Validity and Reliability of Quantitative Electroencephalography

Immediate and Transient Perturbances in EEG Within Seconds Following Controlled Soccer Head Impact

Athletes in contact and collision sports can sustain frequent subconcussive head impacts. Although most impacts exhibit low kinematics around or below 10 g of head linear acceleration, there is growing concern regarding the cumulative effects of repetitive sports head impacts. Even mild impacts can lead to brain deformations as shown through neuroimaging and finite element modeling, and thus may result in mild and transient effects on the brain, prompting further investigations of the biomechanical dose-brain response relationship. Here we report findings from a novel laboratory study with continuous monitoring of brain activity through electroencephalography (EEG) during controlled soccer head impacts. Eight healthy participants performed simulated soccer headers at 2 mild levels (6 g, 4 rad/s and 10 g, 8 rad/s) and three directions (frontal, oblique left, oblique right). Participants were instrumented with an inertial measurement unit (IMU) bite bar and EEG electrodes for synchronized head kinematics and brain activity measurements throughout the experiment. After an impact, EEG exhibited statistically significant elevation of relative and absolute delta power that recovered within two seconds from the impact moment. These changes were statistically significantly higher for 10 g impacts compared with 6 g impacts in some topographical regions, and oblique impacts resulted in contralateral delta power increases. Post-session resting state measurements did not indicate any cumulative effects. Our findings suggest that even mild soccer head impacts could lead to immediate, transient neurophysiological changes. This study paves the way for further dose-response studies to investigate the cumulative effects of mild sports head impacts, with implications for long-term athlete brain health.

Comparative Analysis of LORETA Z Score Neurofeedback and Cognitive Rehabilitation on Quality of Life and Response Inhibition in Individuals with Opioid Addiction

Background. Previous studies has shown that conventional neurofeedback and cognitive rehabilitation can improve psychological outcomes in people with opioid use disorders. However, the effectiveness of LORETA Z-score neurofeedback (LZNFB) and attention bias modification training on quality of life and inhibitory control of these people has not been investigated yet. LZNFB targets deeper brain structures with higher precision, compared to conventional neurofeedback that typically focuses on surface EEG activity. The present study aims to compare the effect of these two methods on quality of life and response inhibition in men with opioid use disorders under methadone maintenance therapy (MMT). Methods. In this randomized controlled clinical trial with a pre-test, post-test, follow-up design, 30 men with opioid use disorders under MMT were randomly assigned into three groups of LZNFB, attention bias modification training, and control (MMT alone). The LZNFB and Cognitive Rehabilitation groups received 20 and 15 sessions of treatment, respectively. The Persian versions WHO Quality of Life-BREEF questionnaire and the Go/No-Go test were completed by the participants before, immediately after, and one month after interventions. The collected data were analyzed in SPSS v.22 software. Results. Both intervention groups showed a significant improvement in quality-of-life score and a significant reduction in response time at the post-test phase (P < .05), where LZNFB group showed more improvement in quality of life and more reduction in response inhibition. After one month, the increase in quality of life continued in both groups, while the decrease in response time continued only in the LZNFB group. Conclusion. Both LZNFB and attention bias modification training are effective in improving quality of life and response inhibition of men with OUD under MMT, however, LZNFB is more effective.

Effectiveness of Low-Resolution Brain Electromagnetic Tomography Z Score Neurofeedback Comparison with Cognitive Rehabilitation in Depression and Anxiety in Opioid Use Disorder

Background: Previous studies have shown that conventional neurofeedback (NFB) and cognitive rehabilitation can improve psychological outcomes in people with opioid use disorders (OUDs). However, the effectiveness of Low-Resolution Brain Electromagnetic Tomography (LORETA) Z-score neurofeedback (LZNFB) and attention bias modification training (ABMT) on depression and anxiety of these people has not been investigated yet. The present study aims to compare the effect of these two methods on depression and anxiety of men with OUD under methadone maintenance therapy (MMT). Methods: In this randomized controlled clinical trial with a pre-test, post-test, and follow-up design, 30 men with OUD under MMT were randomly assigned into three groups of LZNFB, ABMT, and control (MMT alone). The LZNFB group underwent LZNFB at 20 sessions. The ABMT using the dot-probe task was provided individually to the second group for 2 weeks at 15 sessions. The Beck Anxiety Inventory and the Beck Depression Inventory were completed by the participants before, immediately after, and 1-month after interventions. The collected data were analyzed in SPSS v.22 software. Results: Both intervention groups showed a significant reduction in anxiety and depression at the post-test phase (p < 0.05), where LZNFB group showed more decrease in anxiety and depression than the ABMT group. This decrease continued in the follow-up period. Conclusion: Both LZNFB and ABMT with the dot-robe task are effective in reducing depression and anxiety of men with OUD under MMT. However, LZNFB is more effective. These findings add to the growing body of literature supporting the effectiveness of NFB and cognitive rehabilitation therapy in treating addiction-related comorbidities.

Quantitative electroencephalography in cerebral amyloid angiopathy

OBJECTIVE

We investigated whether quantitative electroencephalography (qEEG) correlates with cognition and cortical superficial siderosis (cSS) in cerebral amyloid angiopathy.

METHODS

We included patients with sporadic (sCAA) and hereditary Dutch-type CAA (D-CAA). Spectral measures and the phase lag index (PLI) were analyzed on qEEG. Cognition was assessed with the MoCA and cSS presence was scored on 3T-MRI. Linear regression analyses were performed to investigate these qEEG measures and cognition. Independent samples T-tests were used to analyze the qEEG measure differences between participants with and without cSS.

