Putative EEG measures of social anxiety: Comparing frontal alpha asymmetry and delta-beta cross-frequency correlation

Extracting Stress-Related EEG Patterns From Pre-Sleep EEG for Forecasting Slow-Wave Sleep Deficiency

Sleep is vital to our daily activity. Lack of proper sleep can impair functionality and overall health. While stress is known for its detrimental impact on sleep quality, the precise effect of pre-sleep stress on subsequent sleep structure remains unknown. This study introduced a novel approach to study the pre-sleep stress effect on sleep structure, specifically slow-wave sleep (SWS) deficiency. To achieve this, we selected forehead resting EEG immediately before and upon sleep onset to extract stress-related neurological markers through power spectra and entropy analysis. These markers include beta/delta correlation, alpha asymmetry, fuzzy entropy (FuzzEn) and spectral entropy (SpEn). Fifteen subjects were included in this study. Our results showed that subjects lacking SWS often exhibited signs of stress in EEG, such as an increased beta/delta correlation, higher alpha asymmetry, and increased FuzzEn in frontal EEG. Conversely, individuals with ample SWS displayed a weak beta/delta correlation and reduced FuzzEn. Finally, we employed several supervised learning models and found that the selected neurological markers can predict subsequent SWS deficiency. Our investigation demonstrated that the classifiers could effectively predict varying levels of slow-wave sleep (SWS) from pre-sleep EEG segments, achieving a mean balanced accuracy surpassing 0.75. The SMOTE-Tomek resampling method could improve the performance to 0.77. This study suggests that stress-related neurological markers derived from pre-sleep EEG can effectively predict SWS deficiency. Such information can be integrated with existing sleep-improving techniques to provide a personalized sleep forecasting and improvement solution.

In the anticipation of threat: Neural regulatory activity indicated by delta-beta correlation and its relation to anxiety

The anticipation of oncoming threats is emotionally challenging and related to anxiety. The current study aimed to investigate the neural regulatory processes during the anticipatory preparations in stressful situations in relation to trait anxiety, especially in an uncertainty-related stressful situation. To this end, we measured within-subjects delta-beta amplitude-amplitude correlation (AAC) and phase-amplitude coupling (PAC) with electroencephalography using a well-defined stress-inducing paradigm in 28 high-trait-anxiety (HTA) and 29 low-trait-anxiety (LTA) college students. Specifically, a threat probability task was conducted, where participants anticipated the future stimuli under the uncertain (i.e., an average of 50% electric shocks), certain (i.e., 100% electric shocks) and no threat conditions, as well as a resting state task. Results showed a generally larger delta-beta AAC in the LTA group relative to the HTA group across conditions, supporting the hypothesis that delta-beta AAC reflects the efficiency of stress regulation and trait anxiety could compromise this adaptive regulatory activity. Furthermore, a larger delta-beta PAC was found under the uncertain threat condition relative to the no threat condition, indicating the sensitivity of delta-beta PAC in reflecting state anxiety. These findings indicate that while delta-beta AAC is more related to trait anxiety and could distinguish between high and low trait anxiety irrespective of conditions, delta-beta PAC is more related to state anxiety and is sensitive enough to detect the uncertainty-related anxious state.

Electrophysiological signatures of anxiety in Parkinson's disease

Anxiety is a common non-motor symptom in Parkinson's disease (PD) occurring in up to 31% of the patients and affecting their quality of life. Despite the high prevalence, anxiety symptoms in PD are often underdiagnosed and, therefore, undertreated. To date, functional and structural neuroimaging studies have contributed to our understanding of the motor and cognitive symptomatology of PD. Yet, the underlying pathophysiology of anxiety symptoms in PD remains largely unknown and studies on their neural correlates are missing. Here, we used resting-state electroencephalography (RS-EEG) of 68 non-demented PD patients with or without clinically-defined anxiety and 25 healthy controls (HC) to assess spectral and functional connectivity fingerprints characterizing the PD-related anxiety. When comparing the brain activity of the PD anxious group (PD-A, N = 18) to both PD non-anxious (PD-NA, N = 50) and HC groups (N = 25) at baseline, our results showed increased fronto-parietal delta power and decreased frontal beta power depicting the PD-A group. Results also revealed hyper-connectivity networks predominating in delta, theta and gamma bands against prominent hypo-connectivity networks in alpha and beta bands as network signatures of anxiety in PD where the frontal, temporal, limbic and insular lobes exhibited the majority of significant connections. Moreover, the revealed EEG-based electrophysiological signatures were strongly associated with the clinical scores of anxiety and followed their progression trend over the course of the disease. We believe that the identification of the electrophysiological correlates of anxiety in PD using EEG is conducive toward more accurate prognosis and can ultimately support personalized psychiatric follow-up and the development of new therapeutic strategies.

The role of engagement and arousal in emotion regulation: an EEG study

Cognitive reappraisal and expressive suppression are well-studied strategies of emotion regulation (ER). However, the results on their physiological basis are controversial. While in some studies, ER was accompanied by the inhibition of the nervous system, others suggested that ER even might increase arousal and engagement. We calculated the inter-subject correlation (ISC) and indices of engagement, valence and arousal of EEG during suppression, reappraisal, or natural watching of neutral and negative videos. First, both suppression and reappraisal provoked a higher ISC in comparison with watching negative or neutral videos. We consider this as a marker of engagement to the task and feedback processing required for ER. Second, the engagement index was lower during ER compared to watching negative videos in central electrodes, whereas both strategies provoked a higher engagement in frontal electrodes. Third, the arousal index of EEG was higher during all negative conditions; therefore, regulation required a certain level of arousal. In summary, different EEG measures seem to be sensitive to different aspects of ER.

