Electrophysiological Correlates of Subitizing in Healthy Aging

Modern neurophysiological techniques indexing normal or abnormal brain aging

Brain aging is associated with a decline in cognitive performance, motor function and sensory perception, even in the absence of neurodegeneration. The underlying pathophysiological mechanisms remain incompletely understood, though alterations in neurogenesis, neuronal senescence and synaptic plasticity are implicated. Recent years have seen advancements in neurophysiological techniques such as electroencephalography (EEG), magnetoencephalography (MEG), event-related potentials (ERP) and transcranial magnetic stimulation (TMS), offering insights into physiological and pathological brain aging. These methods provide real-time information on brain activity, connectivity and network dynamics. Integration of Artificial Intelligence (AI) techniques promise as a tool enhancing the diagnosis and prognosis of age-related cognitive decline. Our review highlights recent advances in these electrophysiological techniques (focusing on EEG, ERP, TMS and TMS-EEG methodologies) and their application in physiological and pathological brain aging. Physiological aging is characterized by changes in EEG spectral power and connectivity, ERP and TMS parameters, indicating alterations in neural activity and network function. Pathological aging, such as in Alzheimer's disease, is associated with further disruptions in EEG rhythms, ERP components and TMS measures, reflecting underlying neurodegenerative processes. Machine learning approaches show promise in classifying cognitive impairment and predicting disease progression. Standardization of neurophysiological methods and integration with other modalities are crucial for a comprehensive understanding of brain aging and neurodegenerative disorders. Advanced network analysis techniques and AI methods hold potential for enhancing diagnostic accuracy and deepening insights into age-related brain changes.

Training attentive individuation leads to visuo-spatial working memory improvement in low-performing older adults: An online study

Cognitive decrements are typical of physiological aging. Among these age-related cognitive changes, visuo-spatial working memory (vWM) decline has a prominent role due to its effects on other cognitive functions and daily routines. To reinforce vWM in the aging population, several cognitive training interventions have been developed in the past years. Given that vWM functioning depends (at least partially) on the efficiency of attention selection of the relevant objects, in the present study we implemented a short (five sessions), online intervention that primarily trained attentive individuation of target items and tested training effects on a vWM task. Attention training effects were compared with practice (i.e., a group that repeatedly performed the same vWM task) and test-retest effects (i.e., a passive group). After the training, the results showed attention training effects of the same magnitude as practice effects, confirming that the enhancement of attentive individuation has a positive cascade influence on maintaining items in vWM. Moreover, training and practice effects were only evident in low-performing older adults. Thus, interindividual differences at baseline crucially contribute to training outcomes and are a fundamental factor to be accounted for in the implementation of cognitive training protocols.

Connectivity alterations underlying the breakdown of pseudoneglect: New insights from healthy and pathological aging

A right-hemisphere dominance for visuospatial attention has been invoked as the most prominent neural feature of pseudoneglect (i.e., the leftward visuospatial bias exhibited in neurologically healthy individuals) but the neurophysiological underpinnings of such advantage are still controversial. Previous studies investigating visuospatial bias in multiple-objects visual enumeration reported that pseudoneglect is maintained in healthy elderly and amnesic mild cognitive impairment (aMCI), but not in Alzheimer’s disease (AD). In this study, we aimed at investigating the neurophysiological correlates sustaining the rearrangements of the visuospatial bias along the progression from normal to pathological aging. To this aim, we recorded EEG activity during an enumeration task and analyzed intra-hemispheric fronto-parietal and inter-hemispheric effective connectivity adopting indexes from graph theory in patients with mild AD, patients with aMCI, and healthy elderly controls (HC). Results revealed that HC showed the leftward bias and stronger fronto-parietal effective connectivity in the right as compared to the left hemisphere. A breakdown of pseudoneglect in patients with AD was associated with both the loss of the fronto-parietal asymmetry and the reduction of inter-hemispheric parietal interactions. In aMCI, initial alterations of the attentional bias were associated with a reduction of parietal inter-hemispheric communication, but not with modulations of the right fronto-parietal connectivity advantage, which remained intact. These data provide support to the involvement of fronto-parietal and inter-parietal pathways in the leftward spatial bias, extending these notions to the complex neurophysiological alterations characterizing pathological aging.

