Post-stroke upper limb recovery is correlated with dynamic resting-state network connectivity

Motor recovery is still limited for people with stroke especially those with greater functional impairments. In order to improve outcome, we need to understand more about the mechanisms underpinning recovery. Task-unbiased, blood flow-independent post-stroke neural activity can be acquired from resting brain electrophysiological recordings and offers substantial promise to investigate physiological mechanisms, but behaviourally relevant features of resting-state sensorimotor network dynamics have not yet been identified. Thirty-seven people with subcortical ischaemic stroke and unilateral hand paresis of any degree were longitudinally evaluated at 3 weeks (early subacute) and 12 weeks (late subacute) after stroke. Resting-state magnetoencephalography and clinical scores of motor function were recorded and compared with matched controls. Magnetoencephalography data were decomposed using a data-driven hidden Markov model into 10 time-varying resting-state networks. People with stroke showed statistically significantly improved Action Research Arm Test and Fugl-Meyer upper extremity scores between 3 weeks and 12 weeks after stroke (both P < 0.001). Hidden Markov model analysis revealed a primarily alpha-band ipsilesional resting-state sensorimotor network which had a significantly increased life-time (the average time elapsed between entering and exiting the network) and fractional occupancy (the occupied percentage among all networks) at 3 weeks after stroke when compared with controls. The life-time of the ipsilesional resting-state sensorimotor network positively correlated with concurrent motor scores in people with stroke who had not fully recovered. Specifically, this relationship was observed only in ipsilesional rather in contralesional sensorimotor network, default mode network or visual network. The ipsilesional sensorimotor network metrics were not significantly different from controls at 12 weeks after stroke. The increased recruitment of alpha-band ipsilesional resting-state sensorimotor network at subacute stroke served as functionally correlated biomarkers exclusively in people with stroke with not fully recovered hand paresis, plausibly reflecting functional motor recovery processes.

The association between working memory precision and the nonlinear dynamics of frontal and parieto-occipital EEG activity

Electrophysiological working memory (WM) research shows brain areas communicate via macroscopic oscillations across frequency bands, generating nonlinear amplitude modulation (AM) in the signal. Traditionally, AM is expressed as the coupling strength between the signal and a prespecified modulator at a lower frequency. Therefore, the idea of AM and coupling cannot be studied separately. In this study, 33 participants completed a color recall task while their brain activity was recorded through EEG. The AM of the EEG data was extracted using the Holo-Hilbert spectral analysis (HHSA), an adaptive method based on the Hilbert-Huang transforms. The results showed that WM load modulated parieto-occipital alpha/beta power suppression. Furthermore, individuals with higher frontal theta power and lower parieto-occipital alpha/beta power exhibited superior WM precision. In addition, the AM of parieto-occipital alpha/beta power predicted WM precision after presenting a target-defining probe array. The phase-amplitude coupling (PAC) between the frontal theta phase and parieto-occipital alpha/beta AM increased with WM load while processing incoming stimuli, but the PAC itself did not predict the subsequent recall performance. These results suggest frontal and parieto-occipital regions communicate through theta-alpha/beta PAC. However, the overall recall precision depends on the alpha/beta AM following the onset of the retro cue.

A holo-spectral EEG analysis provides an early detection of cognitive decline and predicts the progression to Alzheimer's disease

Aims

Our aim was to differentiate patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) from cognitively normal (CN) individuals and predict the progression from MCI to AD within a 3-year longitudinal follow-up. A newly developed Holo-Hilbert Spectral Analysis (HHSA) was applied to resting state EEG (rsEEG), and features were extracted and subjected to machine learning algorithms.

Methods

A total of 205 participants were recruited from three hospitals, with CN (n = 51, MMSE > 26), MCI (n = 42, CDR = 0.5, MMSE ≥ 25), AD1 (n = 61, CDR = 1, MMSE < 25), AD2 (n = 35, CDR = 2, MMSE < 16), and AD3 (n = 16, CDR = 3, MMSE < 16). rsEEG was also acquired from all subjects. Seventy-two MCI patients (CDR = 0.5) were longitudinally followed up with two rsEEG recordings within 3 years and further subdivided into an MCI-stable group (MCI-S, n = 36) and an MCI-converted group (MCI-C, n = 36). The HHSA was then applied to the rsEEG data, and features were extracted and subjected to machine-learning algorithms.

Results

(a) At the group level analysis, the HHSA contrast of MCI and different stages of AD showed augmented amplitude modulation (AM) power of lower-frequency oscillations (LFO; delta and theta bands) with attenuated AM power of higher-frequency oscillations (HFO; beta and gamma bands) compared with cognitively normal elderly controls. The alpha frequency oscillation showed augmented AM power across MCI to AD1 with a reverse trend at AD2. (b) At the individual level of cross-sectional analysis, implementation of machine learning algorithms discriminated between groups with good sensitivity (Sen) and specificity (Spec) as follows: CN elderly vs. MCI: 0.82 (Sen)/0.80 (Spec), CN vs. AD1: 0.94 (Sen)/0.80 (Spec), CN vs. AD2: 0.93 (Sen)/0.90 (Spec), and CN vs. AD3: 0.75 (Sen)/1.00 (Spec). (c) In the longitudinal MCI follow-up, the initial contrasted HHSA between MCI-S and MCI-C groups showed significantly attenuated AM power of alpha and beta band oscillations. (d) At the individual level analysis of longitudinal MCI groups, deploying machine learning algorithms with the best seven features resulted in a sensitivity of 0.9 by the support vector machine (SVM) classifier, with a specificity of 0.8 yielded by the decision tree classifier.

Conclusion

Integrating HHSA into EEG signals and machine learning algorithms can differentiate between CN and MCI as well as also predict AD progression at the MCI stage.

Predicting Adverse Recanalization Therapy Outcomes in Acute Ischemic Stroke Patients Using Characteristic Gut Microbiota

Recanalization therapy is the most effective treatment for eligible patients with acute ischemic stroke (AIS). Gut microbiota are involved in the pathological mechanisms and outcomes of AIS. However, the association of gut microbiota features with adverse recanalization therapy outcomes remains unclear. Herein, we investigated gut microbiota features associated with neurological deficits in patients with AIS after recanalization therapy and whether they predict the patients' functional outcomes. We collected fecal samples from 51 patients with AIS who received recanalization therapy and performed 16S rRNA gene sequencing (V3-V4). We compared the gut microbiota diversity and community composition between mild to moderate and severe disability groups. Next, the characteristic gut microbiota was compared between groups, and we noted that the characteristic gut microbiota in patients with mild to moderate disability included Bilophila, Butyricimonas, Oscillospiraceae_UCG-003, and Megamonas. Moreover, the relative abundance of Bacteroides fragilis, Fusobacterium sp., and Parabacteroides gordonii was high in patients with severe disability. The characteristic gut microbiota was correlated with neurological deficits, and areas under the receiver operating characteristic curves confirmed that the characteristic microbiota predicted adverse recanalization therapy outcomes. In conclusion, gut microbiota characteristics are correlated with recanalization therapy outcomes in patients with AIS. Gut microbiota may thus be a promising biomarker associated with early neurological deficits and predict recanalization therapy outcomes.