Positive future thinking without task-relevance increases anxiety and frontal stress regulation

Negative anticipatory biases can affect the way we interpret and subjectively experience events. Through its role in emotion regulation, positive future thinking may provide an accessible way to attenuate these biases. However, it is unclear whether positive future thinking works ubiquitously, independent of contextual relevance. Here, we used a positive future thinking intervention (task-relevant; task-irrelevant and control condition) prior to a social stress task to adapt the way this task was experienced. We assessed subjective and objective stress measures and also recorded resting state electroencephalography (EEG) to assess intervention related differences in the level of frontal delta-beta coupling, which is considered a neurobiological substrate of stress regulation. Results show that the intervention reduced subjective stress and anxiety, and increased social fixation behavior and task performance, but only if future thinking was task-relevant. Paradoxically, task-irrelevant positive future thoughts enhanced negative perceptual biases and stress reactivity. This increase in stress reactivity was corroborated by elevated levels of frontal delta-beta coupling during event anticipation, which suggests an increased demand for stress regulation. Together, these findings show that positive future thinking can mitigate the negative emotional, behavioral and neurobiological consequences of a stressful event, but that it should not be applied indiscriminately.

Machine learning for the detection of social anxiety disorder using effective connectivity and graph theory measures

Introduction

The early diagnosis and classification of social anxiety disorder (SAD) are crucial clinical support tasks for medical practitioners in designing patient treatment programs to better supervise the progression and development of SAD. This paper proposes an effective method to classify the severity of SAD into different grading (severe, moderate, mild, and control) by using the patterns of brain information flow with their corresponding graphical networks.

Methods

We quantified the directed information flow using partial directed coherence (PDC) and the topological networks by graph theory measures at four frequency bands (delta, theta, alpha, and beta). The PDC assesses the causal interactions between neuronal units of the brain network. Besides, the graph theory of the complex network identifies the topological structure of the network. Resting-state electroencephalogram (EEG) data were recorded for 66 patients with different severities of SAD (22 severe, 22 moderate, and 22 mild) and 22 demographically matched healthy controls (HC).

Results

PDC results have found significant differences between SAD groups and HCs in theta and alpha frequency bands (p < 0.05). Severe and moderate SAD groups have shown greater enhanced information flow than mild and HC groups in all frequency bands. Furthermore, the PDC and graph theory features have been used to discriminate three classes of SAD from HCs using several machine learning classifiers. In comparison to the features obtained by PDC, graph theory network features combined with PDC have achieved maximum classification performance with accuracy (92.78%), sensitivity (95.25%), and specificity (94.12%) using Support Vector Machine (SVM).

Discussion

Based on the results, it can be concluded that the combination of graph theory features and PDC values may be considered an effective tool for SAD identification. Our outcomes may provide new insights into developing biomarkers for SAD diagnosis based on topological brain networks and machine learning algorithms.

Exploring the construct of anticipatory stress in finding a job after residency training through cognitive interviewing: Implications for learner well-being and health workforce planning

Background: Anticipatory stress (AS) is denoted by concern about future events for which there is little control. Most AS research has been physiological studies such as measuring salivary cortisol levels. Medical learners may experience AS regarding employment after residency, however AS a psychological construct across career stages has not previously been studied. The objective of this study is to explore the psychological construct of employment AS in medical students, residents, and former Program Directors (PDs). Methods: Participants were recruited from a large Canadian medical school via purposive sampling. Semi-structured interviews with n=21 participants (six medical students, nine residents, and six PDs) were transcribed verbatim, and coded by two independent reviewers using thematic analysis. Results: Participants agreed that financial, family, and geographical factors exacerbate AS, and it is mitigated by flexibility, social support, and being proactive. External support, job market saturation, and differences between medical specialities also influence AS. Perspectives unique to participant groups included: medical students reflecting on a hidden curriculum and preoccupation with proximal issues over distal concerns of employment; residents experiencing competing residency program demands; former PDs finding that resident competency, yearly hiring fluctuations, and existing stress impact AS. Consequences of AS include physical and psychological manifestations, performance anxiety, and pursuing additional training. Conclusions: Perceptions of AS vary by medical career stage. Individual, program and systems-level changes can help manage and address the underlying cause of AS: an unreliable job market for physicians. Correcting the mismatch between residency positions and job openings may be a proactive, preventative approach.

Predictors of the Health-Related Quality of Life (HRQOL) in SF-36 in Knee Osteoarthritis Patients: A Multimodal Model With Moderators and Mediators

Purpose

The study aimed to examine associations between the 36-item short form health survey (SF-36) in clinical and neurophysiological measures to identify its predictors in patients with knee osteoarthritis (KOA) in a rehabilitation program.

Methods

We analyzed data from our cohort study (DEFINE cohort). We analyzed data from our KOA arm, with 107 patients, including clinical assessments, demographic data, pain scales, motor function (Timed Up and Go Test (TUG), 10 meters walk test, and 6-minute walk), balance (BBS), sleepiness (ESS), and Transcranial Magnetic Stimulation (TMS) and Electroencephalography (EEG).