Cognitive control, interference inhibition, and ordering of information during working memory in younger and older healthy adults

Investigating effects of aging on neurophysiological mechanisms underlying working memory provides a better understanding of potential targets for brain intervention to prevent cognitive decline. Theta-gamma coupling (TGC) indexes the ability to order information processed during working memory tasks. Frontal theta event-related synchronization (ERS) and parietal alpha event-related desynchronization (ERD) index cognitive control and interference inhibition, respectively. Relative contributions of TGC, theta ERS, and alpha ERD in relation to stimulus presentation are not characterized. Further, differential effect of normal aging on pre- or post-stimulus processes is unknown. Electroencephalography was recorded in 66 younger and 41 older healthy participants while performing 3-back working memory task. We assessed relationships between 3-back task performance and each of post-stimulus TGC, pre-stimulus parietal alpha ERD, and pre-stimulus frontal theta ERS in each age group. While older adults performed worse on 3-back task than younger adults, TGC, alpha ERD, or theta ERS did not differ between the two groups. TGC was positively associated with 3-back performance in both age groups; pre-stimulus alpha ERD was associated with performance among younger adults; and pre-stimulus theta ERS was not associated with performance in either group. Our findings suggest that both pre-stimulus interference inhibition and post-stimulus ordering of information are important for working memory in younger adults. In contrast, performance in older adults appears to depend only on post-stimulus ordering of information. These specific contributions of neurophysiological resources may explain the poorer performance of older adults and suggest different targets to enhance working memory in age groups.

Alpha desynchronization during Stroop test unmasks cognitively healthy individuals with abnormal CSF Amyloid/Tau

Synaptic dysfunctions precede cognitive decline in Alzheimer's disease by decades, affect executive functions, and can be detected by quantitative electroencephalography (qEEG). We used quantitative electroencephalography combined with Stroop testing to identify changes of inhibitory controls in cognitively healthy individuals with an abnormal versus normal ratio of cerebrospinal fluid (CSF) amyloid/total-tau. We studied two groups of participants (60-94 years) with either normal (CH-NAT or controls, n = 20) or abnormal (CH-PAT, n = 21) CSF amyloid/tau ratio. We compared: alpha event-related desynchronization (ERD), alpha spectral entropy (SE), and their relationships with estimated cognitive reserve. CH-PATs had more negative occipital alpha ERD, and higher frontal and occipital alpha SE during low load congruent trials, indicating hyperactivity. CH-PATs demonstrated fewer frontal SE changes with higher load, incongruent Stroop testing. Correlations of alpha ERD with estimated cognitive reserve were significant in CH-PATs but not in CH-NATs. These results suggested compensatory hyperactivity in CH-PATs compared to CH-NATs. We did not find differences in alpha ERD comparisons with individual CSF amyloid(A), p-tau(T), total-tau(N) biomarkers.

Task switching reveals abnormal brain-heart electrophysiological signatures in cognitively healthy individuals with abnormal CSF amyloid/tau, a pilot study

Electroencephalographic (EEG) alpha oscillations have been related to heart rate variability (HRV) and both change in Alzheimer’s disease (AD). We explored if task switching reveals altered alpha power and HRV in cognitively healthy individuals with AD pathology in cerebrospinal fluid (CSF) and whether HRV improves the AD pathology classification by alpha power alone.

We compared low and high alpha event-related desynchronization (ERD) and HRV parameters during task switch testing between two groups of cognitively healthy participants classified by CSF amyloid/tau ratio: normal (CH-NAT, n = 19) or pathological (CH-PAT, n = 27). For the task switching paradigm, participants were required to name the color or word for each colored word stimulus, with two sequential stimuli per trial. Trials include color (cC) or word (wW) repeats with low load repeating, and word (cW) or color switch (wC) for high load switching. HRV was assessed for RR interval, standard deviation of RR-intervals (SDNN) and root mean squared successive differences (RMSSD) in time domain, and low frequency (LF), high frequency (HF), and LF/HF ratio in frequency domain.

