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Marder MA, Miller GA. The future of psychophysiology, then and now. Biol Psychol 2024; 189:108792. [PMID: 38588815 DOI: 10.1016/j.biopsycho.2024.108792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024]
Abstract
Since its founding in 1973, Biological Psychology has showcased and provided invaluable support to psychophysiology, a field that has grown and changed enormously. This article discusses some constancies that have remained fundamental to the journal and to the field as well as some important trends. Some aspects of our science have not received due consideration, affecting not only the generalizability of our findings but the way we develop and evaluate our research questions and the potential of our field to contribute to the common good. The article offers a number of predictions and recommendations for the next period of growth of psychophysiology.
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Affiliation(s)
| | - Gregory A Miller
- University of Illinois Urbana-Champaign, USA; University of California, Los Angeles, USA
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Singh J, Singh S, Gupta S, Chavan BS. Cognitive Remediation and Schizophrenia: Effects on Brain Complexity. Neurosci Lett 2023; 808:137268. [PMID: 37100222 DOI: 10.1016/j.neulet.2023.137268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 04/28/2023]
Abstract
The objective of this study is to investigate nonlinear neural dynamics of chronic patients with schizophrenia following 3 months of cognitive remediation and to find correlations with neuropsychological measures of cognition. Twenty nine patients were randomized to Cognitive Training (CT) and Treatment as Usual (TAU) group. The system complexity is estimated by Correlation Dimension (D2) and Largest Lyapunov Exponent (LLE) from the reconstructed attractor of the underlying system. Significant increase in dimensional complexity (D2) over time is observed in prefrontal and medial frontal-central regions in eyes open and arithmetic condition; and posterior parietal-occipital region under eyes closed after 3 months. Dynamical complexity (LLE) significantly decreased over time in medial left central region under eyes closed and eyes open condition; prefrontal region in eyes open and lateral right temporal region in arithmetic condition. Interaction is significant for medial left central region with TAU group exhibiting greater decrease in LLE compared to CT group. The CT group showed significant correlation of increased D2 with focused attention. In this study it is found that patients with schizophrenia exhibit higher dimensional and lower dynamical complexity over time indicating improvement in neurodynamics of underlying physiological system.
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Affiliation(s)
- Jaskirat Singh
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India
| | - Sukhwinder Singh
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India.
| | - Savita Gupta
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India.
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, Pincode:160032, India.
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Haining K, Grent-'t-Jong T, Chetcuti B, Gajwani R, Gross J, Kearns C, Krishnadas R, Lawrie SM, Molavi S, Paton C, Queirazza F, Richardson E, Schultze-Lutter F, Schwannauer M, Uhlhaas PJ. Computerised cognitive training during early-stage psychosis improves cognitive deficits and gamma-band oscillations: A pilot study. Schizophr Res 2022; 243:217-219. [PMID: 35461044 DOI: 10.1016/j.schres.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Kate Haining
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK
| | - Tineke Grent-'t-Jong
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | | | - Ruchika Gajwani
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Joachim Gross
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK; Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | | | | | | | | | | | - Filippo Queirazza
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK
| | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Peter J Uhlhaas
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
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Popov T, Rockstroh B, Miller GA. Oscillatory connectivity as a mechanism of auditory sensory gating and its disruption in schizophrenia. Psychophysiology 2021; 59:e13770. [PMID: 33491212 DOI: 10.1111/psyp.13770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 01/26/2023]
Abstract
Although innumerable studies using an auditory sensory gating paradigm have confirmed that individuals with schizophrenia (SZ) show less reduction in brain response to the second in a pair of clicks, this large literature has not yielded consensus on the circuit(s) responsible for gating nor for the gating difference in SZ. Clinically stable adult inpatients (N = 157) and matched community participants (N = 90) participated in a standard auditory sensory gating protocol. Responses to paired clicks were quantified as peak-to-peak amplitude from a response at approximately 50 ms to a response at approximately 100 ms in MEG-derived source waveforms. For bilateral sources in each of four regions near Heschl's gyrus, the gating ratio was computed as the response to the second stimulus divided by the response to the first stimulus. Spectrally resolved Granger causality quantified effective connectivity among regions manifested in alpha-band oscillatory coupling before and during stimulation. Poorer sensory gating localized to A1 in SZ than in controls confirmed previous results, here found in adjacent brain regions as well. Spontaneous, stimulus-independent effective connectivity within the hemisphere from angular gyrus to portions of the superior temporal gyrus was lower in SZ and correlated with gating ratio. Significant involvement of frontal and subcortical brain regions previously proposed as contributing to the auditory gating abnormality was not found. Findings point to endogenous connectivity evident in a sequence of activity from angular gyrus to portions of superior temporal gyrus as a mechanism contributing to normal and abnormal gating in SZ and potentially to sensory and cognitive symptoms.
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Affiliation(s)
- Tzvetan Popov
- Methods of Plasticity Research Laboratory, Department of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Gregory A Miller
- Department of Psychology, UCLA, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
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Parker DA, Trotti RL, McDowell JE, Keedy SK, Gershon ES, Ivleva EI, Pearlson GD, Keshavan MS, Tamminga CA, Sweeney JA, Clementz BA. Auditory paired-stimuli responses across the psychosis and bipolar spectrum and their relationship to clinical features. Biomark Neuropsychiatry 2020; 3:100014. [PMID: 36644018 PMCID: PMC9837793 DOI: 10.1016/j.bionps.2020.100014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background EEG responses during auditory paired-stimuli paradigms are putative biomarkers of psychosis syndromes. The initial iteration of the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP1) showed unique and common patterns of abnormalities across schizophrenia (SZ), schizoaffective disorder (SAD), and bipolar disorder with psychosis (BDP). This study replicates those findings in new and large samples of psychosis cases and extends them to an important comparison group, bipolar disorder without psychosis (BDNP). Methods Paired stimuli responses from 64-sensor EEG recording were compared across psychosis (n = 597; SZ = 225, SAD = 201, BDP = 171), BDNP (n = 66), and healthy (n = 415) subjects from the second iteration of B-SNIP. EEG activity was analyzed in voltage and in the time-frequency domain. Principal component analysis (PCA) over sensors (sPCA) was used to efficiently capture EEG voltage responses to the paired stimuli. Evoked power was calculated via a Morlet wavelet procedure. A frequency PCA divided evoked power data into three frequency bands: Low (4-17 Hz), Beta (18-32 Hz), and Gamma (33-55 Hz). Each time-course (ERP Voltage, Low, Beta, and Gamma) were then segmented into 20 ms bins and analyzed for group differences. To efficiently summarize the multiple EEG components that best captured group differences we used multivariate discriminant and correlational analyses. This approach yields a reduced set of measures that may be useful in subsequent biomarker investigations. Results Group ANOVAs identified 17 time-ranges that showed significant group differences (p < .05 after FDR correction), constructively replicating B-SNIP1 findings. Multivariate linear discriminant analysis parsimoniously selected variables that best accounted for group differences: The P50 response to S1 and S2 uniquely separated BDNP from healthy and psychosis subjects (BDNP > all other groups); the S1 N100 response separated groups along an axis of psychopathology severity (HC > BDNP > BDP > SAD > SZ); the S1 P200 response indexed psychosis psychopathology (HC/BDNP > SAD/SZ/BDP); and the preparatory period to the S2 stimulus separated SZ from other groups (SZ > SAD/BDP>HC/BDNP).Canonical correlation identified an association between the neural responses during the S1 N100, S1 N200 and S2 preparatory period and PANSS positive symptoms and social functioning. The neural responses during the S1 P50 and S1 N100 were associated with PANSS Negative/General, MADRS and Young Mania symptoms. Conclusions This study constructively replicated prior B-SNIP1 research on auditory deviations observed during the paired stimuli task in SZ, SAD and BDP. Inclusion of a group of BDNP allows for the identification of biomarkers more closely related to affective versus nonaffective clinical phenotypes and neural distinctions between BDP and BDNP. Findings have implications for nosology and future translational work given that some biomarkers are shared across all psychosis and some are unique to affective syndromes.