The role of carrier spectral composition in the perception of musical pitch

Temporal envelope fluctuations of natural sounds convey critical information to speech and music processing. In particular, musical pitch perception is assumed to be primarily underlined by temporal envelope encoding. While increasing evidence demonstrates the importance of carrier fine structure to complex pitch perception, how carrier spectral information affects musical pitch perception is less clear. Here, transposed tones designed to convey identical envelope information across different carriers were used to assess the effects of carrier spectral composition to pitch discrimination and musical-interval and melody identifications. Results showed that pitch discrimination thresholds became lower (better) with increasing carrier frequencies from 1k to 10k Hz, with performance comparable to that of pure sinusoids. Musical interval and melody defined by the periodicity of sine- or harmonic complex envelopes across carriers were identified with greater than 85% accuracy even on a 10k-Hz carrier. Moreover, enhanced interval and melody identification performance was observed with increasing carrier frequency up to 6k Hz. Findings suggest a perceptual enhancement of temporal envelope information with increasing carrier spectral region in musical pitch processing, at least for frequencies up to 6k Hz. For carriers in the extended high-frequency region (8-20k Hz), the use of temporal envelope information to music pitch processing may vary depending on task requirement. Collectively, these results implicate the fidelity of temporal envelope information to musical pitch perception is more pronounced than previously considered, with ecological implications.

The Prognostic Biomarkers of Plasma Trimethylamine N-Oxide and Short-Chain Fatty Acids for Recanalization Therapy in Acute Ischemic Stroke

Bidirectional communication of the microbiota-gut-brain axis is crucial in stroke. Recanalization therapy, namely intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT), are recommended for eligible patients with acute ischemic stroke (AIS). It remains unclear whether gut microbiota metabolites, namely trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs), can predict the prognosis after recanalization therapy. This prospective study recruited patients with AIS receiving IVT, EVT, or both. The National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores were used to assess the severity and functional outcomes of AIS, respectively. A functional outcome of mild-to-moderate disability was defined as a mRS score of 0-3 at discharge. Plasma TMAO and SCFA levels were measured through liquid chromatography with triple-quadrupole mass spectrometry. Fifty-six adults undergoing recanalization therapy for AIS were enrolled. Results showed that TMAO levels were not associated with stroke severity and functional outcomes, while isovalerate levels (one of the SCFAs) were negatively correlated with NIHSS scores at admission and discharge. In addition, high isovalerate levels were independently associated with a decreased likelihood of severe disability. The study concluded that an elevated plasma isovalerate level was correlated with mild stroke severity and disability after recanalization therapy for AIS.

A review of critical brain oscillations in depression and the efficacy of transcranial magnetic stimulation treatment

Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do not respond to these treatments. Therefore, the investigation of reliable and valid brain oscillations as potential indices for facilitating the precision of diagnosis and treatment protocols has become a critical issue. The current review focuses on brain oscillations that, mostly based on EEG power analysis and connectivity, distinguish between MDD and controls, responders and non-responders, and potential depression severity indices, prognostic indicators, and potential biomarkers for rTMS or iTBS treatment. The possible roles of each biomarker and the potential reasons for heterogeneous results are discussed, and the directions of future studies are proposed.

Resting state dynamics in people with varying degrees of anxiety and mindfulness: A nonlinear and nonstationary perspective

Anxiety and mindfulness are two inversely linked traits shown to be involved in various physiological domains. The current study used resting state electroencephalography (EEG) to explore differences between people with low mindfulness-high anxiety (LMHA) (n = 29) and high mindfulness-low anxiety (HMLA) (n = 27). The resting EEG was collected for a total of 6 min, with a randomized sequence of eyes closed and eyes opened conditions. Two advanced EEG analysis methods, Holo-Hilbert Spectral Analysis and Holo-Hilbert cross-frequency phase clustering (HHCFPC) were employed to estimate the power-based amplitude modulation of carrier frequencies, and cross-frequency coupling between low and high frequencies, respectively. The presence of higher oscillation power across the delta and theta frequencies in the LMHA group than the HMLA group might have been due to the similarity between the resting state and situations of uncertainty, which reportedly triggers motivational and emotional arousal. Although these two groups were formed based on their trait anxiety and trait mindfulness scores, it was anxiety that was found to be significant predictor of the EEG power, not mindfulness. It led us to conclude that it might be anxiety, not mindfulness, which might have contributed to higher electrophysiological arousal. Additionally, a higher δ-β and δ-γ CFC in LMHA suggested greater local-global neural integration, consequently a greater functional association between cortex and limbic system than in the HMLA group. The present cross-sectional study may guide future longitudinal studies on anxiety aiming with interventions such as mindfulness to characterize the individuals based on their resting state physiology.

Cortical excitatory and inhibitory correlates of the fronto-limbic circuit in major depression and differential effects of left frontal brain stimulation in a randomized sham-controlled trial

BACKGROUND

Major depressive disorder (MDD), particularly treatment-resistant ones, is associated with abnormal fronto-limbic glucose metabolism. 10-Hz repetitive transcranial magnetic stimulation (rTMS) over left prefrontal cortex (PFC) is believed to normalize the abnormal metabolism to treat depression. However, the exact molecular mechanisms underlying the mood circuit of depressed brains and whether brain stimulation techniques regulate the underlying molecules remain elusive.

METHODS

Whole-brain glucose metabolism and cortical excitatory and inhibitory markers including P30, N45, P60, N100, and LICI (long-interval cortical inhibition) of TMS-evoked potentials from left DLPFC were measured in 40 subjects with MDD patients. The neurophysiological markers were repeated immediately after 1st session of left PFC rTMS, intermittent theta-burst stimulation (iTBS), and sham (randomly assigned).

RESULTS

Brain glucose metabolism in the limbic structures significantly correlated with left PFC P30 (mainly GABA-A and glutamate receptor mediated) and with LICI (mainly GABA-B receptor mediated inhibition) (FWE-corrected p < 0.001). Correlations between other neurophysiological markers (left PFC N45, P60, and N100) and posterior cingulate cortex, a key region in the default mode network, were also noted. One session of rTMS significantly decreased left PFC P60 (mainly glutamate receptor mediated), while a significant group effect was found for LICI (iTBS < sham).

CONCLUSION

The first study showed that the underlying molecular mechanisms of fronto-limbic circuit of MDD brains involved glutamatergic excitation and GABAergic inhibition at specific time points. In addition, one session of rTMS mainly modulated glutamatergic neurotransmission at left PFC, while the mechanisms of iTBS might involve GABA-B receptor mediated inhibition.

CLINICAL TRIALS REGISTRY NUMBER

UMIN000044951.

