Left-hemispheric abnormal EEG activity in relation to impairment and recovery in aphasic patients

Analysis of reading-task-based brain connectivity in dyslexic children using EEG signals

Developmental dyslexia, a neurodevelopment reading disorder, can impact even children with average intelligence. The present study examined the brain connectivity in dyslexic and control children during the reading task using graph theory. 19-channel electroencephalogram (EEG) signals were recorded from 15 dyslexic children and 15 control children. Functional connectivity was estimated by measuring the EEG coherence at 19 electrode locations, and graph measures were calculated using the graph theory method. Reading task results identified deprived task performance in dyslexic children against controls. Graph measures revealed longer path length, reduced clustering coefficient and reduced network efficiencies (in theta and alpha bands) of dyslexic group. At the nodal level, we found a significant increase in delta strength (T4 and T5 electrode locations) and reduced strength in theta (T6, P4, Fp1, F8 and F3) and alpha bands (T4, T3, P4 and F3) during the reading task in dyslexic group. In conclusion, the present study identified distinct graph measures between groups when performing a reading task and showed possible evidence for compromised brain networks in dyslexic group.

Exploratory Study on the Clinical use of EEG for the People with Chronic Stroke and Their Correlation with the Neuropsychological Outcome

Objective. To measure the EEG signals of the people with chronic stroke in eyes-closed and eyes-open condition and study their relationship with the cognitive function and mental wellbeing. Methods. The investigators would conduct cognitive and mental wellbeing tests on recruited subjects. Their EEG signal was acquired by the 16-channel EEG system. The absolute power under different frequency bands and EEG indices (delta alpha ratio and pairwise derived brain symmetry index) in different eye conditions was calculated. Pearson's correlation was conducted to investigate the association between the clinical tests and the EEG index. Results. 32 subjects were recruited for the study. There was a significant correlation between the pairwise derived brain symmetry index (pdBSI) in eyes-open condition with the Stroop Test (p = .002), Paced Auditory Serial Addition Test-3 s (p = .008)/2 s (p = .002) and WHO-5 well-being scale (p = .023). Conclusions. There is a significant correlation between the brain symmetry index and the cognitive and wellbeing assessment. Brain symmetry index over the delta frequency has been found to be the most useful parameter relating to the clinical score.Significance:It is recommended to use EEG as an adjunctive neuropsychological assessment in clinics for people with chronic stroke, especially for clients who could not undertake conventional assessments (eg aphasia, attention problem).Highlights: There is a significant correlation between the EEG index and the clinical neuropsychological assessmentPairwise Derived Brain Symmetry index in delta frequency range correlated with most of the neuropsychological outcome.It is feasible for us to adopt EEG as an adjunctive assessment in clinical settings.

Electrophysiological Changes in Patients with Post-stroke Aphasia: A Systematic Review

Background Magnetoencephalography (MEG) and electroencephalography (EEG) record two main types of data: continuous measurements at rest or during sleep, and event-related potentials/evoked magnetic fields (ERPs/EMFs) that involve specific and repetitive tasks. In this systematic review, we summarized longitudinal studies on recovery from post-stroke aphasia that used continuous or event-related temporal imaging (EEG or MEG). Methods We searched PubMed and Scopus for English articles published from 1950 to May 31, 2022. Results 34 studies were included in this review: 11 were non-interventional studies and 23 were clinical trials that used specific rehabilitation methods, neuromodulation, or drugs. The results of the non-interventional studies suggested that poor language recovery was associated with slow-wave activity persisting over time. The results of some clinical trials indicated that behavioral improvements were correlated with significant modulation of the N400 component. Discussion Compared with continuous EEG, ERP/EMF may more reliably identify biomarkers of therapy-induced effects. Electrophysiology should be used more often to explore language processes that are impaired after a stroke, as it may highlight treatment challenges for patients with post-stroke aphasia.

EEG based functional brain networks analysis in dyslexic children during arithmetic task

Developmental Dyslexia is a neuro-developmental disorder that often refers to a phonological processing deficit regardless of average IQ. The present study investigated the distinct functional changes in brain networks of dyslexic children during arithmetic task performance using an electroencephalogram. Fifteen dyslexic children and fifteen normally developing children (NDC) were recruited and performed an arithmetic task. Brain functional network measures such as node strength, clustering coefficient, characteristic pathlength and small-world were calculated using graph theory methods for both groups. Task performance showed significantly less performance accuracy in dyslexics against NDC. The neural findings showed increased connectivity in the delta band and reduced connectivity in theta, alpha, and beta band at temporoparietal, and prefrontal regions in dyslexic group while performing the task. The node strengths were found to be significantly high in delta band (T3, O1, F8 regions) and low in theta (T5, P3, Pz regions), beta (Pz) and gamma band (T4 and prefrontal regions) during the task in dyslexics compared to the NDC. The clustering coefficient was found to be significantly low in the dyslexic group (theta and alpha band) and characteristic pathlength was found to be significantly high in the dyslexic group (theta and alpha band) compared to the NDC group while performing task. In conclusion, the present study shows evidence for poor fact-retrieval mechanism and altered network topology in dyslexic brain networks during arithmetic task performance.