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Affiliation(s)
| | | | - Jennifer E. McDowell
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Georgia
| | - Sarah K. Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, United States of America
| | - Elliot S. Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, United States of America
| | - Elena I. Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, United States of America
| | - Godfrey D. Pearlson
- Neuroscience, Yale School of Medicine, Institute of Living, Hartford Hospital, United States of America
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, United States of America
| | - Carol A. Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, United States of America
| | - John A. Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, United States of America
| | - Brett A. Clementz
- Departments of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Georgia, Corresponding author at: Psychology Department, 125 Jackson Street, Athens GA, 30601, Greece. (B.A. Clementz)
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Abstract
Schizophrenia (Sz) is a chronic mental disorder characterized by disturbances in thought (such as delusions and confused thinking), perception (hearing voices), and behavior (lack of motivation). The lifetime prevalence of Sz is between 0.3% and 0.7%, with late adolescence and early adulthood, the peak period for the onset of psychotic symptoms. Causal factors in Sz include environmental and genetic factors and especially their interaction. About 50% of individuals with a diagnosis of Sz have lifelong impairment.
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Dale CL, Brown EG, Herman AB, Hinkley LBN, Subramaniam K, Fisher M, Vinogradov S, Nagarajan SS. Intervention-specific patterns of cortical function plasticity during auditory encoding in people with schizophrenia. Schizophr Res 2020; 215:241-249. [PMID: 31648842 PMCID: PMC7035971 DOI: 10.1016/j.schres.2019.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/06/2019] [Accepted: 10/03/2019] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a neurocognitive illness characterized by behavioral and neural impairments in both early auditory processing and higher order verbal working memory. Previously we have shown intervention-specific cognitive performance improvements with computerized, targeted training of auditory processing (AT) when compared to a computer games (CG) control intervention that emphasized visual processing. To investigate spatiotemporal changes in patterns of neural activity specific to the AT intervention, the current study used magnetoencephalography (MEG) imaging to derive induced high gamma band oscillations (HGO) during auditory encoding, before and after 50 h (∼10 weeks) of exposure to either the AT or CG intervention. During stimulus encoding, AT intervention-specific changes in high gamma activity occurred in left middle frontal and left middle-superior temporal cortices. In contrast, CG intervention-specific changes were observed in right medial frontal and supramarginal gyri during stimulus encoding, and in bilateral temporal cortices during response preparation. These data reveal that, in schizophrenia, intensive exposure to either training of auditory processing or exposure to visuospatial activities produces significant but complementary patterns of cortical function plasticity within a distributed fronto-temporal network. These results underscore the importance of delineating the specific neuroplastic effects of targeted behavioral interventions to ensure desired neurophysiological changes and avoid unintended consequences on neural system functioning.
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Affiliation(s)
- Corby L Dale
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States; San Francisco Veterans' Affairs Medical Center, United States.
| | - Ethan G Brown
- Weill Cornell Medical College, New York, United States
| | - Alexander B Herman
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States; UCB-UCSF Graduate Program in Bioengineering, University of California, Berkeley, United States; Medical Science Training Program, University of California, San Francisco, United States
| | - Leighton B N Hinkley
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States
| | - Karuna Subramaniam
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States
| | - Melissa Fisher
- San Francisco Veterans' Affairs Medical Center, United States; Department of Psychiatry, University of California, San Francisco, United States
| | - Sophia Vinogradov
- San Francisco Veterans' Affairs Medical Center, United States; Department of Psychiatry, University of California, San Francisco, United States
| | - Srikantan S Nagarajan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States; UCB-UCSF Graduate Program in Bioengineering, University of California, Berkeley, United States
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Dondé C, Mondino M, Brunelin J, Haesebaert F. Sensory-targeted cognitive training for schizophrenia. Expert Rev Neurother 2019; 19:211-225. [PMID: 30741038 DOI: 10.1080/14737175.2019.1581609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Auditory and visual dysfunctions are key pathophysiological features of schizophrenia (Sz). Therefore, remedial interventions that directly target such impairments could potentially drive gains in higher-order cognition (e.g., memory, executive functions, emotion processing), symptoms and functional outcome, in addition to improving sensory abilities in this population. Here, we reviewed available sensory-targeted cognitive training (S-TCT) programs that were investigated so far in Sz patients. Area covered: A systematic review of the literature was conducted following PRISMA guidelines. Twenty-seven relevant records were included. The superiority of S-TCT over control conditions on higher-order cognition measures was repeatedly demonstrated, but mostly lost significance at later endpoints of evaluation. Clinical symptoms and functional outcome were improved in a minority of studies. S-TCT interventions were associated with the relative normalization of several neurobiological biomarkers of neuroplasticity and sensory mechanisms. Expert commentary: S-TCT, although time-intensive, is a cost-efficient, safe and promising technique for Sz treatment. Its efficacy on higher-order cognition opens a critical window for clinical and functional improvement. The biological impact of S-TCT may allow for the identification of therapeutic biomarkers to further precision-medicine. Additional research is required to investigate the long-term effects of S-TCT, optimal training parameters and potential confounding factors associated with the illness.
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Affiliation(s)
- Clément Dondé
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
| | - Marine Mondino
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
| | - Jérôme Brunelin
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
| | - Frédéric Haesebaert
- a INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response Team , Lyon, F-69678 , France.,b University Lyon 1 , Villeurbanne, F-69000 , France.,c Centre Hospitalier Le Vinatier, Department of Psychiatry , Bron, F-69000 , France
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Beilharz F, Castle DJ, Phillipou A, Rossell SL. Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial. Pilot Feasibility Stud 2018; 4:189. [PMID: 30598835 PMCID: PMC6302469 DOI: 10.1186/s40814-018-0384-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 12/07/2018] [Indexed: 01/08/2023] Open
Abstract
Background Body dysmorphic disorder (BDD) is a characterised by perceived defects or flaws in appearance which are associated with distressing thoughts, repetitive or obsessive behaviours, and significant impairment in social and occupational functioning. A core feature of BDD involves abnormalities of visual processing, although this is not typically a focus of psychological and psychiatric treatments. While current treatments generally show moderate effectiveness in the short-term, those with BDD can have high relapse rates, as they still 'see' their flaws or defects. The current research trials a visual training program designed to remediate visual abnormalities and reduce symptom severity of BDD. Methods This is a single-group open-label pilot study assessing the feasibility and potential efficacy of a 10-week visual training program. This pilot trial will be conducted at Swinburne University of Technology, Melbourne, Australia, and will recruit up to 20 participants diagnosed with BDD. These participants will complete pre- and post-assessments and a 10-week visual training program encompassing three phases of basic visual processing, face and emotion recognition, and self-perception. The primary outcomes focus on feasibility and acceptability of the intervention, with secondary outcomes exploring clinical outcomes related to symptom severity, quality of life and eye movements. Discussion This pilot trial will translate the empirical findings of abnormalities in visual processing among those diagnosed with BDD, to an innovative treatment method across a range of visual processing levels. This trial will assess the feasibility and potential efficacy of such a visual training program, paving the way for further research including a future definitive randomised control trial. Trial registration Australian New Zealand Clinical Trial Registry, ACTRN 12618000274279, Registered 22nd February 2018.
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Affiliation(s)
- Francesca Beilharz
- 1Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - David J Castle
- 1Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,2Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.,3Psychiatry, Faculty of Medicine, University of Melbourne, Melbourne, Australia
| | - Andrea Phillipou
- 1Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,2Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.,3Psychiatry, Faculty of Medicine, University of Melbourne, Melbourne, Australia
| | - Susan L Rossell
- 1Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,2Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
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Popova P, Rockstroh B, Miller GA, Wienbruch C, Carolus AM, Popov T. The impact of cognitive training on spontaneous gamma oscillations in schizophrenia. Psychophysiology 2018; 55:e13083. [PMID: 29624694 DOI: 10.1111/psyp.13083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 12/27/2022]
Abstract
Schizophrenia patients exhibit less gamma-frequency EEG/MEG activity (>30 Hz), a finding interpreted as evidence of poor temporal neural organization and functional network communication. Research has shown that neuroplasticity-oriented training can improve task-related oscillatory dynamics, indicating some reorganization capacity in schizophrenia. Demonstrating a generalization of such task training effects to spontaneous oscillations at rest would not only enrich understanding of this neuroplastic potential but inform the interpretation of spontaneous gamma oscillations in the service of normal cognitive function. In the present study, neuromagnetic resting-state oscillatory brain activity and cognitive performance were assessed before and after training in 61 schizophrenia patients, who were randomly assigned to 4 weeks of neuroplasticity-oriented targeted cognitive training or treatment as usual (TAU). Gamma power of 40-90 Hz increased after training, but not after TAU, in a frontoparietal network. Across two types of training, this increase was related to improved cognitive test performance. These results indicate that abnormal oscillatory dynamics in schizophrenia patients manifested in spontaneous gamma activity can be changed with neuroplasticity-oriented training parallel to cognitive performance.