Results

Our results showed 83.19% of patients were female with an average age of 68.6 years and an average number of days of pain was 96 days; around 31.86% were using more than five medications per day. Regarding the multimodal model to explain SF-36, the main variables relevant to the quality of life (QoL) were related to emotional aspects, such as anxiety and depression. Moreover, our study added findings with polymorphism (OPRM1/rs1799971) predicting mental aspects. Cognitive variables were important in predicting the mental health, emotional, and social support dimensions of the SF-36. In the physical domain, pain-related variables predominantly predicted QoL in these relationships. The domain of vitality significantly predicted all dimensions studied, except for mental and general health.

Conclusion

The results help in understanding the aspects that contribute to QoL and are discussed considering the general literature on physical rehabilitation and specific to this clinical group. Furthermore, the statistical methods allowed us to explore and effectively understand the dimensions related to QoL.

Individual differences in frontal alpha asymmetry moderate the relationship between acute stress responsivity and state and trait anxiety in adolescents

Stress is a risk factor in the development and maintenance of psychopathology, particularly anxiety. Despite theory suggesting differences in stress responsivity may explain heterogeneity in anxiety, findings remain contradictory. This may be due to failure to account for individuals' neurobiological states and outdated methodologic analyses which confound conceptually and biologically distinct stress response pathways. In 145 adolescents, this study examined whether individual differences in neural activation underlying motivational states, indexed by resting frontal alpha asymmetry (FAA) before and after the Trier Social Stress Test (TSST), moderate the relationship between stress responsivity (measured by cortisol) and anxiety. Adolescents with rightward FAA activation (indexed by changes in resting FAA pre-to-post TSST) and high trait anxiety showed blunted cortisol reactivities while those with leftward FAA activation and high state anxiety showed prolonged cortisol recoveries. Our work reveals individual differences in vulnerability to psychosocial stressors and is the first study to show that FAA activation moderates the relationships between anxiety and distinct phases of the stress response in adolescents.

Children's shyness and frontal electroencephalogram delta-beta correlation in the pediatric surgical setting

The prospect of surgery is a unique psychologically threatening context for children, often leading to experiences of preoperative anxiety. Recent research suggests that individual differences in children's temperament may influence responses to the surgical setting. In the present study, we examined whether individual differences in shyness were related to differences in frontal electroencephalogram (EEG) delta-beta correlation, a proposed neural correlate of emotion regulation and dysregulation, among children anticipating surgery. Seventy-one children (36 boys, M_age  = 10.3 years, SD_age  = 1.7 years) undergoing elective surgery self-reported on their own shyness, and their parents also reported on their child's shyness. Using a mobile, dry sensor EEG headband, frontal EEG measures were collected and self- and observer-reported measures of state anxiety were obtained at the children's preoperative visit (Time 1) and on the day of surgery (Time 2). A latent cluster analysis derived classes of low shy (n = 37) and high shy (n = 34) children using the child- and parent-reported shyness measures. We then compared the two classes on frontal EEG delta-beta correlation using between- and within-subjects analyses. Although children classified as high versus low in shyness had higher self- and observer-reported state anxiety across both time periods, frontal EEG delta-beta correlation increased from T1 to T2 only among low shy children using a between-subjects delta-beta correlation measure. We discuss the interpretation of a relatively higher delta-beta correlation as a correlate of emotion regulatory versus dysregulatory strategies for some children in a "real-world," surgical context.

Electrophysiological Correlates of Shyness Affected by Facial Attractiveness

Previous neurological studies of shyness have focused on the hemispheric asymmetry of alpha spectral power. To the best of our knowledge, few studies have focused on the interaction between different frequencies bands in the brain of shyness. Additionally, shy individuals are even shyer when confronted with a group of people they consider superior to them. This study aimed to reveal the neural basis of shy individuals using the delta-beta correlation. Further, it aimed to investigate the effect of evaluators’ facial attractiveness on the delta-beta correlation of shyness during the speech anticipation phase. We recorded electroencephalogram (EEG) activity of 94 participants during rest and anticipation of the public speaking phase. Moreover, during the speech anticipation phase, participants were presented with high or low facial attractiveness. The results showed that, as predicted, the delta-beta correlation in the frontal region was more robust for high shyness than for low shyness during the speech anticipation phase. However, no significant differences were observed in the delta-beta correlation during the baseline phase. Further exploration found that the delta-beta correlation was more robust for high facial attractiveness than low facial attractiveness in the high shyness group. However, no significant difference was found in the low-shyness group. This study suggests that a stronger delta-beta correlation might be the neural basis for shy individuals. Moreover, high facial attractiveness might enhance the delta-beta correlation of high shyness in anticipation of public speaking.

A Two-Person Neuroscience Approach for Social Anxiety: A Paradigm With Interbrain Synchrony and Neurofeedback

Social anxiety disorder has been widely recognised as one of the most commonly diagnosed mental disorders. Individuals with social anxiety disorder experience difficulties during social interactions that are essential in the regular functioning of daily routines; perpetually motivating research into the aetiology, maintenance and treatment methods. Traditionally, social and clinical neuroscience studies incorporated protocols testing one participant at a time. However, it has been recently suggested that such protocols are unable to directly assess social interaction performance, which can be revealed by testing multiple individuals simultaneously. The principle of two-person neuroscience highlights the interpersonal aspect of social interactions that observes behaviour and brain activity from both (or all) constituents of the interaction, rather than analysing on an individual level or an individual observation of a social situation. Therefore, two-person neuroscience could be a promising direction for assessment and intervention of the social anxiety disorder. In this paper, we propose a novel paradigm which integrates two-person neuroscience in a neurofeedback protocol. Neurofeedback and interbrain synchrony, a branch of two-person neuroscience, are discussed in their own capacities for their relationship with social anxiety disorder and relevance to the paradigm. The newly proposed paradigm sets out to assess the social interaction performance using interbrain synchrony between interacting individuals, and to employ a multi-user neurofeedback protocol for intervention of the social anxiety.

