Auditory P3a assessment of male alcoholics

Effect of retrieval reward on episodic recognition with different difficulty: ERP evidence

Previous studies found that the reward effect is stronger in more difficult retrieval tasks of item memory. However, it remains unclear whether the effect of reward is influenced by the memory task difficulty level in the source memory. We investigated the effects and neural mechanisms of the processing depth during encoding and rewards at retrieval on the item and source memory using event-related potentials (ERPs). Participants were required to carry out the congruity-judgment (deep processing) and size-judgment (shallow processing) tasks during encoding, and they completed separate object and background tests (half presented with reward) immediately after encoding. The results revealed that congruity-judgment (compare to size-judgment) task had longer response time in encoding phase, and evoked significantly greater reward differences at Prs (the hit rate minus the false alarm rate) in item retrieval, and the reward (relative to no reward) significantly improved recognition accuracy in source retrieval. ERP results also showed that congruity-judgment (compare to size-judgment) task evoked the larger N170, P3a, LPP and a decreased P3b of the stimuli in encoding phase, and elicited the wider distribution of LPC and LPN reward effects (i.e., the average amplitudes under the reward condition were significantly more positive than under the non-reward condition) in item retrieval, and the reward effects at FN400, LPC, and LPN were found only in the congruity-judged items with optimal difficulty in source retrieval. The results suggest that reward at retrieval evoked a greater boost in the congruity-judged stimuli, whether in item or source retrieval, which maybe be related to their optimal retrieval difficulty (Pr is closer to medium 0.50). This meant that the reward is more effective in memory retrieval with optimal difficulty.

The effect of cognitive reappraisal and expression suppression on sadness and the recognition of sad scenes: An event-related potential study

Previous studies have found differences in the cognitive and neural mechanisms between cognitive reappraisal and expression suppression in the regulation of various negative emotions and the recognition of regulated stimuli. However, whether these differences are valid for sadness remains unclear. As such, we investigated the effect of cognitive reappraisal and expression suppression on sadness regulation and the recognition of sad scenes adopting event-related potentials (ERPs). Twenty-eight healthy undergraduate and graduate students took part in this study. In the regulation phase, the participants were asked to down-regulation, expressive suppression, or maintain their sad emotion evoked by the sad images, and then to perform an immediately unexpected recognition task involving the regulated images. The behavioral results show that down-regulation reappraisal significantly diminished subjective feelings of sadness, but expressive suppression did not; both strategies impaired the participants' recognition of sad images, and expressive suppression had a greater damaging effect on the recognition of sad images than down-regulation reappraisal. The ERP results indicate that reappraisal (from 300 ms to 1,500 ms after image onset) and expressive suppression (during 300-600 ms) significantly reduced the late positive potential (LPP) induced by sadness. These findings suggest that down-regulation reappraisal and expression suppression can effectively decrease sadness, and that down-regulation reappraisal (relative to expression suppression) is a more effective regulation strategy for sadness. Both strategies impair the recognition of sad scenes, and expression suppression (compared to down-regulation reappraisal) leads to relatively greater impairment in the recognition of sad scenes.

Encoding tasks moderated the reward effect on brain activity during memory retrieval

Previous studies have explored the effects of retrieval reward and depth of processing in encoding on recognition, but it remains unclear whether and how reward and depth of processing during encoding influence recognition. We investigated the effect and neural mechanisms of encoding reward and processing depth on recognition using event-related potentials (ERPs) in this study. In the study phase, participants were asked to perform two encoding tasks: congruity-judgment (deep processing) and size-judgment (shallow processing) in reward and no-reward conditions. The test phases included object (item) and background (source) tests. The results of item retrieval showed that the accuracy of rewarded items was higher than that of unrewarded items only in the congruity-judgment task, and the reward effect (the average amplitudes in the reward condition were significantly more positive than those in the no-reward condition) in the 300–500 and 500–700 ms were greater in the congruity-judgment task than in the size-judgment task. The results of source retrieval showed that the accuracy of rewarded items was higher than that of unrewarded items, that the difference in the size-judgment task was significantly larger, and that the reward effect in the 300–500 and 500–700 ms were greater in the size-judgment task than in the congruity-judgment task. In conclusion, the encoding task moderated the reward effect in item and source memory.

Association of lifetime major depressive disorder with enhanced attentional sensitivity measured with P3 response in young adult twins

Major depression is associated with alterations in the auditory P3 event-related potential (ERP). However, the persistence of these abnormalities after recovery from depressive episodes, especially in young adults, is not well known. Furthermore, the potential influence of substance use on this association is poorly understood. Young adult twin pairs (N=177) from the longitudinal FinnTwin16 study were studied with a psychiatric interview, and P3a and P3b ERPs elicited by task-irrelevant novel sounds and targets, respectively. Dyadic linear mixed-effect models were used to distinguish the effects of lifetime major depressive disorder from familial factors and effects of alcohol problem drinking and tobacco smoking. P3a amplitude was significantly increased and P3b latency decreased, in individuals with a history of lifetime major depression, when controlling the fixed effects of alcohol abuse, tobacco, gender, twins' birth order, and zygosity. These results suggest that past lifetime major depressive disorder may be associated with enhanced attentional sensitivity.

The Effects of Reward on Associative Memory Depend on Unitization Depths

Previous studies have found that reward effect is stronger for more difficult to retrieve items, but whether this effect holds true for the associative memory remains unclear too. We investigated the effects and neural mechanisms of the different unitization depths and reward sets on encoding associative memory using event-related potentials (ERPs), which were recorded through a Neuroscan system with a 64-channel electrode cap according to the international 10–20 system, and five electrodes (Fz, FCz, Cz, CPz, and Pz) were selected for analysis. Thirty healthy college students took part in this study. During encoding, participants were carried out two encoding tasks, a congruity-judgment task with high unitization and a color-judgment task with low unitization, with half of the items rewarded. The test phase was conducted immediately after the encoding phase. The results for false alarm rates and Prs (i.e., hit rates for old pairs minus false alarm rates for new pairs) in relational retrieval revealed that the reward differences in the color-judgment task were greater than those in the congruity-judgment task. The ERP results further showed significant reward effects (i.e., the reward significantly improved the average amplitudes compared to no reward) at P300 (300–500 ms) and LPP (500–800 ms) in the color-judgment task both for intact and rearranged items, and the reward effects at LPP (electrodes Fz, FCz, Cz, CPz, and Pz) were distributed more widely than the reward effects at P300 (electrodes Fz and FCz) in the color-judgment task. These results suggest that reward provided a greater boost when retrieving associative memory of low unitized items.

