Retest reliability of individual alpha ERD topography assessed by human electroencephalography

Literature review of stroke assessment for upper-extremity physical function via EEG, EMG, kinematic, and kinetic measurements and their reliability

BACKGROUND

Significant clinician training is required to mitigate the subjective nature and achieve useful reliability between measurement occasions and therapists. Previous research supports that robotic instruments can improve quantitative biomechanical assessments of the upper limb, offering reliable and more sensitive measures. Furthermore, combining kinematic and kinetic measurements with electrophysiological measurements offers new insights to unlock targeted impairment-specific therapy. This review presents common methods for analyzing biomechanical and neuromuscular data by describing their validity and reporting their reliability measures.

METHODS

This paper reviews literature (2000-2021) on sensor-based measures and metrics for upper-limb biomechanical and electrophysiological (neurological) assessment, which have been shown to correlate with clinical test outcomes for motor assessment. The search terms targeted robotic and passive devices developed for movement therapy. Journal and conference papers on stroke assessment metrics were selected using PRISMA guidelines. Intra-class correlation values of some of the metrics are recorded, along with model, type of agreement, and confidence intervals, when reported.

RESULTS

A total of 60 articles are identified. The sensor-based metrics assess various aspects of movement performance, such as smoothness, spasticity, efficiency, planning, efficacy, accuracy, coordination, range of motion, and strength. Additional metrics assess abnormal activation patterns of cortical activity and interconnections between brain regions and muscle groups; aiming to characterize differences between the population who had a stroke and the healthy population.

CONCLUSION

Range of motion, mean speed, mean distance, normal path length, spectral arc length, number of peaks, and task time metrics have all demonstrated good to excellent reliability, as well as provide a finer resolution compared to discrete clinical assessment tests. EEG power features for multiple frequency bands of interest, specifically the bands relating to slow and fast frequencies comparing affected and non-affected hemispheres, demonstrate good to excellent reliability for populations at various stages of stroke recovery. Further investigation is needed to evaluate the metrics missing reliability information. In the few studies combining biomechanical measures with neuroelectric signals, the multi-domain approaches demonstrated agreement with clinical assessments and provide further information during the relearning phase. Combining the reliable sensor-based metrics in the clinical assessment process will provide a more objective approach, relying less on therapist expertise. This paper suggests future work on analyzing the reliability of metrics to prevent biasedness and selecting the appropriate analysis.

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.

Stimulus-induced narrowband gamma oscillations are test–retest reliable in human EEG

Visual stimulus-induced gamma oscillations in electroencephalogram (EEG) recordings have been recently shown to be compromised in subjects with preclinical Alzheimer’s Disease (AD), suggesting that gamma could be an inexpensive biomarker for AD diagnosis provided its characteristics remain consistent across multiple recordings. Previous magnetoencephalography studies in young subjects have reported consistent gamma power over recordings separated by a few weeks to months. Here, we assessed the consistency of stimulus-induced slow (20–35 Hz) and fast gamma (36–66 Hz) oscillations in subjects (n = 40) (age: 50–88 years) in EEG recordings separated by a year, and tested the consistency in the magnitude of gamma power, its temporal evolution and spectral profile. Gamma had distinct spectral/temporal characteristics across subjects, which remained consistent across recordings (average intraclass correlation of ~0.7). Alpha (8–12 Hz) and steady-state-visually evoked-potentials were also reliable. We further tested how EEG features can be used to identify 2 recordings as belonging to the same versus different subjects and found high classifier performance (AUC of ~0.89), with temporal evolution of slow gamma and spectral profile being most informative. These results suggest that EEG gamma oscillations are reliable across sessions separated over long durations and can also be a potential tool for subject identification.

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.

Deficits in Early Sensory and Cognitive Processing Are Related to Phase and Nonphase EEG Activity in Multiple Sclerosis Patients

Currently, there is scarce knowledge about the relation between spectral bands modulations and the basis of cognitive impairment in multiple sclerosis (MS). In this sense, analyzing the evoked or phase activity can confirm results from traditional event-related potential (ERP) studies. However, studying the induced or nonphase activity may be necessary to elucidate hidden compensatory or affected cognitive mechanisms. In this study, 30 remitting-relapsing multiple sclerosis patients and 30 healthy controls (HCs) matched in sociodemographic variables performed a visual oddball task. The main goal was to analyze phase and nonphase alpha and gamma bands by applying temporal spectral evolution (TSE) and its potential relation with cognitive impairment in these patients. The behavioural results showed slower reaction time and poorer accuracy in MS patients compared to controls. In contrast, the time-frequency analysis of electroencephalography (EEG) revealed a delay in latency and lower amplitude in MS patients in evoked and induced alpha compared to controls. With respect to the gamma band, there were no differences between the groups. In summary, MS patients showed deficits in early sensorial (evoked alpha activity) and cognitive processing (induced alpha activity in longer latencies), whereas the induced gamma band supported the hypothesis of its role in translation of attentional focus (induced activity) and did not show strong activity in this paradigm (visual oddball).