Results showed that CH-PATs compared to CH-NATs presented: 1) increased (less negative) low alpha ERD during low load repeat trials and lower word switch cost (low alpha: p = 0.008, Cohen’s d = −0.83, 95% confidence interval −1.44 to −0.22, and high alpha: p = 0.019, Cohen’s d = −0.73, 95% confidence interval −1.34 to −0.13); 2) decreasing HRV from rest to task, suggesting hyper-activated sympatho-vagal responses. 3) CH-PATs classification by alpha ERD was improved by supplementing HRV signatures, supporting a potentially compromised brain-heart interoceptive regulation in CH-PATs. Further experiments are needed to validate these findings for clinical significance.

Neural Mechanism of Repeated Transcranial Magnetic Stimulation to Enhance Visual Working Memory in Elderly Individuals With Subjective Cognitive Decline

Visual working memory (VWM), the core process inherent to many advanced cognitive processes, deteriorates with age. Elderly individuals usually experience defects in the processing of VWM. The dorsolateral prefrontal cortex is a key structure for the top-down control of working memory processes. Many studies have shown that repeated transcranial magnetic stimulation (rTMS) improves VWM by modulating the excitability of neurons in the target cortical region, though the underlying neural mechanism has not been clarified. Therefore, this study sought to assess the characteristics of brain memory function post-rTMS targeting the left dorsolateral prefrontal cortex. The study stimulated the left dorsolateral prefrontal cortex in elderly individuals by performing a high-frequency rTMS protocol and evaluated behavioral performance using cognitive tasks and a VWM task. Based on the simultaneously recorded electroencephalogram signals, event-related potential and event-related spectral perturbation analysis techniques were used to investigate the variation characteristics of event-related potential components' (N2PC and CDA) amplitudes and neural oscillations in elderly individuals to elucidate the effect of high-frequency rTMS. The results found that rTMS enhanced VWM performance and significantly improved attention and executive function in elderly individuals with subjective cognitive decline. We therefore speculate that rTMS enhances VWM by increasing the N2PC and CDA amplitude, alongside increasing β oscillation activity. This would improve the attention and allocation of resources in elderly individuals such as to improve an individual's VWM.

Changes in theta and alpha oscillatory signatures of attentional control in older and middle age

BACKGROUND

Recent behavioural research has reported age-related changes in the costs of refocusing attention from a temporal (rapid serial visual presentation) to a spatial (visual search) task. Using magnetoencephalography, we have now compared the neural signatures of attention refocusing between three age groups (19-30, 40-49 and 60+ years) and found differences in task-related modulation and cortical localisation of alpha and theta oscillations. Efficient, faster refocusing in the youngest group compared to both middle age and older groups was reflected in parietal theta effects that were significantly reduced in the older groups. Residual parietal theta activity in older individuals was beneficial to attentional refocusing and could reflect preserved attention mechanisms. Slowed refocusing of attention, especially when a target required consolidation, in the older and middle-aged adults was accompanied by a posterior theta deficit and increased recruitment of frontal (middle-aged and older groups) and temporal (older group only) areas, demonstrating a posterior to anterior processing shift. Theta but not alpha modulation correlated with task performance, suggesting that older adults' stronger and more widely distributed alpha power modulation could reflect decreased neural precision or dedifferentiation but requires further investigation. Our results demonstrate that older adults present with different alpha and theta oscillatory signatures during attentional control, reflecting cognitive decline and, potentially, also different cognitive strategies in an attempt to compensate for decline.