The Prognostic Utility of Electroencephalography in Stroke Recovery: A Systematic Review and Meta-Analysis

BACKGROUND

Improved ability to predict patient recovery would guide post-stroke care by helping clinicians personalize treatment and maximize outcomes. Electroencephalography (EEG) provides a direct measure of the functional neuroelectric activity in the brain that forms the basis for neuroplasticity and recovery, and thus may increase prognostic ability.

OBJECTIVE

To examine evidence for the prognostic utility of EEG in stroke recovery via systematic review/meta-analysis.

METHODS

Peer-reviewed journal articles that examined the relationship between EEG and subsequent clinical outcome(s) in stroke were searched using electronic databases. Two independent researchers extracted data for synthesis. Linear meta-regressions were performed across subsets of papers with common outcome measures to quantify the association between EEG and outcome.

RESULTS

75 papers were included. Association between EEG and clinical outcomes was seen not only early post-stroke, but more than 6 months post-stroke. The most studied prognostic potential of EEG was in predicting independence and stroke severity in the standard acute stroke care setting. The meta-analysis showed that EEG was associated with subsequent clinical outcomes measured by the Modified Rankin Scale, National Institutes of Health Stroke Scale, and Fugl-Meyer Upper Extremity Assessment (r = .72, .70, and .53 from 8, 13, and 12 papers, respectively). EEG improved prognostic abilities beyond prediction afforded by standard clinical assessments. However, the EEG variables examined were highly variable across studies and did not converge.

CONCLUSIONS

EEG shows potential to predict post-stroke recovery outcomes. However, evidence is largely explorative, primarily due to the lack of a definitive set of EEG measures to be used for prognosis.

Distinct Slow-Wave Activity Patterns in Resting-State Electroencephalography and Their Relation to Language Functioning in Low-Grade Glioma and Meningioma Patients

Introduction

Brain tumours frequently cause language impairments and are also likely to co-occur with localised abnormal slow-wave brain activity. However, it is unclear whether this applies specifically to low-grade brain tumours. We investigate slow-wave activity in resting-state electroencephalography (EEG) in low-grade glioma and meningioma patients, and its relation to pre- and postoperative language functioning.

Method

Patients with a glioma (N = 15) infiltrating the language-dominant hemisphere and patients with a meningioma (N = 10) with mass effect on this hemisphere underwent extensive language testing before and 1 year after surgery. EEG was registered preoperatively, postoperatively (glioma patients only), and once in healthy individuals. Slow-wave activity in delta- and theta- frequency bands was evaluated visually and quantitatively by spectral power at three levels over the scalp: the whole brain, the affected hemisphere, and the affected region.

Results

Glioma patients had increased delta activity (affected area) and increased theta activity (all levels) before and after surgery. In these patients, increased preoperative theta activity was related to the presence of language impairment, especially to poor word retrieval and grammatical performance. Preoperative slow-wave activity was also related to postoperative language outcomes. Meningioma patients showed no significant increase in EEG slow-wave activity compared to healthy individuals, but they presented with word retrieval, grammatical, and writing problems preoperatively, as well as with writing impairments postoperatively.

Discussion

Although the brain-tumour pathology in low-grade gliomas and meningiomas has a different effect on resting-state brain activity, patients with low-grade gliomas and meningiomas both suffer from language impairments. Increased theta activity in glioma patients can be considered as a language-impairment marker, with prognostic value for language outcome after surgery.

Electroencephalogram (EEG) With or Without Transcranial Magnetic Stimulation (TMS) as Biomarkers for Post-stroke Recovery: A Narrative Review

Stroke is one of the leading causes of death and disability. Despite the high prevalence of stroke, characterizing the acute neural recovery patterns that follow stroke and predicting long-term recovery remains challenging. Objective methods to quantify and characterize neural injury are still lacking. Since neuroimaging methods have a poor temporal resolution, EEG has been used as a method for characterizing post-stroke recovery mechanisms for various deficits including motor, language, and cognition as well as predicting treatment response to experimental therapies. In addition, transcranial magnetic stimulation (TMS), a form of non-invasive brain stimulation, has been used in conjunction with EEG (TMS-EEG) to evaluate neurophysiology for a variety of indications. TMS-EEG has significant potential for exploring brain connectivity using focal TMS-evoked potentials and oscillations, which may allow for the system-specific delineation of recovery patterns after stroke. In this review, we summarize the use of EEG alone or in combination with TMS in post-stroke motor, language, cognition, and functional/global recovery. Overall, stroke leads to a reduction in higher frequency activity (≥8 Hz) and intra-hemispheric connectivity in the lesioned hemisphere, which creates an activity imbalance between non-lesioned and lesioned hemispheres. Compensatory activity in the non-lesioned hemisphere leads mostly to unfavorable outcomes and further aggravated interhemispheric imbalance. Balanced interhemispheric activity with increased intrahemispheric coherence in the lesioned networks correlates with improved post-stroke recovery. TMS-EEG studies reveal the clinical importance of cortical reactivity and functional connectivity within the sensorimotor cortex for motor recovery after stroke. Although post-stroke motor studies support the prognostic value of TMS-EEG, more studies are needed to determine its utility as a biomarker for recovery across domains including language, cognition, and hemispatial neglect. As a complement to MRI-based technologies, EEG-based technologies are accessible and valuable non-invasive clinical tools in stroke neurology.