RESULTS

We included 92 participants (44 D-CAA; 48 sCAA). A lower average peak frequency (β[95 %CI] = 0.986[0.252-1.721]; P = 0.009) and a higher spectral ratio (β[95 %CI] = -0.918[-1.761--0.075]; P = 0.033) on qEEG correlated with a lower MoCA score, irrespective of a history of symptomatic intracerebral hemorrhage (sICH). The PLI showed no correlation to the MoCA. qEEG slowing was not different in those with or without cSS.

CONCLUSIONS

Spectral qEEG (but not PLI) reflects cognitive performance in patients with CAA with and without a history of sICH. We found no association between qEEG slowing and cSS.

SIGNIFICANCE

qEEG could be a valuable biomarker, especially in challenging cognitive testing situations in CAA, and a potential predictive tool in future studies.

Differential roles of brain oscillations in numerical processing: evidence from resting-state EEG and mental number line

Recent works point to the importance of emotions in special-numerical associations. There remains a notable gap in understanding the electrophysiological underpinnings of such associations. Exploring resting-state (rs) EEG, particularly in frontal regions, could elucidate emotional aspects, while other EEG measures might offer insights into the cognitive dimensions correlating with behavioral performance. The present work investigated the relationship between rs-EEG measures (emotional and cognitive traits) and performance in the mental number line (MNL). EEG activity in theta (3-7 Hz), alpha (8-12 Hz, further subdivided into low-alpha and high-alpha), sensorimotor rhythm (SMR, 13-15 Hz), beta (16-25 Hz), and high-beta/gamma (28-40 Hz) bands was assessed. 76 university students participated in the study, undergoing EEG recordings at rest before engaging in a computerized number-to-position (CNP) task. Analysis revealed significant associations between frontal asymmetry, specific EEG frequencies, and MNL performance metrics (i.e., mean direction bias, mean absolute error, and mean reaction time). Notably, theta and beta asymmetries correlated with direction bias, while alpha peak frequency (APF) and beta activity related to absolute errors in numerical estimation. Moreover, the study identified significant correlations between relative amplitude indices (i.e., theta/beta ratio, theta/SMR ratio) and both absolute errors and reaction times (RTs). Our findings offer novel insights into the emotional and cognitive aspects of EEG patterns and their links to MNL performance.

Fat tails and the need to disclose distribution parameters of qEEG databases

Neurometry (a.k.a. quantitative EEG or qEEG) is a popular method to assess clinically relevant abnormalities in the electroencephalogram. Neurometry is based on norm values for the distribution of specific EEG parameters and believed to show good psychometric properties such as test-retest reliability. Many psychometric properties only hold under the Gaussian distribution and become problematic when distributions are fat-tailed. EEG signals are typically fat-tailed and do not show fast convergence to a Gaussian distribution. To circumvent this property of EEG, log-transformations have frequently, but not always been employed. In Monte Carlo simulations, we investigated the impact of fat-tails (i.e. deviations from Gaussian) on the cut-off criteria and changeability of what in neurometry is termed "abnormal EEG". Even slight deviations from the Gaussian distribution as measured by skewness and kurtosis lead to large inflation in the number of false positive qEEG findings. The more stringent the cutoff value adopted, the larger the inflation. Moreover, "abnormal EEG" seems to recover spontaneously at rates not compatible with the alleged test-retest reliability of qEEG. Alternative methods should be employed to determine cut-off values for diagnostics purposes, since a large number of false positive results emerge even when slight deviations from the Gaussian distribution are present. We argue that distribution properties of qEEG databases should be disclosed in much more detail by commercial providers to avoid questionable research practices and promote diagnostic transparency. We provide recommendations for the improvement of psychometric properties of existing qEEG databases.

Spontaneous dyadic behaviour predicts the emergence of interpersonal neural synchrony

Synchronization of neural activity across brains - interpersonal neural synchrony (INS) - is emerging as a powerful marker of social interaction that predicts success of multi-person coordination, communication, and cooperation. As the origins of INS are poorly understood, we tested whether and how INS might emerge from spontaneous dyadic behavior. We recorded neural activity (EEG) and human behavior (full-body kinematics, eye movements and facial expressions) while dyads of participants were instructed to look at each other without speaking or making co-verbal gestures. We made four fundamental observations. First, despite the absence of a structured social task, INS emerged spontaneously only when participants were able to see each other. Second, we show that such spontaneous INS, comprising specific spectral and topographic profiles, did not merely reflect intra-personal modulations of neural activity, but it rather reflected real-time and dyad-specific coupling of neural activities. Third, using state-of-art video-image processing and deep learning, we extracted the temporal unfolding of three notable social behavioral cues - body movement, eye contact, and smiling - and demonstrated that these behaviors also spontaneously synchronized within dyads. Fourth, we probed the correlates of INS in such synchronized social behaviors. Using cross-correlation and Granger causality analyses, we show that synchronized social behaviors anticipate and in fact Granger cause INS. These results provide proof-of-concept evidence for studying interpersonal neural and behavioral synchrony under natural and unconstrained conditions. Most importantly, the results suggest that INS could be conceptualized as an emergent property of two coupled neural systems: an entrainment phenomenon, promoted by real-time dyadic behavior.