Neuropsychophysiological Measures of Alcohol Dependence: Can We Use EEG in the Clinical Assessment?

Addiction management is complex, and it requires a bio-psycho-social perspective, that ought to consider the multiple etiological and developmental factors. Because of this, a large amount of resources has been allocated to assess the vulnerability to dependence, i.e., to identify the processes underlying the transition from substance use to dependence, as well as its course, in order to determine the key points in its prevention, treatment, and recovery. Consequently, knowledge \from neuroscience must be taken into account, which is why different initiatives have emerged with this objective, such as the "Research Domain Criteria" (RDoC), and the "Addiction Neuroclinical Assessment" (ANA). Particularly, neuropsychophysiological measures could be used as markers of cognitive and behavioral attributes or traits in alcohol dependence, and even trace clinical change. In this way, the aim of this narrative review is to provide an overview following ANA clinical framework, to the most robust findings in neuropsychophysiological changes in alcohol dependence, that underlie the main cognitive domains implicated in addiction: incentive salience, negative emotionality, and executive functioning. The most consistent results have been found in event-related potential (ERP) analysis, especially in the P3 component, that could show a wide clinical utility, mainly for the executive functions. The review also shows the usefulness of other components, implicated in affective and substance-related processing (P1, N1, or the late positive potential LPP), as well as event-related oscillations, such as theta power, with a possible use as vulnerability or clinical marker in alcohol dependence. Finally, new tools emerging from psychophysiology research, based on functional connectivity or brain graph analysis could help toward a better understanding of altered circuits in alcohol dependence, as well as communication efficiency and effort during mental operations. This review concludes with an examination of these tools as possible markers in the clinical field and discusses methodological differences, the need for more replicability studies and incipient lines of work. It also uses consistent findings in psychophysiology to draw possible treatment targets and cognitive profiles in alcohol dependence.

The P300 in alcohol use disorder: A meta-analysis and meta-regression

OBJECTIVE

The P300 ERP component is a marker of reduced capacity in alcohol use disorder (AUD) to engage attentional mechanisms and update memory representations. No meta-analysis to date has been completed comparing effect size estimates of auditory vs. visual stimuli in AUD. In addition, there is a lack of consensus on whether the P3b in women is reduced, or whether the P3a - an earlier, more frontally distributed component - is reduced in AUD.

METHODS

Strict inclusion criteria and data-analysis plans were implemented. Eligible studies needed to diagnose AUD using DSM or ICD-10 and exclude patients with any psychiatric co-morbidities. Data analysis was completed using a refined variance estimator of the random effects model.

RESULTS

Effect size estimates were large for both auditory (Hedges' g = 1.01, p = .056) and visual (Hedges' g = 0.77, p = .040) P300 amplitudes, but only marginally significant for the auditory modality. Auditory P300 latency was significantly increased in AUD patients (Hedges' g = 0.73, p = .027). The moderator analysis did not show significant sex differences for either auditory (p = .97) or visual (p = .45) P3b. Finally, the P3a was not reduced in patients with AUD (Hedges' g = 1.01; p = .59).

CONCLUSION

This meta-analysis clarifies important questions related to P300 in AUD. By resolving inconsistencies, it is hoped that this information will facilitate the design of futurestudies.

Event-related evoked potential versus clinical tests in assessment of subclinical cognitive impairment in chronic hepatitis C virus

Context

Chronic infection by hepatitis C virus causes impairment in neurocognitive function in up to 50% of patients which may not be detected by clinical tests.

Aim

Early detection of neurocognitive impairment in chronic hepatitis C patients and investigating the cognitive function in HCV patient by p300 and clinical test.

Materials and methods

The study included 60 patients with chronic hepatitis C and 30 healthy controls. Participants were subjected to a biochemical, hematological assessment, mini-mental state examination, Montreal Cognitive Assessment, P300, polymerase chain reaction (PCR), and fibroscan made for hepatitis C patients.

Results

The digit span, attention, concentration, and memory were significantly lower in patients than controls. The delayed P300 peak latency and the reduction of its amplitude were significantly evident in patients with liver fibrosis than the controls and patients without fibrosis. These abnormalities were significantly higher with increasing the grade of fibrosis. All patients with cognitive impairment (reduced mini-mental state score) had abnormal P300-evoked responses. P300 could detect neurocognitive impairment in some patients with normal neurocognitive functions by clinical test. P300 had sensitivity (100%), specificity (59.26), positive predictive value (75%), negative predictive value (100%), and accuracy (81.67) in the detection of neurocognitive impairment in HCV patient.

Conclusion

Patients with chronic hepatitis C infection had significant impairment in their cognitive functions. This impairment increases with the increase in grade of hepatic fibrosis. P300 can detect minimal and subclinical impairment of cognitive function at early stages of chronic hepatitis with accuracy (81.67).

Trial registration

PACTR on 19 march 2018 retrospectively. Identification number for the registry is PACTR201804003215168.

A review on EEG-based methods for screening and diagnosing alcohol use disorder

The screening test for alcohol use disorder (AUD) patients has been of subjective nature and could be misleading in particular cases such as a misreporting the actual quantity of alcohol intake. Although the neuroimaging modality such as electroencephalography (EEG) has shown promising research results in achieving objectivity during the screening and diagnosis of AUD patients. However, the translation of these findings for clinical applications has been largely understudied and hence less clear. This study advocates the use of EEG as a diagnostic and screening tool for AUD patients that may help the clinicians during clinical decision making. In this context, a comprehensive review on EEG-based methods is provided including related electrophysiological techniques reported in the literature. More specifically, the EEG abnormalities associated with the conditions of AUD patients are summarized. The aim is to explore the potentials of objective techniques involving quantities/features derived from resting EEG, event-related potentials or event-related oscillations data.

