Qualitative and quantitative EEG abnormalities in violent offenders with antisocial personality disorder

Electroencephalographic and morphometric abnormalities in psychopath offenders

The main goals of the present study were to replicate and extend current knowledge related to paralimbic dysfunctions associated with psychopathy. The research evaluated the quantitative electroencephalography, current density (CD) source and synchronization likelihood analysis during the rest condition and structural magnetic resonance imaging images to compare volumetric and cortical thickness, in inmates recruited from two prisons located in Havana City. The Psychopathy Checklist-Revised (PCL-R) was used as a quantitative measure of psychopathy. This study showed most beta energy and less alpha activity in male psychopath offenders. Low-resolution electromagnetic tomography signified an increase of beta activity in psychopath offender groups within paralimbic regions. The superior temporal gyrus volume was associated with the F1 factor while the fusiform, anterior cingulate and associative occipital areas were primarily associated with the F2 factor of PCL-R scale. Cortical thickness in the left dorsal anterior cingulate cortex and the temporal pole was negatively associated with PCL-R total score.

EEG Markers in Emotionally Unstable Personality Disorder-A Possible Outcome Measure for Neurofeedback: A Narrative Review

Objectives. There is growing evidence for the use of biofeedback (BF) in affective disorders, dissocial personality disorder, and in children with histories of abuse. Electroencephalogram (EEG) markers could be used as neurofeedback in emotionally unstable personality disorder (EUPD) management especially for those at high risk of suicide when emotionally aroused. This narrative review investigates the evidence for EEG markers in EUPD. Methods. PRISMA guidelines were used to conduct a narrative review. A structured search method was developed and implemented in collaboration with an information specialist. Studies were identified via 3 electronic database searches of MEDLINE, Embase, and PsycINFO. A predesigned inclusion/exclusion criterion was applied to selected papers. A thematic analysis approach with 5 criteria was used. Results. From an initial long list of 5250 papers, 229 studies were identified and screened, of which 44 met at least 3 of the predesigned inclusion criteria. No research to date investigates EEG-based neurofeedback in EUPD. A number of different EEG biomarkers are identified but there is poor consistency between studies. Conclusions. The findings heterogeneity may be due to the disorder complexity and the variable EEG related parameters studied. An alternative explanation may be that there are a number of different neuromarkers, which could be clustered together with clinical symptomatology, to give new subdomains. Quantitative EEGs in particular may be helpful to identify more specific abnormalities. EEG standardization of neurofeedback protocols based on specific EEG abnormalities detected may facilitate targeted use of neurofeedback as an intervention in EUPD.

Balancing the brain of offenders with psychopathy? Resting state EEG and electrodermal activity after a pilot study of brain self-regulation training

Although investigation of the brains of criminals began quite early in the history of psychophysiological research, little is known about brain plasticity of offenders with psychopathy. Building on our preliminary study reporting successful brain self-regulation using slow cortical potential (SCP) neurofeedback in offenders with psychopathy, we investigated the central nervous and autonomic peripheral changes occurring after brain self-regulation in a group of severe male offenders with psychopathy. Regarding the central nervous system, an overall suppression of the psychopathic overrepresentation of slow frequency bands was found, such as delta and theta band activity, after EEG neurofeedback. In addition, an increase in alpha band activity could be observed after the SCP self-regulation training. Electrodermal activity adaptively changed according to the regulation task, and this flexibility improved over training time. The results of this study point towards a constructive learning process and plasticity in neural and peripheral measures of offenders with psychopathy.

Sex Differences in QEEG in Psychopath Offenders

Introduction. Functional brain differences related to sex in psychopathic behavior represent an important field of neuroscience research; there are few studies on this area, mainly in offender samples. Objective. The aim of this study was to investigate the presence of electrophysiological differences between male and female psychopath offenders; specifically, we wanted to assess whether the results in quantitative EEG, low-resolution electromagnetic tomography (LORETA), and changes in synchronous brain activity could be related to sex influence. Sample and Methods. The study included 31 male and 12 female psychopath offenders, according to the Hare Psychopathy Checklist-Revised criteria from 2 prisons located in Havana City. The EEG visual inspection characteristics and the use of frequency domain quantitative analysis techniques are described. Results. The resting EEG visual analyses revealed a high percentage of EEG abnormalities in both studied groups. Significant statistical differences between the mean parameters of cross spectral measures between psychopathic offender groups were found in the beta band at bilateral frontal derivation and centroparietal areas. LORETA showed differences especially in the paralimbic and parieto-occipital areas Synchronization likelihood revealed a significant group effect in the 26 to 30 Hz band. These results indicate that combining quantitative EEG, LORETA analysis, and synchronization likelihood may improve the neurofunctional differentiation between psychopath offenders of both sexes.