Exposure to nature is associated with decreased functional connectivity within the distress network: A resting state EEG study

Introduction

Despite the well-established evidence supporting the restorative potential of nature exposure, the neurophysiological underpinnings of the restorative cognitive/emotional effect of nature are not yet fully understood. The main purpose of the current study was to investigate the association between exposure to nature and electroencephalography (EEG) functional connectivity in the distress network.

Methods

Fifty-three individuals (11 men and 42 women; mean age 21.38 ± 1.54 years) were randomly assigned to two groups: (i) a green group and (ii) a gray group. A slideshow consisting of images depicting natural and urban scenarios were, respectively, presented to the green and the gray group. Before and after the slideshow, 5 min resting state (RS) EEG recordings were performed. The exact low-resolution electromagnetic tomography (eLORETA) software was used to execute all EEG analyses.

Results

Compared to the gray group, the green group showed a significant increase in positive emotions (F _{1; 50} = 9.50 p = 0.003) and in the subjective experience of being full of energy and alive (F _{1; 50} = 4.72 p = 0.035). Furthermore, as compared to urban pictures, the exposure to natural images was associated with a decrease of delta functional connectivity in the distress network, specifically between the left insula and left subgenual anterior cingulate cortex (T = -3.70, p = 0.023).

Discussion

Our results would seem to be in accordance with previous neurophysiological studies suggesting that experiencing natural environments is associated with brain functional dynamics linked to emotional restorative processes.

EPIAMNE: A New Scoring System for Differentiating Transient EPIleptic AMNEsia from Transient Global Amnesia

Transient epileptic amnesia (TEA) is a rare cause of acute amnestic syndromes (AAS), often misdiagnosed as transient global amnesia (TGA). We proposed a scoring system—the EPIlepsy AMNEsia (EPIAMNE) score—using quantitative EEG (qEEG) analysis to obtain a tool for differentiating TEA from TGA. We retrospectively reviewed clinical information and standard EEGs (stEEG) of 19 patients with TEA and 21 with TGA. We computed and compared Power Spectral Density, demonstrating an increased relative theta power in TGA. We subsequently incorporated qEEG features in EPIAMNE score, together with clinical and stEEG features. ROC curve models and pairwise ROC curve comparison were used to evaluate and compare the diagnostic accuracy for TEA detection of EPIAMNE score, presence of symptoms atypical for TGA (pSymAT) and identification of anomalies (interictal epileptiform or temporal focal spiky transients) at stEEG (PosEEG). Area Under the Curve (AUC) of EPIAMNE score revealed to be higher than PosEEG and pSymAT (AUCEPIAMNE = 0.95, AUCpSymAT = 0.85, AUCPosEEG = 0.67) and this superiority proved to be statistically significant (p-valueEPIAMNE-PosEEG and p-valueEPIAMNE-pSymAT < 0.05). In conclusion, EPIAMNE score classified TEA with higher accuracy than PosEEG and pSymAT. This approach could become a promising tool for the differential diagnosis of AAS, especially for early TEA detection.

A test-retest resting, and cognitive state EEG dataset during multiple subject-driven states

Here we present a test-retest dataset of electroencephalogram (EEG) acquired at two resting (eyes open and eyes closed) and three subject-driven cognitive states (memory, music, subtraction) with both short-term (within 90 mins) and long-term (one-month apart) designs. 60 participants were recorded during three EEG sessions. Each session includes EEG and behavioral data along with rich samples of behavioral assessments testing demographic, sleep, emotion, mental health and the content of self-generated thoughts (mind wandering). This data enables the investigation of both intra- and inter-session variability not only limited to electrophysiological changes, but also including alterations in resting and cognitive states, at high temporal resolution. Also, this dataset is expected to add contributions to the reliability and validity of EEG measurements with open resource.

Stability of spectral estimates in resting-state magnetoencephalography: Recommendations for minimal data duration with neuroanatomical specificity

The principle of resting-state paradigms is appealing and practical for collecting data from impaired patients and special populations, especially if data collection times can be minimized. To achieve this goal, researchers need to ensure estimated signal features of interest are robust. In electro- and magnetoencephalography (EEG, MEG) we are not aware of any studies of the minimal length of data required to yield a robust one-session snapshot of the frequency-spectrum derivatives that are typically used to characterize the complex dynamics of the brain’s resting-state. We aimed to fill this knowledge gap by studying the stability of common spectra measures of resting-state MEG source time series obtained from large samples of single-session recordings from shared data repositories featuring different recording conditions and instrument technologies (OMEGA: N = 107; Cam-CAN: N = 50). We discovered that the rhythmic and arrhythmic spectral properties of intrinsic brain activity can be robustly estimated in most cortical regions when derived from relatively short segments of 30-s to 120-s of resting-state data, regardless of instrument technology and resting-state paradigm. Using an adapted leave-one-out approach and Bayesian analysis, we also provide evidence that the stability of spectral features over time is unaffected by age, sex, handedness, and general cognitive function. In summary, short MEG sessions are sufficient to yield robust estimates of frequency-defined brain activity during resting-state. This study may help guide future empirical designs in the field, particularly when recording times need to be minimized, such as with patient or special populations.

Biofeedback as an intervention for persistent post-concussive symptoms: A randomized feasibility trial

Background

Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible.

Purpose

To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms.

Methods

Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the intervention group completed three 20 min low-resolution electromagnetic tomography neurofeedback sessions per week and at-home heart rate variability biofeedback training every morning and night for 8 weeks. Feasibility was evaluated according to recruitment capability and sample characteristics, data collection procedures, suitability of the intervention and study procedures, management and implementation of the study intervention, and preliminary participant responses to the intervention.