Methodological Considerations about the Use of Bimodal Oddball P300 in Psychiatry: Topography and Reference Effect

Event-related potentials (ERPs) bimodal oddball task has disclosed increased sensitivity to show P300 modulations to subclinical symptoms. Even if the utility of such a procedure has still to be confirmed at a clinical level, gathering normative values of this new oddball variant may be of the greatest interest. We specifically addressed the challenge of defining the best location for the recording of P3a and P3b components and selecting the best reference to use by investigating the effect of an offline re-reference procedure on recorded bimodal P3a and P3b. Forty young and healthy subjects were submitted to a bimodal (synchronized and always congruent visual and auditory stimuli) three-stimulus oddball task in which 140 frequent bimodal stimuli, 30 deviant “target” stimuli and 30 distractors were presented. Task consisted in clicking as soon as possible on the targets, and not paying attention to frequent stimuli and distractors. This procedure allowed us to record, for each individual, the P3a component, referring to the novelty process related to distractors processing, and the P3b component, linked to the processing of the target stimuli. Results showed that both P3a and P3b showed maximal amplitude in Pz. However, P3a displayed a more central distribution. Nose reference was also shown to give maximal amplitudes compared with average and linked mastoids references. These data were discussed in light of the necessity to develop multi-site recording guidelines to furnish sets of ERPs data comparable across laboratories.

Reward processing deficits and impulsivity in high-risk offspring of alcoholics: A study of event-related potentials during a monetary gambling task

BACKGROUND

Individuals at high risk to develop alcoholism often manifest neurocognitive deficits as well as increased impulsivity. The goal of the present study is to elucidate reward processing deficits, externalizing disorders, and impulsivity as elicited by electrophysiological, clinical and behavioral measures in subjects at high risk for alcoholism from families densely affected by alcoholism in the context of brain maturation across age groups and gender.

METHODS

Event-related potentials (ERPs) and current source density (CSD) during a monetary gambling task (MGT) were measured in 12-25 year old offspring (N=1864) of families in the Collaborative Study on the Genetics of Alcoholism (COGA) Prospective study; the high risk (HR, N=1569) subjects were from families densely affected with alcoholism and the low risk (LR, N=295) subjects were from community families. Externalizing disorders and impulsivity scores were also compared between LR and HR groups.

RESULTS

HR offspring from older (16-25 years) male and younger (12-15 years) female subgroups showed lower P3 amplitude than LR subjects. The amplitude decrement was most prominent in HR males during the loss condition. Overall, P3 amplitude increase at anterior sites and decrease at posterior areas were seen in older compared to younger subjects, suggesting frontalization during brain maturation. The HR subgroups also exhibited hypofrontality manifested as weaker CSD activity during both loss and gain conditions at frontal regions. Further, the HR subjects had higher impulsivity scores and increased prevalence of externalizing disorders. P3 amplitudes during the gain condition were negatively correlated with impulsivity scores.

CONCLUSIONS

Older male and younger female HR offspring, compared to their LR counterparts, manifested reward processing deficits as indexed by lower P3 amplitude and weaker CSD activity, along with higher prevalence of externalizing disorders and higher impulsivity scores.

SIGNIFICANCE

Reward related P3 is a valuable measure reflecting neurocognitive dysfunction in subjects at risk for alcoholism, as well as to characterize reward processing and brain maturation across gender and age group.

The use of current source density as electrophysiological correlates in neuropsychiatric disorders: A review of human studies

The use of current source density (CSD), the Laplacian of the scalp surface voltage, to map the electrical activity of the brain is a powerful method in studies of cognitive and affective phenomena. During the last few decades, mapping of CSD has been successfully applied to characterize several neuropsychiatric conditions such as alcoholism, schizophrenia, depression, anxiety disorders, childhood/developmental disorders, and neurological conditions (i.e., epilepsy and brain lesions) using electrophysiological data from resting state and during cognitive performance. The use of CSD and Laplacian measures has proven effective in elucidating topographic and activation differences between groups: i) patients with a specific diagnosis vs. healthy controls, ii) subjects at high risk for a specific diagnosis vs. low risk or normal controls, and iii) patients with specific symptom(s) vs. patients without these symptom(s). The present review outlines and summarizes the studies that have employed CSD measures in investigating several neuropsychiatric conditions. The advantages and potential of CSD-based methods in clinical and research applications along with some of the limitations inherent in the CSD-based methods are discussed in the review, as well as future directions to expand the implementation of CSD to other potential clinical applications. As CSD methods have proved to be more advantageous than using scalp potential data to understand topographic and source activations, its clinical applications offer promising potential, not only for a better understanding of a range of psychiatric conditions, but also for a variety of focal neurological disorders, including epilepsy and other conditions involving brain lesions and surgical interventions.

Understanding alcohol use disorders with neuroelectrophysiology

Neurocognitive deficits associated with impairments in various brain regions and neural circuitries, particularly involving frontal lobes, have been associated with chronic alcoholism, as well as with a predisposition to develop alcohol use and related disorders (AUDs). AUD is a multifactorial disorder caused by complex interactions between behavioral, genetic, and environmental liabilities. Neuroelectrophysiologic techniques are instrumental in understanding brain and behavior relationships and have also proved very useful in evaluating the genetic diathesis of alcoholism. This chapter describes findings from neuroelectrophysiologic measures (electroencephalogram, event-related potentials, and event-related oscillations) related to acute and chronic effects of alcohol on the brain and those that reflect underlying deficits related to a predisposition to develop AUDs and related disorders. The utility of these measures as effective endophenotypes to identify and understand genes associated with brain electrophysiology, cognitive networks, and AUDs has also been discussed.

Effects of memantine on event-related potential, oscillations, and complexity in individuals with and without family histories of alcoholism

OBJECTIVE

Enhanced N-methyl-D-aspartate (NMDA) receptor function associated with a positive family history of alcoholism (FHP) has been hypothesized to contribute to the heritable risk for alcoholism. The objective of this study was to evaluate the relationship of alcoholism family history, NMDA receptor function, and cortical information processing by testing acute effects of the NMDA receptor antagonist memantine on event-related potential (ERP).

METHOD

Twenty-two healthy FHP and 20 healthy family history-negative (FHN; no alcoholic relatives) subjects were administered placebo or 40 mg of memantine under double-blind counterbalanced conditions on two separate occasions. Electroencephalogram data were collected from eight channels with eyes open during an auditory oddball discrimination task. We evaluated P3b amplitude, total theta, alpha activity, and fractal dimension from ERP trials.

