatomical and functional frame.

Increased Event-Related Potentials and Alpha-, Beta-, and Gamma-Activity Associated with Intentional Actions

Objective: Internally guided actions are defined as being purposeful, self-generated and offering choices between alternatives. Intentional actions are essential to reach individual goals. In previous empirical studies, internally guided actions were predominantly related to functional responses in frontal and parietal areas. The aim of the present study was to distinguish event-related potentials and oscillatory responses of intentional actions and externally guided actions. In addition, we compared neurobiological findings of the decision which action to perform with those referring to the decision whether or not to perform an action.

Methods: Twenty-eight subjects participated in adapted go/nogo paradigms, including a voluntary selection condition allowing participants to (1) freely decide whether to press the response button or (2) to decide whether they wanted to press the response button with the right index finger or the left index finger.

Results: The reaction times were increased when participants freely decided whether and how they wanted to respond compared to the go condition. Intentional processes were associated with a fronto-centrally located N2 and P3 potential. N2 and P3 amplitudes were increased during intentional actions compared to instructed responses (go). In addition, increased activity in the alpha-, beta- and gamma-frequency range was shown during voluntary behavior rather than during externally guided responses.

Conclusion: These results may indicate that an additional cognitive process is needed for intentional actions compared to instructed behavior. However, the neural responses were comparatively independent of the kind of decision that was made (1) decision which action to perform; (2) decision whether or not to perform an action).

Significance: The study demonstrates the importance of fronto-central alpha-, beta-, and gamma oscillations for voluntary behavior.