Results

Thirty-three individuals were recruited and 24 completed this study (seven intervention participants, nine persistent post-concussive symptoms control participants, and eight healthy control participants). One-quarter of participants (four intervention participants and three persistent post-concussive symptoms control participants) experienced simulator sickness during the driving simulator task and had to withdraw from the study. Intervention participants had an 88% and 86% compliance rate for the low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback sessions, respectively. Low-resolution electromagnetic tomography neurofeedback sessions took approximately 1 h to complete per participant. Preliminary analysis indicated that the intervention reduced electroencephalograph z-score deviation with a very large effect size ( d = 1.36) compared to the other study groups.

Conclusions

Pilot studies evaluating the efficacy of low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback should be performed to confirm these preliminary findings. However, the protocol should be modified to reduce participant fatigue and withdrawal. This trial was registered with Clinicialtrials.gov (NCT03338036; https://clinicaltrials.gov/ct2/show/NCT03338036?term=03338036&draw=2&rank=1 ).

Characteristic changes in EEG spectral powers of patients with opioid-use disorder as compared with those with methamphetamine- and alcohol-use disorders

Electroencephalography (EEG) likely reflects activity of cortical neurocircuits, making it an insightful estimation for mental health in patients with substance use disorder (SUD). EEG signals are recorded as sinusoidal waves, containing spectral amplitudes across several frequency bands with high spatio-temporal resolution. Prior work on EEG signal analysis has been made mainly at individual electrodes. These signals can be evaluated from advanced aspects, including sub-regional and hemispheric analyses. Due to limitation of computational techniques, few studies in earlier work could conduct data analyses from these aspects. Therefore, EEG in patients with SUD is not fully understood. In the present retrospective study, spectral powers from a data house containing opioid (OUD), methamphetamine/stimulants (MUD), and alcohol use disorder (AUD) were extracted, and then converted into five distinct topographic data (i.e., electrode-based, cortical subregion-based, left-right hemispheric, anterior-posterior based, and total cortex-based analyses). We found that data conversion and reorganization in the topographic way had an impact on EEG spectral powers in patients with OUD significantly different from those with MUD or AUD. Differential changes were observed from multiple perspectives, including individual electrodes, subregions, hemispheres, anterior-posterior cortices, and across the cortex as a whole. Understanding the differential changes in EEG signals may be useful for future work with machine learning and artificial intelligence (AI), not only for diagnostic but also for prognostic purposes in patients with SUD.

Resting state EEG biomarkers of cognitive decline associated with Alzheimer's disease and mild cognitive impairment

In this paper, we explore the utility of resting-state EEG measures as potential biomarkers for the detection and assessment of cognitive decline in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Neurophysiological biomarkers of AD derived from EEG and FDG-PET, once characterized and validated, would expand the set of existing diagnostic molecular biomarkers of AD pathology with associated biomarkers of disease progression and neural dysfunction. Since symptoms of AD often begin to appear later in life, successful identification of EEG-based biomarkers must account for age-related neurophysiological changes that occur even in healthy individuals. To this end, we collected EEG data from individuals with AD (n = 26), MCI (n = 53), and cognitively normal healthy controls stratified by age into three groups: 18-40 (n = 129), 40-60 (n = 62) and 60-90 (= 55) years old. For each participant, we computed power spectral density at each channel and spectral coherence between pairs of channels. Compared to age matched controls, in the AD group, we found increases in both spectral power and coherence at the slower frequencies (Delta, Theta). A smaller but significant increase in power of slow frequencies was observed for the MCI group, localized to temporal areas. These effects on slow frequency spectral power opposed that of normal aging observed by a decrease in the power of slow frequencies in our control groups. The AD group showed a significant decrease in the spectral power and coherence in the Alpha band consistent with the same effect in normal aging. However, the MCI group did not show any significant change in the Alpha band. Overall, Theta to Alpha ratio (TAR) provided the largest and most significant differences between the AD group and controls. However, differences in the MCI group remained small and localized. We proposed a novel method to quantify these small differences between Theta and Alpha bands' power using empirically derived distributions of spectral power across the time domain as opposed to averaging power across time. We defined Power Distribution Distance Measure (PDDM) as a distance measure between probability distribution functions (pdf) of Theta and Alpha power. Compared to average TAR, using PDDF enhanced the statistical significance, the effect size, and the spatial distribution of significant effects in the MCI group. We designed classifiers for differentiating individual MCI and AD participants from age-matched controls. The classification performance measured by the area under ROC curve after cross-validation were AUC = 0.85 and AUC = 0.6, for AD and MCI classifiers, respectively. Posterior probability of AD, TAR, and the proposed PDDM measure were all significantly correlated with MMSE score and neuropsychological tests in the AD group.

Special Report on the Impact of the COVID-19 Pandemic on Clinical EEG and Research and Consensus Recommendations for the Safe Use of EEG

INTRODUCTION

The global COVID-19 pandemic has affected the economy, daily life, and mental/physical health. The latter includes the use of electroencephalography (EEG) in clinical practice and research. We report a survey of the impact of COVID-19 on the use of clinical EEG in practice and research in several countries, and the recommendations of an international panel of experts for the safe application of EEG during and after this pandemic.

METHODS

Fifteen clinicians from 8 different countries and 25 researchers from 13 different countries reported the impact of COVID-19 on their EEG activities, the procedures implemented in response to the COVID-19 pandemic, and precautions planned or already implemented during the reopening of EEG activities.