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Affiliation(s)
- Petia Popova
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Gregory A Miller
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Almut M Carolus
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Tzvetan Popov
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Simons DJ, Boot WR, Charness N, Gathercole SE, Chabris CF, Hambrick DZ, Stine-Morrow EAL. Do "Brain-Training" Programs Work? Psychol Sci Public Interest 2018; 17:103-186. [PMID: 27697851 DOI: 10.1177/1529100616661983] [Citation(s) in RCA: 559] [Impact Index Per Article: 93.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In 2014, two groups of scientists published open letters on the efficacy of brain-training interventions, or "brain games," for improving cognition. The first letter, a consensus statement from an international group of more than 70 scientists, claimed that brain games do not provide a scientifically grounded way to improve cognitive functioning or to stave off cognitive decline. Several months later, an international group of 133 scientists and practitioners countered that the literature is replete with demonstrations of the benefits of brain training for a wide variety of cognitive and everyday activities. How could two teams of scientists examine the same literature and come to conflicting "consensus" views about the effectiveness of brain training?In part, the disagreement might result from different standards used when evaluating the evidence. To date, the field has lacked a comprehensive review of the brain-training literature, one that examines both the quantity and the quality of the evidence according to a well-defined set of best practices. This article provides such a review, focusing exclusively on the use of cognitive tasks or games as a means to enhance performance on other tasks. We specify and justify a set of best practices for such brain-training interventions and then use those standards to evaluate all of the published peer-reviewed intervention studies cited on the websites of leading brain-training companies listed on Cognitive Training Data (www.cognitivetrainingdata.org), the site hosting the open letter from brain-training proponents. These citations presumably represent the evidence that best supports the claims of effectiveness.Based on this examination, we find extensive evidence that brain-training interventions improve performance on the trained tasks, less evidence that such interventions improve performance on closely related tasks, and little evidence that training enhances performance on distantly related tasks or that training improves everyday cognitive performance. We also find that many of the published intervention studies had major shortcomings in design or analysis that preclude definitive conclusions about the efficacy of training, and that none of the cited studies conformed to all of the best practices we identify as essential to drawing clear conclusions about the benefits of brain training for everyday activities. We conclude with detailed recommendations for scientists, funding agencies, and policymakers that, if adopted, would lead to better evidence regarding the efficacy of brain-training interventions.
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Affiliation(s)
- Daniel J Simons
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | - Neil Charness
- Department of Psychology, Florida State University Institute for Successful Longevity, Florida State University
| | - Susan E Gathercole
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK School of Clinical Medicine, University of Cambridge
| | | | | | - Elizabeth A L Stine-Morrow
- Department of Educational Psychology, University of Illinois at Urbana-Champaign Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign
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Perez VB, Tarasenko M, Miyakoshi M, Pianka ST, Makeig SD, Braff DL, Swerdlow NR, Light GA. Mismatch Negativity is a Sensitive and Predictive Biomarker of Perceptual Learning During Auditory Cognitive Training in Schizophrenia. Neuropsychopharmacology 2017; 42:2206-2213. [PMID: 28139679 PMCID: PMC5603809 DOI: 10.1038/npp.2017.25] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/12/2017] [Accepted: 01/16/2017] [Indexed: 02/04/2023]
Abstract
Computerized cognitive training is gaining empirical support for use in the treatment of schizophrenia (SZ). Although cognitive training is efficacious for SZ at a group level when delivered in sufficiently intensive doses (eg, 30-50 h), there is variability in individual patient response. The identification of biomarkers sensitive to the neural systems engaged by cognitive training interventions early in the course of treatment could facilitate personalized assignment to treatment. This proof-of-concept study was conducted to determine whether mismatch negativity (MMN), an event-related potential index of auditory sensory discrimination associated with cognitive and psychosocial functioning, would predict gains in auditory perceptual learning and exhibit malleability after initial exposure to the early stages of auditory cognitive training in SZ. MMN was assessed in N=28 SZ patients immediately before and after completing 1 h of a speeded time-order judgment task of two successive frequency-modulated sweeps (Posit Science 'Sound Sweeps' exercise). All SZ patients exhibited the expected improvements in auditory perceptual learning over the 1 h training period (p<0.001), consistent with previous results. Larger MMN amplitudes recorded both before and after the training exercises were associated with greater gains in auditory perceptual learning (r=-0.5 and r=-0.67, respectively, p's<0.01). Significant pretraining vs posttraining MMN amplitude reduction was also observed (p<0.02). MMN is a sensitive index of the neural systems engaged in a single session of auditory cognitive training in SZ. These findings encourage future trials of MMN as a biomarker for individual assignment, prediction, and/or monitoring of patient response to procognitive interventions, including auditory cognitive training in SZ.
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Affiliation(s)
- Veronica B Perez
- VISN 22 Mental Illness Research, Education & Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA,California School of Professional Psychology, Alliant International University, San Diego, CA, USA
| | - Melissa Tarasenko
- VISN 22 Mental Illness Research, Education & Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Makoto Miyakoshi
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Sean T Pianka
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Scott D Makeig
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - David L Braff
- VISN 22 Mental Illness Research, Education & Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Gregory A Light
- VISN 22 Mental Illness Research, Education & Clinical Center (MIRECC), San Diego VA Healthcare System, San Diego, CA, USA,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA,Psychiatry Service 116A, VISN-22 Mental Illness Research, Education & Clinical Center (MIRECC), San Diego VA Healthcare System, University of California, 3350 La Jolla Village Drive, San Diego, CA 92161, USA, Tel: +1 619 543 2496, Fax: + 619 543 1801, E-mail:
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13
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Fisher M, Herman A, Stephens DB, Vinogradov S. Neuroscience-informed computer-assisted cognitive training in schizophrenia. Ann N Y Acad Sci 2017; 1366:90-114. [PMID: 27111135 DOI: 10.1111/nyas.13042] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 01/09/2023]
Abstract
Schizophrenia is a heterogeneous psychiatric syndrome characterized by psychosis. It is also a neurodevelopmental disorder. In the earliest phases of the illness, at-risk individuals exhibit subtle, nonspecific symptoms, including cognitive dysfunction and progressive brain volumetric loss. Generally, schizophrenia is characterized by abnormal/inefficient neural system operations and neural oscillatory activity, as well as functional disconnectivity across frontal-temporo parietal and frontal-subcortical networks; it thus may best be described as a widespread neural oscillatory connectomopathy. Despite earlier views of schizophrenia as an inevitably progressive neurodegenerative disease, emerging evidence indicates that endogenous neuroplastic capacity is retained. An active area of research is directed at understanding how best to harness this learning-induced neuroplasticity to enhance neural system functioning, improve cognition, and prevent-and possibly even reverse-disease progression. In this review, we present an overview of results from the most widely used computer-assisted cognitive-training programs in schizophrenia, contrasting a broad neuropsychological rehabilitation approach with a targeted cognitive-training approach. We then review studies on the neurobiological effects of these two training methods. Finally, we discuss future directions with a focus on the "oscillatory connectome" as a key area of investigation for developing the most precise and scientifically informed treatment approaches for this illness.
