Manipulation of frontal brain asymmetry by cognitive tasks

Mild Cognitive Impairment in African Americans Is Associated with Differences in EEG Theta/Beta Ratio

BACKGROUND

Identification of older individuals with increased risk for cognitive decline can contribute not only to personal benefits (e.g., early treatment, evaluation of treatment), but could also benefit clinical trials (e.g., patient selection). We propose that baseline resting-state electroencephalography (rsEEG) could provide markers for early identification of cognitive decline.

OBJECTIVE

To determine whether rsEEG theta/beta ratio (TBR) differed between mild cognitively impaired (MCI) and healthy older adults.

METHODS

We analyzed rsEEG from a sample of 99 (ages 60-90) consensus-diagnosed, community-dwelling older African Americans (58 cognitively typical and 41 MCI). Eyes closed rsEEGs were acquired before and after participants engaged in a visual motion direction discrimination task. rsEEG TBR was calculated for four midline locations and assessed for differences as a function of MCI status. Hemispheric asymmetry of TBR was also analyzed at equidistant lateral electrode sites.

RESULTS

Results showed that MCI participants had a higher TBR than controls (p = 0.04), and that TBR significantly differed across vertex location (p < 0.001) with the highest TBR at parietal site. MCI and cognitively normal controls also differed in hemispheric asymmetries, such that MCI show higher TBR at frontal sites, with TBR greater over right frontal electrodes in the MCI group (p = 0.003) and no asymmetries found in the cognitively normal group. Lastly, we found a significant task aftereffect (post-task compared to pre-task measures) with higher TBR at posterior locations (Oz p = 0.002, Pz p = 0.057).

CONCLUSION

TBR and TBR asymmetries differ between MCI and cognitively normal older adults and may reflect neurodegenerative processes underlying MCI symptoms.

Stress Classification by Multimodal Physiological Signals Using Variational Mode Decomposition and Machine Learning

In this pandemic situation, importance and awareness about mental health are getting more attention. Stress recognition from multimodal sensor based physiological signals such as electroencephalogram (EEG) and electrocardiography (ECG) signals is a very cost-effective way due to its noninvasive nature. A dataset, recorded during the mental arithmetic task, consisting of EEG + ECG signals of 36 participants is used. It contains two categories of performance, namely, “Good” (nonstressed) and “Bad” (stressed) (Gupta et al. 2018 and Eraldeír et al. 2018). This paper presents an effective approach for the recognition of stress marker at frontal, temporal, central, and occipital lobes. It processes the multimodality physiological signals. The variational mode decomposition (VMD) strategy is used for data preprocessing and for the decomposition of signals into various oscillatory mode functions. Poincare plots (PP) are derived from the first eight variational modes and features from these plots have been extracted such as mean, area, and central tendency measure of the elliptical region. The statistical significance of the extracted features with p < 0.5 has been performed using the Wilcoxson test. The multilayer perceptron (MPLN) and Support Vector Machine (SVM) algorithms are used for the classification of stress and nonstress categories. MLPN has achieved the maximum accuracies of 100% for frontal and temporal lobes. The suggested method can be incorporated in noninvasive EEG signal processing based automated stress identification systems.

Neural Efficiency in Athletes: A Systematic Review

According to the neural efficiency hypothesis (NEH), professionals have more effective cortical functions in cognitive tasks. This study is focusing on providing a systematic review of sport-related NEH studies with functional neuroimaging or brain stimulation while performing a sport-specific task, with the aim to answer the question: How does long-term specialized training change an athlete's brain and improve efficiency? A total of 28 studies (N = 829, Experimental Group n = 430) from 2001 to 2020 (Median = 2014, SD = 5.43) were analyzed and results were organized into four different sections: expert-novice samples, perceptual-cognitive tasks and neuroimaging technologies, efficiency paradox, and the cluster analysis. Researchers examined a wide range of sport-specific videos and multiple object tracking (MOT) specific to 18 different sports and utilized blood oxygenation-level dependent (BOLD) functional magnetic resonance imaging (fMRI), functional near-infrared spectroscopy (fNIRS), and electroencephalogram (EEG). Expert-novice comparisons were often adopted into investigations about the variations in general about optimal-controlled performance, neurophysiology, and behavioral brain research. Experts tended to perform at faster speeds, more accurate motor behavior, and with greater efficiency than novices. Experts report lower activity levels in the sensory and motor cortex with less energy expenditure, experts will possibly be more productive. These findings generally supported the NEH across the studies reviewed. However, an efficiency paradox and proficient brain functioning were revealed as the complementary hypothesis of the NEH. The discussion concentrates on strengths and key limitations. The conclusion highlights additional concerns and recommendations for prospective researchers aiming to investigate a broader range of populations and sports.