Evaluating the Different Stages of Parkinson's Disease Using Electroencephalography With Holo-Hilbert Spectral Analysis

Electroencephalography (EEG) can reveal the abnormalities of dopaminergic subcortico-cortical circuits in patients with Parkinson's disease (PD). However, conventional time-frequency analysis of EEG signals cannot fully reveal the non-linear processes of neural activities and interactions. A novel Holo-Hilbert Spectral Analysis (HHSA) was applied to reveal non-linear features of resting state EEG in 99 PD patients and 59 healthy controls (HCs). PD patients demonstrated a reduction of β bands in frontal and central regions, and reduction of γ bands in central, parietal, and temporal regions. Compared with early-stage PD patients, late-stage PD patients demonstrated reduction of β bands in the posterior central region, and increased θ and δ2 bands in the left parietal region. θ and β bands in all brain regions were positively correlated with Hamilton depression rating scale scores. Machine learning algorithms using three prioritized HHSA features demonstrated "Bag" with the best accuracy of 0.90, followed by "LogitBoost" with an accuracy of 0.89. Our findings strengthen the application of HHSA to reveal high-dimensional frequency features in EEG signals of PD patients. The EEG characteristics extracted by HHSA are important markers for the identification of depression severity and diagnosis of PD.

Safety of transcranial magnetic stimulation in unipolar depression: A systematic review and meta-analysis of randomized-controlled trials

BACKGROUND

To study the safety and patients' tolerance of transcranial magnetic stimulation (TMS), we conducted a systematic review and meta-analysis of the major depressive disorder population.

METHODS

Our study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the literature published before April 30th, 2021 and performed a random-effects meta-analyses which included drop-out due to adverse events, serious adverse events and other non-serious adverse events as primary and secondary outcomes.

RESULTS

A total of 53 randomized sham-controlled trials with 3,273 participants were included. There was no increased risk of drop-out due to an adverse event (active TMS intervention group=3.3%, sham TMS intervention group=2.3%, odds ratio = 1.30, 95% CI= 0.78-2.16, P = 0.31) or a serious adverse event (active TMS intervention group=0.9%, sham TMS intervention group=1.5%, odds ratio = 0.67, 95% CI= 0.29-1.55, P = 0.35). Our findings suggest that TMS intervention may significantly increase the risk of non-serious adverse events including: headaches (active TMS intervention group=22.6%, sham TMS intervention group=16.2%, odds ratio = 1.48, 95% CI= 1.15-1.91, P = 0.002), discomfort (active TMS intervention group=10.9%, sham TMS intervention group=5.0%, odds ratio 1.98, 95% CI= 1.22-3.21, P = 0.006) and pain (active TMS intervention group=23.8%, sham TMS intervention group=5.2%, odds ratio= 8.09, 95% CI= 4.71-13.90, P < 0.001) at the stimulation site, but these non-serious events were mostly mild and transient after TMS treatment.

CONCLUSIONS

These findings provide evidence for the safety and patients' tolerance of transcranial magnetic stimulation technique as an alternative monotherapy or as an add-on treatment for major depressive disorder.

A checklist for assessing the methodological quality of concurrent tES-fMRI studies (ContES checklist): a consensus study and statement

Low-intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation, applies weak electrical stimulation to modulate the activity of brain circuits. Integration of tES with concurrent functional MRI (fMRI) allows for the mapping of neural activity during neuromodulation, supporting causal studies of both brain function and tES effects. Methodological aspects of tES-fMRI studies underpin the results, and reporting them in appropriate detail is required for reproducibility and interpretability. Despite the growing number of published reports, there are no consensus-based checklists for disclosing methodological details of concurrent tES-fMRI studies. The objective of this work was to develop a consensus-based checklist of reporting standards for concurrent tES-fMRI studies to support methodological rigor, transparency and reproducibility (ContES checklist). A two-phase Delphi consensus process was conducted by a steering committee (SC) of 13 members and 49 expert panelists through the International Network of the tES-fMRI Consortium. The process began with a circulation of a preliminary checklist of essential items and additional recommendations, developed by the SC on the basis of a systematic review of 57 concurrent tES-fMRI studies. Contributors were then invited to suggest revisions or additions to the initial checklist. After the revision phase, contributors rated the importance of the 17 essential items and 42 additional recommendations in the final checklist. The state of methodological transparency within the 57 reviewed concurrent tES-fMRI studies was then assessed by using the checklist. Experts refined the checklist through the revision and rating phases, leading to a checklist with three categories of essential items and additional recommendations: (i) technological factors, (ii) safety and noise tests and (iii) methodological factors. The level of reporting of checklist items varied among the 57 concurrent tES-fMRI papers, ranging from 24% to 76%. On average, 53% of checklist items were reported in a given article. In conclusion, use of the ContES checklist is expected to enhance the methodological reporting quality of future concurrent tES-fMRI studies and increase methodological transparency and reproducibility.

Predictive roles of brain-derived neurotrophic factor Val66Met polymorphism on antidepressant efficacy of different forms of prefrontal brain stimulation monotherapy: A randomized, double-blind, sham-controlled study

BACKGROUND

Although repetitive transcranial magnetic stimulation (rTMS) and prolonged intermittent theta-burst stimulation (piTBS) can induce changes in synaptic plasticity, the influence of brain-derived neurotrophic factor (BDNF) genotypes on their antidepressant effects remain unknown. Hence, we investigated the BDNF polymorphism contribution to the antidepressant effect of different forms left-sided prefrontal stimulations in a randomized, sham-controlled study METHODS: Seventy-five patients with medication-resistant depression were randomly assigned into three monotherapy groups: piTBS, high-frequency(HF) rTMS, or sham. The acute treatment period was two weeks. 17-item Hamilton Depression Rating scale (HDRS-17) were applied at baseline, week-1, and week-2. The primary outcome was percentage changes of HDRS-17 (%HDRS-17 changes) analyzed by generalized estimating equation (GEE) model.

RESULTS

The GEE analysis revealed a significant interaction between group, time, and BDNF genotypes effects on %HDRS-17 changes over time.  In patients carrying Val homozygotes, piTBS and HF-rTMS both exhibited significantly greater %HDRS reduction than sham at week-2. In Met carriers, only piTBS showed better efficacy than sham at week-2 (piTBS vs. sham, -41.1% vs.-18.9%, p=0.004). Regarding the influence of different BDNF genotypes on antidepressant efficacy in each intervention, only HF-rTMS exhibited significantly different degrees of %HDRS-17 changes between Val homozygotes and Met carriers (-68.5% vs. -26.4%, p=0.012, respectively), but piTBS delivered the consistent efficacy regardless of the BDNF polymorphism.

CONCLUSIONS

This is the first study to confirm the different impacts of BDNF genotypes on the effect of different left-sided prefrontal brain stimulation. BDNF Val66Met polymorphism may play a role in the antidepressant response of piTBS and HF-rTMS. (Trial Registration Number UMIN-CTR:UMIN000020892: Registration date: Feb.4, 2016).