Estimating the statistical power to detect set-size effects in contralateral delay activity

The contralateral delay activity (CDA) is an event-related potential component commonly used to examine the online processes of visual working memory. Here, we provide a robust analysis of the statistical power that is needed to achieve reliable and reproducible results with the CDA. Using two very large EEG datasets that examined the contrast between CDA amplitude with set sizes 2 and 6 items and set sizes 2 and 4 items, we present a subsampling analysis that estimates the statistical power achieved with varying numbers of subjects and trials based on the proportion of significant tests in 10,000 iterations. We also generated simulated data using Bayesian multilevel modeling to estimate power beyond the bounds of the original datasets. The number of trials and subjects required depends critically on the effect size. Detecting the presence of the CDA-a reliable difference between contralateral and ipsilateral electrodes during the memory period-required only 30-50 clean trials with a sample of 25 subjects to achieve approximately 80% statistical power. However, for detecting a difference in CDA amplitude between two set sizes, a substantially larger number of trials and subjects were required; approximately 400 clean trials with 25 subjects to achieve 80% power. Thus, to achieve robust tests of how CDA activity differs across conditions, it is essential to be mindful of the estimated effect size. We recommend researchers designing experiments to detect set-size differences in the CDA collect substantially more trials per subject.

Learning by task repetition enhances object individuation and memorization in the elderly

A decline in visuospatial Working Memory (vWM) is a hallmark of cognitive aging across various tasks, and facing this decline has become the target of several studies. In the current study we tested whether older adults can benefit from task repetition in order to improve their performance in a vWM task. While learning by task repetition has been shown to improve vWM performance in young adulthood, little is known on whether a similar enhancement can be achieved also by the aging population. By combining different behavioral and electrophysiological measures, we investigated whether practicing a specific task (delayed match-to-sample judgement) over four consecutive sessions could improve vWM in healthy aging, and which are the neurophysiological and cognitive mechanisms modulated by learning. Behavioral data revealed that task repetition boosted performance in older participants, both in terms of sensitivity to change (as revealed by d' measures) as well as capacity estimate (as measured by k values). At the electrophysiological level, results indicated that only after task repetition both target individuation (as evidenced by the N2pc) and vWM maintenance (as reflected by the CDA) were modulated by target numerosity. Our results suggest that repetition learning is effective in enhancing vWM in aging and acts through modifications at different stages of stimulus processing.

Assessment of Cognitive Aging Using an SSVEP-Based Brain–Computer Interface System

Cognitive deterioration caused by illness or aging often occurs before symptoms arise, and its timely diagnosis is crucial to reducing its medical, personal, and societal impacts. Brain–computer interfaces (BCIs) stimulate and analyze key cerebral rhythms, enabling reliable cognitive assessment that can accelerate diagnosis. The BCI system presented analyzes steady-state visually evoked potentials (SSVEPs) elicited in subjects of varying age to detect cognitive aging, predict its magnitude, and identify its relationship with SSVEP features (band power and frequency detection accuracy), which were hypothesized to indicate cognitive decline due to aging. The BCI system was tested with subjects of varying age to assess its ability to detect aging-induced cognitive deterioration. Rectangular stimuli flickering at theta, alpha, and beta frequencies were presented to subjects, and frontal and occipital Electroencephalographic (EEG) responses were recorded. These were processed to calculate detection accuracy for each subject and calculate SSVEP band power. A neural network was trained using the features to predict cognitive age. The results showed potential cognitive deterioration through age-related variations in SSVEP features. Frequency detection accuracy declined after age group 20–40, and band power declined throughout all age groups. SSVEPs generated at theta and alpha frequencies, especially 7.5 Hz, were the best indicators of cognitive deterioration. Here, frequency detection accuracy consistently declined after age group 20–40 from an average of 96.64% to 69.23%. The presented system can be used as an effective diagnosis tool for age-related cognitive decline.

Alpha desynchronization during simple working memory unmasks pathological aging in cognitively healthy individuals