Psychometric properties of infant electroencephalography: Developmental stability, reliability, and construct validity of frontal alpha asymmetry and delta-beta coupling

Resting-state electroencephalography (EEG) provides developmental neuroscientists a noninvasive view into the neural underpinnings of cognition and emotion. Recently, the psychometric properties of two widely used neural measures in early childhood-frontal alpha asymmetry and delta-beta coupling-have come under scrutiny. Despite their growing use, additional work examining how the psychometric properties of these neural signatures may change across infancy is needed. The current study examined the developmental stability, split-half reliability, and construct validity of infant frontal alpha asymmetry and delta-beta coupling. Infants provided resting-state EEG data at 8, 12, and 18 months of age (N = 213). Frontal alpha asymmetry and delta-beta coupling showed significant developmental change from 8 to 18 months. Reliability for alpha asymmetry, and alpha, delta, and beta power, individually, was generally good. In contrast, the reliability of delta-beta coupling scores was poor. Associations between frontal alpha asymmetry and approach tendencies generally emerged, whereas stronger (over-coupled) delta-beta coupling scores were associated with profiles of dysregulation and low inhibition. However, the individual associations varied across time and specific measures of interest. We discuss these findings with a developmental lens, highlighting the importance of repeated measures to better understand links between neural signatures and typical and atypical development.

Deriving within-person estimates of delta-beta coupling: A novel measure for identifying individual differences in emotion and neural function in childhood

Delta-beta coupling is increasingly used to understand early emotional development. However, little is known about the development of the coupling, limiting its utility for identifying normative or aberrant functioning. We used a prospective longitudinal sample (N = 122) to compare measures of within-person and between-person coupling between ages 3 and 5, track the developmental trajectory of coupling, identify individual differences in patterns of development, and explore emotion-related predictors and outcomes of discrete developmental patterns. Within-person measures, limited in overall utility, were most useful when (1) statistical approaches produced more homogenous groups within the overall sample (extreme groups or latent classes) or (2) the full developmental course was considered. We found two trajectories of change in frontal coupling and three trajectories of change in parietal coupling. Coupling trajectories were predicted by observed fear and approach/avoidance at age 3. In addition, high levels of frontal coupling at age 3 that declined and then levelled out through age 5 were associated with lower levels of internalizing by age 5. This work provides a foundation for understanding normative change in delta-beta coupling across the preschool years and useful insight for the use of this metric in future work.

Individual dynamics of delta-beta coupling: using a multilevel framework to examine inter- and intraindividual differences in relation to social anxiety and behavioral inhibition

BACKGROUND

Variation in EEG-derived delta-beta coupling has recently emerged as a potential neural marker of emotion regulation, providing a novel and noninvasive method for assessing a risk factor for anxiety. However, our understanding of delta-beta coupling has been limited to group-level comparisons, which provide limited information about an individual's neural dynamics.

METHODS

The present study used multilevel modeling to map second-by-second coupling patterns between delta and beta power. Specifically, we examined how inter- and intraindividual delta-beta coupling patterns changed as a function of social anxiety symptoms and temperamental behavioral inhibition (BI).

RESULTS

We found that stronger inter- and intraindividual delta-beta coupling were both associated with social anxiety. In contrast, the high-BI group showed weaker coupling relative to the non-BI group, a pattern that did not emerge when analyzing continuous scores of BI.

CONCLUSIONS

In characterizing inter- and intraindividual coupling across the sample, we illustrate the utility of examining neural processes across levels of analysis in relation to psychopathology to create multilevel assessments of functioning and risk.

Delta-beta cross-frequency coupling as an index of stress regulation during social-evaluative threat

Coupling between delta (1-4 Hz) and beta (14-30 Hz) oscillations is posited to reflect subcortico-cortical communication and stress regulation. To validate delta-beta coupling (DBC) as an index of neural stress regulation, we investigated whether DBC changes during stress and whether these changes are associated with established stress responses. We induced stress using a social-evaluative threat (impromptu speech) task and measured frontal and parietal delta-beta amplitude-amplitude correlation (AAC) and phase-amplitude coupling (PAC), as well as cardiovascular, affective, and endocrine stress responses. Results showed no significant changes in either AAC or PAC in response to stress and no correlations with stress responses. However, baseline AAC tended to be related to more adaptive endocrine stress responses. Our results suggest that delta-beta AAC or PAC are not valid neural indices of stress regulation itself, but rather traits that relate to differences in neuroendocrine stress responses.