Color-dependent changes in humans during a verbal fluency task under colored light exposure assessed by SPA-fNIRS

Light evokes robust visual and nonvisual physiological and psychological effects in humans, such as emotional and behavioral responses, as well as changes in cognitive brain activity and performance. The aim of this study was to investigate how colored light exposure (CLE) and a verbal fluency task (VFT) interact and affect cerebral hemodynamics, oxygenation, and systemic physiology as determined by systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS). 32 healthy adults (17 female, 15 male, age: 25.5 ± 4.3 years) were exposed to blue and red light for 9 min while performing a VFT. Before and after the CLE, subjects were in darkness. We found that this long-term CLE-VFT paradigm elicited distinct changes in the prefrontal cortex and in most systemic physiological parameters. The subjects' performance depended significantly on the type of VFT and the sex of the subject. Compared to red light, blue evoked stronger responses in cerebral hemodynamics and oxygenation in the visual cortex. Color-dependent changes were evident in the recovery phase of several systemic physiological parameters. This study showed that the CLE has effects that endure at least 15 min after cessation of the CLE. This underlines the importance of considering the persistent influence of colored light on brain function, cognition, and systemic physiology in everyday life.

Individual Differences in Hemodynamic Responses Measured on the Head Due to a Long-Term Stimulation Involving Colored Light Exposure and a Cognitive Task: A SPA-fNIRS Study

When brain activity is measured by neuroimaging, the canonical hemodynamic response (increase in oxygenated hemoglobin ([O2Hb]) and decrease in deoxygenated hemoglobin ([HHb]) is not always seen in every subject. The reason for this intersubject-variability of the responses is still not completely understood. This study is performed with 32 healthy subjects, using the systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS) approach. We investigate the intersubject variability of hemodynamic and systemic physiological responses, due to a verbal fluency task (VFT) under colored light exposure (CLE; blue and red). Five and seven different hemodynamic response patterns were detected in the subgroup analysis of the blue and red light exposure, respectively. We also found that arterial oxygen saturation and mean arterial pressure were positively correlated with [O2Hb] at the prefrontal cortex during the CLE-VFT independent of the color of light and classification of the subjects. Our study finds that there is substantial intersubject-variability of cerebral hemodynamic responses, which is partially explained by subject-specific systemic physiological changes induced by the CLE-VFT. This means that both subgroup analyses and the additional assessment of systemic physiology are of crucial importance to achieve a comprehensive understanding of the effects of a CLE-VFT on human subjects.

The effects of emotion on working memory: Valence versus motivation

It is unclear whether the effects of emotional state on working memory (WM) are valence-based or motivation-based since the type of emotions used in previous research differed on both dimensions of emotion. Especially, effects of anger, which is a negative but approach-related emotional state, were mostly overlooked. To distinguish between valence vs. motivation accounts, two experiments were conducted in which participants were induced one of four emotional states to create approach-positive (happiness), avoidance-negative (fear), approach-negative (anger), and control (neutral) conditions, followed by Self-ordered Pointing Task (Experiment 1) or N-Back task (Experiment 2) as WM measures. The main effect of emotion on WM accuracy was not significant in neither experiment. In the second experiment, however, reaction times (RTs) in the avoidance-related emotion condition were significantly faster compared to those in approach-related conditions, without compromising accuracy. Together the two experiments suggest that the motivational dimension of emotional state is more effective on WM than the valence dimension, especially on the RTs, indicating working memory updating efficiency.