Our aim is to explore if cognitive challenge combined with objective physiology can reveal abnormal frontal alpha event-related desynchronization (ERD), in early Alzheimer's disease (AD). We used quantitative electroencephalography (qEEG) to investigate brain activities during N-back working memory (WM) processing at two different load conditions (N = 0 or 2) in an aging cohort. We studied 60-100 year old participants, with normal cognition, and who fits one of two subgroups from cerebrospinal fluid (CSF) proteins: cognitively healthy (CH) with normal amyloid/tau ratio (CH-NAT, n = 10) or pathological amyloid/tau ratio (CH-PAT, n = 14). We recorded behavioral performances, and analyzed alpha power and alpha spectral entropy (SE) at three occasions: during the resting state, and at event-related desynchronization (ERD) [250 ~ 750 ms] during 0-back and 2-back. During 0-back WM testing, the behavioral performance was similar between the two groups, however, qEEG notably differentiated CH-PATs from CH-NATs on the simple, 0-back testing: Alpha ERD decreased from baseline only in the parietal region in CH-NATs, while it decreased in all brain regions in CH-PATs. Alpha SE did not change in CH-NATs, but was increased from baseline in the CH-PATs in frontal and left lateral regions (p<0.01), and was higher in the frontal region (p<0.01) of CH-PATs compared to CH-NATs. The alpha ERD and SE analyses suggest there is frontal lobe dysfunction during WM processing in the CH-PAT stage. Additional power and correlations with behavioral performance were also explored. This study provide pilot information to further evaluate whether this biomarker has clinical significance.

Neural Processing of Repeated Search Targets Depends Upon the Stimuli: Real World Stimuli Engage Semantic Processing and Recognition Memory

Recent evidence has suggested that visual working memory (VWM) plays an important role in representing the target prior to initiating a visual search. The more familiar we are with the search target, the more refined the representation of the target (or "target template") becomes. This sharpening of the target template is thought to underlie the reduced response time (RT) and increased accuracy associated with repeatedly searching for the same target. Perhaps target representations transition from limited-capacity VWM to Long-Term Memory (LTM) as targets repeat. In prior work, amplitude of an event-related potential (ERP) component associated with VWM representation decreased with target repetition, broadly supporting this notion. However, previous research has focused on artificial stimuli (Landolt Cs) that are far removed from search targets in the real world. The current study extends this work by directly comparing target representations for artificial stimuli and common object images. We found VWM representation follows the same pattern for real and artificial stimuli. However, the initial selection of the real world objects follows a much different pattern than more typical artificial stimuli. Further, the morphology of nonlateralized waveforms was substantially different for the two stimulus categories. This suggests that the two types of stimuli were processed in fundamentally different ways. We conclude that object type strongly influences how we deploy attentional and mnemonic resources prior to search. Early attentional selection of familiar objects may facilitate additional LTM processes that lead to behavioral benefits not seen with more simplistic stimuli.

Pseudoneglect is maintained in aging but not in mild Alzheimer's disease: new insights from an enumeration task

Neurologically healthy young adults display a behavioral bias, called pseudoneglect, which favors the processing of stimuli appearing in the left visual field. Pseudoneglect arises from the right hemisphere dominance for visuospatial attention. Previous studies investigating the effects of normal aging on pseudoneglect in line bisection and greyscale tasks have produced divergent results. In addition, scarce systematic investigations of visual biases in dementia have been reported. The aim of the present study was to evaluate whether the leftward bias appearing during an enumeration task in young adults would be preserved in normal aging and at different stages of severity of Alzheimer's disease. In Experiment 1, young and older healthy adults showed a comparable pseudoneglect, performing better when targets appeared in the left visual field. In Experiment 2, the leftward bias was maintained in amnesic mild cognitive impairment patients (aMCI), but it vanished in mild Alzheimer's disease patients (AD). The maintenance of pseudoneglect in normal aging and in aMCI patients is consistent with compensatory phenomena involving the right fronto-parietal network, which allow maintaining the right hemisphere dominance. Conversely, the lack of pseudoneglect in the sample of AD patients likely results from a loss of the right hemisphere dominance, caused by the selective degeneration of the right fronto-parietal network. These results highlight the need of further systematic investigations of visuospatial biases along the continuum of normal and pathological aging, both for a better understanding of the changes characterizing cognitive aging and for improvements in the evaluation of neglect in Alzheimer's disease.

Neural Dynamics of Multiple Object Processing in Mild Cognitive Impairment and Alzheimer's Disease: Future Early Diagnostic Biomarkers?