RESULTS

Of the 15 clinical centers responding, 11 reported a total stoppage of all EEG activities, while 4 reduced the number of tests per day. In research settings, all 25 laboratories reported a complete stoppage of activity, with 7 laboratories reopening to some extent since initial closure. In both settings, recommended precautions for restarting or continuing EEG recording included strict hygienic rules, social distance, and assessment for infection symptoms among staff and patients/participants.

CONCLUSIONS

The COVID-19 pandemic interfered with the use of EEG recordings in clinical practice and even more in clinical research. We suggest updated best practices to allow safe EEG recordings in both research and clinical settings. The continued use of EEG is important in those with psychiatric diseases, particularly in times of social alarm such as the COVID-19 pandemic.

Electroencephalographic (EEG) alterations in young women with high subclinical eating pathology levels: a quantitative EEG study

PURPOSE

To explore electroencephalographic (EEG) alterations in young women with different eating disorder (ED) psychopathology levels.

METHODS

Thirty-seven young women completed general and ED psychopathology (i.e., the ED Examination Questionnaire; EDE-Q) measures. EEG power spectra data were investigated in two conditions: (a) 5 min of resting state (RS) and (b) 5 min of RS after a single taste of a milkshake (ML-RS). EEG analyses were performed using exact Low-Resolution Electromagnetic Tomography software (eLORETA).

RESULTS

Cluster analysis performed on the EDE-Q responses revealed a group of 17 women with high levels of ED pathology falling into the subclinical (i.e., sub-threshold) EDs category and a group of 20 women with low levels of ED pathology (controls). In the RS conditions, no significant modifications were observed between groups. Compared to controls, women with subclinical EDs showed an increase in theta activity in the parieto-occipital areas in the ML-RS condition. After controlling for body mass index and general psychopathology, theta activity in these brain structures was positively associated with EDE-Q global and subscale (restraint, shape and weight concern) scores.

CONCLUSIONS

Our results may reflect the neurophysiological substrate of ED psychopathology core features like shape/weight concerns. Previous brain imaging and qEEG studies with full-syndrome ED patients also underscored the involvement of parieto-occipital areas in ED pathophysiology. These studies also found brain alterations in the RS condition, not observed here. This is notable given that full-syndrome and subclinical EDs are considered as different manifestations of the same disease along a severity spectrum.

LEVEL OF EVIDENCE

Level V, cross-sectional, electroencephalographic, descriptive study.

Power Spectral Differences between Transient Epileptic and Global Amnesia: An eLORETA Quantitative EEG Study

Transient epileptic amnesia (TEA) is a rare epileptic condition, often confused with transient global amnesia (TGA). In a real-life scenario, differential diagnosis between these two conditions can be hard. In this study we use power spectral analysis empowered by exact Low Resolution Brain Electromagnetic Tomography (eLORETA) to evidence the differences between TEA and TGA. Fifteen patients affected by TEA (64.2 ± 5.2 y.o.; 11 female/4 male; 10 left and 5 right temporal epileptic focus) and 15 patients affected by TGA (65.8 ± 7.2 y.o.; 11 females/4 males) were retrospectively identified in our clinical records. All patients recorded EEGs after symptoms offset. EEGs were analyzed with eLORETA to evidence power spectral contrast between the two conditions. We used an inverse problem solution to localize the source of spectral differences. We found a significant increase in beta band power over the affected hemisphere of TEA patients. Significant results corresponded to the uncus and para-hippocampal gyrus, respectively Brodmann’s Areas: 36, 35, 28, 34. We present original evidence of an increase in beta power in the affected hemisphere (AH) of TEA as compared to TGA. These differences involve key areas of the memory network located in the mesial temporal lobe. Spectral asymmetries could be used in the future to recognize cases of amnesia with a high risk of epilepsy.

Brain Cortex Activity in Children With Anterior Open Bite: A Pilot Study

Anterior open bite (AOB) is related to functional alterations of the stomatognathic system. There are no studies concerning brain activation of the cortex comparing children with and without AOB during rest and activities such as deglutition and phonation. The aim of this study was to determine the activity of the brain cortex of children with AOB at rest and during phonation and deglutition and to evaluate the association of intelligence quotient (IQ), attention (Test of Variables of Attention, known as TOVA), beats per minute (BPM), and oxygen saturation measurement (SpO₂) with brain activity in subjects with AOB. Fourteen children (seven with AOB and seven without AOB) with mixed dentition, aged 10–13 years, underwent an IQ test, TOVA, SpO₂, and quantitative electroencephalography (QEEG). Electrodes were set in the scalp, according to the 10–20 protocol. Data were analyzed using statistical tests to assess comparisons between children with and without AOB. The results showed that IQ, TOVA, SpO₂, or BPM did not show any statistically significant differences between the groups, except for the response time (contained in TOVA) (p = 0.03). Significant differences were found for the brain activity during rest (Condition 1) of the tongue, between children with and without AOB (p < 0.05 for alpha/theta and alpha peaks), whereas there were no differences during function (Condition 2). The findings of this investigation provide insights about the cortex activity of the brain while the tongue is in the resting position in children with AOB. This may imply an altered activity of the brain cortex, which should be considered when diagnosing and treating AOB. Other diagnostic techniques derived from investigations based on neuroscience could develop new diagnostic and therapeutic techniques to give better solutions to children with malocclusions. Treatments should be focused not only on the teeth but also on the brain cortex.