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry, University of California, San Francisco, and San Francisco Department of Veterans Affairs Medical Center, San Francisco, California
| | - Alexander Herman
- School of Medicine, University of California, San Francisco, California
| | | | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco, and San Francisco Department of Veterans Affairs Medical Center, San Francisco, California
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14
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Haigh SM. Variable sensory perception in autism. Eur J Neurosci 2017; 47:602-609. [DOI: 10.1111/ejn.13601] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Sarah M. Haigh
- Clinical Neurophysiology Research Laboratory; Western Psychiatric Institute and Clinic; Department of Psychiatry; University of Pittsburgh School of Medicine; 3501 Forbes Avenue Suite 420 Pittsburgh PA 15213 USA
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15
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Foss-Feig JH, Adkinson BD, Ji JL, Yang G, Srihari VH, McPartland JC, Krystal JH, Murray JD, Anticevic A. Searching for Cross-Diagnostic Convergence: Neural Mechanisms Governing Excitation and Inhibition Balance in Schizophrenia and Autism Spectrum Disorders. Biol Psychiatry 2017; 81:848-861. [PMID: 28434615 PMCID: PMC5436134 DOI: 10.1016/j.biopsych.2017.03.005] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 02/06/2017] [Accepted: 03/05/2017] [Indexed: 01/08/2023]
Abstract
Recent theoretical accounts have proposed excitation and inhibition (E/I) imbalance as a possible mechanistic, network-level hypothesis underlying neural and behavioral dysfunction across neurodevelopmental disorders, particularly autism spectrum disorder (ASD) and schizophrenia (SCZ). These two disorders share some overlap in their clinical presentation as well as convergence in their underlying genes and neurobiology. However, there are also clear points of dissociation in terms of phenotypes and putatively affected neural circuitry. We highlight emerging work from the clinical neuroscience literature examining neural correlates of E/I imbalance across children and adults with ASD and adults with both chronic and early-course SCZ. We discuss findings from diverse neuroimaging studies across distinct modalities, conducted with electroencephalography, magnetoencephalography, proton magnetic resonance spectroscopy, and functional magnetic resonance imaging, including effects observed both during task and at rest. Throughout this review, we discuss points of convergence and divergence in the ASD and SCZ literature, with a focus on disruptions in neural E/I balance. We also consider these findings in relation to predictions generated by theoretical neuroscience, particularly computational models predicting E/I imbalance across disorders. Finally, we discuss how human noninvasive neuroimaging can benefit from pharmacological challenge studies to reveal mechanisms in ASD and SCZ. Collectively, we attempt to shed light on shared and divergent neuroimaging effects across disorders with the goal of informing future research examining the mechanisms underlying the E/I imbalance hypothesis across neurodevelopmental disorders. We posit that such translational efforts are vital to facilitate development of neurobiologically informed treatment strategies across neuropsychiatric conditions.
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Affiliation(s)
- Jennifer H Foss-Feig
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; Seaver Autism Center, Icahn School of Medicine at Mount Sinai Hospital, New York, New York; Child Study Center, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Brendan D Adkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Genevieve Yang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - James C McPartland
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Division of Neurocognition, Neurocomputation, & Neurogenetics (N3), Yale University School of Medicine, New Haven, Connecticut; Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Division of Neurocognition, Neurocomputation, & Neurogenetics (N3), Yale University School of Medicine, New Haven, Connecticut; Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Division of Neurocognition, Neurocomputation, & Neurogenetics (N3), Yale University School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
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16
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Kantrowitz JT, Epstein ML, Beggel O, Rohrig S, Lehrfeld JM, Revheim N, Lehrfeld NP, Reep J, Parker E, Silipo G, Ahissar M, Javitt DC. Neurophysiological mechanisms of cortical plasticity impairments in schizophrenia and modulation by the NMDA receptor agonist D-serine. Brain 2017; 139:3281-3295. [PMID: 27913408 DOI: 10.1093/brain/aww262] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/20/2016] [Accepted: 08/29/2016] [Indexed: 11/12/2022] Open
Abstract
Schizophrenia is associated with deficits in cortical plasticity that affect sensory brain regions and lead to impaired cognitive performance. Here we examined underlying neural mechanisms of auditory plasticity deficits using combined behavioural and neurophysiological assessment, along with neuropharmacological manipulation targeted at the N-methyl-D-aspartate type glutamate receptor (NMDAR). Cortical plasticity was assessed in a cohort of 40 schizophrenia/schizoaffective patients relative to 42 healthy control subjects using a fixed reference tone auditory plasticity task. In a second cohort (n = 21 schizophrenia/schizoaffective patients, n = 13 healthy controls), event-related potential and event-related time-frequency measures of auditory dysfunction were assessed during administration of the NMDAR agonist d-serine. Mismatch negativity was used as a functional read-out of auditory-level function. Clinical trials registration numbers were NCT01474395/NCT02156908 Schizophrenia/schizoaffective patients showed significantly reduced auditory plasticity versus healthy controls (P = 0.001) that correlated with measures of cognitive, occupational and social dysfunction. In event-related potential/time-frequency analyses, patients showed highly significant reductions in sensory N1 that reflected underlying impairments in θ responses (P < 0.001), along with reduced θ and β-power modulation during retention and motor-preparation intervals. Repeated administration of d-serine led to intercorrelated improvements in (i) auditory plasticity (P < 0.001); (ii) θ-frequency response (P < 0.05); and (iii) mismatch negativity generation to trained versus untrained tones (P = 0.02). Schizophrenia/schizoaffective patients show highly significant deficits in auditory plasticity that contribute to cognitive, occupational and social dysfunction. d-serine studies suggest first that NMDAR dysfunction may contribute to underlying cortical plasticity deficits and, second, that repeated NMDAR agonist administration may enhance cortical plasticity in schizophrenia.
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Affiliation(s)
- Joshua T Kantrowitz
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA .,2 Division of Experimental Therapeutics, Departments of Psychiatry and Neuroscience, Columbia University, New York, NY, USA
| | - Michael L Epstein
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA.,3 Graduate Center, City University of New York, New York, NY, USA
| | - Odeta Beggel
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Stephanie Rohrig
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Jonathan M Lehrfeld
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Nadine Revheim
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Nayla P Lehrfeld
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Jacob Reep
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Emily Parker
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Gail Silipo
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA
| | - Merav Ahissar
- 4 Edmond and Lily Safra Center for Brain Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Daniel C Javitt
- 1 Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, USA.,2 Division of Experimental Therapeutics, Departments of Psychiatry and Neuroscience, Columbia University, New York, NY, USA
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17
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Edgar JC, Fisk CL, Chen YH, Stone-Howell B, Hunter MA, Huang M, Bustillo JR, Cañive JM, Miller GA. By our bootstraps: Comparing methods for measuring auditory 40 Hz steady-state neural activity. Psychophysiology 2017; 54:1110-1127. [PMID: 28421620 DOI: 10.1111/psyp.12876] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/10/2017] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
Although the 40 Hz auditory steady-state response (ASSR) is of clinical interest, the construct validity of EEG and MEG measures of 40 Hz ASSR cortical microcircuits is unclear. This study evaluated several MEG and EEG metrics by leveraging findings of (a) an association between the 40 Hz ASSR and age in the left but not right hemisphere, and (b) right- > left-hemisphere differences in the strength of the 40 Hz ASSR. The contention is that, if an analysis method does not demonstrate a left 40 Hz ASSR and age relationship or hemisphere differences, then the obtained measures likely have low validity. Fifty-three adults were presented 500 Hz stimuli modulated at 40 Hz while MEG and EEG were collected. ASSR activity was examined as a function of phase similarity (intertrial coherence) and percent change from baseline (total power). A variety of head models (spherical and realistic) and a variety of dipole source modeling strategies (dipole source localization and dipoles fixed to Heschl's gyri) were compared. Several sensor analysis strategies were also tested. EEG sensor measures failed to detect left 40 Hz ASSR and age associations or hemisphere differences. A comparison of MEG and EEG head-source models showed similarity in the 40 Hz ASSR measures and in estimating age and left 40 Hz ASSR associations, indicating good construct validity across models. Given a goal of measuring the 40 Hz ASSR cortical microcircuits, a source-modeling approach was shown to be superior in measuring this construct versus methods that rely on EEG sensor measures.