Influence of Exposure at Different Altitudes on the Executive Function of Plateau Soldiers-Evidence From ERPs and Neural Oscillations

This study investigates the changes in soldiers' brain executive function at different altitude environments and their relationship with blood oxygen saturation. Stratified sampling was conducted in different altitude 133 active-duty soldiers who were stationed in Weinan (347 m, n = 34), Nyingchi (2,950 m, n = 32), Lhasa (3,860 m, n = 33), and Nagqu (4,890 m, n = 34) for 2 years. The Go/NoGo paradigm with event-related potentials (ERPs) and event-related oscillations (EROs) was used to explore the time and neural oscillation courses of response inhibition. Behavioral results revealed that at the 4,890-m altitude area, the soldiers had the highest false alarm rate, the longest reaction time, and the slowest information transmission rate. The electrophysiological results revealed that NoGo-N2 and N2d decreased with increasing altitude, with significant changes at 3,860 m; the amplitudes of NoGo-P3 and P3d in plateau groups were significantly more negative than the plain and changed significantly at 2,950 m. The results of correlation analysis showed that NoGo-P3 was negatively correlated with altitude (r = −0.358, p = 0.000), positively correlated with SpO₂ (r = 0.197, p = 0.041) and information translation rate (ITR) (r = 0.202, p = 0.036). P3d was negatively correlated with altitude (r = −0.276, p = 0.004) and positively correlated with ITR (r = 0.228, p = 0.018). N2d was negatively correlated with ITR (r = 0.204, p = 0.034). The power spectrum analysis of NoGo-N2 and NoGo-P3 showed that the power of δ and θ bands at the plateau area was significantly lower than the plain area and showed a significant step-by-step decrease; the α-band power increases significantly only in the area of 4,890 m. The effect of chronic hypoxia exposure at different altitudes of the plateau on the response inhibition of soldiers was manifested: 3,860 m was the altitude at which the brain response inhibition function decreased during the conflict monitoring stage, and 2,950 m was the altitude at which it dropped during the response inhibition stage. In addition, the soldier's brain's executive function was closely related to SpO₂, and a reduction in SpO₂ may lead to a decline in response inhibition.

Individual test-retest reliability of evoked and induced alpha activity in human EEG data

Diverse psychological mechanisms have been associated with modulations of different EEG frequencies. To the extent of our knowledge, there are few studies of the test-retest reliability of these modulations in the human brain. To assess evoked and induced alpha reliabilities related to cognitive processing, EEG data from twenty subjects were recorded in 58 derivations in two different sessions separated by 49.5 ± 48.9 (mean ± standard deviation) days. A visual oddball was selected as the cognitive task, and three main parameters were analyzed for evoked and induced alpha modulations (latency, amplitude and topography). Latency and amplitude for evoked and induced modulations showed stable behavior between the two sessions. The correlation between sessions for alpha evoked and induced topographies in the grand average (group level) was r = 0.923, p<0.001; r = 0.962, p<0.001, respectively. The within-subject correlation values for evoked modulation ranged from 0.472 to 0.974 (mean: 0.766), whereas induced activity showed a different range, 0.193 to 0.892 (mean: 0.655). Individual analysis of the test-retest reliability showed a higher heterogeneity in the induced modulation, probably due to the heterogeneous phases found in the second case. However, despite this heterogeneity in phase values for induced activity relative to the onset of the stimuli, an excellent correlation score was obtained for group topography, with values that were better than those of the grand average evoked topography. As a main conclusion, induced alpha activity can be observed as a stable and reproducible response in the cognitive processing of the human brain.