Electrophysiologic evidence of reorganization in poststroke aphasia

Electrophysiologic methods have been used to investigate neural changes in individuals with poststroke aphasia. The major types of electrophysiologic measures include the event-related potential (ERP) and spectral power, and aspects of both (including amplitude, topography, and power) have been shown to differ in people with aphasia. Not only that, these measures are sensitive to spontaneous and treatment-induced language change. The purpose of this chapter is to review evidence of poststroke reorganization in the language network that has been identified in the acute and chronic phases of poststroke aphasia. The chapter will begin with a brief introduction to electrophysiologic methods and then focus on evidence from the most commonly studied ERPs and spectral bands in aphasia.

Brain Signals to Rescue Aphasia, Apraxia and Dysarthria Speech Recognition

In this paper, we propose a deep learning-based algorithm to improve the performance of automatic speech recognition (ASR) systems for aphasia, apraxia, and dysarthria speech by utilizing electroencephalography (EEG) features recorded synchronously with aphasia, apraxia, and dysarthria speech. We demonstrate a significant decoding performance improvement by more than 50% during test time for isolated speech recognition task and we also provide preliminary results indicating performance improvement for the more challenging continuous speech recognition task by utilizing EEG features. The results presented in this paper show the first step towards demonstrating the possibility of utilizing non-invasive neural signals to design a real-time robust speech prosthetic for stroke survivors recovering from aphasia, apraxia, and dysarthria. Our aphasia, apraxia, and dysarthria speech-EEG data set will be released to the public to help further advance this interesting and crucial research.

Spectral Resting-State EEG (rsEEG) in Chronic Aphasia Is Reliable, Sensitive, and Correlates With Functional Behavior

We investigated spectral resting-state EEG in persons with chronic stroke-induced aphasia to determine its reliability, sensitivity, and relationship to functional behaviors. Resting-state EEG has not yet been characterized in this population and was selected given the demonstrated potential of resting-state investigations using other neuroimaging techniques to guide clinical decision-making. Controls and persons with chronic stroke-induced aphasia completed two EEG recording sessions, separated by approximately 1 month, as well as behavioral assessments of language, sensorimotor, and cognitive domains. Power in the classic frequency bands (delta, theta, alpha, and beta) was examined via spectral analysis of resting-state EEG data. Results suggest that power in the theta, alpha, and beta bands is reliable for use as a repeated measure. Significantly greater theta and lower beta power was observed in persons with aphasia (PWAs) than controls. Finally, in PWAs theta power negatively correlated with performance on a discourse informativeness measure, while alpha and beta power positively correlated with performance on the same measure. This indicates that spectral rsEEG slowing observed in PWAs in the chronic stage is pathological and suggests a possible avenue for directly altering brain activation to improve behavioral function. Taken together, these results suggest that spectral resting-state EEG holds promise for sensitive measurement of functioning and change in persons with chronic aphasia. Future studies investigating the utility of these measures as biomarkers of frank or latent aphasic deficits and treatment response in chronic stroke-induced aphasia are warranted.

Effects of somatosensory electrical stimulation on motor function and cortical oscillations

Background

Few patients recover full hand dexterity after an acquired brain injury such as stroke. Repetitive somatosensory electrical stimulation (SES) is a promising method to promote recovery of hand function. However, studies using SES have largely focused on gross motor function; it remains unclear if it can modulate distal hand functions such as finger individuation.

Objective

The specific goal of this study was to monitor the effects of SES on individuation as well as on cortical oscillations measured using EEG, with the additional goal of identifying neurophysiological biomarkers.

Methods

Eight participants with a history of acquired brain injury and distal upper limb motor impairments received a single two-hour session of SES using transcutaneous electrical nerve stimulation. Pre- and post-intervention assessments consisted of the Action Research Arm Test (ARAT), finger fractionation, pinch force, and the modified Ashworth scale (MAS), along with resting-state EEG monitoring.

Results

SES was associated with significant improvements in ARAT, MAS and finger fractionation. Moreover, SES was associated with a decrease in low frequency (0.9-4 Hz delta) ipsilesional parietomotor EEG power. Interestingly, changes in ipsilesional motor theta (4.8–7.9 Hz) and alpha (8.8–11.7 Hz) power were significantly correlated with finger fractionation improvements when using a multivariate model.

Conclusions

We show the positive effects of SES on finger individuation and identify cortical oscillations that may be important electrophysiological biomarkers of individual responsiveness to SES. These biomarkers can be potential targets when customizing SES parameters to individuals with hand dexterity deficits. Trial registration: NCT03176550; retrospectively registered.

Electronic supplementary material

The online version of this article (10.1186/s12984-017-0323-1) contains supplementary material, which is available to authorized users.