Estimating Mental Health Conditions of Patients with Opioid Use Disorder

Objectives

Noninvasive estimation of cortical activity aberrance may be a challenge but gives valuable clues of mental health in patients. The goal of the present study was to characterize specificity of electroencephalogram (EEG) electrodes used to assess spectral powers associated with mental health conditions of patients with opioid use disorder.

Methods

This retrospective study included 16 patients who had been diagnosed with opioid use disorder in comparison with 16 sex- and age-matched healthy controls. EEG electrodes were placed in the frontal (FP1, FP2, F3, F4, F7, F8, and Fz), central (C3, C4, and Cz), temporal (T3, T4, T5, and T6), parietal (P3, P4, and Pz), and occipital scalp (O1 and O2). Spectral powers of δ, θ, α, β, and γ oscillations were determined, and their distribution was topographically mapped with those electrodes on the scalp.

Results

Compared to healthy controls, the spectral powers at low frequencies (<8 Hz; δ and θ) were increased in most electrodes across the scalp, while powers at the high frequencies (>12 Hz; β and γ) were selectively increased only at electrodes located in the frontal and central scalp. Among 19 electrodes, F3, F4, Fz, and Cz were highly specific in detecting increases in δ, θ, β, and γ powers of patients with opioid use disorders.

Conclusion

Results of the present study demonstrate that spectral powers are topographically distributed across the scalp, which can be quantitatively characterized. Electrodes located at F3, F4, Fz, and Cz could be specifically utilized to assess mental health in patients with opioid use disorders. Mechanisms responsible for neuroplasticity involving cortical pyramidal neurons and μ-opioid receptor regulations are discussed within the context of changes in EEG microstates.

Abnormal EEG Power Spectra in Acute Transient Global Amnesia: A Quantitative EEG Study

Transient global amnesia (TGA) is a clinical syndrome characterized by retrograde and anterograde amnesia without other neurological deficits. Although electroencephalography (EEG) methods are commonly used in both clinical and research setting with TGA patients, few studies have investigated neurophysiological pattern in TGA using quantitative EEG (qEEG). The main aim of the present study was to extend these previous findings by exploring EEG power spectra differences between patients with acute TGA and healthy controls using the exact low-resolution brain electromagnetic tomography software (eLORETA). EEG was recorded during 5 minutes of resting state. Sixteen patients (mean age: 66.81 ± 7.94 years) during acute TGA and 16 healthy subjects were enrolled. All patients showed hippocampal or parahippocampal signal abnormalities in diffusion-weighted magnetic resonance imaging performed from 2 to 5 days after the onset of TGA. Compared with healthy controls, TGA patients showed a decrease of theta power localized in the temporal lobe (Brodmann areas, BAs 21-22-38) and frontal lobe (BAs 8-9-44-45). A decrease of EEG beta power in the bilateral precuneus (BA 7) and in the bilateral postcentral gyrus (BAs 3-4-5) was also observed in TGA individuals. Taken together, our results could reflect the neurophysiological substrate of the severe impairment of both episodic memory and autobiographical memory which affect TGA patients during the acute phase.

Abnormal Resting-State Quantitative Electroencephalogram in Children With Central Auditory Processing Disorder: A Pilot Study

In this study, we showed an abnormal resting-state quantitative electroencephalogram (QEEG) pattern in children with central auditory processing disorder (CAPD). Twenty-seven children (16 male, 11 female; mean age = 10.7 years) with CAPD and no symptoms of other developmental disorders, as well as 23 age- and sex-matched, typically developing children (TDC, 11 male, 13 female; mean age = 11.8 years) underwent examination of central auditory processes (CAPs) and QEEG evaluation consisting of two randomly presented blocks of “Eyes Open” (EO) or “Eyes Closed” (EC) recordings. Significant correlations between individual frequency band powers and CAP tests performance were found. The QEEG studies revealed that in CAPD relative to TDC there was no effect of decreased delta absolute power (1.5–4 Hz) in EO compared to the EC condition. Furthermore, children with CAPD showed increased theta power (4–8 Hz) in the frontal area, a tendency toward elevated theta power in EO block, and reduced low-frequency beta power (12–15 Hz) in the bilateral occipital and the left temporo-occipital regions for both EO and EC conditions. Decreased middle-frequency beta power (15–18 Hz) in children with CAPD was observed only in the EC block. The findings of the present study suggest that QEEG could be an adequate tool to discriminate children with CAPD from normally developing children. Correlation analysis shows relationship between the individual EEG resting frequency bands and the CAPs. Increased power of slow waves and decreased power of fast rhythms could indicate abnormal functioning (hypoarousal of the cortex and/or an immaturity) of brain areas not specialized in auditory information processing.