Cognitive reappraisal capacity mediates the relationship between prefrontal recruitment during reappraisal of anger-eliciting events and paranoia-proneness

Difficulties in emotion regulation, particularly in using adaptive regulation strategies such as cognitive reappraisal, are a commonly observed correlate of paranoia. While it has been suggested that poor implementation of cognitive reappraisal in dealing with aversive events precedes the onset of subclinical paranoid thinking, there is little empirical research on neural activation patterns during cognitive reappraisal efforts that might indicate vulnerability towards paranoid thinking. Prefrontal EEG alpha asymmetry changes were recorded while n = 57 participants were generating alternative appraisals of anger-eliciting events, and were linked to a behavioral measure of basic cognitive reappraisal capacity and self-reported paranoia proneness (assessed by personality facets of hostility and suspiciousness; Personality Inventory for DSM-5). Mediation analysis revealed that less left-lateralized activation at ventrolateral prefrontal sites during reappraisal efforts predicted a higher degree of paranoia proneness. This relationship was mediated through poorer cognitive reappraisal capacity. Matching previous evidence, findings suggest that inappropriate brain activation during reappraisal efforts impairs individuals' capacity to come up with effective alternative interpretations for anger-evoking situations, which may accentuate personality features related to increased paranoid thinking. The findings add to our understanding of neurally underpinned impairments in the capacity to generate cognitive reappraisals and their link to maladaptive personality and behavior.

Reappraisal inventiveness: impact of appropriate brain activation during efforts to generate alternative appraisals on the perception of chronic stress in women

BACKGROUND AND OBJECTIVES

Previous research indicated that more left-lateralized prefrontal activation during cognitive reappraisal efforts was linked to a greater capacity for generating reappraisals, which is a prerequisite for the effective implementation of cognitive reappraisal in everyday life. The present study examined whether the supposedly appropriate brain activation is relevant in terms of more distal outcomes, i.e., chronic stress perception.

DESIGN AND METHODS

Prefrontal EEG alpha asymmetry was recorded while female participants were generating reappraisals for stressful events and was correlated with their self-reported chronic stress levels in everyday life (n = 80).

RESULTS

Women showing less left-lateralized brain activity in the ventrolateral prefrontal cortex during cognitive reappraisal efforts reported experiencing more stress in their daily lives. This effect was independent of self-efficacy beliefs in managing negative emotions.

CONCLUSION

These findings underline the practical relevance of individual differences in appropriate brain activation during emotion regulation efforts and the assumedly related basic capacity for the generation of cognitive reappraisals to the feeling of being stressed. Implications include the selection of interventions for the improvement of coping with stress in women in whom the capability for appropriate brain activation during reappraisal efforts may be impaired, e.g., due to depression or old age.

The capacity for generating cognitive reappraisals is reflected in asymmetric activation of frontal brain regions

Encouraging patients to use cognitive reappraisal constitutes the core of modern psychotherapeutic approaches. However, evidence for specific neural correlates of the capacity for cognitive reappraisal, which is a necessary prerequisite for the effective implementation of cognitive reappraisal in everyday life, has been sparse to date. In the present study, the capacity for cognitive reappraisal was studied in terms of the participants’ inventiveness in generating alternative appraisals of anger-evoking events, and was correlated with frontal EEG alpha asymmetry recorded while the participants were generating reappraisals as well as during a common creative idea generation task. During cognitive reappraisal efforts, individuals higher on the capacity for generating cognitive reappraisals showed more left-lateralized activity in lateral prefrontal cortex, specifically in ventrolateral prefrontal cortex extending toward the frontal pole. This effect was observed independently from the activation during novel idea generation without emotional component, indicating that specific demands are implicated in the generation of reappraisals of emotional events. Taken together, the results indicate that individuals higher on the capacity for cognitive reappraisal are more capable or more prone to recruit appropriate brain regions when the situation demands coming up with alternative appraisals of stressful events. The findings may stimulate the development of more individually targeted interventions.

Intraindividual and Interindividual Differences in Spontaneous Eye Blinking: Relationships to Working Memory Performance and Frontal EEG Asymmetry

The rate and timing of spontaneous eye blinking (SB) may be used to explore mechanisms of cognitive activity in infancy. In particular, SB rate is believed to reflect some dimensions of dopamine function; therefore, we hypothesized that SB rate would relate to working memory performance and to frontal electroencephalogram (EEG) asymmetry. Forty, 10-mo-old infants completed an A-not-B task while SB and EEG were measured throughout. We found that SB rate varied across phases of the task, variability in SB rate was positively related to working memory performance, and frontal EEG asymmetry was related to individual differences in the rate of SB. Results provide indirect, but convergent support for the hypothesis that SB rate reflects dopamine function early in human development. As such, these results have implications for understanding the tonic and phasic effects of dopamine on cognitive activity early in human development.