Critical role of rhythms in prefrontal transcranial magnetic stimulation for depression: A randomized sham-controlled study

Repetitive transcranial magnetic stimulation (rTMS) is an alternative treatment for depression, but the neural correlates of the treatment are currently inconclusive, which might be a limit of conventional analytical methods. The present study aimed to investigate the neurophysiological evidence and potential biomarkers for rTMS and intermittent theta burst stimulation (iTBS) treatment. A total of 61 treatment‐resistant depression patients were randomly assigned to receive prolonged iTBS (piTBS; N = 19), 10 Hz rTMS (N = 20), or sham stimulation (N = 22). Each participant went through a treatment phase with resting state electroencephalography (EEG) recordings before and after the treatment phase. The aftereffects of stimulation showed that theta‐alpha amplitude modulation frequency (f_am) was associated with piTBS_Responder, which involves repetitive bursts delivered in the theta frequency range, whereas alpha carrier frequency (f_c) was related to 10 Hz rTMS, which uses alpha rhythmic stimulation. In addition, theta‐alpha amplitude modulation frequency was positively correlated with piTBS antidepressant efficacy, whereas the alpha frequency was not associated with the 10 Hz rTMS clinical outcome. The present study showed that TMS stimulation effects might be lasting, with changes of brain oscillations associated with the delivered frequency. Additionally, theta‐alpha amplitude modulation frequency may be as a function of the degree of recovery in TRD with piTBS treatment and also a potential EEG‐based predictor of antidepressant efficacy of piTBS in the early treatment stage, that is, first 2 weeks.

Linking Pupil Size Modulated by Global Luminance and Motor Preparation to Saccade Behavior

Saccades are rapid eye movements that are used to move the high acuity fovea in a serial manner in the exploration of the visual scene. Stimulus contrast is known to modulate saccade latency and metrics possibly via changing visual activity in the superior colliculus (SC), a midbrain structure causally involved in saccade generation. However, the quality of visual signals should also be modulated by the amount of lights projected onto the retina, which is gated by the size of the pupil. Although absolute pupil size should modulate visual signals and in turn affect saccade responses, research examining this relationship is very limited. Besides, pupil size is associated with motor preparation. However, the role of pupil dilation in saccade metrics remains unexplored. Through varying peripheral background luminance level and target visual contrast in the saccade task, we investigated the role of absolute pupil size and baseline-corrected pupil dilation in saccade latency and metrics. Higher target detection accuracy was obtained with lower background luminance level, and larger absolute pupil diameter correlated with smaller saccade amplitude and higher saccade peak velocities. More interestingly, the comparable modulation between pupil dilation and stimulus contrast was obtained, showing larger pupil dilation (or higher contrast stimuli) correlating with faster saccade latencies, larger amplitude, higher peak velocities, and smaller endpoint deviation. Together, our results demonstrated the influence of absolute pupil size induced by global luminance level and baseline-corrected pupil dilation associated with motor preparation on saccade latency and metrics, implicating the role of the SC in this behavior.

Within-cycle instantaneous frequency profiles report oscillatory waveform dynamics

The nonsinusoidal waveform is emerging as an important feature of neuronal oscillations. However, the role of single-cycle shape dynamics in rapidly unfolding brain activity remains unclear. Here, we develop an analytical framework that isolates oscillatory signals from time series using masked empirical mode decomposition to quantify dynamical changes in the shape of individual cycles (along with amplitude, frequency, and phase) with instantaneous frequency. We show how phase-alignment, a process of projecting cycles into a regularly sampled phase grid space, makes it possible to compare cycles of different durations and shapes. "Normalized shapes" can then be constructed with high temporal detail while accounting for differences in both duration and amplitude. We find that the instantaneous frequency tracks nonsinusoidal shapes in both simulated and real data. Notably, in local field potential recordings of mouse hippocampal CA1, we find that theta oscillations have a stereotyped slow-descending slope in the cycle-wise average yet exhibit high variability on a cycle-by-cycle basis. We show how principal component analysis allows identification of motifs of theta cycle waveform that have distinct associations to cycle amplitude, cycle duration, and animal movement speed. By allowing investigation into oscillation shape at high temporal resolution, this analytical framework will open new lines of inquiry into how neuronal oscillations support moment-by-moment information processing and integration in brain networks.NEW & NOTEWORTHY We propose a novel analysis approach quantifying nonsinusoidal waveform shape. The approach isolates oscillations with empirical mode decomposition before waveform shape is quantified using phase-aligned instantaneous frequency. This characterizes the full shape profile of individual cycles while accounting for between-cycle differences in duration, amplitude, and timing. We validated in simulations before applying to identify a range of data-driven nonsinusoidal shape motifs in hippocampal theta oscillations.

Revealing the Dynamic Nature of Amplitude Modulated Neural Entrainment With Holo-Hilbert Spectral Analysis

Patterns in external sensory stimuli can rapidly entrain neuronally generated oscillations observed in electrophysiological data. Here, we manipulated the temporal dynamics of visual stimuli with cross-frequency coupling (CFC) characteristics to generate steady-state visual evoked potentials (SSVEPs). Although CFC plays a pivotal role in neural communication, some cases reporting CFC may be false positives due to non-sinusoidal oscillations that can generate artificially inflated coupling values. Additionally, temporal characteristics of dynamic and non-linear neural oscillations cannot be fully derived with conventional Fourier-based analyses mainly due to trade off of temporal resolution for frequency precision. In an attempt to resolve these limitations of linear analytical methods, Holo-Hilbert Spectral Analysis (HHSA) was investigated as a potential approach for examination of non-linear and non-stationary CFC dynamics in this study. Results from both simulation and SSVEPs demonstrated that temporal dynamic and non-linear CFC features can be revealed with HHSA. Specifically, the results of simulation showed that the HHSA is less affected by the non-sinusoidal oscillation and showed possible cross frequency interactions embedded in the simulation without any a priori assumptions. In the SSVEPs, we found that the time-varying cross-frequency interaction and the bidirectional coupling between delta and alpha/beta bands can be observed using HHSA, confirming dynamic physiological signatures of neural entrainment related to cross-frequency coupling. These findings not only validate the efficacy of the HHSA in revealing the natural characteristics of signals, but also shed new light on further applications in analysis of brain electrophysiological data with the aim of understanding the functional roles of neuronal oscillation in various cognitive functions.

Task-Modulated Brain Activity Predicts Antidepressant Responses of Prefrontal Repetitive Transcranial Magnetic Stimulation: A Randomized Sham-Control Study

Background

Prolonged intermittent theta-burst stimulation (piTBS) and repetitive transcranial magnetic stimulation (rTMS) are effective antidepressant interventions for major depressive disorder (MDD). Cognition-modulated frontal theta (frontalθ) activity had been identified to predict the antidepressant response to 10-Hz left prefrontal rTMS. However, whether this marker also predicts that of piTBS needs further investigation.

Methods

The present double-blind randomized trial recruited 105 patients with MDD who showed no response to at least one adequate antidepressant treatment in the current episode. The recruited patients were randomly assigned to one of three groups: group A received piTBS monotherapy; group B received rTMS monotherapy; and group C received sham stimulation. Before a 2-week acute treatment period, electroencephalopgraphy (EEG) and cognition-modulated frontal theta changes (Δfrontalθ) were measured. Depression scores were evaluated at baseline, 1 week, and 2 weeks after the initiation of treatment.