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Affiliation(s)
- J Christopher Edgar
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Charles L Fisk
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yu-Han Chen
- Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, Pennsylvania
| | - Breannan Stone-Howell
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico.,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, New Mexico
| | - Michael A Hunter
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico.,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, New Mexico
| | - Mingxiong Huang
- University of California, San Diego, Department of Radiology, San Diego, California.,San Diego VA Healthcare System, Department of Radiology, San Diego, California
| | - Juan R Bustillo
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico
| | - José M Cañive
- University of New Mexico School of Medicine, Department of Psychiatry, Center for Psychiatric Research, Albuquerque, New Mexico.,New Mexico Raymond G. Murphy VA Healthcare System, Psychiatry Research, Albuquerque, New Mexico
| | - Gregory A Miller
- University of California, Los Angeles, Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California
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18
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Clayson PE, Miller GA. Psychometric considerations in the measurement of event-related brain potentials: Guidelines for measurement and reporting. Int J Psychophysiol 2017; 111:57-67. [DOI: 10.1016/j.ijpsycho.2016.09.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/05/2016] [Accepted: 09/09/2016] [Indexed: 02/07/2023]
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19
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Measuring the capacity for auditory system plasticity: An examination of performance gains during initial exposure to auditory-targeted cognitive training in schizophrenia. Schizophr Res 2016; 172:123-30. [PMID: 26851143 PMCID: PMC5072522 DOI: 10.1016/j.schres.2016.01.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/07/2016] [Accepted: 01/10/2016] [Indexed: 12/28/2022]
Abstract
UNLABELLED Auditory-Targeted Cognitive Training (ATCT), which aims to improve auditory information processing efficiency, has shown great promise for remediating cognitive deficits in schizophrenia (SZ). However, there is substantial heterogeneity in the degree of cognitive gains made during ATCT, and some patients show negligible benefit after completing therapeutic doses of training. Identifying individual differences that can be measured early in the course of ATCT and that predict subsequent cognitive benefits from the intervention is therefore important. The present study calculated a variety of performance metrics during the initial hour of exposure to ATCT Sound Sweeps, a frequency discrimination time-order judgment task, and investigated the relationships of these metrics to demographic, clinical, and cognitive characteristics of SZ patients. Thirty-seven SZ outpatients completed measures of auditory attention, working memory, verbal memory, and executive functioning, followed by 1h of Sound Sweeps training. Performance metrics, calculated after the first training level, the first training stage (Levels 1-4), and the entire hour of training included baseline and best auditory processing speed (APS) scores, as well as percent improvement in APS after training. The number of training levels completed by each participant was also calculated. Baseline and best APS correlated with performance in all cognitive domains, whereas APS improvements only correlated with verbal memory. Number of training levels completed was marginally associated with auditory attention only. CONCLUSIONS Sound Sweeps performance correlates with a range of neurocognitive abilities. APS improvement may provide a particularly sensitive index of "plasticity potential" within the neural network underlying verbal learning and memory.
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20
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Isaac C, Januel D. Neural correlates of cognitive improvements following cognitive remediation in schizophrenia: a systematic review of randomized trials. SOCIOAFFECTIVE NEUROSCIENCE & PSYCHOLOGY 2016; 6:30054. [PMID: 26993787 PMCID: PMC4799394 DOI: 10.3402/snp.v6.30054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/31/2015] [Accepted: 02/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Cognitive impairments are a core feature in schizophrenia and are linked to poor social functioning. Numerous studies have shown that cognitive remediation can enhance cognitive and functional abilities in patients with this pathology. The underlying mechanism of these behavioral improvements seems to be related to structural and functional changes in the brain. However, studies on neural correlates of such enhancement remain scarce. OBJECTIVES We explored the neural correlates of cognitive enhancement following cognitive remediation interventions in schizophrenia and the differential effect between cognitive training and other therapeutic interventions or patients' usual care. METHOD We searched MEDLINE, PsycInfo, and ScienceDirect databases for studies on cognitive remediation therapy in schizophrenia that used neuroimaging techniques and a randomized design. Search terms included randomized controlled trial, cognitive remediation, cognitive training, rehabilitation, magnetic resonance imaging, positron emission tomography, electroencephalography, magnetoencephalography, near infrared spectroscopy, and diffusion tensor imaging. We selected randomized controlled trials that proposed multiple sessions of cognitive training to adult patients with a schizophrenia spectrum disorder and assessed its efficacy with imaging techniques. RESULTS In total, 15 reports involving 19 studies were included in the systematic review. They involved a total of 455 adult patients, 271 of whom received cognitive remediation. Cognitive remediation therapy seems to provide a neurobiological enhancing effect in schizophrenia. After therapy, increased activations are observed in various brain regions mainly in frontal - especially prefrontal - and also in occipital and anterior cingulate regions during working memory and executive tasks. Several studies provide evidence of an improved functional connectivity after cognitive training, suggesting a neuroplastic effect of therapy through mechanisms of functional reorganization. Neurocognitive and social-cognitive training may have a cumulative effect on neural networks involved in social cognition. The variety of proposed programs, imaging tasks, and techniques may explain the heterogeneity of observed neural improvements. Future studies would need to specify the effect of cognitive training depending on those variables.
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Affiliation(s)
- Clémence Isaac
- Unité de Recherche Clinique, EPS Ville Evrard, Neuilly-Sur-Marne, France;
| | - Dominique Januel
- Unité de Recherche Clinique, EPS Ville Evrard, Neuilly-Sur-Marne, France
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21
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Keil J, Roa Romero Y, Balz J, Henjes M, Senkowski D. Positive and Negative Symptoms in Schizophrenia Relate to Distinct Oscillatory Signatures of Sensory Gating. Front Hum Neurosci 2016; 10:104. [PMID: 27014035 PMCID: PMC4789458 DOI: 10.3389/fnhum.2016.00104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/25/2016] [Indexed: 02/02/2023] Open
Abstract
Oscillatory activity in neural populations and temporal synchronization within these populations are important mechanisms contributing to perception and cognition. In schizophrenia, perception and cognition are impaired. Aberrant gating of irrelevant sensory information, which has been related to altered oscillatory neural activity, presumably contributes to these impairments. However, the link between schizophrenia symptoms and sensory gating deficits, as reflected in oscillatory activity, is not clear. In this electroencephalography study, we used a paired-stimulus paradigm to investigate frequency-resolved oscillatory activity in 22 schizophrenia patients and 22 healthy controls. We found sensory gating deficits in patients compared to controls, as reflected in reduced gamma-band power and alpha-band phase synchrony difference between the first and the second auditory stimulus. We correlated these markers of neural activity with a five-factor model of the Positive and Negative Syndrome Scale. Gamma-band power sensory gating was positively correlated with positive symptoms. Moreover, alpha-band phase synchrony sensory gating was negatively correlated with negative symptoms. A cluster analysis revealed three schizophrenia phenotypes, characterized by (i) aberrant gamma-band power and high positive symptoms, (ii) aberrant alpha-band phase synchrony, low positive, and low negative symptom scores or (iii) by intact sensory gating and high negative symptoms. Our study demonstrates that aberrant neural synchronization, as reflected in gamma-band power and alpha-band phase synchrony, relates to the schizophrenia psychopathology. Different schizophrenia phenotypes express distinct levels of positive and negative symptoms as well as varying degrees of aberrant oscillatory neural activity. Identifying the individual phenotype might improve therapeutic interventions in schizophrenia.
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Affiliation(s)
- Julian Keil
- Multisensory Integration Group, Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin Berlin, Germany
| | - Yadira Roa Romero
- Multisensory Integration Group, Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin Berlin, Germany
| | - Johanna Balz
- Multisensory Integration Group, Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin Berlin, Germany
| | - Melissa Henjes
- Multisensory Integration Group, Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin Berlin, Germany
| | - Daniel Senkowski
- Multisensory Integration Group, Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité - Universitätsmedizin Berlin Berlin, Germany
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Akimoto Y, Nozawa T, Kanno A, Kambara T, Ihara M, Ogawa T, Goto T, Taki Y, Yokoyama R, Kotozaki Y, Nouchi R, Sekiguchi A, Takeuchi H, Miyauchi CM, Sugiura M, Okumura E, Sunda T, Shimizu T, Tozuka E, Hirose S, Nanbu T, Kawashima R. High-gamma power changes after cognitive intervention: preliminary results from twenty-one senior adult subjects. Brain Behav 2016; 6:e00427. [PMID: 26855826 PMCID: PMC4733105 DOI: 10.1002/brb3.427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 12/08/2015] [Accepted: 12/11/2015] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Brain-imaging techniques have begun to be popular in evaluating the effectiveness of cognitive intervention training. Although gamma activities are rarely used as an index of training effects, they have several characteristics that suggest their potential suitability for this purpose. This pilot study examined whether cognitive training in elderly people affected the high-gamma activity associated with attentional processing and whether high-gamma power changes were related to changes in behavioral performance. METHODS We analyzed (MEG) magnetoencephalography data obtained from 35 healthy elderly subjects (60-75 years old) who had participated in our previous intervention study in which the subjects were randomly assigned to one of the three types of intervention groups: Group V trained in a vehicle with a newly developed onboard cognitive training program, Group P trained with a similar program but on a personal computer, and Group C was trained to solve a crossword puzzle as an active control group. High-gamma (52-100 Hz) activity during a three-stimulus visual oddball task was measured before and after training. As a result of exclusion in the MEG data analysis stage, the final sample consisted of five subjects in Group V, nine subjects in Group P, and seven subjects in Group C. RESULTS Results showed that high-gamma activities were differently altered between groups after cognitive intervention. In particular, members of Group V, who showed significant improvements in cognitive function after training, exhibited increased high-gamma power in the left middle frontal gyrus during top-down anticipatory target processing. High-gamma power changes in this region were also associated with changes in behavioral performance. CONCLUSIONS Our preliminary results suggest the usefulness of high-gamma activities as an index of the effectiveness of cognitive training in elderly subjects.