Dyadic behavioral synchrony between behaviorally inhibited and non-inhibited peers is associated with concordance in EEG frontal Alpha asymmetry and Delta-Beta coupling

Behavioral synchrony during social interactions is foundational for the development of social relationships. Behavioral inhibition (BI), characterized by wariness to social novelty and increased anxiety, may influence how children engage in moment-to-moment behavioral synchrony. EEG-derived frontal Alpha asymmetry and Delta-Beta coupling reflect approach-avoidance behavior and emotion regulation, respectively. We examined the relation between intradyadic behavioral synchrony in energy levels and peer gaze, BI, and EEG measures (N = 136, 68 dyads, Mean_Age = 10.90 years) during unstructured and structured interactions. Energy levels were negatively synchronized when both children exhibited right Alpha asymmetry. If either child exhibited left Alpha asymmetry, the dyad exhibited more positive synchrony. Peer gaze was less synchronized during the unstructured task with left Alpha asymmetry. Greater positive Delta-Beta coupling in BI children was associated with more peer gaze synchrony. Peer gaze was asynchronous when BI children exhibited negative Delta-Beta coupling and their partner exhibited positive coupling.

Electroencephalographic Investigation of the Effect of Skill Level and Social Inhibition on Simulated Handgun Shooting

We examined effects of Social Inhibition (SI), and Skill Level (SL) on simulated handgun shooting performance. Electroencephalogram (EEG) was also recorded in order to measure task-related changes in cortical activity. Participants consisted of Novice (NSL) and Experienced (ESL) shooters who were randomly assigned to shoot while in the presence of an audience (Hi SI) or alone (Low SI). The results revealed that NSL were less accurate than ESL in all conditions as was predicted. Shooting accuracy was predicted by alpha and beta amplitude, indicating different roles for attention and anxiety. Prefrontal alpha amplitude was significantly influenced by SL and SI, with a finding that ES showed RH deactivation while NS showed LH deactivation. Findings are discussed in terms of theories of motor control and SI.

Positive Shyness in the Brain: Frontal Electroencephalogram Alpha Asymmetry and Delta-Beta Correlation in Children

Positive shyness is thought to be an approach-dominant form of shyness, whereas non-positive shyness is thought to be an avoidance-dominant form of shyness. This study examined electrocortical and behavioral correlates of motivation and emotion in relation to these shy subtypes in 67 children (M_age  = 10.41 years, SD = 3.23). Using resting state electroencephalography, findings revealed that positive shy and low shy children had greater relative left frontal alpha asymmetry compared to non-positive shy children, and positive shy children had a higher frontal delta-beta correlation compared to other groups. Non-positive shy children scored highest on parent-reported school avoidance. These findings converge with previous work reporting distinct correlates in positive and non-positive shyness, extending this to two brain measures of motivation and emotion.

Review of EEG, ERP, and Brain Connectivity Estimators as Predictive Biomarkers of Social Anxiety Disorder

Social anxiety disorder (SAD) is characterized by a fear of negative evaluation, negative self-belief and extreme avoidance of social situations. These recurrent symptoms are thought to maintain the severity and substantial impairment in social and cognitive thoughts. SAD is associated with a disruption in neuronal networks implicated in emotional regulation, perceptual stimulus functions, and emotion processing, suggesting a network system to delineate the electrocortical endophenotypes of SAD. This paper seeks to provide a comprehensive review of the most frequently studied electroencephalographic (EEG) spectral coupling, event-related potential (ERP), visual-event potential (VEP), and other connectivity estimators in social anxiety during rest, anticipation, stimulus processing, and recovery states. A search on Web of Science provided 97 studies that document electrocortical biomarkers and relevant constructs pertaining to individuals with SAD. This study aims to identify SAD neuronal biomarkers and provide insight into the differences in these biomarkers based on EEG, ERPs, VEP, and brain connectivity networks in SAD patients and healthy controls (HC). Furthermore, we proposed recommendations to improve methods of delineating the electrocortical endophenotypes of SAD, e.g., a fusion of EEG with other modalities such as functional magnetic resonance imaging (fMRI) and magnetoencephalograms (MEG), to realize better effectiveness than EEG alone, in order to ultimately evolve the treatment selection process, and to review the possibility of using electrocortical measures in the early diagnosis and endophenotype examination of SAD.

Behavioral inhibition and EEG delta-beta correlation in early childhood: Comparing a between-subjects and within-subjects approach

Heightened delta-beta correlation has been conceptualized as reflecting exaggerated neural regulation and has been implicated in anxiety. Behavioral inhibition (BI) is a temperament characterized by wariness to novelty and is a robust predictor of anxiety, but delta-beta correlation has not been investigated in relation to childhood BI. We examined the relation between BI and between-subjects (i.e., across participants) and within-subjects (i.e., across data epochs) measures of baseline EEG delta-beta correlation in 118 children. Using a between-subjects measure, children scoring high on BI had higher delta-beta correlation relative to low BI children at frontal and central, and marginally higher in parietal, brain regions. Using a within-subjects measure, continuous BI scores were positively correlated with central and parietal delta-beta correlation. Delta-beta correlation may be a neural correlate of BI in childhood that displays differences in region specificity, correlation strength, and variability of correlation values when comparing between- and within-subjects measures.

EEG for Diagnosis of Adult ADHD: A Systematic Review With Narrative Analysis

BACKGROUND

Attention deficit hyperactivity disorder is a common neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity and or impulsivity. Since the development of the concept, a reliable biomarker to aid diagnosis has been sought. One potential method is the use of electroencephalogram to measure neuronal activity. The aim of this review is to provide an up to date synthesis of the literature surrounding the potential use of electroencephalogram for diagnosis of attention deficit hyperactivity disorder in adulthood.

