Temporal stability of multichannel, multimodal ERP recordings

Effects of low-dose milnacipran on event-related potentials and neuropsychological tests in persons with traumatic brain injury: A preliminary study

INTRODUCTION

Psychostimulants are among the most commonly used pharmacological agents for countering cognitive dysfunction and/or enhancing rehabilitation in persons with brain injury. It was postulated that milnacipran, a serotonin-norepinephrine reuptake inhibitor, would be effective against cognitive dysfunction in non-depressed persons with brain injury.

METHODS

Eighteen patients were recruited with at least moderate disability more than 4 months after a traumatic brain injury (TBI) and they were randomized to an 8-week, placebo-controlled, double-blind trial. Cognitive dysfunction was assessed at baseline with the Trail Making Test, the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Wechsler Memory Scale-Revised (WMS-R) and measurement of event-related potentials (ERPs) both before randomization and after an 8-week administration of milnacipran or placebo.

RESULTS

N2 and P3 latencies in the milnacipran group were significantly shortened by the intervention. Moreover, the Verbal Intelligence Quotient and Full Intelligence Quotient scores of the WAIS-R and the delayed recall score of the WMS-R were significantly higher than baseline after milnacipran intervention.

CONCLUSION

Milnacipran administration improved ERP measures of attention and information processing in non-depressed persons with brain injury and also improved scores on three sub-scales of standard neuropsychological tests of cognitive dysfunction. Therefore, this intervention merits validation by additional, larger studies.

Retest reliability of individual p3 topography assessed by high density electroencephalography

BACKGROUND

Some controversy remains about the potential applicability of cognitive potentials for evaluating the cerebral activity associated with cognitive capacity. A fundamental requirement is that these neurophysiological parameters show a high level of stability over time. Previous studies have shown that the reliability of diverse parameters of the P3 component (latency and amplitude) ranges between moderate and high. However, few studies have paid attention to the retest reliability of the P3 topography in groups or individuals. Considering that changes in P3 topography have been related to different pathologies and healthy aging, the main objective of this article was to evaluate in a longitudinal study (two sessions) the reliability of P3 topography in a group and at the individual level.

RESULTS

The correlation between sessions for P3 topography in the grand average of groups was high (r = 0.977, p<0.001). The within-subject correlation values ranged from 0.626 to 0.981 (mean: 0.888). In the between-subjects topography comparisons, the correlation was always lower for comparisons between different subjects than for within-subjects correlations in the first session but not in the second session.

CONCLUSIONS

The present study shows that P3 topography is highly reliable for group analysis (comprising the same subjects) in different sessions. The results also confirmed that retest reliability for individual P3 maps is suitable for follow-up studies for a particular subject. Moreover, P3 topography appears to be a specific marker considering that the between-subjects correlations were lower than the within-subject correlations. However, P3 topography appears more similar between subjects in the second session, demonstrating that is modulated by experience. Possible clinical applications of all these results are discussed.

Test-retest reliability of chemosensory evoked potentials

This study investigated the test-retest reliability of chemosensory event-related potentials in humans. Olfactory event-related potentials and chemosomatosensory event-related potentials were evaluated in 20 healthy, normosmic subjects. Phenyl ethyl alcohol (PEA, 40% v/v) and H(2)S (4 ppm) served as olfactory stimuli whereas CO(2) (60% v/v) was the chemosomatosensory stimulus. Fifteen stimuli of each compound were applied to each nostril. Identical stimulation sequences were used during three test sessions. Sessions 1 and 2 were separated by a mean of 6.8 days; sessions 2 and 3 by 12.5 days. Electroencephalographic recordings were made from Fz, Cz, Pz, C3, and C4. Amplitudes and latencies of P1, N1, P2, N2, and P3 were measured. Pearson's correlation coefficient was calculated to test the test-retest reliability, and the general linear model examined the differences. Most correlations ranged between 0.4 < r < 0.75. Latencies correlated significantly better (P = 0.008) between sessions than amplitudes, even though with CO(2) stimulus amplitudes correlated significantly better than with PEA (P = 0.006) or H(2)S (P = 0.003). No differences arose between measurements from different nostrils for any stimulus. Chemosensory event-related potentials show good test-retest reliability. Carbon dioxide amplitudes exhibit better signal-to-noise ratios than PEA or H(2)S amplitudes. Chemosensory event-related potentials are a clinically valuable objective and are reproducible.