Quantitative electroencephalographic and neuropsychological investigation of an alternative measure of frontal lobe executive functions: the Figure Trail Making Test

The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning. Relatively little is known about right frontal lobe contributions to executive functioning given the paucity of measures sensitive to right frontal functioning. The present investigation reports the development and initial validation of a new measure designed to be sensitive to right frontal lobe functioning, the Figure Trail Making Test (FTMT). The FTMT, the classic Trial Making Test, and the Ruff Figural Fluency Test (RFFT) were administered to 42 right-handed men. The results indicated a significant relationship between the FTMT and both the TMT and the RFFT. Performance on the FTMT was also related to high beta EEG over the right frontal lobe. Thus, the FTMT appears to be an equivalent measure of executive functioning that may be sensitive to right frontal lobe functioning. Applications for use in frontotemporal dementia, Alzheimer’s disease, and other patient populations are discussed.

Hostility, driving anger, and dangerous driving: the emerging role of hemispheric preference

BACKGROUND

Various studies have implicated psychosocial variables (e.g., hostility) in risk of dangerous driving and traffic accidents. However, whether these variables are related to more basic neurobiological factors, and whether such associations have implications for the modification of psychosocial risk factors in the context of driving, have not been examined in depth. This study examined the relationship between hemispheric preference (HP), hostility and self-reported dangerous driving, and the ability to affect driving anger via hemisphere activating cognitive exercises (HACE).

METHODS

In Study 1, 254 Turkish students completed questionnaires of hostility, HP and driving behavior. In Study 2, we conducted a "proof of concept" experimental study, and tested effects of left, right and neutral HACE on driving anger, by exposing N=650 Turkish students to written scenarios including either logical (left hemisphere), visuo-spatial (right hemisphere) or "mild doses" of both types of contents (control).

RESULTS

In Study 1, left-HP was associated with higher hostility and with more dangerous driving, and hostility mediated the relationship between L-HP and reported driving behavior. In Study 2, only right-HACE led to immediate significant reductions in self-reported driving anger.

CONCLUSIONS

Left-HP is related to hostility and to dangerous driving, and it may be possible to partly reduce driving anger by right-HACE. Future studies must replicate these findings with objective measures, more enduring interventions and longer follow-ups.

Serotonin transporter genotype (5-HTTLPR) and electrocortical responses indicating the sensitivity to negative emotional cues

Growing literature indicates that emotional reactivity and regulation are strongly linked to genetic modulation of serotonergic neurotransmission. However, until now, most studies have focused on the relationship between genotypic markers, in particular the serotonin transporter-linked polymorphic region (5-HTTLPR), and neural structures using MRI. The current study aimed to bridge the gap between the relevant MRI literature on the effects of the 5-HTTLPR genotype and the research tradition focusing on transient lateralized changes of electrocortical activity in the prefrontal cortex using electroencephalography (EEG). Lateral shifts of EEG alpha asymmetry in response to an aversive film consisting of scenes of real injury and death were assessed in healthy participants (n = 165). To evaluate the specificity of the 5-HTTLPR effect, participants were also tested for the COMT Val158Met polymorphism which is linked to dopamine inactivation. While viewing the film, individuals homozygous for the 5-HTTLPR short allele displayed a clear lateral shift of dorsolateral frontal activity to the right, which was virtually absent in participants carrying the long allele. The heightened electrocortical response to the aversive stimulation and its direction indicates a greater propensity of s/s homozygotes to experience withdrawal oriented affect in response to negative emotion cues in the environment. Moreover, together with previous research the findings support the notion of a link between the serotonergic system and self-regulation related to avoidance motivation, and a link between the dopaminergic system and self-regulation related to approach motivation.

Frontal brain asymmetry and transient cardiovascular responses to the perception of humor

The study examined the relationship of individual differences in prefrontal brain asymmetry, measured by the EEG in resting conditions, to the individual's responsivity in the context of humor (n=42). Several weeks after the EEG recording, immediate cardiovascular responses to the perception of humor and behavioral indicators of humor processing were obtained in an experimental paradigm involving non-verbal cartoons. Relatively greater resting activity in the left than right prefrontal cortex, particularly at the ventrolateral positions, was associated with faster detection of humor, a more pronounced cardiac response to the perception of humor (heart rate and cardiac output), and more accessible internal positive affective states (indicated by faster reports of amusement levels). The study confirms and extends findings of the relevance of prefrontal brain asymmetry to affective responsivity, contributing evidence in the domain of positive affect and humor, and demonstrating relationships to the immediate cardiovascular response pattern to an emotional event.