RESULTS

FHP and FHN subjects did not differ in P3b amplitude. A significant Group × Drug interaction was observed in theta, alpha activity, and fractal dimension at the parietal and occipital sites. FHP individuals exhibited significantly higher fractal dimension and lower theta and alpha activity after placebo relative to FHN subjects. Following memantine administration, theta activity decreased in both groups but more markedly for FHN individuals. Alpha activity decreased for FHN subjects and increased for FHP individuals, whereas the fractal dimension decreased for FHP subjects and increased for FHN subjects after memantine.

CONCLUSIONS

A plausible interpretation of these results is that FHP individuals may have altered NMDA receptor function compared with FHN individuals. These findings provide additional evidence of differences in the regulation of NMDA receptor function between FHP and FHN individuals.

Hyperactivation of right inferior frontal cortex in young binge drinkers during response inhibition: a follow-up study

AIMS

The objective of this study was to examine brain activity, with particular attention to prefrontal function, during response execution and inhibition in youths who have engaged in binge drinking (BD) for at least 2 years.

DESIGN

Event-related potentials (ERPs) were recorded twice within 3 years, during performance of a Go/NoGo task.

SETTING

The study was part of a longitudinal study of the neurocognitive effects of BD.

PARTICIPANTS

A total of 48 undergraduate students, 25 controls (14 females) and 23 binge drinkers (10 females), with no personal or family history of alcoholism or psychopathological disorders.

MEASUREMENTS

The Go-P3 and NoGo-P3 components of the ERPs were examined by principal component analysis and exact low-resolution tomography analysis (eLORETA).

FINDINGS

Binge drinkers showed larger Go-P3 amplitudes than controls in the first and second evaluations (P = 0.019). They also showed larger NoGo-P3 amplitude in the second evaluation (P = 0.002). eLORETA analyses in the second evaluation revealed significantly greater activation of the right inferior frontal cortex (rIFC) in binge drinkers than in controls during successful inhibition (P < 0.05).

CONCLUSIONS

Young binge drinkers appear to show abnormal brain activity as measured by event-related potentials during response execution and inhibition which may represent a neural antecedent of difficulties in impulse control.

Neurocognitive deficits in male alcoholics: an ERP/sLORETA analysis of the N2 component in an equal probability Go/NoGo task

In alcoholism research, studies concerning time-locked electrophysiological aspects of response inhibition have concentrated mainly on the P3 component of the event-related potential (ERP). The objective of the present study was to investigate the N2 component of the ERP to elucidate possible brain dysfunction related to the motor response and its inhibition using a Go/NoGo task in alcoholics. The sample consisted of 78 abstinent alcoholic males and 58 healthy male controls. The N2 peak was compared across group and task conditions. Alcoholics showed significantly reduced N2 peak amplitudes compared to normal controls for Go as well as NoGo task conditions. Control subjects showed significantly larger NoGo than Go N2 amplitudes at frontal regions, whereas alcoholics did not show any differences between task conditions at frontal regions. Standardized low resolution electromagnetic tomography analysis (sLORETA) indicated that alcoholics had significantly lower current density at the source than control subjects for the NoGo condition at bilateral anterior prefrontal regions, whereas the differences between groups during the Go trials were not statistically significant. Furthermore, NoGo current density across both groups revealed significantly more activation in bilateral anterior cingulate cortical (ACC) areas, with the maximum activation in the right cingulate regions. However, the magnitude of this difference was much less in alcoholics compared to control subjects. These findings suggest that alcoholics may have deficits in effortful processing during the motor response and its inhibition, suggestive of possible frontal lobe dysfunction.

The P300 event-related brain potential as a neurobiological endophenotype for substance use disorders: a meta-analytic investigation

Endophenotypes are intermediate phenotypes on the putative causal pathway from genotype to phenotype and can aid in discovering the genetic etiology of a disorder. There are currently very few suitable endophenotypes available for substance use disorders (SUD). The amplitude of the P300 event-related brain potential is a possible candidate. The present study determined whether the P300 amplitude fulfils two fundamental criteria for an endophenotype: (1) an association with the disorder (disease marker), and (2) presence in unaffected biological relatives of those who have the disorder (vulnerability marker). For this purpose, two separate meta-analyses were performed. Meta-analysis 1 investigated the P300 amplitude in relation to SUD in 39 studies and Meta-analysis 2 investigated P300 amplitude in relation to a family history (FH+) of SUD in 35 studies. The findings indicate that a reduced P300 amplitude is significantly associated with SUD (d=0.51) and, though to a lesser extent, with a FH+ of SUD (d=0.28). As a disease maker, the association between reduced P300 amplitude and SUD is significantly larger for participants that were exclusively recruited from treatment facilities (d=0.67) than by other methods (i.e., community samples and family studies; d=0.45 and 0.32, respectively), and larger for abstinent SUD patients (d=0.71) than for current substance users (d=0.37). Furthermore, in contrast to FH+ males, a P300 amplitude reduction seems not to be present in FH+ females (d=-0.07). Taken together, these results suggest that P300 amplitude reduction can be both a useful disease and vulnerability marker and is a promising neurobiological endophenotype for SUD, though only in males. Implications and future directions are discussed.

Topography, power, and current source density of θ oscillations during reward processing as markers for alcohol dependence

Recent studies have linked alcoholism with a dysfunctional neural reward system. Although several electrophysiological studies have explored reward processing in healthy individuals, such studies in alcohol-dependent individuals are quite rare. The present study examines theta oscillations during reward processing in abstinent alcoholics. The electroencephalogram (EEG) was recorded in 38 abstinent alcoholics and 38 healthy controls as they performed a single outcome gambling task, which involved outcomes of either loss or gain of an amount (10 or 50¢) that was bet. Event-related theta band (3.0-7.0 Hz) power following each outcome stimulus was computed using the S-transform method. Theta power at the time window of the outcome-related negativity (ORN) and positivity (ORP) (200-500 ms) was compared across groups and outcome conditions. Additionally, behavioral data of impulsivity and task performance were analyzed. The alcoholic group showed significantly decreased theta power during reward processing compared to controls. Current source density (CSD) maps of alcoholics revealed weaker and diffuse source activity for all conditions and weaker bilateral prefrontal sources during the Loss 50 condition when compared with controls who manifested stronger and focused midline sources. Furthermore, alcoholics exhibited increased impulsivity and risk-taking on the behavioral measures. A strong association between reduced anterior theta power and impulsive task-performance was observed. It is suggested that decreased power and weaker and diffuse CSD in alcoholics may be due to dysfunctional neural reward circuitry. The relationship among alcoholism, theta oscillations, reward processing, and impulsivity could offer clues to understand brain circuitries that mediate reward processing and inhibitory control.