Alteration of Testosterone Levels Changes Brain Wave Activity Patterns and Induces Aggressive Behavior in Rats

Testosterone is responsible for several changes in the brain, including behavioral and emotional responses, memory, and cognition. Given this, we investigated changes in the brain wave profile caused by supplementation with exogenous testosterone in both castrated and non-castrated rats. We also investigated the serum testosterone levels, renal and hepatic function, and the lipid and behavioral profiles. We found changes in the spectral wave power in both groups (castrated and non-castrated animals) supplemented with exogenous testosterone, consistent with an aggressive/hostile profile. These changes were observed in the electrocorticographic evaluation associated with increased power in low-frequency (delta and theta) and high-frequency (beta and gamma) activity in the supplemented animals. The castrated animals presented a significant decrease of wave power in the alpha frequency. This correlated with a decrease of the performance of the animals in the elevated plus-maze evaluation, given that the alpha wave is linked to the execution and visualization of motor processes. In the behavioral evaluation, the castrated animals presented a reduced permanence time in the elevated-plus maze, although this was prevented by the supplementation of testosterone. Testosterone supplementation induced aggressive behavior in non-castrated animals, but not in castrated ones. Supplemented animals had significantly elevated serum testosterone levels, while their urea levels were significantly lower, but without clinical significance. Our data indicate that testosterone supplementation in non-castrated rats, but not in castrated ones, causes electrocorticographic changes that could be associated with more aggressive and hostile behavior, in addition to indicating a potential for personality disorder. However, further studies are required to elucidate the cellular and molecular changes caused by acute testosterone supplementation.

Changes in Resting EEG in Colombian Ex-combatants ith Antisocial Personality Disorder

INTRODUCTION

Although the social and economic consequences of Colombian internal conflicts mainly affected the civilian population, they also had other implications. The ex-combatants, the other side of the conflict, have been the subject of many studies that question their personality structures and antisocial features. Results suggest that ex-combatants usually have characteristics of an antisocial personality disorder (ASPD) that is related with their behaviour.

METHODS

Quantitative EEG (qEEG) was used to evaluate differences in cortical activity patterns between an ex-combatants group and a control group. The Psychopathy Checklist-Revised (PCL-R) was used to assess the presence of ASPD in the ex-combatants group, as well as the Diagnostic Interview for Genetic Studies (DIGS) for other mental disorders classified in the DCI-10.

RESULTS

There are significant differences in psychopathy levels between groups, as well as in alpha-2 and beta waves, especially in left temporal and frontal areas for alpha-2 waves and left temporal-central regions for beta waves.

CONCLUSIONS

qEEG measurements allow spectral resting potential to be differentiated between groups that are related with features typically involved in antisocial personality disorder, and to correlate them with patterns in the questionnaires and clinical interview.

EEG in psychiatric practice: to do or not to do?

Electroencephalography (EEG) is a non-invasive investigation that can aid the diagnosis of psychiatric and neuropsychiatric disorders. A good predictor of an abnormal EEG recording is the presence of an organic factor identified during the clinical assessment. The non-invasiveness and low cost of the procedure and its ability to measure spontaneous brain activity appear to attract clinicians to utilise this investigative tool. However, studies have reported that EEGs arising from psychiatric referrals have the lowest abnormality detection rate. The focus of this article is to improve this by highlighting the current pitfalls and providing recommendations for appropriate utilisation of EEG. We describe specific EEG changes associated with major psychiatric disorders. We conclude by offering pragmatic considerations when referring a patient for EEG, emphasising the fact that the information provided to the neurophysiologist plays a crucial role in interpreting the EEG recording in a diagnostically meaningful way.