METHODS

A search of PsycINFO, PubMed, and EMBASE was undertaken in February 2019 for peer-reviewed articles exploring electroencephalogram patterns in adults (18 years with no upper limit) diagnosed with attention deficit hyperactivity disorder.

RESULTS

Differences in electroencephalogram activity are potentially unique to adult attention deficit hyperactivity disorder populations. Strongest support was derived for elevated levels of both absolute and relative theta power, alongside the observation that alpha activity is able to typically differentiate between adult attention deficit hyperactivity disorder and normative populations.

CONCLUSIONS

Electroencephalogram can have a use in clinical settings to aid adult attention deficit hyperactivity disorder diagnosis, but areas of inconsistency are apparent.

Data for "Social-evaluative threat: Stress response stages and influences of biological sex and neuroticism"

This Data In Brief article contains supplementary materials to the article "Social-evaluative threat: stress response stages and influences of biological sex and neuroticism" [1], and describes analysis results of an open dataset [2]. Additional information is provided regarding the methods, particularly: the analysis of individual stress response peak times per stress system, and the statistical analysis. Importantly, correlation tables are presented between the different stress systems, both for baseline stress levels as well as for stress responses, and significant associations are displayed in scatter plots.

EEG cross-frequency correlations as a marker of predisposition to affective disorders

EEG cross-frequency amplitude-amplitude correlation (CF-AAC) has been considered as a potential marker of social anxiety and other affective disturbances. Functional significance of this phenomenon remains unclear, partly because the majority of studies used channel-level analysis, which precluded the spatial localization of observed effects. It is not also clear whether CF-AAC may serve as a marker of specific pathological conditions and specific states, or a more general predisposition to affective disturbances. We used source-level analysis of EEG data obtained in resting conditions in a nonclinical sample and patients with major depressive disorder (MDD) and investigated associations of CF-AAC measures with a broad range of known risk factors for affective disorders, including age, gender, genotype, stress exposure, personality, and self-reported ‘neurotic’ symptomatology. A consistent pattern of associations showed that all investigated risk factors were associated with an enhancement of CF-AAC in cortical regions associated with emotional and self-referential processing. It could be concluded that CF-AAC is a promising candidate marker of a general predisposition to affective disorders at preclinical stages.

Social-evaluative threat: Stress response stages and influences of biological sex and neuroticism

Social-evaluative threat (SET) - when the self could be negatively judged by others - can cause pronounced responses in the different stress systems: threat/challenge appraisal, the sympathetic (SNS) and parasympathetic (PNS) nervous systems, experienced motivation and affect, and the hypothalamus-pituitary-adrenal (HPA) axis. Here, we utilize a four-stage stress response model to shed light on the complex associations between different stress responses, where earlier stages are hypothesized to predict later stages. Additionally, we take into account important moderators, such as biological sex (controlling for menstrual cycle phase), personality traits (neuroticism and extraversion), and baseline stress levels. Thirty-seven men and 30 women in their luteal phase participated in an impromptu public speaking task to induce SET. Stress responses in four different stages were measured using: self-reported appraisal (threat or challenge, stage 1: S1), cardiovascular measures (pre-ejection period as SNS index, respiratory sinus arrhythmia as PNS index, S2), self-reported motivation and affect (state approach motivation, state anxiety, S3) and endocrine measures (cortisol as HPA index, S4). Stress reactivity was calculated by subtracting individual peaks from baseline. Results showed that SET induced pronounced stress reactivity in stages two to four. Against expectations, self-reported appraisal (S1) or motivation and affect (S3) did not predict later stress reactivity. As hypothesized, increased SNS (but not PNS) reactivity (S2) predicted increased HPA reactivity (S4). Bayesian model comparison confirmed the absence of sex differences in stress reactivity, likely due to controlling for menstrual cycle phase and sex differences in neuroticism levels. Higher trait neuroticism predicted blunted SNS (S2) and HPA (S4) reactivity, while higher baseline stress levels predicted blunted stages two and three reactivity overall. In conclusion, this rigorously controlled experiment partly supports and partly contradicts previous findings regarding associations between stress response stages, and offers new insight into the causes of blunted HPA responses in women.

Frontal delta-beta cross-frequency coupling in high and low social anxiety: An index of stress regulation?

Cross-frequency coupling (CFC) between frontal delta (1–4 Hz) and beta (14–30 Hz) oscillations has been suggested as a candidate neural correlate of social anxiety disorder, a disorder characterized by fear and avoidance of social and performance situations. Prior studies have used amplitude-amplitude correlation (AAC) as a CFC measure and hypothesized it as a candidate neural mechanism of affective control. However, using this metric has yielded inconsistent results regarding the direction of CFC, and the functional significance of coupling strength is uncertain. To offer a better understanding of CFC in social anxiety, we compared frontal delta-beta AAC with phase-amplitude coupling (PAC) – a mechanism for information transfer through neural circuits. Twenty high socially anxious (HSA) and 32 low socially anxious (LSA) female undergraduates participated in a social performance task (SPT). Delta-beta PAC and AAC were estimated during the resting state, as well as the anticipation and recovery conditions. Results showed significantly more AAC in LSA than HSA participants during early anticipation, as well as significant values during all conditions in LSA participants only. PAC did not distinguish between LSA and HSA participants, and instead was found to correlate with state nervousness during early anticipation, but in LSA participants only. Together, these findings are interpreted to suggest that delta-beta AAC is a plausible neurobiological index of adaptive stress regulation and can distinguish between trait high and low social anxiety during stress, while delta-beta PAC might be sensitive enough to reflect mild state anxiety in LSA participants.