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Affiliation(s)
- Yoritaka Akimoto
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Takayuki Nozawa
- Smart Ageing International Research Center Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Akitake Kanno
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Toshimune Kambara
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan; Japan Society for the Promotion of Science (JSPS) Tokyo 102-8472 Japan
| | - Mizuki Ihara
- Smart Ageing International Research Center Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Takeshi Ogawa
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Takakuni Goto
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Yasuyuki Taki
- Division of Developmental Cognitive Neuroscience Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Ryoichi Yokoyama
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Yuka Kotozaki
- Smart Ageing International Research Center Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Rui Nouchi
- Smart Ageing International Research Center Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan; Human and Social Response Research Division International Research Institute of Disaster Science Tohoku University Sendai 980-8575 Japan
| | - Atsushi Sekiguchi
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan; Division of Medical Neuroimage Analysis Department of Community Medical Supports Tohoku Medical Megabank Organization Tohoku University Sendai 980-8575 Japan; Department of Adult Mental Health National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira 187-8553 Japan
| | - Hikaru Takeuchi
- Division of Developmental Cognitive Neuroscience Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Carlos Makoto Miyauchi
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
| | - Motoaki Sugiura
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan; Human and Social Response Research Division International Research Institute of Disaster Science Tohoku University Sendai 980-8575 Japan
| | - Eiichi Okumura
- Department of Epileptology Tohoku University Graduate School of Medicine Sendai 980-8575 Japan
| | - Takashi Sunda
- Mobility Services Laboratory Research Division 2 Nissan Motor Co., Ltd. Kanagawa 243-0123 Japan
| | - Toshiyuki Shimizu
- Mobility Services Laboratory Research Division 2 Nissan Motor Co., Ltd. Kanagawa 243-0123 Japan
| | - Eiji Tozuka
- Vehicle Test and Measurement Technology Development Department CAE and Testing Division 1 Nissan Motor Co., Ltd. Kanagawa 243-0192 Japan
| | - Satoru Hirose
- Mobility Services Laboratory Research Division 2 Nissan Motor Co., Ltd. Kanagawa 243-0123 Japan
| | - Tatsuyoshi Nanbu
- Prototype and Test Department Research Division 2 Nissan Motor Co., Ltd. Kanagawa 243-0123 Japan
| | - Ryuta Kawashima
- Department of Functional Brain Imaging Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan; Smart Ageing International Research Center Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan; Division of Developmental Cognitive Neuroscience Institute of Development, Aging and Cancer Tohoku University Sendai 980-8575 Japan
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23
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Kustermann T, Rockstroh B, Kienle J, Miller GA, Popov T. Deficient attention modulation of lateralized alpha power in schizophrenia. Psychophysiology 2016; 53:776-85. [DOI: 10.1111/psyp.12626] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/15/2016] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - Johanna Kienle
- Department of Psychology; University of Konstanz; Konstanz Germany
| | - Gregory A. Miller
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences; University of California Los Angeles; Los Angeles California USA
| | - Tzvetan Popov
- Department of Psychology; University of Konstanz; Konstanz Germany
- Donders Institute for Brain, Cognition and Behavior, Center for Cognitive Neuroimaging; Radboud University; Nijmegen The Netherlands
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24
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Edgar JC, Fisk CL, Liu S, Pandey J, Herrington JD, Schultz RT, Roberts TPL. Translating Adult Electrophysiology Findings to Younger Patient Populations: Difficulty Measuring 40-Hz Auditory Steady-State Responses in Typically Developing Children and Children with Autism Spectrum Disorder. Dev Neurosci 2016; 38:1-14. [PMID: 26730806 DOI: 10.1159/000441943] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/23/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND x03B3; (∼30-80 Hz) brain rhythms are thought to be abnormal in neurodevelopmental disorders such as schizophrenia and autism spectrum disorder (ASD). In adult populations, auditory 40-Hz click trains or 40-Hz amplitude-modulated tones are used to assess the integrity of superior temporal gyrus (STG) 40-Hz x03B3;-band circuits. As STG 40-Hz auditory steady-state responses (ASSRs) are not fully developed in children, tasks using these stimuli may not be optimal in younger patient populations. The present study examined this issue in typically developing (TD) children as well as in children with ASD, using source localization to directly assess activity in the principal generators of the 40-Hz ASSR in the left and right primary/secondary auditory cortices. METHODS 40-Hz amplitude-modulated tones of 1 s duration were binaurally presented while magnetoencephalography data were obtained from 48 TD children (45 males; 7-14 years old) and 42 ASD children (38 males; 8-14 years old). T1-weighted structural MRI was obtained. Using single dipoles anatomically constrained to each participant's left and right Heschl's Gyrus, left and right 40-Hz ASSR total power (TP) and intertrial coherence (ITC) measures were obtained. Associations between 40-Hz ASSR TP, ITC and age as well as STG gray matter cortical thickness (CT) were assessed. Group STG function and structure differences were also examined. RESULTS TD and ASD did not differ in 40-Hz ASSR TP or ITC. In TD and ASD, age was associated with left and right 40-Hz ASSR ITC (p < 0.01). The interaction term was not significant, indicating in both groups a ∼0.01/year increase in ITC. 40-Hz ASSR TP and ITC were greater in the right than left STG. Groups did not differ in STG CT, and no associations were observed between 40-Hz ASSR activity and STG CT. Finally, right STG transient x03B3; (50-100 ms and 30-50 Hz) was greater in TD versus ASD (significant for TP, trend for ITC). CONCLUSIONS The 40-Hz ASSR develops, in part, via an age-related increase in neural synchrony. Greater right than left 40-Hz ASSRs (ITC and TP) suggested earlier maturation of right versus left STG neural network(s). Given a ∼0.01/year increase in ITC, 40-Hz ASSRs were weak or absent in many of the younger participants, suggesting that 40-Hz driving stimuli are not optimal for examining STG 40-Hz auditory neural circuits in younger populations. Given the caveat that 40-Hz auditory steady-state neural networks are poorly assessed in children, the present analyses did not point to atypical development of STG 40-Hz ASSRs in higher-functioning children with ASD. Although groups did not differ in 40-Hz auditory steady-state activity, replicating previous studies, there was evidence for greater right STG transient x03B3; activity in TD versus ASD.
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Affiliation(s)
- J Christopher Edgar
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa., USA
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Dale CL, Brown EG, Fisher M, Herman AB, Dowling AF, Hinkley LB, Subramaniam K, Nagarajan SS, Vinogradov S. Auditory Cortical Plasticity Drives Training-Induced Cognitive Changes in Schizophrenia. Schizophr Bull 2016; 42:220-8. [PMID: 26152668 PMCID: PMC4681549 DOI: 10.1093/schbul/sbv087] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Schizophrenia is characterized by dysfunction in basic auditory processing, as well as higher-order operations of verbal learning and executive functions. We investigated whether targeted cognitive training of auditory processing improves neural responses to speech stimuli, and how these changes relate to higher-order cognitive functions. Patients with schizophrenia performed an auditory syllable identification task during magnetoencephalography before and after 50 hours of either targeted cognitive training or a computer games control. Healthy comparison subjects were assessed at baseline and after a 10 week no-contact interval. Prior to training, patients (N = 34) showed reduced M100 response in primary auditory cortex relative to healthy participants (N = 13). At reassessment, only the targeted cognitive training patient group (N = 18) exhibited increased M100 responses. Additionally, this group showed increased induced high gamma band activity within left dorsolateral prefrontal cortex immediately after stimulus presentation, and later in bilateral temporal cortices. Training-related changes in neural activity correlated with changes in executive function scores but not verbal learning and memory. These data suggest that computerized cognitive training that targets auditory and verbal learning operations enhances both sensory responses in auditory cortex as well as engagement of prefrontal regions, as indexed during an auditory processing task with low demands on working memory. This neural circuit enhancement is in turn associated with better executive function but not verbal memory.