Results

The Δfrontalθ at baseline was significantly correlated with depression score changes at week 1 (r = -0.383, p = 0.025) and at week 2 for rTMS group (r = -0.419, p = 0.014), but not for the piTBS and sham groups. The area under the receiver operating characteristic curve for Δfrontalθ was 0.800 for the rTMS group (p = 0.003) and was 0.549 for the piTBS group (p = 0.619).

Conclusion

The predictive value of higher baseline Δfrontalθ for antidepressant efficacy for rTMS not only replicates previous results but also implies that the antidepressant responses to rTMS could be predicted reliably at baseline and both piTBS and rTMS could be effective through different neurobiological mechanisms.

Dynamical EEG Indices of Progressive Motor Inhibition and Error-Monitoring

Response inhibition has been widely explored using the stop signal paradigm in the laboratory setting. However, the mechanism that demarcates attentional capture from the motor inhibition process is still unclear. Error monitoring is also involved in the stop signal task. Error responses that do not complete, i.e., partial errors, may require different error monitoring mechanisms relative to an overt error. Thus, in this study, we included a “continue go” (Cont_Go) condition to the stop signal task to investigate the inhibitory control process. To establish the finer difference in error processing (partial vs. full unsuccessful stop (USST)), a grip-force device was used in tandem with electroencephalographic (EEG), and the time-frequency characteristics were computed with Hilbert–Huang transform (HHT). Relative to Cont_Go, HHT results reveal (1) an increased beta and low gamma power for successful stop trials, indicating an electrophysiological index of inhibitory control, (2) an enhanced theta and alpha power for full USST trials that may mirror error processing. Additionally, the higher theta and alpha power observed in partial over full USST trials around 100 ms before the response onset, indicating the early detection of error and the corresponding correction process. Together, this study extends our understanding of the finer motor inhibition control and its dynamic electrophysiological mechanisms.

Efficacy and tolerability of theta-burst stimulation for major depression: A systematic review and meta-analysis

BACKGROUND

Repetitive transcranial magnetic stimulation (rTMS) is the current treatment option for major depression (MD). Theta-burst stimulation (TBS), a variation of rTMS, affords a short stimulation duration, low stimulation pulse intensity, and possibility to improve rTMS efficiency. This systematic review and meta-analysis examined the studies on efficacy and tolerability of TBS in patients with MD.

METHODS

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the literature from 1990 until May 24, 2020, and performed a random-effects meta-analysis by including response and remission rates of depression and dropout rates as main outcome measures.

RESULTS

In total, 10 studies including 6 randomized controlled trials (RCTs; n = 294) and 4 uncontrolled clinical trials (non-RCTs; n = 297) were included. The overall effect size of response rate and remission rates were 0.38 (95% confidence interval [CI]: 0.29-0.48) and 0.20 (95% CI: 0.13-0.29), respectively. Notably, the TBS group showed favorable efficacy without major adverse events.

CONCLUSIONS

TBS treatment was more efficient in terms of time and energy than the standard rTMS was. Our meta-analysis provided evidence that the application of TBS to the dorsolateral prefrontal cortex is associated with significant antidepressant effects along with favorable tolerability.

Frontoparietal Beta Amplitude Modulation and its Interareal Cross-frequency Coupling in Visual Working Memory

Visual working memory (VWM) relies on sustained neural activities that code information via various oscillatory frequencies. Previous studies, however, have emphasized time-frequency power changes, while overlooking the possibility that rhythmic amplitude variations can also code frequency-specific VWM information in a completely different dimension. Here, we employed the recently-developed Holo-Hilbert spectral analysis to characterize such nonlinear amplitude modulation(s) (AM) underlying VWM in the frontoparietal systems. We found that the strength of AM in mid-frontal beta and gamma oscillations during late VWM maintenance and VWM retrieval correlated with people's VWM performance. When behavioral performance was altered with transcranial electric stimulation, AM power changes during late VWM maintenance in beta, but not gamma, tracked participants' VWM variations. This beta AM likely codes information by varying its amplitude in theta period for long-range propagation, as our connectivity analysis revealed that interareal theta-beta couplings-bidirectional between mid-frontal and right-parietal during VWM maintenance and unidirectional from right-parietal to left-middle-occipital during late VWM maintenance and retrieval-underpins VWM performance and individual differences.

To Go or Not to Go: Degrees of Dynamic Inhibitory Control Revealed by the Function of Grip Force and Early Electrophysiological Indices

A critical issue in executive control is how the nervous system exerts flexibility to inhibit a prepotent response and adapt to sudden changes in the environment. In this study, force measurement was used to capture “partial” unsuccessful trials that are highly relevant in extending the current understanding of motor inhibition processing. Moreover, a modified version of the stop-signal task was used to control and eliminate potential attentional capture effects from the motor inhibition index. The results illustrate that the non-canceled force and force rate increased as a function of stop-signal delay (SSD), offering new objective indices for gauging the dynamic inhibitory process. Motor response (time and force) was a function of delay in the presentation of novel/infrequent stimuli. A larger lateralized readiness potential (LRP) amplitude in go and novel stimuli indicated an influence of the novel stimuli on central motor processing. Moreover, an early N1 component reflects an index of motor inhibition in addition to the N2 component reported in previous studies. Source analysis revealed that the activation of N2 originated from inhibitory control associated areas: the right inferior frontal gyrus (rIFG), pre-motor cortex, and primary motor cortex. Regarding partial responses, LRP and error-related negativity (ERNs) were associated with error correction processes, whereas the N2 component may indicate the functional overlap between inhibition and error correction. In sum, the present study has developed reliable and objective indices of motor inhibition by introducing force, force-rate and electrophysiological measures, further elucidating our understandings of dynamic motor inhibition and error correction.

Neurophysiological signatures of hand motor response to dual-transcranial direct current stimulation in subacute stroke: a TMS and MEG study

Background

Dual transcranial direct current stimulation (tDCS) to the bilateral primary motor cortices (M1s) has potential benefits in chronic stroke, but its effects in subacute stroke, when behavioural effects might be expected to be greater, have been relatively unexplored. Here, we examined the neurophysiological effects and the factors influencing responsiveness of dual-tDCS in subacute stroke survivors.

Methods

We conducted a randomized sham-controlled crossover study in 18 survivors with first-ever, unilateral subcortical ischaemic stroke 2–4 weeks after stroke onset and 14 matched healthy controls. Participants had real dual-tDCS (with an ipsilesional [right for controls] M1 anode and a contralesional M1 [left for controls] cathode; 2 mA for 20mins) and sham dual-tDCS on separate days, with concurrent paretic [left for controls] hand exercise. Using transcranial magnetic stimulation (TMS) and magnetoencephalography (MEG), we recorded motor evoked potentials (MEPs), the ipsilateral silent period (iSP), short-interval intracortical inhibition, and finger movement-related cortical oscillations before and immediately after tDCS.