Frontal brain delta-beta correlation, salivary cortisol, and social anxiety in children

BACKGROUND

Correlated activity of slow-wave (e.g. delta) and fast-wave (e.g. beta) frontal brain oscillations is thought to be an electrophysiological correlate of individual differences in neuroendocrine activity and anxiety in adult samples. We know, however, relatively little about the physiological and functional correlates of delta-beta coupling in children.

METHOD

We examined whether longitudinal patterns of children's basal salivary cortisol and social anxiety across two visits separated by 1 year were associated with frontal brain delta-beta correlation in children (M_age  = 7.59 years, SD = 1.70). At Time 1 (T1), resting baseline electroencephalogram (EEG) recordings were collected from the children and delta and beta power was measured, and at both T1 and Time 2 (T2), basal salivary cortisol was measured, and parents reported on children's symptoms of social anxiety.

RESULTS

Using latent class growth curve analysis, we found that children's salivary cortisol across visits was characterized by a high, stable class (53%), and a low, unstable class (47%), and children's social anxiety was characterized by a high, stable class (50%) and a low, stable class (50%). Using Fisher's r-to-z transformation, we found that frontal EEG delta-beta correlation was significantly stronger among children with high, stable salivary cortisol levels (compared to the low, unstable class; z = 2.11, p = .02), and among children with high, stable social anxiety levels (compared to the low, stable class; z = 1.72, p = .04).

CONCLUSIONS

These findings demonstrate that longitudinal patterns of neuroendocrine stress activity and social anxiety may be associated with the correlation of EEG power in slow and fast frontal brain oscillations as early as childhood.

Cross-Frequency Coupling in Developmental Perspective

It is generally assumed that different electroencephalogram (EEG) frequency bands are somehow related to different computational modes in the brain. Integration of these computational modes is reflected in the phenomenon of cross-frequency coupling (CFC). On slow temporal scales, CFC may reflect trait-like properties, which posits a question of its developmental trends. This is the first study that explored source-level CFC measures in a developmental perspective using both cross-sectional and longitudinal designs. CFC measures demonstrated good test-retest stability and proved to be higher in adults in cortical areas participating in sensory-motor integration, response inhibition, and attentional control. In children, greater CFC was observed in parietal regions involved in self-centered cognition. Over the period from 7 to 10 years, CFC demonstrated nonlinear growth trajectories. Introversion was associated with higher CFC in cortical areas related to emotion, attention, and social cognition, implying that the association between introversion and CFC appears early in the development.

Frontal alpha asymmetry moderates the relations between behavioral inhibition and social-effect ERN

Behavioral inhibition (BI) is an early temperamental precursor of anxiety disorders, characterized by withdrawal from novel situations. Some but not all young children with BI go on to display anxiety disorders. Neural correlates, such as frontal alpha asymmetry or event-related negativity (ERN), could moderate the relations between early BI and later anxiety. The goal of this longitudinal study was to test frontal alpha asymmetry as a potential moderator of the relation between BI and later anxiety, and of the relation between BI and the social-effect ERN. 100 children were assessed for BI at ages 2 and 3, and we collected EEG during resting state and the social Flanker task at age 12. Frontal alpha asymmetry did not correlate with BI or anxiety, nor did it moderate the relation between early BI and later anxiety. However, frontal alpha asymmetry did moderate the relation between BI and the social-effect ERN. This suggests that, in adolescents who previously manifested BI, a pattern of resting EEG associated with avoidance predicts hypersensitivity to errors in a social context.

Heart rate variability as candidate endophenotype of social anxiety: A two-generation family study

BACKGROUND

Social anxiety disorder (SAD) is the extreme fear and avoidance of one or more social situations. The goal of the current study was to investigate whether heart rate variability (HRV) during resting state and a social performance task (SPT) is a candidate endophenotype of SAD.

METHODS

In this two-generation family study, patients with SAD with their partner and children, and their siblings with partner and children took part in a SPT (total n = 121, 9 families, 3-30 persons per family, age range: 8-61 years, 17 patients with SAD). In this task, participants had to watch and evaluate the speech of a female peer, and had to give a similar speech. HRV was measured during two resting state phases, and during anticipation, speech and recovery phases of the SPT. We tested two criteria for endophenotypes: co-segregation with SAD within families and heritability.

RESULTS

HRV did not co-segregate with SAD within families. Root mean square of successive differences during the first resting phase and recovery, and high frequency power during all phases of the task were heritable.

LIMITATIONS

It should be noted that few participants were diagnosed with SAD. Results during the speech should be interpreted with caution, because the duration was short and there was a lot of movement.

CONCLUSIONS

HRV during resting state and the SPT is a possible endophenotype, but not of SAD. As other studies have shown that HRV is related to different internalizing disorders, HRV might reflect a transdiagnostic genetic vulnerability for internalizing disorders. Future research should investigate which factors influence the development of psychopathology in persons with decreased HRV.