Adaptive Plasticity in the Healthy Language Network: Implications for Language Recovery after Stroke

Across the last three decades, the application of noninvasive brain stimulation (NIBS) has substantially increased the current knowledge of the brain's potential to undergo rapid short-term reorganization on the systems level. A large number of studies applied transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in the healthy brain to probe the functional relevance and interaction of specific areas for different cognitive processes. NIBS is also increasingly being used to induce adaptive plasticity in motor and cognitive networks and shape cognitive functions. Recently, NIBS has been combined with electrophysiological techniques to modulate neural oscillations of specific cortical networks. In this review, we will discuss recent advances in the use of NIBS to modulate neural activity and effective connectivity in the healthy language network, with a special focus on the combination of NIBS and neuroimaging or electrophysiological approaches. Moreover, we outline how these results can be transferred to the lesioned brain to unravel the dynamics of reorganization processes in poststroke aphasia. We conclude with a critical discussion on the potential of NIBS to facilitate language recovery after stroke and propose a phase-specific model for the application of NIBS in language rehabilitation.

Supine posture inhibits cortical activity: Evidence from Delta and Alpha EEG bands

Past studies have shown consistent evidence that body position significantly affects brain activity, revealing that both head-down and horizontal bed-rest are associated with cortical inhibition and altered perceptual and cognitive processing. The present study investigates the effects of body position on spontaneous, open-eyes, resting-state EEG cortical activity in 32 young women randomly assigned to one of two conditions, seated position (SP) or horizontal bed rest (BR). A between-group repeated-measure experimental design was used, EEG recordings were made from 38 scalp locations, and low-frequency (delta and alpha) amplitudes of the two groups were compared in four different conditions: when both groups (a) were seated (T0), (b) assumed two different body positions (seated vs. supine conditions, immediate [T1] and 120min later [T2]), and (c) were seated again (T3). Overall, the results showed no a priori between-group differences (T0) before experimental manipulation. As expected, delta amplitude, an index of cortical inhibition in awake resting participants, was significantly increased in group BR, revealing both rapid (T1) and mid-term (T2) inhibitory effects of supine or horizontal positions. Instead, the alpha band was highly sensitive to postural transitions, perhaps due to baroreceptor intervention and, unlike the delta band, underwent habituation and decreased after a 2-h bed rest. These results indicate clear-cut differences at rest between the seated and supine positions, thus supporting the view that the role of body position in the differences found between brain metabolic methods (fMRI and PET) in which participants lie horizontally, and EEG-MEG-TMS techniques with participants in a seated position, has been largely underestimated so far.

Recovery Potential After Acute Stroke

In acute stroke, the major factor for recovery is the early use of thrombolysis aimed at arterial recanalization and reperfusion of ischemic brain tissue. Subsequently, neurorehabilitative training critically improves clinical recovery due to augmention of postlesional plasticity. Neuroimaging and electrophysiology studies have revealed that the location and volume of the stroke lesion, the affection of nerve fiber tracts, as well as functional and structural changes in the perilesional tissue and in large-scale bihemispheric networks are relevant biomarkers of post-stroke recovery. However, associated disorders, such as mood disorders, epilepsy, and neurodegenerative diseases, may induce secondary cerebral changes or aggravate the functional deficits and, thereby, compromise the potential for recovery.

Electroencephalographic changes following direct current deep brain stimulation of auditory cortex: a new model for investigating neuromodulation

BACKGROUND

Although deep brain (DBS) and transcranial direct current stimulation (tDCS) are used as investigative tools and therapies for a variety of neurological and psychiatric conditions, their mechanisms of action remain poorly understood. Therefore, there is a need for new animal models of neuromodulation.

OBJECTIVE

To introduce and validate a direct current DBS (DC-DBS) model that will use the anatomic precision of intracranial electrodes, as used in DBS, to apply direct current, as used in tDCS, over primary auditory cortex (A1) and induce electroencephalographic (EEG) changes.

METHODS

Twenty-four mice were assigned to 1 of 2 stimulation groups or a sham group and were implanted with electrodes in A1. Stimulation groups underwent DC-DBS stimulation for 20 minutes at 20 μA. Auditory EEG was recorded before stimulation and at 1 hour, 1 week, and 2 weeks poststimulation. EEG was analyzed for changes in N1 (N100 in humans, N40 in mice) amplitude and latency as well as delta and theta power.

RESULTS

DC-DBS led to significant EEG changes (all P values < .05). Among the stimulated animals, there were durable reductions in delta and theta power. There were no differences within the sham group, and neither N40 latencies nor amplitudes changed across time.

CONCLUSION

Our results show DC-DBS-induced reductions in slow-wave activity consistent with recent tDCS studies. We propose that this model will provide a means to explore basic mechanisms of neuromodulation and could facilitate future application of DC-DBS in humans.

Beta EEG band: a measure of functional brain damage and language reorganization in aphasic patients after recovery

Functional reorganization of language was investigated in a group of eleven non-fluent aphasic patients after linguistic recovery and in a group of matched healthy adults. The ElectroEncephaloGram (EEG) was recorded from 38 scalp electrodes and high-beta band (21-28 Hz), an index of cognitive cortical arousal, was computed as normalized percentage across 0-100 Hz spectral range in six electrode clusters during three linguistic tasks: Phonological, Semantic and Orthographic/visuo-perceptual. During the Phonological task, controls showed greater beta activation on left versus right central cluster, whereas aphasic patients exhibited an inverted pattern of lateralization. In addition, patients' left central cluster, located over the core lesion, showed reduced beta activity with respect to controls. A similar inhibited activation was found in aphasics' left posterior cluster located over undamaged areas. At left anterior locations, aphasics, unlike controls, exhibited larger left versus right beta activity during both Phonological and Orthographic/visuo-perceptual tasks. Results point to substantial reorganization of language in recovered non-fluent aphasics at left prefrontal sites located anterior to the damaged Broca's area and inhibited language-related activation in left posterior undamaged, but disconnected, regions.