Intra- and interindividual differences in lateralized cognitive performance and asymmetrical EEG activity in the frontal cortex

The study shows that changes in relative verbal vs. figural working memory and fluency performance from one session to a second session two to 3 weeks apart covary with spontaneously occurring changes of cortical asymmetry in the lateral frontal and central cortex, measured by electroencephalography (EEG) in resting conditions before the execution of tasks. That is, it was examined whether the current state of cortical asymmetry predicts verbal vs. figural performance. The findings complete the circle from studies showing correlations between changes of EEG asymmetry in the lateral frontal cortex and changes of mood to studies showing correlations between changes of mood and changes of relative verbal vs. figural working memory and fluency performance. The study suggests that state-dependent changes of lateralized cortical activity may underlie certain cognitive-emotional interactions observed in previous studies, and supports the assumption of reciprocal influences of specific emotional and specific cognitive processes.

Emotion and executive functioning: the effect of normal mood states on fluency tasks

Induced positive affect (PA) can improve verbal fluency performance, and induced negative affect (NA) can increase design fluency performance (Bartolic, Basso, Schefft, Glauser, & Titanic-Schefft, 1999). Building on this, the current study investigated associations between everyday mood states and executive functions. Participants (N = 74, mean age = 51.19 years) completed verbal and design fluency tasks and a self-report affect task. PA was associated with better verbal fluency performance, although NA was not associated with design fluency. Variations in everyday PA may be associated with cognitive performance, whereas greater shifts in NA might be needed to establish associations with executive functioning.

Long-term stability of electroencephalographic asymmetry and power in 3 to 9 year-old children

We investigated the test-retest stability of resting EEG asymmetry and power in the alpha frequency range across a 0.6- to 3-year interval in 125 children (57 girls and 68 boys) for two age groups, 87 preschool children (3 to 5 year-olds) and 38 school-age children (6 to 9 year-olds). Children were from families with a parent's history of unipolar or bipolar depression (36 girls and 43 boys) or control families with no parent history of depression nor any other psychiatric disorder (21 girls and 25 boys). Frontal EEG asymmetry stability was low to moderate; intraclass correlations ranged from zero to 0.48 in the eyes-open condition, and from 0.19 to 0.45 in the eyes-closed condition. Also, parietal EEG asymmetry was low to moderate; intraclass correlations ranged from 0.21 to 0.52 in the eyes-open condition and from 0.27 to 0.72 in the eyes-closed condition. Stability of EEG asymmetry was not related to age, sex of the child, or parent's history of mood disorder. Frontal and parietal EEG power appeared moderately to highly stable. Intraclass correlations were between 0.65 and 0.86 in the eyes-open condition and between 0.52 and 0.90 in the eyes-closed condition. Although stability of EEG power was not statistical significantly different between preschool and school-age children, it consistently showed higher stability values in school-age children than in preschool children. Stability in school-age children approached values as has been reported for adults. The findings provide partial support to the concept of frontal EEG asymmetry as a trait marker in childhood.

Brain activation in elderly people with and without dementia: Influences of gender and medication

Patients suffering from dementia show altered functional brain activation patterns especially in prefrontal brain regions, as research suggests. The present study follows three aims: to replicate these findings, to investigate treatment effects when administering galantamine, and to put gender differences in focus. We compared 12 patients with dementia to 12 age- and gender-matched healthy subjects regarding changes in haemoglobin concentration in brain tissue while performing a verbal fluency task (VFT). Concentration changes of oxygenated (O(2)Hb) and deoxygenated (HHb) haemoglobin were measured by multi-channel near-infrared spectroscopy (NIRS), an easily applicable and non-invasive method of optical topography. In the patient group, measurement was repeated 4 and 8 weeks after starting treatment with galantamine. The results showed a reduced increase in O(2)Hb during task performance for patients compared to healthy controls. Furthermore, female subjects showed more pronounced activation in O(2)Hb as well as HHb compared to male subjects. Regarding treatment effects, no clear results could be obtained. In HHb, evidence for an entrainment effect was found. In the light of existing literature, the present study suggests an interaction of gender and age regarding brain activation patterns which should be aimed at in future investigations.