The aim of this study was to investigate the behavioral and electrophysiological dynamics of multiple object processing (MOP) in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to test whether its neural signatures may represent reliable diagnostic biomarkers. Behavioral performance and event-related potentials [N2pc and contralateral delay activity (CDA)] were measured in AD, MCI, and healthy controls during a MOP task, which consisted in enumerating a variable number of targets presented among distractors. AD patients showed an overall decline in accuracy for both small and large target quantities, whereas in MCI patients, only enumeration of large quantities was impaired. N2pc, a neural marker of attentive individuation, was spared in both AD and MCI patients. In contrast, CDA, which indexes visual short term memory abilities, was altered in both groups of patients, with a non-linear pattern of amplitude modulation along the continuum of the disease: a reduction in AD and an increase in MCI. These results indicate that AD pathology shows a progressive decline in MOP, which is associated to the decay of visual short-term memory mechanisms. Crucially, CDA may be considered as a useful neural signature both to distinguish between healthy and pathological aging and to characterize the different stages along the AD continuum, possibly becoming a reliable candidate for an early diagnostic biomarker of AD pathology.

Early selection versus late correction: Age-related differences in controlling working memory contents

We examined whether a reduced ability to ignore irrelevant information is responsible for the age-related decline of working memory (WM) functions. By means of event-related brain potentials, we will show that filtering is not out of service in older adults but shifted to a later processing stage. Participants performed a visual short-term memory task (change-detection task) in which targets were presented along with distractors. To allow early selection, a cue was presented in advance of each display, indicating where the targets were to appear. Despite this relatively easy selection criterion, older adults' filtering was delayed as indicated by the amplitude pattern of the contralateral delay activity. Importantly, WM-equated younger adults did not show a delay indicating that the delay is specific to older adults and not a general phenomenon that comes with low WM capacity. Moreover, the analysis of early visual potentials revealed qualitatively different perceptual/attentional processing between the age groups. Young adults exhibited stronger distractor sensitivity that in turn facilitated filtering. Older adults, in contrast, seemed to initially store distractors and to suppress them after the fact. These early selection versus late-correction modes suggest an age-related shift in the strategy to control the contents of WM. (PsycINFO Database Record

Object individuation and compensation in healthy aging

Theories on neural compensation suggest that aged participants overactivate the brain areas involved in a task to compensate for the age-related decline. In this electrophysiological study, we investigated the temporal locus of neural overactivation in aging during multiple target processing. We measured performance and three event-related brain potential responses (N1, N2pc, and contralateral delay activity) in young and old adults, while they enumerated a variable number (1-4) of targets presented in an easy (distractor absent) or difficult (distractor present) condition. The main results indicated that although N2pc (∼200 ms) increased in amplitude in the distractor-present condition in the young group, no modulation occurred for the old group. Old participants were associated with larger N2pc amplitudes than young participants in the distractor-absent condition, where both groups had comparable levels of accuracy. These effects were not present for N1 and contralateral delay activity. Overall, the data suggest that in enumeration, aging is associated with compensatory effects that rely on the selection mechanism responsible for target individuation.

Electrophysiological Advances on Multiple Object Processing in Aging

EEG research conducted in the past 5 years on multiple object processing has begun to define how the aging brain tracks the numerosity of the objects presented in the visual field for different goals. We review the recent EEG findings in healthy older individuals (age range: 65-75 years approximately) on perceptual, attentional and memory mechanisms-reflected in the N1, N2pc and contralateral delayed activity (CDA) components of the EEG, respectively-during the execution of a variety of cognitive tasks requiring simultaneous processing of multiple elements. The findings point to multiple loci of neural changes in multi-object analysis, and suggest the involvement of early perceptual mechanisms, attentive individuation and working memory (WM) operations in the neural and cognitive modification due to aging. However, the findings do not simply reflect early impairments with a cascade effect over subsequent stages of stimulus processing, but in fact highlight interesting dissociations between the effects occurring at the various stages of stimulus processing. Finally, the results on older adults indicate the occurrence of neural overactivation in association to good levels of performance in easy perceptual contexts, thus providing some hints on the existence of compensatory phenomena that are associated with the functioning of early perceptual mechanisms.