[The p300 cognitive event-related potential. II. Individual variability and clinical application in psychopathology]

The P300 wave is one of the cognitive components of the event-related potential (ERP) that is used to investigate the cognitive processes, and which can be used to study patient populations with a variety of psychiatric disorders. Its clinical utility has been increased by the identification of factors that contribute to the variability in its amplitude and latency. However, its value as a diagnostic index has not been entirely established. It can provide a useful recording of patients' information processing, and indicate the severity of the clinical state and its possible evolution. It can also assist in determining what therapeutic approach to adopt. In the present review, the findings in the literature concerning interindividual variation in the P300 wave are first described; several variables significantly influence the amplitude and latency of this wave, such as age, gender, intelligence and personality. Following this, the relevance of the data in the literature on the clinical applications of P300 in psychopathology is examined, including the studies undertaken to obtain an objective diagnostic index for mental disorders and also those carried out to assess the problems concerning the interpretation of information connected with the mental pathologies examined. P300-associated findings on dementia, schizophrenia, depression, alcoholism, drug addiction, anxiety disorders (panic disorder, obsessive-compulsive disorder, and post-traumatic stress syndrome) and on personality disorders (schizoid, antisocial or borderline personality disorder) have been examined in detail.

The auditory event-related potential is a stable and reliable measure in elderly subjects over a 3 year period

OBJECTIVES

Valid markers of psychobiological processes, including changes over the lifespan, must be reliable. This study investigated the reliability of the auditory event-related potential (ERP) over a 3 year period.

METHODS

Predictable and unpredictable rare tones were embedded in common-to-rare sequences at 3 different ratios (2:3, 2:5 and 2:8). Forty-six older (mean age 72.3 years) volunteers pressed a key to the rare tones, and ERPs (Fz, Cz and Pz) and reaction time (RT) were measured. Reliability across years was assessed using 3 methods: (1) determination of the stability of waveform components (P1, N1, P2, N2 and P3); (2) cross-correlation of successive 15 ms epochs of within-subject ERPs; and (3) cross-correlation of 15 ms epochs of between-subject ERPs.

RESULTS

With all analyses, the ERP was stable. Analysis of the scored components indicated that P3 was especially stable in the unpredictable rare (2:8) condition. Earlier components were equally stable across all conditions. Analysis of 15 ms ERP epochs indicated significant ERP stability 60 ms after stimulation, lasting over 640 ms.

CONCLUSIONS

Robust within-subject reliability of the ERP strengthens its potential use for detecting preclinical changes in at-risk elderly populations.

P300 from an auditory oddball task: inter-laboratory consistency

Event-related potentials (ERPs) were recorded from normal subjects for the purpose of evaluating measurement consistency among six laboratories located in different cities within the United States. At each laboratory location 15 male subjects were tested using a simple auditory stimulus discrimination task and identical electrophysiological equipment and recording methods. Assessment of the N1, P2, N2, and P3(00) potentials from both the target and standard stimuli resulted in no reliable differences among laboratories for component amplitudes, latencies, and scalp distributions. Quantitative evaluation of overall waveform and specific component morphology yielded good to excellent agreement across laboratories. The findings suggest that large-scale inter-laboratory human electrophysiological studies are feasible and may prove of value when using ERPs to evaluate cognitive function in humans.

Neuropsychological measures and event-related potentials in alcoholics: interrelationships, long-term reliabilities, and prediction of resumption of drinking

Sober male and female alcoholics and peer controls were tested and then retested 14 months later on neuropsychological performance tests (NTP) and also had event-related potentials (ERPs) recorded (non-concurrently) to visual stimulation. Both NTP and ERP measures distinguish male alcoholics from peer controls at test and retest; NTP, but not ERP, scores distinguish female alcoholics from peer controls. Both measures manifest moderate to high reliabilities over time and are correlated modestly. NTP and ERP measures obtained at the end of treatment predict future resumers and abstainers 8 to 14 months later. The results demonstrate the utility of biopsychological approaches to alcoholism and support Grant's (1986) concept of alcoholics as suffering from an intermediate duration (subacute) organic mental disorder.