Results

Stroke survivors had decreased excitability in ipsilesional M1 with a relatively excessive transcallosal inhibition from the contralesional to ipsilesional hemisphere at baseline compared with controls, as quantified by decreased MEPs and increased iSP duration. Dual-tDCS led to increased MEPs and decreased iSP duration in ipsilesional M1. The magnitude of the tDCS-induced MEP increase in stroke survivors was predicted by baseline contralesional-to-ipsilesional transcallosal inhibition (iSP) ratio. Baseline post-movement synchronization in α-band activity in ipsilesional M1 was decreased after stroke compared with controls, and its tDCS-induced increase correlated with upper limb score in stroke survivors. No significant adverse effects were observed during or after dual-tDCS.

Conclusions

Task-concurrent dual-tDCS in subacute stroke can safely and effectively modulate bilateral M1 excitability and inter-hemispheric imbalance and also movement-related α-activity.

Antidepressant Efficacy of Prolonged Intermittent Theta Burst Stimulation Monotherapy for Recurrent Depression and Comparison of Methods for Coil Positioning: A Randomized, Double-Blind, Sham-Controlled Study

BACKGROUND

Prolonged intermittent theta burst stimulation (piTBS) with triple doses of the standard protocol is an updated form of repetitive transcranial magnetic stimulation, and it is an effective add-on intervention for major depressive disorder. In the present study, our objective was to investigate the antidepressant efficacy of piTBS monotherapy. Efficacy between the standard 5-cm method and magnetic resonance imaging (MRI)-guided coil positioning to the left dorsolateral prefrontal cortex method was also compared.

METHODS

In the present double-blind, randomized, sham-controlled trial, 105 patients with recurrent depression who exhibited no responses to at least one adequate antidepressant treatment for the prevailing episode were assigned randomly to one of three groups: piTBS monotherapy (n = 35), repetitive transcranial magnetic stimulation monotherapy (n = 35), or sham stimulation (n = 35). The acute treatment period was 2 weeks. Half of the patients were randomized to MRI navigation in each group.

RESULTS

No serious adverse events were observed. The piTBS group exhibited significantly greater decreases in depression scores than the sham group at week 2 (-40.0% vs. -13.9%; p < .001 after correcting for multiple comparisons by Bonferroni [effect size (Cohen's d) = 1.12]), and the odds ratio for responses was high. The MRI navigation method (-32.4%) did not yield better antidepressant effects than the standard method (-40.6%). Brain stimulation and 17-item Hamilton Depression Rating Scale changes in the first week were the most important variables for predicting antidepressant responses.

CONCLUSIONS

Left prefrontal piTBS monotherapy is effective for the treatment of recurrent depression, and the MRI-guided method of coil targeting is not better than the standard method.

Early transcranial direct current stimulation treatment exerts neuroprotective effects on 6-OHDA-induced Parkinsonism in rats

BACKGROUND

Transcranial direct current stimulation (tDCS) has been proven to be able to modulate motor cortical plasticity might have potential as an alternative, adjunctive therapy for Parkinson's disease (PD). However, the efficacy of tDCS in PD is still uncertain. A disease animal model may be useful to clarify the existence of a treatment effect and to explore an effective therapeutic strategy using tDCS protocols.

OBJECTIVE

The current study was designed to identify the comprehensive therapeutic effects of tDCS in 6-hydroxydopamine (6-OHDA)-lesioned PD rats.

METHODS

Following early and long-term tDCS application (starting 24 h after PD lesion, 300 μA anodal tDCS, 20 min/day, 5 days/week) in awake PD animals for a total of 4 weeks, the effects of tDCS on motor and non-motor behaviors as well as dopaminergic neuron degeneration levels, were identified.

RESULTS

We found that the 4-week tDCS intervention significantly alleviated 6-OHDA-induced motor deficits in locomotor activity, akinesia, gait pattern and anxiety-like behavior, but not in apomorphine-induced rotations, recognition memory and depression-like behavior. Immunohistochemically, tyrosine hydroxylase (TH)-positive neurons in the substantia nigra were significantly preserved in the tDCS intervention group.

CONCLUSIONS

These results suggest that early and long-term tDCS could exert neuroprotective effects and reduce the aggravation of motor dysfunctions in a 6-OHDA-induced PD rat model. Furthermore, this preclinical model may enhance the promising possibility of the potential use of tDCS and serve as a translational platform to further identify the therapeutic mechanism of tDCS for PD or other neurological disorders.

Low delta and high alpha power are associated with better conflict control and working memory in high mindfulness, low anxiety individuals

Working memory capacity (WMC) can predict conflict control ability. Measures of both abilities are impaired by anxiety, which is often inversely linked with mindfulness. It has been shown that a combination of high mindfulness and low anxiety is associated with better conflict control and WMC. The current study explored the electrophysiology related to such behavioral differences. Two experimental groups, one with high mindfulness and low anxiety (HMLA) and one with low mindfulness and high anxiety (LMHA), performed a color Stroop task and a change detection task, both with simultaneous electroencephalogram (EEG) recording. An advanced EEG analytical approach, Hilbert–Huang transform (HHT) analysis, was employed. This is regarded as a robust method to analyze non-linear and non-stationary signals. Lower delta activity at posterior temporal and occipital regions was seen in the HMLA group for the Stroop conflict conditions and might be generally associated with higher accuracy in this group and indicative of higher attentiveness. Higher accuracy rates and WMC were seen in the HMLA group and might be specifically associated with the higher alpha activity observed in prefrontal cortex, fronto-central and centro-parietal regions in this group. Future studies should explore how mindfulness and anxiety can independently affect these cognitive functions and their associated neurophysiology.

Neuromodulatory Effects of Transcranial Direct Current Stimulation on Motor Excitability in Rats

Transcranial direct current stimulation (tDCS) is a noninvasive technique for modulating neural plasticity and is considered to have therapeutic potential in neurological disorders. For the purpose of translational neuroscience research, a suitable animal model can be ideal for providing a stable condition for identifying mechanisms that can help to explore therapeutic strategies. Here, we developed a tDCS protocol for modulating motor excitability in anesthetized rats. To examine the responses of tDCS-elicited plasticity, the motor evoked potential (MEP) and MEP input-output (IO) curve elicited by epidural motor cortical electrical stimulus were evaluated at baseline and after 30 min of anodal tDCS or cathodal tDCS. Furthermore, a paired-pulse cortical electrical stimulus was applied to assess changes in the inhibitory network by measuring long-interval intracortical inhibition (LICI) before and after tDCS. In the results, analogous to those observed in humans, the present study demonstrates long-term potentiation- (LTP-) and long-term depression- (LTD-) like plasticity can be induced by tDCS protocol in anesthetized rats. We found that the MEPs were significantly enhanced immediately after anodal tDCS at 0.1 mA and 0.8 mA and remained enhanced for 30 min. Similarly, MEPs were suppressed immediately after cathodal tDCS at 0.8 mA and lasted for 30 min. No effect was noted on the MEP magnitude under sham tDCS stimulation. Furthermore, the IO curve slope was elevated following anodal tDCS and presented a trend toward diminished slope after cathodal tDCS. No significant differences in the LICI ratio of pre- to post-tDCS were observed. These results indicated that developed tDCS schemes can produce consistent, rapid, and controllable electrophysiological changes in corticomotor excitability in rats. This newly developed tDCS animal model could be useful to further explore mechanical insights and may serve as a translational platform bridging human and animal studies, establishing new therapeutic strategies for neurological disorders.