Source localization of posterior slow waves of youth using dipole modeling

AIM

Posterior slow waves of youth have a well-known electroencephalographic pattern that peaks in adolescence and usually disappears in adulthood. In general, posterior slow waves of youth are regarded as normal, but some reports have suggested that their presence is related to immature personalities or inappropriate social behavior. The physiological significance of this electroencephalographic pattern, however, remains unclear. The purpose of this study was to investigate the neural origins of posterior slow waves of youth using dipole source modeling.

METHODS

Electroencephalographic epochs, including clear posterior slow waves of youth, were visually selected from electroencephalograms obtained from six normal adolescents using 25 scalp electrodes. The selected epochs were then averaged by arranging the negative peak of the slow waves at the occipital area of each epoch on the time axis. The averaged waveforms consisting of six right and one left posterior slow waves of youth were used for dipole source analysis. A single equivalent current dipole was estimated for the averaged waveforms.

RESULTS

The best equivalent current dipoles were estimated to be located in or around the fusiform and middle occipital gyrus ipsilateral to the posterior slow waves of youth.

CONCLUSIONS

The location of the estimated dipoles of posterior slow waves of youth was on the so-called ventral visual pathway. Further research is required to clarify the physiological significance of posterior slow waves of youth with respect to their origin.

Electroencephalographic dipole source modeling of frontal intermittent rhythmic delta activity

BACKGROUND

Frontal intermittent rhythmic delta activity (FIRDA) on electroencephalography (EEG) consists of a run of rhythmic delta waves with frontal predominance. Although FIRDA is a relatively common abnormal EEG finding, the underlying mechanisms that produce FIRDA remain unclear. The aim of this study was to investigate the cortical source of FIRDA using dipole source modeling.

METHODS

We selected EEG epochs, including typical FIRDAs, from EEG recordings obtained using 25 scalp electrodes on 5 subjects. We averaged these epochs by arranging the negative peaks of the delta waves at the Fp electrodes and estimated dipoles for nine averaged waveforms.

RESULTS

Averaged waveforms were explained by a single-dipole model in seven FIRDAs and by a two-dipole model in the remaining two FIRDAs with high reliability. Estimated dipoles had a radial orientation with respect to the frontal pole and were located in the medial frontal region. The anterior cingulate cortex was the most common dipole location.

CONCLUSIONS

This is the first study to approach the fundamental FIRDA mechanism by dipole source modeling and to clarify that FIRDA may be generated from the medial frontal region, particularly from the anterior cingulate cortex.

Resting state cortical electroencephalographic rhythms are related to gray matter volume in subjects with mild cognitive impairment and Alzheimer's disease

Cortical gray matter volume and resting state cortical electroencephalographic rhythms are typically abnormal in subjects with amnesic mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here we tested the hypothesis that in amnesic MCI and AD subjects, abnormalities of EEG rhythms are a functional reflection of cortical atrophy across the disease. Eyes-closed resting state EEG data were recorded in 57 healthy elderly (Nold), 102 amnesic MCI, and 108 AD patients. Cortical gray matter volume was indexed by magnetic resonance imaging recorded in the MCI and AD subjects according to Alzheimer's disease neuroimaging initiative project (http://www.adni-info.org/). EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), beta2 (20-30 Hz), and gamma (30-40 Hz). These rhythms were indexed by LORETA. Compared with the Nold, the MCI showed a decrease in amplitude of alpha 1 sources. With respect to the Nold and MCI, the AD showed an amplitude increase of delta sources, along with a strong amplitude reduction of alpha 1 sources. In the MCI and AD subjects as a whole group, the lower the cortical gray matter volume, the higher the delta sources, the lower the alpha 1 sources. The better the score to cognitive tests the higher the gray matter volume, the lower the pathological delta sources, and the higher the alpha sources. These results suggest that in amnesic MCI and AD subjects, abnormalities of resting state cortical EEG rhythms are not epiphenomena but are strictly related to neurodegeneration (atrophy of cortical gray matter) and cognition.

Delta EEG band as a marker of left hypofrontality for language in schizophrenia patients

Frontal hypoactivation has consistently been demonstrated in schizophrenia patients. We hypothesized that this well-known deficit is asymmetrical, ie, centered over left frontal locations and, in-line with Crow's theory, associated with both loss of linguistic asymmetry and correlated with positive symptoms. Electroencephalography delta band was used as a quantitative index of cortical inhibition in 17 paranoid schizophrenia patients with prevailing positive symptoms and 17 matched control subjects. Delta amplitude was measured by 38 electrodes, while participants performed 3 linguistic tasks, visuoperceptual, rhyming, and semantic judgment. Compared with control subjects, patients did not show overall delta band differences, revealing no detrimental effects of pharmacological treatment. In healthy participants, analysis of 4 quadrants/regions of interest revealed higher delta amplitude in right vs left anterior sites, indicating significant left anterior disinhibition during linguistic processing. Instead, patients showed bilateral delta band distribution and, compared with control subjects, significant greater delta amplitude (ie, brain inhibition) in linguistic left anterior centers. Patients' left hypofrontality was functionally related to their lack of hemispheric specialization for language and was positively correlated with higher levels of delusions (P1) and conceptual disorganization (P2) Positive and Negative Syndrome Scale subscales. Results suggest, in schizophrenia patients, a functional deficit of Broca's area, a region playing a fundamental hierarchical role between and within hemispheres by integrating many basic processes in linguistic and conceptual organization. The significant correlation between lack of anterior asymmetry and increased positive symptoms is in-line with Crow's hypothesis postulating the etiological role of disrupted linguistic frontal asymmetry on the onset of the key symptoms of schizophrenia.