A longitudinal twin study of effects of adolescent alcohol abuse on the neurophysiology of attention and orienting

BACKGROUND

Long-term functional brain effects of adolescent alcohol abuse remain uncertain, partially because of difficulties in distinguishing inherited deficits from neuronal effects of ethanol and by confounds associated with alcohol abuse, especially nicotine exposure. We conducted a longitudinal twin study to determine neurocognitive effects of adolescent alcohol abuse, as measured with the auditory event-related potential (ERP) component P3, a putative marker of genetic vulnerability to alcoholism.

METHODS

Twin pairs (N=177; 150 selected for intrapair concordance/discordance for alcohol-related problems at age 18½) were recruited from ongoing studies of twins born 1975-1979 in Finland. Alcohol and tobacco use were assessed with questionnaires at ages 16, 17, 18½, and ~25, and by a structured psychiatric interview concurrent with the ERP testing at mean age 25.8. During ERP recordings, subjects were instructed to detect target tones within a train of frequent "standards" and to ignore occasional "novel" sounds. To distinguish familial factors from ethanol effects, ERP and self-reported alcohol use measures were incorporated into hierarchical multiple regression (HMR) analysis, and intrapair differences in ERP were associated with intra-pair differences in alcohol variables.

RESULTS

Novel-sound P3 amplitude correlated negatively with self-reported alcohol use in both between- and within-family analyses. No similar effect was observed for target-tone P3. HMR results suggest that twins' similarity for novel-sound P3 amplitude is modulated by their alcohol use, and this effect of alcohol use is influenced by genetic factors.

CONCLUSIONS

Our results, from a large sample of twins selected from a population-based registry for pairwise concordance/discordance for alcohol problems at 18½, demonstrate that adolescent alcohol abuse is associated with subtle neurophysiological changes in attention and orienting. The changes are reflected in decreased novel-sound P3 amplitude and may be modified by genetic factors.

Frontally mediated inhibitory processing and white matter microstructure: age and alcoholism effects

RATIONALE

The NOGO P3 event-related potential is a sensitive marker of alcoholism, relates to EEG oscillation in the δ and θ frequency ranges, and reflects activation of an inhibitory processing network. Degradation of white matter tracts related to age or alcoholism should negatively affect the oscillatory activity within the network.

OBJECTIVE

This study aims to evaluate the effect of alcoholism and age on δ and θ oscillations and the relationship between these oscillations and measures of white matter microstructural integrity.

METHODS

Data from ten long-term alcoholics to 25 nonalcoholic controls were used to derive P3 from Fz, Cz, and Pz using a visual GO/NOGO protocol. Total power and across trial phase synchrony measures were calculated for δ and θ frequencies. DTI, 1.5 T, data formed the basis of quantitative fiber tracking in the left and right cingulate bundles and the genu and splenium of the corpus callosum. Fractional anisotropy and diffusivity (λL and λT) measures were calculated from each tract.

RESULTS

NOGO P3 amplitude and δ power at Cz were smaller in alcoholics than controls. Lower δ total power was related to higher λT in the left and right cingulate bundles. GO P3 amplitude was lower and GO P3 latency was longer with advancing age, but none of the time-frequency analysis measures displayed significant age or diagnosis effects.

CONCLUSIONS

The relation of δ total power at CZ with λT in the cingulate bundles provides correlational evidence for a functional role of fronto-parietal white matter tracts in inhibitory processing.

Reduced resource optimization in male alcoholics: N400 in a lexical decision paradigm

BACKGROUND

Event Related Potential (ERP) studies have highlighted some measures, notably P3 amplitude, that are associated with both state and trait deficits in alcoholism, while studies examining N400 amplitude in alcoholism are few. The present study aims to examine differences in the N400 component, an electrophysiological correlate of semantic priming, in event-related potentials from a lexical decision task in 87 alcohol dependent subjects and 57 community controls.

METHODS

 Each subject was presented with 300 stimuli sequentially in a quasi-randomized design, where 150 stimuli were words and 150 were non-words. The subjects made a lexical decision indicating the word/non-word status with a button press. Among the words, 50 words (primed) were always preceded by their antonyms (prime, n=50), whereas the remaining 50 words were unrelated. N400 amplitude and latency measures were compiled from ERPs to the primed and unprimed words. Corresponding reaction time (RT) and response characteristics were also analyzed.

RESULTS

Control subjects revealed a significant attenuation of the N400 response to the primed word when compared to the unprimed word. Significantly less attenuation was observed in alcohol dependent subjects. No significant group differences were seen for latency and behavioral measures. All subjects had slower RT for unprimed words compared to primed words; however significantly less RT savings between the unprimed and primed condition was noted for alcoholics.

CONCLUSIONS

 These results suggest a reduced flexibility in the cognitive networks and a lack of resource optimization in alcoholics. The reduced attenuation of N400 during the primed condition in the alcohol dependent subjects may reflect an inability to engage similar neuronal substrates associated with semantic relatedness as seen in the controls. As diminished N400 attenuation during priming is observed in both alcoholics and high risk subjects, it may be a marker of risk and a good endophenotype for alcoholism.

Contributions of studies on alcohol use disorders to understanding cerebellar function

Neuropathological, neuropsychological, and neuroimaging studies of human alcoholism provide evidence for degradation of frontal, pontine, thalamic, and cerebellar brain sites and disturbed associated functions. Current studies using neuroimaging combined with examination of executive functions, traditionally considered the sole purview of the frontal lobes, have identified a role for the cerebellum serving as a compensatory processing adjunct to enable normal performance on challenging tasks tapping executive functions. This overview proposes that disruption of an executive frontocerebellar network is a major contributor to characteristic behaviors of alcoholism that, on the one hand, enable alcohol use disorders, and on the other hand, lead to compensation for dysfunctions in alcoholism traditionally considered frontally-based.