Human visual steady-state responses to amplitude-modulated flicker: Latency measurement

The response latency of steady-state visually evoked potentials (SSVEPs) is a sensitive measurement for investigating visual functioning of the human brain, specifically in visual development and for clinical evaluation. This latency can be measured from the slope of phase versus frequency of responses by using multiple frequencies of stimuli. In an attempt to provide an alternative measurement of this latency, this study utilized an envelope response of SSVEPs elicited by amplitude-modulated visual stimulation and then compared with the envelope of the generating signal, which was recorded simultaneously with the electroencephalography recordings. The advantage of this measurement is that it successfully estimates the response latency based on the physiological envelope in the entire waveform. Results showed the response latency at the occipital lobe (Oz channel) was approximately 104.55 ms for binocular stimulation, 97.14 ms for the dominant eye, and 104.75 ms for the nondominant eye with no significant difference between these stimulations. Importantly, the response latency at frontal channels (125.84 ms) was significantly longer than that at occipital channels (104.11 ms) during binocular stimulation. Together with strong activation of the source envelope at occipital cortex, these findings support the idea of a feedforward process, with the visual stimuli propagating originally from occipital cortex to anterior cortex. In sum, these findings offer a novel method for future studies in measuring visual response latencies and also potentially shed a new light on understanding of how long collective neural activities take to travel in the human brain.

Perspective-taking across cultures: shared biases in Taiwanese and British adults

The influential hypothesis by Markus & Kitayama (Markus, Kitayama 1991. Psychol. Rev. 98, 224) postulates that individuals from interdependent cultures place others above self in interpersonal contexts. This led to the prediction and finding that individuals from interdependent cultures are less egocentric than those from independent cultures (Wu, Barr, Gann, Keysar 2013. Front. Hum. Neurosci. 7, 1-7; Wu, Keysar. 2007 Psychol. Sci. 18, 600-606). However, variation in egocentrism can only provide indirect evidence for the Markus and Kitayama hypothesis. The current study sought direct evidence by giving British (independent) and Taiwanese (interdependent) participants two perspective-taking tasks on which an other-focused 'altercentric' processing bias might be observed. One task assessed the calculation of simple perspectives; the other assessed the use of others' perspectives in communication. Sixty-two Taiwanese and British adults were tested in their native languages at their home institutions of study. Results revealed similar degrees of both altercentric and egocentric interference between the two cultural groups. This is the first evidence that listeners account for a speaker's limited perspective at the cost of their own performance. Furthermore, the shared biases point towards similarities rather than differences in perspective-taking across cultures.

Revealing the Electrophysiological Correlates of Working Memory-Load Effects in Symmetry Span Task With HHT Method

Complex span task is one of the commonly used cognitive tasks to evaluate an individual's working memory capacity (WMC). It is a dual task consisting of a distractor subtask and a memory subtask. Though multiple studies have utilized complex span tasks, the electrophysiological correlates underlying the encoding and retrieval processes in working memory span task remain uninvestigated. One previous study that assessed electroencephalographic (EEG) measures utilizing complex span task found no significant difference between its working memory loads, a typical index observed in other working memory tasks (e.g., n-back task and digital span task). The following design constructs of the paradigm might have been the reason. (1) The fixed-time limit of the distractor subtask may have hindered the assessment of individual WMC precisely. (2) Employing a linear-system-favoring EEG data analysis method for a non-linear system such as the human brain. In the current study, the participants perform the Raven Advanced Progressive Matrices (RAMP) task on 1 day and the symmetry span (Sspan) task on the other. Prior to the formal Sspan task, the participants were instructed to judge 15 simple symmetry questions as quickly as possible. A participant-specific time-limit is chartered from these symmetry questions. The current study utilizes the Sspan task sequential to a distractor subtask. Instead of the fixed time-limit exercised in the previous study, the distractor subtask of the current study was equipped with the participant-specific time-limit obtained from the symmetry questions. This could provide a precise measure of individual WMC. This study investigates if the complex span task resonates EEG patterns similar to the other working memory tasks in terms of working memory-load by utilizing ensemble empirical mode decomposition (EEMD) of Hilbert-Huang transform (HHT). Prior expectations were to observe a decrement in the P300 component of event-related mode (ERM) and a decrement in the power of alpha and beta band frequency with increasing working memory-load. We observed a significantly higher P300 amplitude for the low-load condition compared to the high-load condition over the circumscribed brain network across F4 and C4 electrodes. Time-frequency analysis revealed a significant difference between the high- and low-load conditions at alpha and beta band over the frontal, central, and parietal channels. The results from our study demonstrate precise differences in EEG data pertaining to varied memory-load differences in the complex span task. Thus, assessing complex span tasks with the HHT-based analysis may aid in achieving a better signal to noise ratio and effect size for the results in working memory EEG studies.

Anodal and Cathodal tDCS Over the Right Frontal Eye Fields Impacts Spatial Probability Processing Differently in Pro- and Anti-saccades

Learning regularities that exist in the environment can help the visual system achieve optimal efficiency while reducing computational burden. Using a pro- and anti-saccade task, studies have shown that probabilistic information regarding spatial locations can be a strong modulator of frontal eye fields (FEF) activities and consequently alter saccadic behavior. One recent study has also shown that FEF activities can be modulated by transcranial direct current stimulation, where anodal tDCS facilitated prosaccades but cathodal tDCS prolonged antisaccades. These studies together suggest that location probability and tDCS can both alter FEF activities and oculomotor performance, yet how these two modulators interact with each other remains unclear. In this study, we applied anodal or cathodal tDCS over right FEF, and participants performed an interleaved pro- and anti-saccade task. Location probability was manipulated in prosaccade trials but not antisaccade trials. We observed that anodal tDCS over rFEF facilitated prosaccdes toward low-probability locations but not to high-probability locations; whereas cathodal tDCS facilitated antisaccades away from the high-probability location (i.e., same location as the low-probability locations in prosaccades). These observed effects were specific to rFEF as tDCS over the SEF in a separate control experiment did not yield similar patterns. These effects were also more pronounced in low-performers who had slower saccade reaction time. Together, we conclude that (1) the overlapping spatial endpoint between prosaccades (i.e., toward low-probability location) and antisaccades (i.e., away from high-probability location) possibly suggest an endpoint-selective mechanism within right FEF, (2) anodal tDCS and location probability cannot be combined to produce a bigger facilitative effect, and (3) anodal rFEF tDCS works best on low-performers who had slower saccade reaction time. These observations are consistent with the homeostasis account of tDCS effect and FEF functioning.