ERP Correlates of Word Production before and after Stroke in an Aphasic Patient

Changes in brain activity characterizing impaired speech production after brain damage have usually been investigated by comparing aphasic speakers with healthy subjects because prestroke data are normally not available. However, when interpreting the results of studies of stroke patients versus healthy controls, there is an inherent difficulty in disentangling the contribution of neuropathology from other sources of between-subject variability. In the present work, we had an unusual opportunity to study an aphasic patient with severe anomia who had incidentally performed a picture naming task in an ERP study as a control subject one year before suffering a left hemisphere stroke. The fortuitous recording of this patient's brain activity before his stroke allows direct comparison of his pre- and poststroke brain activity in the same language production task. The subject did not differ from other healthy subjects before his stroke, but presented major electrophysiological differences after stroke, both in comparison to himself before stroke and to the control group. ERP changes consistently appeared after stroke in a specific time window starting about 250 msec after picture onset, characterized by a single divergent but stable topographic configuration of the scalp electric field associated with a cortical generator abnormally limited to left temporal posterior perilesional areas. The patient's pattern of anomia revealed a severe lexical–phonological impairment and his ERP responses diverged from those of healthy controls in the time window that has previously been associated with lexical–phonological processes during picture naming. Given that his prestroke ERPs were indistinguishable from those of healthy controls, it seems highly likely that the change in his poststroke ERPs is due to changes in language production processes as a consequence of stroke. The patient's neurolinguistic deficits, combined with the ERPs results, provide unique evidence for the role of left temporal cortex in lexical–phonological processing from about 250 to 450 msec during word production.

Stratifying patients with stroke in trials that target brain repair

A number of therapies are emerging that have the potential to reduce poststroke disability by promoting repair. Careful evaluation of patients with stroke might help distinguish those who are most likely to respond to a restorative therapy from those who lack biological substrate needed to achieve gains. Potential approaches to such stratification are considered, including measures of brain injury or of poststroke brain function.

Comparing electrophysiological correlates of word production in immediate and delayed naming through the analysis of word age of acquisition effects

Most EEG studies analysing speech production with event related brain potential (ERP) have adopted silent metalinguistic tasks or delayed or tacit picture naming in order to avoid possible artefacts during motor preparation. A central issue in the interpretation of these results is whether the processes involved in those tasks are comparable to those involved in overt speech production. In the present study we addressed a methodological issue about the integration of stimulus-aligned and response-aligned ERPs in immediate overt picture naming in comparison to delayed production, coupled with a theoretical point on the effect of word Age of Acquisition (AoA). High density EEG recordings were used and waveform analyses and spatio-temporal segmentation were combined on stimulus-aligned and response-aligned ERPs. The same sequence and duration of topographic maps appeared in the immediate and delayed production until around 350 ms after picture onset, revealing similar encoding processes until the beginning of phonological encoding, but modulations linked to word AoA were only observed in the immediate production. Considering stimulus-aligned and response-aligned ERPs together allowed to identify that a stable topography starting around 350 ms lasts 30 ms longer for late-acquired than for early-acquired words. This difference falls within the time-window of phonological encoding and its modulation can be linked to the longer production latencies for late-acquired words.

Functional imaging and related techniques: an introduction for rehabilitation researchers

Functional neuroimaging and related neuroimaging techniques are becoming important tools for rehabilitation research. Functional neuroimaging techniques can be used to determine the effects of brain injury or disease on brain systems related to cognition and behavior and to determine how rehabilitation changes brain systems. These techniques include: functional magnetic resonance imaging (fMRI), positron emission tomography (PET), electroencephalography (EEG), magnetoencephalography (MEG), near infrared spectroscopy (NIRS), and transcranial magnetic stimulation (TMS). Related diffusion weighted magnetic resonance imaging techniques (DWI), including diffusion tensor imaging (DTI) and high angular resolution diffusion imaging (HARDI), can quantify white matter integrity. With the proliferation of these imaging techniques in rehabilitation research, it is critical that rehabilitation researchers, as well as consumers of rehabilitation research, become familiar with neuroimaging techniques, what they can offer, and their strengths and weaknesses The purpose to this review is to provide such an introduction to these neuroimaging techniques.

Ibuprofen treatment modifies cortical sources of EEG rhythms in mild Alzheimer's disease

OBJECTIVE

Non-steroidal anti-inflammatory drugs such as ibuprofen have a protective role on risk of Alzheimer's disease (AD). Here we evaluated the hypothesis that long-term ibuprofen treatment affects cortical sources of resting electroencephalographic (EEG) rhythms in mild AD patients.