Self-guided Positive Imagery Training: Effects beyond the Emotions-A Loreta Study

Previously we demonstrated that a 12-week lasting self-guided positive imagery training had a positive effect on the psycho-emotional state of healthy subjects and was associated with an increase in functional connectivity in the brain. Here we repeated the previous project, but expanded the study, testing the hypothesis that training can also affect cognitive functions. Twenty subjects (half of them with subthreshold depression according CES-D) participated in the program of positive imagery training for 12 weeks. The schedule began with group training for 2 days, followed by training at home. Evaluations of cognitive functions and electroencephalographic (EEG) activity were conducted during three examinations as follows: E0-baseline (1 month before the training); E1-pre-training and E2-post-training. CNS Vital Signs battery was used to test the following cognitive domains: verbal and visual memory, executive functions, cognitive flexibility, social acuity, non-verbal reasoning. EEGs (19-channel) were recorded at rest with closed eyes and analyzed with Low-resolution electromagnetic tomography software. One-way repeated measures ANOVA, followed by pairwise comparison showed a significant increase after training (E2 vs. E1; E2 vs. E0) in the number of correct hits for positive emotions received during perception of emotions test (POET); after the sample was split according to the initial presence of depressive symptoms, the effect was present only in the subgroup with subthreshold depressive symptomatology. Post-training (E2 vs. E1; E2 vs. E0) the number of correct answers on non-verbal reasoning test increased; this effect was observed only in the subgroup that does have any depressive symptoms. Comparison of EEG post-training vs. pre-training demonstrated a significant reduction in current source density (CSD) after the training in the left hemisphere (insular cortex, frontal and temporal lobes in delta, theta and alpha1 bands). The observed changes were presented only in the subgroup with initial subthreshold depressive symptomatology. A negative correlation was found between POET and CSD in the left insular cortex for theta band. No significant differences were observed when data from EEG and cognitive tests obtained during pre-training were compared with baseline values. Potential use of training for the rehabilitation of various disturbances with cognitive and emotional deficits is discussed.

Psychospiritual Resiliency: Enhancing Mental Health and Ecclesiastical Collaboration in Caring for Those Experiencing Dissociative Phenomena

Trauma can oftentimes be a catalyst for changes in an individual's religious and spiritual beliefs. Beliefs about the cause of the trauma, for instance, may include attributions of possessing spirits, and are to be found in an increasingly pluralistic and multicultural society. Such preternatural explanations may be referred to as dissociative identity disorder, possession form. Unwittingly, an overreliance on neurobiological explanations and relegation of cultural idioms of distress may diminish effective collaboration with ecclesiastical authorities. Concomitantly, ecclesiastical experts are confronted with bewildering posttrauma dissociative symptomatology, and may not be prepared as diagnosticians to rule out psychobiological explanations. In both instances, client care may be compromised. Noteworthy, the current investigation integrates the author's participant observation research at the Vatican's school of Exorcism in Rome, Italy.

Quantitative electroencephalograms and neuro-optometry: a case study that explores changes in electrophysiology while wearing therapeutic eyeglasses

The brain is equipped with a complex system for processing sensory information, including retinal circuitry comprising part of the central nervous system. Retinal stimulation can influence brain function via customized eyeglasses at both subcortical and cortical levels. We investigated cortical effects from wearing therapeutic eyeglasses, hypothesizing that they can create measureable changes in electroencephalogram (EEG) tracings. A Z-Bell^SM test was performed on a participant to select optimal lenses. An EEG measurement was recorded before and after the participant wore the eyeglasses. Equivalent quantitative electroencephalography (QEEG) analyses (statistical analysis on raw EEG recordings) were performed and compared with baseline findings. With glasses on, the participant's readings were found to be closer to the normed database. The original objective of our investigation was met, and additional findings were revealed. The Z-bell^SM test identified lenses to influence neurotypical brain activity, supporting the paradigm that eyeglasses can be utilized as a therapeutic intervention. Also, EEG analysis demonstrated that encephalographic techniques can be used to identify channels through which neuro-optomertric treatments work. This case study's preliminary exploration illustrates the potential role of QEEG analysis and EEG-derived brain imaging in neuro-optometric research endeavors to affect brain function.

Neuroimaging Measures to Assess the Effectiveness of a Two-Day Marathon Group of Individuals with Early Developmental Trauma: A Pilot Study

Group therapy can be effective with individuals with developmental trauma who re-experience intense physiological traumatic distress and struggle with terror and despair. This modality can address the long-term ramifications of developmental trauma, including problems with perceptions, trust, emotional regulation, and loss of sense of self. Neuroimaging techniques can be combined with group therapy interventions as a way to empirically validate the effectiveness of group psychotherapy on brain structures and networks impacted by trauma. The neuroscience explaining overpowering traumatic responses and related emotions will be reviewed. Results of a pilot study combining group therapy with neuroimaging are presented.

Noninvasive Brain Physiology Monitoring for Extreme Environments: A Critical Review

Our ability to monitor the brain physiology is advancing; however, most of the technology is bulky, expensive, and designed for traditional clinical settings. With long-duration space exploration, there is a need for developing medical technologies that are reliable, low energy, portable, and semiautonomous. Our aim was to review the state of the art for noninvasive technologies capable of monitoring brain physiology in diverse settings. A literature review of PubMed and the Texas Medical Center library sites was performed using prespecified search criteria to identify portable technologies for monitoring physiological aspects of the brain physiology. Most brain-monitoring technologies require a moderate to high degree of operator skill. Some are low energy, but many require a constant external power supply. Most of the technologies lack the accuracy seen in gold standard measures, due to the need for calibration, but may be useful for screening or monitoring relative changes in a parameter. Most of the technologies use ultrasound or electromagnetic radiation as energy sources. There is an important need for further development of portable technologies that can be operated in a variety of extreme environments to monitor brain health.