Dual tasking and working memory in alcoholism: relation to frontocerebellar circuitry

Controversy exists regarding the role of cerebellar systems in cognition and whether working memory compromise commonly marking alcoholism can be explained by compromise of nodes of corticocerebellar circuitry. We tested 17 alcoholics and 31 age-matched controls with dual-task, working memory paradigms. Interference tasks competed with verbal and spatial working memory tasks using low (three item) or high (six item) memory loads. Participants also underwent structural MRI to obtain volumes of nodes of the frontocerebellar system. On the verbal working memory task, both groups performed equally. On the spatial working memory with the high-load task, the alcoholic group was disproportionately more affected by the arithmetic distractor than were controls. In alcoholics, volumes of the left thalamus and left cerebellar Crus I volumes were more robust predictors of performance in the spatial working memory task with the arithmetic distractor than the left frontal superior cortex. In controls, volumes of the right middle frontal gyrus and right cerebellar Crus I were independent predictors over the left cerebellar Crus I, left thalamus, right superior parietal cortex, or left middle frontal gyrus of spatial working memory performance with tracking interference. The brain-behavior correlations suggest that alcoholics and controls relied on the integrity of certain nodes of corticocerebellar systems to perform these verbal and spatial working memory tasks, but that the specific pattern of relationships differed by group. The resulting brain structure-function patterns provide correlational support that components of this corticocerebellar system not typically related to normal performance in dual-task conditions may be available to augment otherwise dampened performance by alcoholics.

Chronic alcoholism: insights from neurophysiology

INTRODUCTION

Increasing knowledge of the anatomical structures and cellular processes underlying psychiatric disorders may help bridge the gap between clinical signs and basic physiological processes. Accordingly, considerable insight has been gained in recent years into a common psychiatric condition, i.e., chronic alcoholism.

MATERIAL AND METHODS

We reviewed various physiological parameters that are altered in chronic alcoholic patients compared to healthy individuals--continuous electroencephalogram, oculomotor measures, cognitive event-related potentials and event-related oscillations--to identify links between these physiological parameters, altered cognitive processes and specific clinical symptoms.

RESULTS

Alcoholic patients display: (1) high beta and theta power in the resting electroencephalogram, suggesting hyperarousal of their central nervous system; (2) abnormalities in smooth pursuit eye movements, in saccadic inhibition during antisaccade tasks, and in prepulse inhibition, suggesting disturbed attention modulation and abnormal patterns of prefrontal activation that may stem from the same prefrontal "inhibitory" cortical dysfunction; (3) decreased amplitude for cognitive event-related potentials situated along the continuum of information-processing, suggesting that alcoholism is associated with neurophysiological deficits at the level of the sensory cortex and not only disturbances involving associative cortices and limbic structures; and (4) decreased theta, gamma and delta oscillations, suggesting cognitive disinhibition at a functional level.

DISCUSSION

The heterogeneity of alcoholic disorders in terms of symptomatology, course and outcome is the result of various pathophysiological processes that physiological parameters may help to define. These alterations may be related to precise cognitive processes that could be easily monitored neurophysiologically in order to create more homogeneous subgroups of alcoholic individuals.

Social cognition in alcoholism: a link to prefrontal cortex dysfunction?

AIMS

Alcoholism is associated with a range of cognitive deficits. These deficits might be explained by the 'frontal lobe hypothesis' which suggests a specific vulnerability of the prefrontal cortex (PFC) to the neurotoxic effects of alcohol. Social cognition is thought to be processed in the PFC, but so far only few studies have addressed the issue of social cognition deficits in alcoholism. This review aims to evaluate the deficits in social cognition in alcoholic patients. In addition an outline for future perspectives is given.

METHODS

Medline and Psyclit searches were performed for a 30-year period (1977-2007).

RESULTS

Alcoholism is associated clearly with social cognition impairments which include emotional face and prosody perception problems, theory of mind deficits and humour processing difficulties.

CONCLUSIONS

In summary, the social cognition impairments are consistent with the frontal lobe hypothesis of alcoholism. Future studies should focus on (i) the delineation of the basic cognitive processes which underlie social cognition deficits; and (ii) their relevance as predictors of treatment outcome in alcoholism.

EEG biofeedback as a treatment for substance use disorders: review, rating of efficacy, and recommendations for further research

Electroencephalographic (EEG) biofeedback has been employed in substance use disorder (SUD) over the last three decades. The SUD is a complex series of disorders with frequent comorbidities and EEG abnormalities of several types. EEG biofeedback has been employed in conjunction with other therapies and may be useful in enhancing certain outcomes of therapy. Based on published clinical studies and employing efficacy criteria adapted by the Association for Applied Psychophysiology and Biofeedback and the International Society for Neurofeedback and Research, alpha theta training-either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse and combined with residential treatment programs, is probably efficacious. Considerations of further research design taking these factors into account are discussed and descriptions of contemporary research are given.

Visual P300s in long-term abstinent chronic alcoholics

BACKGROUND

Evidence of reduced P3b amplitudes in chronic alcoholics and individuals at risk for developing alcoholism suggest that the P3b may be an endophenotypic marker for alcoholism. If this is the case, then long-term abstinent alcoholics (LTAAs) should exhibit reduced P3b amplitudes. Thus far, P3b studies on chronic alcoholics have focused primarily on samples with relatively short-term abstinence (less than 15 months). This study examines the amplitude and latency of the P3b and P3a event-related brain electrical components in LTAAs compared with normal controls (NCs) and whether these measures are related to alcohol use and other subject variables.

METHODS

Electroencephalographs (EEGs) were recorded on 48 LTAAs (mean abstinence=6.7 years) compared with 48 age-matched and gender-matched NCs during a visual P300 experiment consisting of standard, target, and rare nontarget conditions. This paradigm elicited the P3b (target condition) and the P3a (rare nontarget condition) components.

RESULTS

Long-term abstinent alcoholics had reduced P3b amplitudes and increased P3b latencies in comparison with NCs. Long-term abstinent alcoholics also exhibited delayed P3a components, but no P3a amplitude reductions. Alcohol use variables, a family history of alcohol problems, and the duration of alcohol abstinence were not associated with any amplitude or latency variables.