Neurofeedback Training for Psychiatric Disorders Associated with Criminal Offending: A Review

BACKGROUND

Effective treatment interventions for criminal offenders are necessary to reduce risk of criminal recidivism. Evidence about deviant electroencephalographic (EEG)-frequencies underlying disorders found in criminal offenders is accumulating. Yet, treatment modalities, such as neurofeedback, are rarely applied in the forensic psychiatric domain. Since offenders usually have multiple disorders, difficulties adhering to long-term treatment modalities, and are highly vulnerable for psychiatric decompensation, more information about neurofeedback training protocols, number of sessions, and expected symptom reduction is necessary before it can be successfully used in offender populations.

METHOD

Studies were analyzed that used neurofeedback in adult criminal offenders, and in disorders these patients present with. Specifically aggression, violence, recidivism, offending, psychopathy, schizophrenia, attention-deficit hyperactivity disorder (ADHD), substance-use disorder (SUD), and cluster B personality disorders were included. Only studies that reported changes in EEG-frequencies posttreatment (increase/decrease/no change in EEG amplitude/power) were included.

RESULTS

Databases Psychinfo and Pubmed were searched in the period 1990-2017 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resulting in a total of 10 studies. Studies in which neurofeedback was applied in ADHD (N = 3), SUD (N = 3), schizophrenia (N = 3), and psychopathy (N = 1) could be identified. No studies could be identified for neurofeedback applied in cluster B personality disorders, aggression, violence, or recidivism in criminal offenders. For all treatment populations and neurofeedback protocols, number of sessions varied greatly. Changes in behavioral levels ranged from no improvements to significant symptom reduction after neurofeedback training. The results are also mixed concerning posttreatment changes in targeted EEG-frequency bands. Only three studies established criteria for EEG-learning.

CONCLUSION

Implications of the results for the applicability of neurofeedback training in criminal offender populations are discussed. More research focusing on neurofeedback and learning of cortical activity regulation is needed in populations with externalizing behaviors associated with violence and criminal behavior, as well as multiple comorbidities. At this point, it is unclear whether standard neurofeedback training protocols can be applied in offender populations, or whether QEEG-guided neurofeedback is a better choice. Given the special context in which the studies are executed, clinical trials, as well as single-case experimental designs, might be more feasible than large double-blind randomized controls.

Is excessive electroencephalography beta activity associated with delinquent behavior in men with attention-deficit hyperactivity disorder symptomatology?

BACKGROUND/AIMS

The attention-deficit/hyperactivity disorder (ADHD) shows an increased prevalence in delinquents compared to the normal population. In recent studies, a subgroup of subjects with ADHD as well as a subgroup of delinquents displayed excessive electroencephalography (EEG) beta activity, which has been associated with antisocial behavior in ADHD children. We investigated whether delinquent behavior in adults with ADHD symptomatology is related to excessive beta activity.

METHODS

We compared the resting state EEGs (eyes open/closed) of delinquent and nondelinquent subjects with ADHD symptoms and those of a control group regarding EEG power spectra and topography.

RESULTS

Delinquents with ADHD symptomatology showed more beta power at frontal, central and parietal brain regions than nondelinquents with ADHD symptoms.

CONCLUSION

Excessive beta power may thus represent a risk factor for delinquent behavior in adults with ADHD symptomatology. The awareness of such a risk factor may be helpful in the assessment of the risk for delinquent behavior in a psychiatric context and may provide a neurobiological background for therapeutic interventions.

Brain self-regulation in criminal psychopaths

Psychopathic individuals are characterized by impaired affective processing, impulsivity, sensation-seeking, poor planning skills and heightened aggressiveness with poor self-regulation. Based on brain self-regulation studies using neurofeedback of Slow Cortical Potentials (SCPs) in disorders associated with a dysregulation of cortical activity thresholds and evidence of deficient cortical functioning in psychopathy, a neurobiological approach seems to be promising in the treatment of psychopathy. The results of our intensive brain regulation intervention demonstrate, that psychopathic offenders are able to gain control of their brain excitability over fronto-central brain areas. After SCP self-regulation training, we observed reduced aggression, impulsivity and behavioral approach tendencies, as well as improvements in behavioral-inhibition and increased cortical sensitivity for error-processing. This study demonstrates improvements on the neurophysiological, behavioral and subjective level in severe psychopathic offenders after SCP-neurofeedback training and could constitute a novel neurobiologically-based treatment for a seemingly change-resistant group of criminal psychopaths.