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Affiliation(s)
- Corby L. Dale
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA;,Northern California Institute for Research and Education (NCIRE), San Francisco Veterans’ Affairs Medical Center, San Francisco, CA;,*To whom correspondence should be addressed; Biomagnetic Imaging Laboratory Box 0628, 513 Parnassus Avenue, S362, San Francisco, CA 94143-0628, US; tel: (415) 476-6888, fax: (415) 502-4302, e-mail:
| | | | - Melissa Fisher
- Northern California Institute for Research and Education (NCIRE), San Francisco Veterans’ Affairs Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Alexander B. Herman
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA;,UC Berkeley – UC San Francisco Graduate Program in Bioengineering, San Francisco, CA
| | - Anne F. Dowling
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA
| | - Leighton B. Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA
| | - Karuna Subramaniam
- Northern California Institute for Research and Education (NCIRE), San Francisco Veterans’ Affairs Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Srikantan S. Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA;,UC Berkeley – UC San Francisco Graduate Program in Bioengineering, San Francisco, CA
| | - Sophia Vinogradov
- Northern California Institute for Research and Education (NCIRE), San Francisco Veterans’ Affairs Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, San Francisco, CA
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Sun J, Tang Y, Lim KO, Wang J, Tong S, Li H, He B. Abnormal dynamics of EEG oscillations in schizophrenia patients on multiple time scales. IEEE Trans Biomed Eng 2015; 61:1756-64. [PMID: 24845286 DOI: 10.1109/tbme.2014.2306424] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Neuronal oscillations reflect the activity of neuronal ensembles engaged in integrative cognition, and may serve as a functional measure for the cognitive impairment in schizophrenia. This study aims to reveal the abnormal amplitude dynamics of electroencephalogram (EEG) oscillations in schizophrenia patients on multiple time scales. EEGs were recorded from schizophrenia patients ( n = 19) and healthy controls ( n = 16) while they were at resting state with eyes closed, at resting state with eyes open, and at watching video. Detrended fluctuation analysis and measures of life-time and waiting-time were used to characterize the abnormal dynamics of EEG oscillations on both long (1-20 s) and short (≤1 s) time scales. Abnormal dynamics of EEG oscillations in alpha and beta bands were observed. In particular, compared with healthy controls, schizophrenia patients have smaller DFA exponent (implying weaker long-range temporal correlation) in the left fronto-temporal area and smaller DFA exponent, smaller life-time (indicating shorter oscillation burst), and smaller waiting-time in the occipital area in beta band at resting state with eyes open. In addition, schizophrenia patients have larger DFA exponent, larger life-time, and larger waiting-time at some clustered channels in the temporo-parietal area in alpha band at watching video. The present results provide new insights for cognitive deficits and the underlying neuronal dysfunction in schizophrenia.
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Targeted training modifies oscillatory brain activity in schizophrenia patients. NEUROIMAGE-CLINICAL 2015; 7:807-14. [PMID: 26082889 PMCID: PMC4459048 DOI: 10.1016/j.nicl.2015.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 03/03/2015] [Accepted: 03/15/2015] [Indexed: 01/01/2023]
Abstract
Effects of both domain-specific and broader cognitive remediation protocols have been reported for neural activity and overt performance in schizophrenia (SZ). Progress is limited by insufficient knowledge of relevant neural mechanisms. Addressing neuronal signal resolution in the auditory system as a mechanism contributing to cognitive function and dysfunction in schizophrenia, the present study compared effects of two neuroplasticity-based training protocols targeting auditory–verbal or facial affect discrimination accuracy and a standard rehabilitation protocol on magnetoencephalographic (MEG) oscillatory brain activity in an auditory paired-click task. SZ were randomly assigned to either 20 daily 1-hour sessions over 4 weeks of auditory–verbal training (N = 19), similarly intense facial affect discrimination training (N = 19), or 4 weeks of treatment as usual (TAU, N = 19). Pre-training, the 57 SZ showed smaller click-induced posterior alpha power modulation than did 28 healthy comparison participants, replicating Popov et al. (2011b). Abnormally small alpha decrease 300–800 ms around S2 improved more after targeted auditory–verbal training than after facial affect training or TAU. The improvement in oscillatory brain dynamics with training correlated with improvement on a measure of verbal learning. Results replicate previously reported effects of neuroplasticity-based psychological training on oscillatory correlates of auditory stimulus differentiation, encoding, and updating and indicate specificity of cortical training effects. Induced posterior alpha power modulation in auditory paired-click design is abnormally small in schizophrenia patients. Abnormal alpha power modulation improved after neuroplasticity-based auditory training. Results confirm targeted training effects on oscillatory correlates of auditory stimulus discrimination, encoding, updating. No similar effects of visual affect discrimination training on alpha power indicate specificity of cortical training effects.
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Popova P, Popov TG, Wienbruch C, Carolus AM, Miller GA, Rockstroh BS. Changing facial affect recognition in schizophrenia: effects of training on brain dynamics. NEUROIMAGE-CLINICAL 2014; 6:156-65. [PMID: 25379427 PMCID: PMC4215531 DOI: 10.1016/j.nicl.2014.08.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/17/2014] [Accepted: 08/31/2014] [Indexed: 11/17/2022]
Abstract
Deficits in social cognition including facial affect recognition and their detrimental effects on functional outcome are well established in schizophrenia. Structured training can have substantial effects on social cognitive measures including facial affect recognition. Elucidating training effects on cortical mechanisms involved in facial affect recognition may identify causes of dysfunctional facial affect recognition in schizophrenia and foster remediation strategies. In the present study, 57 schizophrenia patients were randomly assigned to (a) computer-based facial affect training that focused on affect discrimination and working memory in 20 daily 1-hour sessions, (b) similarly intense, targeted cognitive training on auditory-verbal discrimination and working memory, or (c) treatment as usual. Neuromagnetic activity was measured before and after training during a dynamic facial affect recognition task (5 s videos showing human faces gradually changing from neutral to fear or to happy expressions). Effects on 10–13 Hz (alpha) power during the transition from neutral to emotional expressions were assessed via MEG based on previous findings that alpha power increase is related to facial affect recognition and is smaller in schizophrenia than in healthy subjects. Targeted affect training improved overt performance on the training tasks. Moreover, alpha power increase during the dynamic facial affect recognition task was larger after affect training than after treatment-as-usual, though similar to that after targeted perceptual–cognitive training, indicating somewhat nonspecific benefits. Alpha power modulation was unrelated to general neuropsychological test performance, which improved in all groups. Results suggest that specific neural processes supporting facial affect recognition, evident in oscillatory phenomena, are modifiable. This should be considered when developing remediation strategies targeting social cognition in schizophrenia.
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Affiliation(s)
- Petia Popova
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Tzvetan G. Popov
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Corresponding author: Department of Psychology, University of Konstanz, P.O. Box 905, Konstanz D-78457, Germany.
| | | | - Almut M. Carolus
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Gregory A. Miller
- Departments of Psychology & Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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Tregellas JR. Neuroimaging biomarkers for early drug development in schizophrenia. Biol Psychiatry 2014; 76:111-9. [PMID: 24094513 PMCID: PMC4026337 DOI: 10.1016/j.biopsych.2013.08.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 08/27/2013] [Accepted: 08/29/2013] [Indexed: 11/18/2022]
Abstract
Given the relative inability of currently available antipsychotic treatments to adequately provide sustained recovery and improve quality of life for patients with schizophrenia, new treatment strategies are urgently needed. One way to improve the therapeutic development process may be an increased use of biomarkers in early clinical trials. Reliable biomarkers that reflect aspects of disease pathophysiology can be used to determine if potential treatment strategies are engaging their desired biological targets. This review evaluates three potential neuroimaging biomarkers: hippocampal hyperactivity, gamma-band deficits, and default network abnormalities. These deficits have been widely replicated in the illness, correlate with measures of positive symptoms, are consistent with models of disease pathology, and have shown initial promise as biomarkers of biological response in early studies of potential treatment strategies. Two key features of these deficits, and a guiding rationale for the focus of this review, are that the deficits are not dependent upon patients' performance of specific cognitive tasks and they have analogues in animal models of schizophrenia, greatly increasing their appeal for use as biomarkers. Using neuroimaging biomarkers such as those proposed here to establish early in the therapeutic development process if treatment strategies are having their intended biological effect in humans may facilitate development of new treatments for schizophrenia.