P3 in young boys as a predictor of adolescent substance use

Event-related potentials were recorded during a visual, continuous performance task from 36 boys before use of alcohol or other drugs began. The boys were sons of 13 recovering alcoholics who themselves had a family history of alcoholism, 11 nonalcoholics with a family history of alcoholism, and 12 nonalcoholics with no family history of alcoholism. Four years after electrophysiological assessment, a behavioral questionnaire was administered (mean age = 16.1 years). A Substance Use score was derived from reported use of alcohol and other drugs, and from highly correlated delinquent behavior scores. P3s of lowest amplitude were associated with the highest adolescent Substance Use. The combination of reduced amplitude and prolonged latency of both target and nontarget P3 significantly predicted adolescent Substance Use scores after correction for subjects' age. Although this is the first electrophysiological predictor of adolescent substance use we are aware of, the effect was small, indicating the utility of P3 as a vulnerability marker for substance abuse disorders is likely to depend on its joint use with other measures.

Long-term test-retest reliability of event-related potentials in normals and alcoholics

The long-term test-retest reliability of event-related potentials (ERP) measures was examined in a group of 44 controls and 71 chronic alcoholics, retested after an average of 14 months. Correlational analyses revealed moderately significant test-retest correlations for visual and auditory target N1, N2, and P3 amplitudes, with significant correlations for N1, N2 and P3 latencies. Controls and alcoholics produced similar test-retest correlations for visual and auditory ERP measures. Men and women produced equally stable ERP measures over time. Overall N1 and P3 amplitudes were most reliable in both groups followed by N2 amplitude, N1 and N2 latency, and P3 latency. The stability of ERP measures found in this study over a 14-month period in both normals and chronic alcoholics supports the use of ERPs in the study of normal and disordered cognitive functioning.

Evidence for terminal decline in the event-related potential of the brain

Precipitous decline (terminal decline) characterizes changes in the elderly just prior to death. The neurological and temporal parameters of terminal decline are not defined. The present study compared sensitive changes in the brain event-related potential (ERP) in 7 subjects who died within 1 year of evaluation with matched controls. Cross-correlation of annual ERPs revealed disorganization within and between subjects in response to memory dependent conditions but not in response to a novel stimulus (oddball). Motor reaction time to targets was not sensitive to decline. The changes associated with impending death were restricted to decline in reliability of the ERP within 1 year of death.

Topographical and temporal stability of the P300

Sixteen normal adults listened to a standard oddball auditory paradigm 3 times, each time separated by 15 min, and this protocol was then repeated 1-2 months later. Stability of the wave forms was measured between 250 and 500 msec for each subject and for each of 16 electrodes by the cross-correlation technique described by Glaser and Ruchkin (1976) and Gevins (1987) in which points on 2 digitized wave forms are paired to produce a correlation coefficient. For each subject, the correlation coefficient was generated for each electrode and then averaged across the 2 parietal and 2 central electrodes to produce a single stability measure for the central electrodes, while the cross-correlation coefficients for the 12 remaining electrodes were averaged for a peripheral stability measure. Three-way repeated measures ANOVAs were performed to determine the significance of cross-correlation coefficient differences. The stability over 15 min for the central electrodes was 0.80, indicating that the P300 was very stable over a short time. The peripheral electrodes were significantly less stable than the central electrodes (P = 0.001). The stability of the wave forms was virtually unchanged when assessed over 1 month (P = 0.9). The target wave forms were significantly more stable than the difference waves (target minus non-target) for both the central and peripheral electrodes (P = 0.04 and 0.01). When the 3 blocks within each session were averaged, there was a significant increase in stability (P less than 0.0005). The wave form cross-correlation coefficients can be used as a measure of the stability of a topographical map over time. The map of the target P300 wave form is very stable, showing no loss in stability from 15 min to 1 month, is more stable than the difference wave form and significantly increases in stability when separate trial blocks are averaged together.