The Leiden Family Lab study on Social Anxiety Disorder: A multiplex, multigenerational family study on neurocognitive endophenotypes

OBJECTIVES

Social anxiety disorder (SAD) is a serious and prevalent psychiatric condition, with a heritable component. However, little is known about the characteristics that are associated with the genetic component of SAD, the so-called "endophenotypes". These endophenotypes could advance our insight in the genetic susceptibility to SAD, as they are on the pathway from genotype to phenotype. The Leiden Family Lab study on Social Anxiety Disorder (LFLSAD) is the first multiplex, multigenerational study aimed to identify neurocognitive endophenotypes of social anxiety.

METHODS

The LFLSAD is characterized by a multidisciplinary approach and encompasses a variety of measurements, including a clinical interview, functional and structural magnetic resonance imaging and an electroencephalography experiment. Participants are family members from 2 generations, from families genetically enriched for SAD.

RESULTS

The sample (n = 132 participants, from 9 families) was characterized by a high prevalence of SAD, in both generations (prevalence (sub)clinical SAD: 38.3%). Furthermore, (sub)clinical SAD was positively related to self-reported social anxiety, fear of negative evaluation, trait anxiety, behavioral inhibition, negative affect, and the level of depressive symptoms.

CONCLUSIONS

By the multidimensional character of the measurements and thorough characterization of the sample, the LFLSAD offers unique opportunities to investigate candidate neurocognitive endophenotypes of SAD.

Will they like me? Neural and behavioral responses to social-evaluative peer feedback in socially and non-socially anxious females

The current study examined neural and behavioral responses to social-evaluative feedback processing in social anxiety. Twenty-two non-socially and 17 socially anxious females (mean age = 19.57 years) participated in a Social Judgment Paradigm in which they received peer acceptance/rejection feedback that was either congruent or incongruent with their prior predictions. Results indicated that socially anxious participants believed they would receive less social acceptance feedback than non-socially anxious participants. EEG results demonstrated that unexpected social rejection feedback elicited a significant increase in theta (4-8 Hz) power relative to other feedback conditions. This theta response was only observed in non-socially anxious individuals. Together, results corroborate cognitive-behavioral studies demonstrating a negative expectancy bias in socially anxiety with respect to social evaluation. Furthermore, the present findings highlight a functional role for theta oscillatory dynamics in processing cues that convey social-evaluative threat, and this social threat-monitoring mechanism seems less sensitive in socially anxious females.

Delta-beta correlation as a candidate endophenotype of social anxiety: A two-generation family study

BACKGROUND

Social anxiety disorder (SAD) is characterized by an extreme and intense fear and avoidance of social situations. In this two-generation family study we examined delta-beta correlation during a social performance task as candidate endophenotype of SAD.

METHODS

Nine families with a target participant (diagnosed with SAD), their spouse and children, as well as target's siblings with spouse and children performed a social performance task in which they gave a speech in front of a camera. EEG was measured during resting state, anticipation, and recovery. Our analyses focused on two criteria for endophenotypes: co-segregation within families and heritability.

RESULTS

Co-segregation analyses revealed increased negative delta-low beta correlation during anticipation in participants with (sub)clinical SAD compared to participants without (sub)clinical SAD. Heritability analyses revealed that delta-low beta and delta-high beta correlation during anticipation were heritable. Delta-beta correlation did not differ between participants with and without (sub)clinical SAD during resting state or recovery, nor between participants with and without SAD during all phases of the task.

LIMITATIONS

It should be noted that participants were seen only once, they all performed the EEG tasks in the same order, and some participants were too anxious to give a speech.

CONCLUSIONS

Delta-low beta correlation during anticipation of giving a speech might be a candidate endophenotype of SAD, possibly reflecting increased crosstalk between cortical and subcortical regions. If validated as endophenotype, delta-beta correlation during anticipation could be useful in studying the genetic basis, as well as improving treatment and early detection of persons at risk for developing SAD.

Frail phenotype is associated with distinct quantitative electroencephalographic findings among end-stage renal disease patients: an observational study

Background

Frailty is prevalent among patients with end-stage renal disease (ESRD) and is associated with an increased risk of cognitive impairment. However, apart from its influence on cognition, it is currently unknown whether frailty affects subtler cerebral function in patients with ESRD.

Methods

Patients with ESRD were prospectively enrolled, with clinical features and laboratory data recorded. The severity of frailty among these patients with ESRD was ascertained using the previously validated simple FRAIL scale, and was categorized as none-to-mild and moderate-to-severe frailty. All participants underwent quantitative electroencephalography (EEG), with band powers documented following the generation of the delta to alpha ratio (DAR) and delta/theta to alpha/beta ratio (DTABR). EEG results were then compared between groups of different levels of frailty.

Results

In this cohort, (mean age: 68.9 ± 10.4 years, 37% male, 3.4 ± 3 years of dialysis), 20, 60, 40, 17, and 6% patients exhibited positivity in the fatigue, resistance, ambulation, illness, and loss-of-body-weight domains, respectively, with 45.7% being none to mildly frail and 54.3% being moderately to severely frail. Those with mild frailty had a significantly higher delta power compared to those with more severe frailty, involving all topographic sites. Patients with ESRD and severe frailty had significantly lower global, left frontal, left temporo-occipital, and right temporo-occipital DAR and DTABR, except in the right frontal area, and tended to have central accentuation of alpha, beta, and theta power, and more homogeneous DTABR and DAR distribution compared to the findings in those with mild frailty.

Conclusions

Frailty in patients with ESRD can have subtler neurophysiological influences, presenting as altered EEG findings, which warrant our attention.