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Affiliation(s)
- Jason R Tregellas
- Research Service, Denver Veterans Affairs Medical Center, and Department of Psychiatry, University of Colorado Medical School, Aurora, Colorado.
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30
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Merzenich MM, Van Vleet TM, Nahum M. Brain plasticity-based therapeutics. Front Hum Neurosci 2014; 8:385. [PMID: 25018719 PMCID: PMC4072971 DOI: 10.3389/fnhum.2014.00385] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 05/15/2014] [Indexed: 11/30/2022] Open
Abstract
The primary objective of this review article is to summarize how the neuroscience of brain plasticity, exploiting new findings in fundamental, integrative and cognitive neuroscience, is changing the therapeutic landscape for professional communities addressing brain-based disorders and disease. After considering the neurological bases of training-driven neuroplasticity, we shall describe how this neuroscience-guided perspective distinguishes this new approach from (a) the more-behavioral, traditional clinical strategies of professional therapy practitioners, and (b) an even more widely applied pharmaceutical treatment model for neurological and psychiatric treatment domains. With that background, we shall argue that neuroplasticity-based treatments will be an important part of future best-treatment practices in neurological and psychiatric medicine.
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Affiliation(s)
| | - Thomas M Van Vleet
- Posit Science Corporation San Francisco, CA, USA ; Medical Research, Department of Veteran Affairs Martinez, CA, USA
| | - Mor Nahum
- Posit Science Corporation San Francisco, CA, USA ; Department of Optometry, University of California at Berkeley Berkeley, CA, USA
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Paquin K, Wilson AL, Cellard C, Lecomte T, Potvin S. A systematic review on improving cognition in schizophrenia: which is the more commonly used type of training, practice or strategy learning? BMC Psychiatry 2014; 14:139. [PMID: 24885300 PMCID: PMC4055167 DOI: 10.1186/1471-244x-14-139] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 04/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this article was to conduct a review of the types of training offered to people with schizophrenia in order to help them develop strategies to cope with or compensate for neurocognitive or sociocognitive deficits. METHODS We conducted a search of the literature using keywords such as "schizophrenia", "training", and "cognition" with the most popular databases of peer-reviewed journals. RESULTS We reviewed 99 controlled studies in total (though nine did not have a control condition). We found that drill and practice training is used more often to retrain neurocognitive deficits while drill and strategy training is used more frequently in the context of sociocognitive remediation. CONCLUSIONS Hypotheses are suggested to better understand those results and future research is recommended to compare drill and strategy with drill and practice training for both social and neurocognitive deficits in schizophrenia.
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Affiliation(s)
- Karine Paquin
- Psychology Department, University of Montreal, Montreal, Canada.
| | | | | | - Tania Lecomte
- Psychology Department, University of Montreal, Montreal, Canada
| | - Stéphane Potvin
- Psychology Department, University of Montreal, Montreal, Canada
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32
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Thorsen AL, Johansson K, Løberg EM. Neurobiology of cognitive remediation therapy for schizophrenia: a systematic review. Front Psychiatry 2014; 5:103. [PMID: 25177300 PMCID: PMC4133649 DOI: 10.3389/fpsyt.2014.00103] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 08/01/2014] [Indexed: 12/13/2022] Open
Abstract
Cognitive impairment is an important aspect of schizophrenia, where cognitive remediation therapy (CRT) is a promising treatment for improving cognitive functioning. While neurobiological dysfunction in schizophrenia has been the target of much research, the neural substrate of cognitive remediation and recovery has not been thoroughly examined. The aim of the present article is to systematically review the evidence for neural changes after CRT for schizophrenia. The reviewed studies indicate that CRT affects several brain regions and circuits, including prefrontal, parietal, and limbic areas, both in terms of activity and structure. Changes in prefrontal areas are the most reported finding, fitting to previous evidence of dysfunction in this region. Two limitations of the current research are the few studies and the lack of knowledge on the mechanisms underlying neural and cognitive changes after treatment. Despite these limitations, the current evidence suggests that CRT is associated with both neurobiological and cognitive improvement. The evidence from these findings may shed light on both the neural substrate of cognitive impairment in schizophrenia, and how better treatment can be developed and applied.
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Affiliation(s)
| | - Kyrre Johansson
- Department of Psychosocial Science, University of Bergen , Bergen , Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital , Bergen , Norway ; Department of Biological and Medical Psychology, University of Bergen , Bergen , Norway
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Auditory event-related potentials and α oscillations in the psychosis prodrome: neuronal generator patterns during a novelty oddball task. Int J Psychophysiol 2013; 91:104-20. [PMID: 24333745 DOI: 10.1016/j.ijpsycho.2013.12.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 12/03/2013] [Accepted: 12/06/2013] [Indexed: 11/23/2022]
Abstract
Prior research suggests that event-related potentials (ERP) obtained during active and passive auditory paradigms, which have demonstrated abnormal neurocognitive function in schizophrenia, may provide helpful tools in predicting transition to psychosis. In addition to ERP measures, reduced modulations of EEG alpha, reflecting top-down control required to inhibit irrelevant information, have revealed attentional deficits in schizophrenia and its prodromal stage. Employing a three-stimulus novelty oddball task, nose-referenced 48-channel ERPs were recorded from 22 clinical high-risk (CHR) patients and 20 healthy controls detecting target tones (12% probability, 500Hz; button press) among nontargets (76%, 350Hz) and novel sounds (12%). After current source density (CSD) transformation of EEG epochs (-200 to 1000ms), event-related spectral perturbations were obtained for each site up to 30Hz and 800ms after stimulus onset, and simplified by unrestricted time-frequency (TF) principal components analysis (PCA). Alpha event-related desynchronization (ERD) as measured by TF factor 610-9 (spectral peak latency at 610ms and 9Hz; 31.9% variance) was prominent over right posterior regions for targets, and markedly reduced in CHR patients compared to controls, particularly in three patients who later developed psychosis. In contrast, low-frequency event-related synchronization (ERS) distinctly linked to novels (260-1; 16.0%; mid-frontal) and N1 sink across conditions (130-1; 3.4%; centro-temporoparietal) did not differ between groups. Analogous time-domain CSD-ERP measures (temporal PCA), consisting of N1 sink, novelty mismatch negativity (MMN), novelty vertex source, novelty P3, P3b, and frontal response negativity, were robust and closely comparable between groups. Novelty MMN at FCz was, however, absent in the three converters. In agreement with prior findings, alpha ERD and MMN may hold particular promise for predicting transition to psychosis among CHR patients.
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Miller GA, Crocker LD, Spielberg JM, Infantolino ZP, Heller W. Issues in localization of brain function: The case of lateralized frontal cortex in cognition, emotion, and psychopathology. Front Integr Neurosci 2013; 7:2. [PMID: 23386814 PMCID: PMC3558680 DOI: 10.3389/fnint.2013.00002] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 01/07/2013] [Indexed: 11/30/2022] Open
Abstract
The appeal of simple, sweeping portraits of large-scale brain mechanisms relevant to psychological phenomena competes with a rich, complex research base. As a prominent example, two views of frontal brain organization have emphasized dichotomous lateralization as a function of either emotional valence (positive/negative) or approach/avoidance motivation. Compelling findings support each. The literature has struggled to choose between them for three decades, without success. Both views are proving untenable as comprehensive models. Evidence of other frontal lateralizations, involving distinctions among dimensions of depression and anxiety, make a dichotomous view even more problematic. Recent evidence indicates that positive valence and approach motivation are associated with different areas in the left-hemisphere. Findings that appear contradictory at the level of frontal lobes as the units of analysis can be accommodated because hemodynamic and electromagnetic neuroimaging studies suggest considerable functional differentiation, in specialization and activation, of subregions of frontal cortex, including their connectivity to each other and to other regions. Such findings contribute to a more nuanced understanding of functional localization that accommodates aspects of multiple theoretical perspectives.
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Affiliation(s)
- Gregory A Miller
- Department of Psychology, University of Delaware Newark, DE, USA ; Department of Psychology, University of Illinois at Urbana-Champaign Champaign, IL, USA ; Zukunftskolleg, University of Konstanz Konstanz, Germany
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