METHODS

Twenty-three AD patients (13 treated AD IBUPROFEN; 10 untreated AD PLACEBO) were enrolled. Resting EEG data were recorded before and 1 year after the ibuprofen/placebo treatment. EEG rhythms were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). LORETA was used for EEG source analysis.

RESULTS

In the AD PLACEBO group, amplitude of delta sources was globally greater at follow-up than baseline. Instead, amplitude of delta sources remained stable or decreased in the majority of the AD IBUPROFEN patients. Clinical (CDR) but not global cognitive status (MMSE) reflected EEG results.

CONCLUSIONS

These results suggest that in mild AD patients, a long-term ibuprofen treatment slightly slows down the progressive increment of delta rhythms as a sign of contrast against the neurodegenerative processes.

SIGNIFICANCE

They motivate future investigations with larger population and extended neuropsychological testing, to study the relationships among ibuprofen treatment, delta cortical sources, and higher order functions.

Delta EEG activity as a marker of dysfunctional linguistic processing in developmental dyslexia

The present study used delta EEG band to test the hypothesis of a cerebral maturational delay and a functional altered cerebral asymmetry for phonological processing in dyslexic children. A group of 14 children with dyslexia and 28 matched controls participated in a linguistic paradigm in which the same words were processed in three tasks: phonological, semantic, and orthographic. Delta amplitude was computed as an index of cortical inhibition in four different phases of word processing. In anterior sites, controls showed left activation (reduced delta) during the phonological task and bilateral activation in the other two tasks. Conversely, children with dyslexia showed greater overall delta amplitude, indexing a cerebral maturation delay and an altered language laterality pattern. In the phonological task they had larger left anterior delta (inhibition of left frontal linguistic locations) and smaller left posterior delta amplitude (activation of left posterior sites silent in controls). Results support the phonological deficit hypothesis of developmental dyslexia and the validity of EEG delta band as functional and clinical measure of language laterality.

Dipole source analysis of temporal slow waves in the elderly

BACKGROUND

Temporal low-voltage irregular delta-waves (TLID) are often found in elderly subjects. The physiological significance of TLID has not been clarified; however, our previous studies suggest that TLID are associated with mild cerebrovascular dysfunction.

OBJECTIVE

The present study aimed to reveal the origin of TLID and their neural mechanisms by dipole source modeling.

METHODS

From electroencephalography records taken from 21 scalp electrodes, clear and typical TLID of 6 elderly subjects (mean age, 69 +/- 6.2 years) were selected. Among these, we selected and averaged 7-12 clear TLID on the left side in each subject, and estimated a single equivalent current dipole for the averaged TLID.

RESULTS

The best equivalent current dipoles were estimated to be located in the medial part of the temporal lobe in or near the parahippocampal gyrus in the hemisphere ipsilateral to the TLID, with a high reliability in all subjects.

CONCLUSIONS

Considering the source localization of TLID, TLID seem to indicate certain dysfunctions of the hippocampus or adjacent regions. This is the first study to report the cerebral origin of TLID and suggest its physiological significance.

Repairing the human brain after stroke: I. Mechanisms of spontaneous recovery

Stroke remains a leading cause of adult disability. Some degree of spontaneous behavioral recovery is usually seen in the weeks after stroke onset. Variability in recovery is substantial across human patients. Some principles have emerged; for example, recovery occurs slowest in those destined to have less successful outcomes. Animal studies have extended these observations, providing insight into a broad range of underlying molecular and physiological events. Brain mapping studies in human patients have provided observations at the systems level that often parallel findings in animals. In general, the best outcomes are associated with the greatest return toward the normal state of brain functional organization. Reorganization of surviving central nervous system elements supports behavioral recovery, for example, through changes in interhemispheric lateralization, activity of association cortices linked to injured zones, and organization of cortical representational maps. A number of factors influence events supporting stroke recovery, such as demographics, behavioral experience, and perhaps genetics. Such measures gain importance when viewed as covariates in therapeutic trials of restorative agents that target stroke recovery.

Functional re-recruitment of dysfunctional brain areas predicts language recovery in chronic aphasia

Functional recovery in response to a brain lesion, such as a stroke, can even occur years after the incident and may be accelerated by effective rehabilitation strategies. In eleven chronic aphasia patients, we administered a short-term intensive language training to improve language functions and to induce cortical reorganization under rigorously controlled conditions. Overt naming performance was assessed during functional magnetic resonance imaging (fMRI) prior to and immediately after the language training. Regions of interest (ROIs) for statistical analyses were constituted by areas with individually determined abnormally high densities of slow wave generators (identified by magnetoencephalography prior to the language intervention) that clustered mainly in left perilesional areas. Three additional individually defined regions served to control for the specificity of the results for the selected respective target region: the homologue area of the individual patient's lesion, the mirror image of the delta ROI in the right hemisphere and left hemispheric regions that did not produce a significant amount of slow wave activity. Treatment-induced changes of fMRI brain activation were highly correlated with improved naming of the trained pictures, but selectively within the pre-training dysfunctional perilesional brain areas. Our results suggest that remodeling of cortical functions is possible even years after a stroke. The behavioral gain seems to be mediated by brain regions that had been partially deprived from input after the initial stroke. We therefore provide first time direct evidence for the importance of treatment-induced functional reintegration of perilesional areas in a heterogeneous sample of chronic aphasia patients.