Automated analysis of background EEG and reactivity during therapeutic hypothermia in comatose patients after cardiac arrest

Visual analysis of electroencephalography (EEG) background and reactivity during therapeutic hypothermia provides important outcome information, but is time-consuming and not always consistent between reviewers. Automated EEG analysis may help quantify the brain damage. Forty-six comatose patients in therapeutic hypothermia, after cardiac arrest, were included in the study. EEG background was quantified with burst-suppression ratio (BSR) and approximate entropy, both used to monitor anesthesia. Reactivity was detected through change in the power spectrum of signal before and after stimulation. Automatic results obtained almost perfect agreement (discontinuity) to substantial agreement (background reactivity) with a visual score from EEG-certified neurologists. Burst-suppression ratio was more suited to distinguish continuous EEG background from burst-suppression than approximate entropy in this specific population. Automatic EEG background and reactivity measures were significantly related to good and poor outcome. We conclude that quantitative EEG measurements can provide promising information regarding current state of the patient and clinical outcome, but further work is needed before routine application in a clinical setting.

Reversing pathologically increased EEG power by acoustic coordinated reset neuromodulation

Acoustic Coordinated Reset (CR) neuromodulation is a patterned stimulation with tones adjusted to the patient's dominant tinnitus frequency, which aims at desynchronizing pathological neuronal synchronization. In a recent proof-of-concept study, CR therapy, delivered 4-6 h/day more than 12 weeks, induced a significant clinical improvement along with a significant long-lasting decrease of pathological oscillatory power in the low frequency as well as γ band and an increase of the α power in a network of tinnitus-related brain areas. As yet, it remains unclear whether CR shifts the brain activity toward physiological levels or whether it induces clinically beneficial, but nonetheless abnormal electroencephalographic (EEG) patterns, for example excessively decreased δ and/or γ. Here, we compared the patients' spontaneous EEG data at baseline as well as after 12 weeks of CR therapy with the spontaneous EEG of healthy controls by means of Brain Electrical Source Analysis source montage and standardized low-resolution brain electromagnetic tomography techniques. The relationship between changes in EEG power and clinical scores was investigated using a partial least squares approach. In this way, we show that acoustic CR neuromodulation leads to a normalization of the oscillatory power in the tinnitus-related network of brain areas, most prominently in temporal regions. A positive association was found between the changes in tinnitus severity and the normalization of δ and γ power in the temporal, parietal, and cingulate cortical regions. Our findings demonstrate a widespread CR-induced normalization of EEG power, significantly associated with a reduction of tinnitus severity.

Coherence, phase differences, phase shift, and phase lock in EEG/ERP analyses

Electroencephalogram (EEG) coherence is a mixture of phase locking interrupted by phase shifts in the spontaneous EEG. Average reference, Laplacian transforms, and independent component (ICA) reconstruction of time series can distort physiologically generated phase differences and invalidate the computation of coherence and phase differences as well as in the computation of directed coherence and phase reset. Time domain measures of phase shift and phase lock are less prone to artifact and are independent of volume conduction. Cross-frequency synchrony in the surface EEG and in Low Resolution Electromagnetic Tomography (LORETA) provides insights into dynamic functions of the brain.

Music therapy modulates fronto-temporal activity in rest-EEG in depressed clients

Fronto-temporal areas process shared elements of speech and music. Improvisational psychodynamic music therapy (MT) utilizes verbal and musical reflection on emotions and images arising from clinical improvisation. Music listening is shifting frontal alpha asymmetries (FAA) in depression, and increases frontal midline theta (FMT). In a two-armed randomized controlled trial (RCT) with 79 depressed clients (with comorbid anxiety), we compared standard care (SC) versus MT added to SC at intake and after 3 months. We found that MT significantly reduced depression and anxiety symptoms. The purpose of this study is to test whether or not MT has an impact on anterior fronto-temporal resting state alpha and theta oscillations. Correlations between anterior EEG, Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A), power spectral analysis (topography, means, asymmetry) and normative EEG database comparisons were explored. After 3 month of MT, lasting changes in resting EEG were observed, i.e., significant absolute power increases at left fronto-temporal alpha, but most distinct for theta (also at left fronto-central and right temporoparietal leads). MT differed to SC at F7-F8 (z scored FAA, p < .03) and T3-T4 (theta, p < .005) asymmetry scores, pointing towards decreased relative left-sided brain activity after MT; pre/post increased FMT and decreased HADS-A scores (r = .42, p < .05) indicate reduced anxiety after MT. Verbal reflection and improvising on emotions in MT may induce neural reorganization in fronto-temporal areas. Alpha and theta changes in fronto-temporal and temporoparietal areas indicate MT action and treatment effects on cortical activity in depression, suggesting an impact of MT on anxiety reduction.

Diffusion spectral imaging modules correlate with EEG LORETA neuroimaging modules

OBJECTIVES

The purpose of this study was to test the hypothesis that the highest temporal correlations between 3-dimensional EEG current source density corresponds to anatomical Modules of high synaptic connectivity.

METHODS

Eyes closed and eyes open EEG was recorded from 19 scalp locations with a linked ears reference from 71 subjects age 13-42 years. LORETA was computed from 1 to 30 Hz in 2,394 cortical gray matter voxels that were grouped into six anatomical Modules corresponding to the ROIs in the Hagmann et al.'s [2008] diffusion spectral imaging (DSI) study. All possible cross-correlations between voxels within a DSI Module were compared with the correlations between Modules.

RESULTS

The Hagmann et al. [ 2008] Module correlation structure was replicated in the correlation structure of EEG three-dimensional current source density.

CONCLUSIONS

EEG Temporal correlation between brain regions is related to synaptic density as measured by diffusion spectral imaging.