Dynamic Causal Modeling of the Relationship between Cognition and Theta-alpha Oscillations in Adults with Down Syndrome

Individuals with Down syndrome (DS) show high inter-subject variability in cognitive ability and have an ultra-high risk of developing dementia (90% lifetime prevalence). Elucidating factors underlying variability in cognitive function can inform us about intellectual disability (ID) and may improve our understanding of factors associated with later cognitive decline. Increased neuronal inhibition has been posited to contribute to ID in DS. Combining electroencephalography (EEG) with dynamic causal modeling (DCM) provides a non-invasive method for investigating excitatory/inhibitory mechanisms. Resting-state EEG recordings were obtained from 36 adults with DS with no evidence of cognitive decline. Theta–alpha activity (4–13 Hz) was characterized in relation to general cognitive ability (raw Kaufmann’s Brief Intelligence Test second Edition (KBIT-2) score). Higher KBIT-2 was associated with higher frontal alpha peak amplitude and higher theta–alpha band power across distributed regions. Modeling this association with DCM revealed intrinsic self-inhibition was the key network parameter underlying observed differences in 4–13 Hz power in relation to KBIT-2 and age. In particular, intrinsic self-inhibition in right V1 was negatively correlated with KBIT-2. Results suggest intrinsic self-inhibition within the alpha network is associated with individual differences in cognitive ability in adults with DS, and may provide a potential therapeutic target for cognitive enhancement.

Multiple evoked and induced alpha modulations in a visual attention task: Latency, amplitude and topographical profiles

Alpha event-related desynchronization (ERD) has been widely applied to understand the psychophysiological role of this band in cognition. In particular, a considerable number of publications have described spectral alterations in several pathologies using this time-frequency approach. However, ERD is not capable of specifically showing nonphase (induced) activity related to the presentation of stimuli. Recent studies have described an evoked and induced activity in the early phases (first 200 ms) of stimulus processing. However, scarce studies have analyzed induced and evoked modulations in longer latencies (>200 ms) and their potential roles in cognitive processing. The main goal of the present study was to analyze diverse evoked and induced modulations in response to visual stimuli. Thus, 58-channel electroencephalogram (EEG) was recorded in 21 healthy subjects during the performance of a visual attention task, and analyses were performed for both target and standard stimuli. The initial result showed that phase-locked and nonphase locked activities coexist in the early processing of target and standard stimuli as has been reported by previous studies. However, more modulations were evident in longer latencies in both evoked and induced activities. Correlation analyses suggest that similar maps were present for evoked and induced activities at different timepoints. In the discussion section, diverse proposals will be stated to define the potential roles of these modulations in the information processing for this cognitive task. As a general conclusion, induced activity enables the observation of cognitive mechanisms that are not visible by ERD or ERP modulations.

Altered individual behavioral and EEG parameters are related to the EDSS score in relapsing-remitting multiple sclerosis patients

Functional neuroanatomy of cognitive impairment in multiple sclerosis is currently still a challenge. During the progression of the disease, several cognitive mechanisms deteriorate thus diminishing the patient’s quality of life. A primary objective in the cognitive assessment of multiple sclerosis (MS) patients is to find reliable measures utilizing diverse neuroimaging techniques. Moreover, especially relevant in the clinical environment is finding technical approaches that could be applied to individual participants and not only for group analysis. A 64-channel electroencephalographic recording (EEG) was made with thirty participants divided into three groups of equivalent size (N = 10) (healthy control, low-EDSS (1–2.5) and moderate-EDSS (4–6)). Correlation analysis was applied to multiple measures: behavior, neuropsychological tests (Paced Auditory Serial Addition Test, 3 seconds (PASAT-3s) and the Symbol Digit Modality Test (SDMT)), Expanded Disability Status Scale (EDSS), even-related potential (P3) and event-related desynchronization (ERD) parameters and the correlation scores between individual participant’s P3/ERD maps and the healthy grand average P3/ERDmaps. Statistical analysis showed that diverse parameters exhibited significant correlations. A remarkable correlation was the moderate score found between SDMT and EDSS (r = −0.679, p = 0.0009). However, the strongest correlation was between the value of integrated measures (reaction time, P3 and ERD latency) and EDSS (r = 0.699, p = 0.0006). In regard to correlations for grand average maps between groups, the P3 component exhibited a lower score according to a more deteriorated condition (higher EDSS). In contrast, ERD maps remained stable with an increase of EDSS. Lastly, a Z-transformation of individual values of all variables included in the study exhibited heterogeneity in cognitive alterations in the multiple sclerosis participants.

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.