Resting EEG sources correlate with attentional span in mild cognitive impairment and Alzheimer's disease

Previous evidence has shown that resting delta and alpha electroencephalographic (EEG) rhythms are abnormal in patients with Alzheimer's disease (AD) and its potential preclinical stage (mild cognitive impairment, MCI). Here, we tested the hypothesis that these EEG rhythms are correlated with memory and attention in the continuum across MCI and AD. Resting eyes-closed EEG data were recorded in 34 MCI and 53 AD subjects. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). EEG cortical sources were estimated by low-resolution brain electromagnetic tomography (LORETA). These sources were correlated with neuropsychological measures such as Rey list immediate recall (word short-term memory), Rey list delayed recall (word medium-term memory), Digit span forward (immediate memory for digits probing focused attention), and Corsi span forward (visuo-spatial immediate memory probing focused attention). A statistically significant negative correlation (Bonferroni corrected, P < 0.05) was observed between Corsi span forward score and amplitude of occipital or temporal delta sources across MCI and AD subjects. Furthermore, a positive correlation was shown between Digit span forward score and occipital alpha 1 sources (Bonferroni corrected, P < 0.05). These results suggest that cortical sources of resting delta and alpha rhythms correlate with neuropsychological measures of immediate memory based on focused attention in the continuum of MCI and AD subjects.

Homocysteine and electroencephalographic rhythms in Alzheimer disease: a multicentric study

High plasma concentration of homocysteine is an independent risk factor for Alzheimer's disease (AD), due to microvascular impairment and consequent neural loss [Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D'Agostino RB, Wilson PW, Wolf PA (2002) Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. N Engl J Med 346(7):476-483]. Is high plasma homocysteine level related to slow electroencephalographic (EEG) rhythms in awake resting AD subjects, as a reflection of known relationships between cortical neural loss and these rhythms? To test this hypothesis, we enrolled 34 mild AD patients and 34 subjects with mild cognitive impairment (MCI). Enrolled people were then subdivided into four sub-groups of 17 persons: MCI and AD subjects with low homocysteine level (MCI- and AD-, homocysteine level <11 micromol/l); MCI and AD subjects with high homocysteine level (MCI+ and AD+, homocysteine level >or=11 micromol/l). Resting eyes-closed EEG data were recorded. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), and beta 2 (20-30 Hz). EEG cortical sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Results showed that delta (frontal and temporal), theta (central, frontal, parietal, occipital, and temporal), alpha 1 (parietal, occipital, and temporal), and alpha 2 (parietal and occipital) sources were stronger in magnitude in AD+ than AD- group. Instead, no difference was found between MCI- and MCI+ groups. In conclusion, high plasma homocysteine level is related to unselective increment of cortical delta, theta, and alpha rhythms in mild AD, thus unveiling possible relationships among that level, microvascular concomitants of advanced neurodegenerative processes, and synchronization mechanisms generating EEG rhythms.

Neurofeedback for treating tinnitus

Many individuals with tinnitus have abnormal oscillatory brain activity. Led by this finding, we have developed a way to normalize such pathological activity by neurofeedback techniques (Weisz et al. (2005). PLoS Med., 2: e153). This is achieved mainly through enhancement of tau activity, i.e., oscillatory activity produced in perisylvian regions within the alpha frequency range (8-12 Hz) and concomitant reduction in delta power range (0.5-4 Hz). This activity is recorded from electrodes placed on the frontal scalp. We have found that modification of the tau-to-delta ratio significantly reduces tinnitus intensity. Participants who successfully modified their oscillatory pattern profited from the treatment to the extent that the tinnitus sensation became completely abolished. Overall, this neurofeedback training was significantly superiorin reducing tinnitus-related distress than frequency discrimination training.

Imaging motor recovery after stroke

Most patients show improvement in the weeks or months after a stroke. Recovery is incomplete, however, leaving most with significant impairment and disability. Because the brain does not grow back to an appreciable extent, this recovery occurs on the basis of change in function of surviving tissues. Brain mapping studies have characterized a number of processes and principles relevant to recovery from stroke in humans. The findings have potential application to improving therapeutics that aim to restore function after stroke.

Intensive language training enhances brain plasticity in chronic aphasia

Background

Focal clusters of slow wave activity in the delta frequency range (1–4 Hz), as measured by magnetencephalography (MEG), are usually located in the vicinity of structural damage in the brain. Such oscillations are usually considered pathological and indicative of areas incapable of normal functioning owing to deafferentation from relevant input sources. In the present study we investigated the change in Delta Dipole Density in 28 patients with chronic aphasia (>12 months post onset) following cerebrovascular stroke of the left hemisphere before and after intensive speech and language therapy (3 hours/day over 2 weeks).

Results

Neuropsychologically assessed language functions improved significantly after training. Perilesional delta activity decreased after therapy in 16 of the 28 patients, while an increase was evident in 12 patients. The magnitude of change of delta activity in these areas correlated with the amount of change in language functions as measured by standardized language tests.

Conclusions

These results emphasize the significance of perilesional areas in the rehabilitation of aphasia even years after the stroke, and might reflect reorganisation of the language network that provides the basis for improved language functions after intensive training.