CONCLUSIONS

Even after very prolonged abstinence, reduced P3b amplitudes are present in chronic alcoholics and are not associated with any family history or alcohol use variables. These results provide equivocal support for reduced P3b amplitude being an endophenotypic marker for alcoholism, but are also consistent with P3b being affected by a threshold of alcohol abuse, with the effect not resolving over long periods of abstinence.

Suppression of early evoked gamma band response in male alcoholics during a visual oddball task

We investigated the early evoked gamma frequency band activity in alcoholics (n=122) and normal controls (n=72) during a visual oddball task. A time-frequency representation method was applied to EEG data in order to obtain phase-locked gamma band activity (29-45 Hz) and was analyzed within a 0-150 ms time window range. Significant reduction of the gamma band response in the frontal region during target stimulus processing was observed in alcoholic compared to control subjects. In contrast, significantly higher gamma band response for the non-target stimulus was observed in alcoholics compared to controls. It is suggested that the reduction in early evoked frontal gamma band response to targets may be associated with frontal lobe dysfunction commonly observed in alcoholics. This perhaps can be characterized by a deficient top-down processing mechanism.

Neurocircuitry in alcoholism: a substrate of disruption and repair

The chronic, excessive consumption of alcohol results in significant modification of selective neural systems of the brain structure, physiology, and function. Quantitative MR structural imaging, diffusion tensor imaging (DTI), and functional MRI (fMRI), together with neuropsychological challenges, have enabled rigorous in vivo characterization of the results of alcoholism on the brain in the human condition. Neuroimaging has also enabled longitudinal study for the examination of alcoholism's dynamic course through periods of drinking and sobriety. Controlled studies have revealed compelling evidence for alcohol-related brain structural and functional modification--some longstanding, some transient, and some compensatory. Patterns of circuitry disruption identified through structural and functional MRI studies suggest a central role for degradation of frontocerebellar neuronal nodes and connecting circuitry affecting widespread brain regions and contributing to alcoholism's salient, enduring, and debilitating cognitive and motor deficits--executive dysfunction, visuospatial impairment, and ataxia.

The utility of neurophysiological markers in the study of alcoholism

OBJECTIVE

This review attempts to differentiate neuroelectric measures (electroencephalogram (EEG), event-related potentials (ERPs) and event-related oscillations (EROs)) related to acute and chronic effects of alcohol on the brain from those that reflect underlying deficits related to the predisposition to develop alcoholism and related disorders. The utility of these neuroelectric measures as endophenotypes for psychiatric genetics is evaluated.

METHODS

This article reviews the main findings of EEG and ERP abnormalities in alcoholics, offspring of alcoholics at high risk to develop alcoholism and the electrophysiological effects of alcohol on high risk compared to low-risk offspring. It highlights findings using EROs, a fast developing tool in examining brain function and cognition. It also reviews evidence of genetic findings related to these electrophysiological measures and their relationship to clinical diagnosis.

RESULTS

Many of these abnormal neuroelectric measures are under genetic control, may precede the development of alcoholism, and may be markers of a predisposition toward the development of a spectrum of disinhibitory conditions including alcoholism. Genetic loci underlying some neuroelectic measures that involve neurotransmitter systems of the brain have been identified.

CONCLUSIONS

Quantitative neuroelectric measures (EEG, ERPs, EROs) provide valuable endophenotypes in the study of genetic risk to develop alcoholism and related disorders.

SIGNIFICANCE

Genetic studies of neuroelectric endophenotypes offer a powerful strategy for identifying susceptibility genes for developing psychiatric disorders, and provide novel insights into etiological factors.

Alcoholism is a disinhibitory disorder: neurophysiological evidence from a Go/No-Go task

Response inhibition is considered a core dimension in alcoholism and its co-existing disorders. The major objective of this study is to compare the magnitude and spatial distribution of ERP components during response activation and inhibition in alcoholics (N = 30) and normal controls (N = 30) using a visual Go/No-Go task. The results indicate that alcoholics manifest a decreased P3(00) amplitude during Go as well as No-Go conditions. The difference between Go and No-Go processing was more evident in controls than in alcoholics. The topography of current source density in alcoholics during the P3 response was found to be very different from that of normals, suggesting that alcoholics perhaps activated inappropriate brain circuitry during cognitive processing. The significantly reduced No-Go P3 along with the relatively less anteriorized CSD topography during No-Go condition suggests poor inhibitory control in alcoholics. It is proposed that the No-Go P3, the electrophysiological signature of response inhibition, can be considered as an endophenotypic marker in alcoholism.

Abnormal CNV in chronic heavy drinkers

OBJECTIVE

We used the contingent negative variation (CNV), a slow negative shift in the human electroencephalogram, to investigate the effects of heavy chronic alcohol use on frontal lobe function.

METHODS

Event-related potentials (ERPs) were recorded from 30 heavy drinkers (HD) and 30 age-, sex-, and education-matched light or non-drinkers (LD), using a classical two-stimulus reaction time (RT) paradigm. Structural magnetic resonance images and neuropsychological tests were also administered.

RESULTS

The amplitude of the late CNV was significantly reduced in HD relative to light drinkers. Moreover, diminished CNV amplitudes in HD appear to be closely related to the amount of recent alcohol consumption. There were no significant differences in neuropsychological measures of frontal lobe function and frontal lobe volume between light and HD. However, in HD, reduced late CNV amplitudes were associated with decreased frontal lobe gray matter volume and poor performance on the Trail Making Test B. In LD but not in HD, late CNV amplitude correlated positively with RT, suggesting that the late CNV reflects some aspect of motor and cognitive preparation.

CONCLUSIONS

The inverse relationships between frontal lobe gray matter volume, performance on the Trail Making Test B, and late CNV amplitude in HD suggest that the ERP abnormalities observed in the current study may be indices of alcohol-related damage to the frontal lobe. The lack of a significant relationship between CNV amplitude and RT in HD suggests that chronic heavy alcohol use may disrupt response preparation.