Anxiety selectively disrupts visuospatial working memory

On the basis of a review of the extant literature describing emotion-cognition interactions, the authors propose 4 methodological desiderata for studying how task-irrelevant affect modulates cognition and present data from an experiment satisfying them. Consistent with accounts of the hemispheric asymmetries characterizing withdrawal-related negative affect and visuospatial working memory (WM) in prefrontal and parietal cortices, threat-induced anxiety selectively disrupted accuracy of spatial but not verbal WM performance. Furthermore, individual differences in physiological measures of anxiety statistically mediated the degree of disruption. A second experiment revealed that individuals characterized by high levels of behavioral inhibition exhibited more intense anxiety and relatively worse spatial WM performance in the absence of threat, solidifying the authors' inference that anxiety causally mediates disruption. These observations suggest a revision of extant models of how anxiety sculpts cognition and underscore the utility of the desiderata.

Frequency-spatial organization of brain electrical activity in creative verbal thought: The role of the gender factor

Gender-related differences in the EEG correlates of creative thought were studied by mapping EEG power during performance of a Remote Associations Task as compared with verbal word-generation and simple association tasks. Right-handed students (18 male, 21 female) took part in the studies. Gender-related differences were seen in the factor structure of measures of verbal activity and in the larger number of words generated for a given letter in women than in men. In terms of the originality of the associations, men and women showed no significant difference, though the dynamics of the power of the beta-2 rhythm during creative thought differed. In males, the search for original associations was accompanied by increases in beta-2 power in both hemispheres at the initial stages of performing the task, with local increases in the beta-2 rhythm in the central parts of the cortex at the end of testing. In women, the increase in beta-2 power was initially greater in the right hemisphere than the left, while there was a relative decrease in beta activity in the parietal-temporal areas of the cortex and an increase in the left anterior frontal areas at the terminal stage of task performance. It is suggested that creative verbal thought is based mostly on an "insight" strategy in males, while women additionally use an "intellectual" strategy.

Long-term stability of frontal electroencephalographic asymmetry in adults with a history of depression and controls

We investigated the stability in resting EEG across a 1- to 3-year interval in 49 adults (33 female and 16 male) with a history of unipolar depression (first onset prior to the age of 14) and 50 controls (33 female and 17 male) with no history of major psychopathology. Current depressive symptoms were quantified by self-report at both assessments. For the entire sample, EEG asymmetry in the alpha range was moderately stable (intraclass correlations between 0.39 and 0.61). Sex, history of depression, depressive symptom severity at Time 2, and change in symptom severity between Time 1 and Time 2 were unrelated to stability of EEG asymmetry. These findings support the view that resting frontal EEG asymmetry reflects a moderately stable individual difference in adults, irrespective of sex and history of depression.

Bilateral prefrontal cortex oxygenation responses to a verbal fluency task: a multichannel time-resolved near-infrared topography study

The letter-fluency task-induced response over the prefrontal cortex is investigated bilaterally on eight subjects using a recently developed compact, eight-channel, time-resolved, near-IR system. The cross-subject mean values of prefrontal cortex oxygen saturation (SO2) were 68.8+/-3.2% (right) and 71.0+/-3.6% (left), and of total hemoglobin concentration (tHb) were 69.6+/-9.6 microM (right) and 69.5+/-9.9 microM (left). The typical cortical activation response to the cognitive task [characterized by an increase in oxyhemoglobin (O2Hb) with a concurrent decrease in deoxyhemoglobin (HHb)] at each measurement point is observed in only four subjects. In this subset, the amplitude of the O2Hb increase and HHb decrease is uniform over each prefrontal cortex area and comparable between the two hemispheres. These findings agree with previous studies using continuous wave functional near-IR spectroscopy and functional magnetic resonance imaging, therefore demonstrating the potential of a time-resolved spectroscopy approach. In addition, a significant increase in SO2 levels was observed in the right (1.1+/-0.5%) compared to left side of the prefrontal cortex (0.9+/-0.5%) (P=0.005). A different pattern of cortical activation (characterized by the lack of HHb decrease or even increased HHb) was observed in the remaining subjects.