Altered sleep in Borderline Personality Disorder in relation to the core dimensions of psychopathology

The aim of the study was to review the literature regarding sleep disturbances in Borderline Personality Disorder (BPD) and to relate the reported sleep alterations to the underlying core dimensions of BPD pathology. We present a qualitative and theoretical review regarding the empirical studies that investigated objective and subjective sleep quality in BPD and in different psychiatric conditions showing high co-morbidity with this disorder. We show that disturbed sleep including sleep fragmentation, alterations in Slow Wave Sleep and REM sleep, and dysphoric dreaming are prevalent symptoms in BPD. We provide a framework relating the specific sleep alterations to the core dimensions of BPD pathology in order to clarify the inconsistencies of the different findings. The specific sleep disturbances in BPD seem to be related to different dimensions of psychopathological functioning and may have detrimental consequences on waking affect and cognition. Investigating disturbed sleep in BPD in relation to waking symptoms and underlying neural functioning would shed more light on the nature of this complex disorder. Moreover, a stronger emphasis on sleep disturbances would enrich the treatment protocols of BPD.

Multimodal quantitative neuroimaging databases and methods: the Cuban Human Brain Mapping Project

This article reviews the contributions of the Cuban Neuroscience Center to the evolution of the statistical parametric mapping (SPM) of quantitative Multimodal Neuroimages (qMN), from its inception to more recent work. Attention is limited to methods that compare individual qMN to normative databases (n/qMN). This evolution is described in three successive stages: (a) the development of one variant of normative topographical quantitative EEG (n/qEEG-top) which carries out statistical comparison of individual EEG spectral topographies with regard to a normative database--as part of the now popular SPM of brain descriptive parameters; (b) the development of n/qEEG tomography (n/qEEG-TOM), which employs brain electrical tomography (BET) to calculate voxelwise SPM maps of source spectral features with respect to a norm; (c) the development of a more general n/qMN by substituting EEG parameters with other neuroimaging descriptive parameters to obtain SPM maps. The study also describes the creation of Cuban normative databases, starting with the Cuban EEG database obtained in the early 90s, and more recently, the Cuban Human Brain Mapping Project (CHBMP). This project has created a 240 subject database of the normal Cuban population, obtained from a population-based random sample, comprising clinical, neuropsychological, EEG, MRI and SPECT data for the same subjects. Examples of clinical studies using qMN are given and, more importantly, receiver operator characteristics (ROC) analyses of the different developments document a sustained effort to assess the clinical usefulness of the techniques.

Quantitative electroencephalographic abnormalities in fibromyalgia patients

There is increasing acceptance that pain in fibromyalgia (FM) is a result of dysfunctional sensory processing in the spinal cord and brain, and a number of recent imaging studies have demonstrated abnormal central mechanisms. The objective of this report is to statistically compare quantitative electroencephalogram (qEEG) measures in 85 FM patients with age and gender matched controls in a normative database. A statistically significant sample (minimum 60 seconds from each subject) of artifact-free EEG data exhibiting a minimum split-half reliability ratio of 0.95 and test-retest reliability ratio of 0.90 was used as the threshold for acceptable data inclusion. FM subject EEG data was compared to EEGs of age and gender matched healthy subjects in the Lifespan Normative Database and analyzed using NeuroGuide 2.0 software. Analyses were based on spectral absolute power, relative power and coherence. Clinical evaluations included the Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory and Fischer dolorimetry for pain pressure thresholds. Based on Z-statistic findings, the EEGs from FM subjects differed from matched controls in the normative database in three features: (1) reduced EEG spectral absolute power in the frontal International 10-20 EEG measurement sites, particularly in the low- to mid-frequency EEG spectral segments; (2) elevated spectral relative power of high frequency components in frontal/central EEG measurement sites; and (3) widespread hypocoherence, particularly in low- to mid-frequency EEG spectral segments, in the frontal EEG measurement sites. A consistent and significant negative correlation was found between pain severity and the magnitude of the EEG abnormalities. No relationship between EEG findings and medicine use was found. It is concluded that qEEG analysis reveals significant differences between FM patients compared to age and gender matched healthy controls in a normative database, and has the potential to be a clinically useful tool for assessing brain function in FM patients.