Auditory P3 in female alcoholics

BACKGROUND

The P3 (P300) has been considered to be a phenotypical marker of the risk for alcoholism. Although reductions in visual P3 in male and female alcoholics have been replicated, studies of auditory target P3 have been inconsistent. Our objective was to study the magnitude of auditory P3 reduction in female alcoholics and to establish the association between P3 reduction and alcoholism while taking into account comorbid depression and psychoactive drug dependence. The characteristics of P3 reduction were further examined by studying the reduction in family history-positive and -negative individuals.

METHODS

Auditory target P3s recorded from 61 scalp electrodes in female alcoholics (n = 71) were compared with P3s from female controls (n = 159) ranging in age from 18 to 50 years. The amplitudes and latencies were statistically analyzed, by using repeated-measures ANOVA, in six regional electrode arrays and at representative electrode sites, with age and comorbid depression as covariates. The effects of family density and clinical variables such as depression and drug dependence were also examined with correlation analysis.

RESULTS

Alcoholic women had significantly lower P3 amplitudes in all six regions and at midline electrode sites. The reductions were not associated with comorbid depression, as shown by low correlations and similar P3 amplitudes at Pz in female alcoholics with and without depression. The P3 amplitudes in women with a high family density were smaller than those in women with a low family density of alcohol dependence. Drug dependency did not influence P3 amplitude, as shown by similar responses in drug-dependent and non-drug-dependent alcoholic women.

CONCLUSIONS

These findings highlight the significance of P3 reductions associated with alcoholism in women, independently of comorbid depression. Family density effects further support the evidence that these findings are heritable. These results suggest that P3 can be considered as a phenotypical marker of vulnerability to alcoholism in women.

[ERPs (N200, P300 and CNV) in alcoholics: relapse risk assessment]

The cognitive event-related potentials were studied in a group of 55 alcoholic patients, paired in age and sex with a group of 18 control subjects, using a protocol oddball (visual and auditory) and a protocol VCN Go/Nogo. The N200 obtained using an auditory oddball paradigm had lower amplitude in alcoholics than in controls. A significant amplitude decrease of visual P300 was also observed in alcoholic male subjects. There was however no difference in auditory P300 between alcoholics and control subjects. Using a Go/Nogo paradigm, a significant difference on the final part of the VCN appears between alcoholic and pilot subjects. In addition, the longitudinal follow-up of the same alcoholic patients showed an electrophysiological profile that allowed dividing them into two different groups. On the initial recording (17 days after weaning), the auditory oddball P300 amplitude was significantly higher at Cz and Pz among patients who relapsed during the 3 months follow-up. The same effect appeared on the CNV protocol, where the amplitude of P300 was higher in patients who subsequently relapsed than for those who remained abstinent. Cognitive ERPs may be clinically useful to improve the prediction of risk of relapse among alcoholic patients.

Electrophysiological evidence of abnormal activation of the cerebral network of involuntary attention in alcoholism

OBJECTIVE

Increased distractibility is a common impairment in alcoholism, but objective evidence has remained elusive. Here, a task designed to investigate with event-related brain potentials (ERPs) the neural mechanism underlying distraction was used to show abnormal involuntary orienting of attention in chronic alcoholism.

METHODS

Fifteen alcoholics and 17 matched healthy controls were instructed to ignore auditory stimuli while concentrating in the discrimination of immediately following visual stimuli. The auditory sequences contained repetitive standard tones occasionally replaced by deviant tones of slightly higher frequency, or by complex novel sounds.

RESULTS

Deviant tones and novel sounds distracted visual performance, i.e. increased reaction time to visual stimuli, similarly in patients and controls. Compared to controls, however, alcoholics showed ERP abnormalities, i.e. enhanced P3a amplitudes over the left frontal region, and a positive posterior deflection instead of the frontally distributed reorienting negativity (RON).

CONCLUSIONS

The enhanced P3a to novelty and subsequent positive wave instead of RON in alcoholics suggests encoding into working memory of task-irrelevant auditory events and provides neurophysiological markers of impaired involuntary attention mechanisms in chronic alcoholism.

Two- and three-stimuli auditory oddball ERP tasks and neuropsychological measures in aging

The purpose of this study was to decide whether the P300 from an auditory three-stimuli oddball task is more sensitive to aging than the P300 from a two-stimuli task, and to investigate the relationship between neuropsychological tests and the different ways of eliciting the P300. Thirty-one adults (21.8-94.7 years) completed five neuropsychological tests and two ERP tasks. The way P300 was elicited did not influence its relationship to aging or neuropsychological scores, and the correlations between the two paradigms were strong for amplitude, but rather weak for latency. The main conclusion is that the P300 from an auditory three-stimulus paradigm is sensitive to aging and neuropsychologically valid.

Auditory P3a deficits in male subjects at high risk for alcoholism

BACKGROUND

Substantial evidence indicates that alcoholism is biologically mediated by a genetic predisposition. As the decreased P300 (P3b) event-related brain potential component does not recover with prolonged abstinence, it is unlikely to be related to drinking history but is more likely to be genetically influenced. This is supported by findings that P3b amplitudes are reduced in subjects at high-risk compared to low-risk for alcoholism. Although there are few studies of P3a in HR subjects, lower P3a amplitudes have been reported with a novel nontarget stimulus paradigm, as well as with a difficult three-stimulus visual paradigm. Using a similar three-tone auditory paradigm in which the discriminability between the target and standard tone is difficult, the P3a component can also be reliably elicited with a rare nontarget perceptually distinct stimulus. This technique was employed in young adult subjects at low-risk and high-risk for alcoholism.

METHODS

A total of 17 low-risk and 24 high-risk male subjects were employed as subjects in an auditory paradigm that yielded a large amplitude P3a with a centro-frontal maximum to the nontarget and a robust low amplitude prolonged P3b with a parietal maximum amplitude to the target stimulus. Current source density maps were derived to assess topographic differences between low-risk and high-risk subjects.

RESULTS

The high-risk group manifested significantly lower P3a amplitudes than the low-risk group at the frontal electrodes to rare nontarget stimuli. High-risk subjects also demonstrated a more disorganized current source density map for P3a compared to low-risk subjects.

CONCLUSIONS

The reduction of P3a in the high-risk group may be due to cortical dysfunction including the frontal and prefrontal cortex. The lower P3a amplitude coupled with more disorganized current source density maps suggest inefficient brain functioning in high-risk subjects.