Corrigendum: Better Cognitive Performance Is Associated With the Combination of High Trait Mindfulness and Low Trait Anxiety

[This corrects the article on p. 627 in vol. 9, PMID: 29780338.].

Meditation Effects on the Control of Involuntary Contingent Reorienting Revealed With Electroencephalographic and Behavioral Evidence

Prior studies have reported that meditation may improve cognitive functions and those related to attention in particular. Here, the dynamic process of attentional control, which allows subjects to focus attention on their current interests, was investigated. Concentrative meditation aims to cultivate the abilities of continuous focus and redirecting attention from distractions to the object of focus during meditation. However, it remains unclear how meditation may influence attentional reorientation, which involves interaction between both top-down and bottom-up processes. We aimed to investigate the modulating effect of meditation on the mechanisms of contingent reorienting by employing a rapid serial visual presentation (RSVP) task in conjunction with electrophysiological recording. We recruited 26 meditators who had an average of 2.9 years of meditation experience and a control group comprising 26 individuals without any prior experience of meditation. All subjects performed a 30-min meditation and a rest condition with data collected pre- and post-intervention, with each intervention given on different days. The state effect of meditation improved overall accuracy for all subjects irrespective of their group. A group difference was observed across interventions, showing that meditators were more accurate and more efficient at attentional suppression, represented by a larger Pd (distractor positive) amplitude of event related modes (ERMs), for target-like distractors than the control group. The findings suggested that better attentional control with respect to distractors might be facilitated by acquiring experience of and skills related to meditation training.

Better Cognitive Performance Is Associated With the Combination of High Trait Mindfulness and Low Trait Anxiety

There are several ways in which cognitive and neurophysiological parameters have been consistently used to explain the variability in cognitive ability between people. However, little has been done to explore how such cognitive abilities are influenced by differences in personality traits. Dispositional mindfulness and anxiety are two inversely linked traits that have been independently attributed to a range of cognitive functions. The current study investigated these two traits in combination along with measures of the attentional network, cognitive inhibition, and visual working memory (VWM) capacity. A total of 392 prospective participants were screened to select two experimental groups each of 30 healthy young adults, with one having high mindfulness and low anxiety (HMLA) and the second having low mindfulness and high anxiety (LMHA). The groups performed an attentional network task, a color Stroop task, and a change detection test of VWM capacity. Results showed that the HMLA group was more accurate than the LMHA group on the Stroop and change detection tasks. Additionally, the HMLA group was more sensitive in detecting changes and had a higher WMC than the LMHA group. This research adds to the literature that has investigated mindfulness and anxiety independently with a comprehensive investigation of the effects of these two traits in conjunction on executive function.

The critical role of phase difference in theta oscillation between bilateral parietal cortices for visuospatial working memory

Visual working memory (VWM) refers to people's ability to maintain and manipulate visual information on line. Its capacity varies between individuals, and neuroimaging studies have suggested a link between one's VWM capacity and theta power in the parietal cortex. However, it is unclear how the parietal cortices communicate with each other in order to support VWM processing. In two experiments we employed transcranial alternate current stimulation (tACS) to use frequency-specific (6 Hz) alternating current to modulate theta oscillation between the left and right parietal cortex with either in-phase (0° difference, Exp 1), anti-phase (180° difference, Exp 2), or sham sinusoidal current stimulation. In Experiment 1, in-phase theta tACS induced an improved VWM performance, but only in low-performers, whereas high-performers suffered a marginally-significant VWM impairment. In Experiment 2, anti-phase theta tACS did not help the low-performers, but significantly impaired high-performers' VWM capacity. These results not only provide causal evidence for theta oscillation in VWM processing, they also highlight the intricate interaction between tACS and individual differences-where the same protocol that enhances low-performers' VWM can backfire for the high-performers. We propose that signal complexity via coherent timing and phase synchronization within the bilateral parietal network is crucial for successful VWM functioning.

Elucidating and Modulating the Neural Correlates of Visuospatial Working Memory via Noninvasive Brain Stimulation

Visuospatial working memory refers to the short-term memory mechanism that enables humans to remember visual information across visual blackout periods such as eyeblinks or eye movements. In recent years, neuroscientific studies have made great progress in uncovering the brain regions that support visuospatial working memory. In this review, we focus on the role of the posterior parietal cortex in forming and maintaining visual information, and use it as an example to highlight how noninvasive brain-stimulation techniques, particularly transcranial magnetic, direct current, and alternating current stimulation, can shed light on this topic because of their unique strengths in modulating brain activities.

Individual Differences and State-Dependent Responses in Transcranial Direct Current Stimulation

Transcranial direct current stimulation (tDCS) has been extensively used to examine whether neural activities can be selectively increased or decreased with manipulations of current polarity. Recently, the field has reevaluated the traditional anodal-increase and cathodal-decrease assumption due to the growing number of mixed findings that report the effects of the opposite directions. Therefore, the directionality of tDCS polarities and how it affects each individual still remain unclear. In this study, we used a visual working memory (VWM) paradigm and systematically manipulated tDCS polarities, types of different independent baseline measures, and task difficulty to investigate how these factors interact to determine the outcome effect of tDCS. We observed that only low-performers, as defined by their no-tDCS corsi block tapping (CBT) performance, persistently showed a decrement in VWM performance after anodal stimulation, whereas no tDCS effect was found when participants were divided by their performance in digit span. In addition, only the optimal level of task difficulty revealed any significant tDCS effect. All these findings were consistent across different blocks, suggesting that the tDCS effect was stable across a short period of time. Lastly, there was a high degree of intra-individual consistency in one’s responsiveness to tDCS, namely that participants who showed positive or negative effect to anodal stimulation are also more likely to show the same direction of effects for cathodal stimulation. Together, these findings imply that tDCS effect is interactive and state dependent: task difficulty and consistent individual differences modulate one’s responsiveness to tDCS, while researchers’ choices of independent behavioral baseline measures can also critically affect how the effect of tDCS is evaluated. These factors together are likely the key contributors to the wide range of “noises” in tDCS effects between individuals, between stimulation protocols, and between different studies in the literature. Future studies using tDCS, and possibly tACS, should take such state-dependent condition in tDCS responsiveness into account.

The Facilitative Effect of Transcranial Direct Current Stimulation on Visuospatial Working Memory in Patients with Diabetic Polyneuropathy: A Pre-post Sham-Controlled Study

Diabetes mellitus can lead to diabetic polyneuropathy (DPN) and cognitive deficits that manifest as peripheral and central neuropathy, respectively. In this study we investigated the relationship between visuospatial working memory (VSWM) capacity and DPN severity, and attempted to improve VSWM in DPN patients via the use of transcranial direct current stimulation (tDCS). Sixteen DPN patients and 16 age- and education-matched healthy control subjects received Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Montreal Cognitive Assessment (MOCA) for baseline cognitive assessment. A forward- and backward-recall computerized Corsi block tapping task (CBT), both with and without a concurrent motor interference task was used to measure VSWM capacity. Each DPN patient underwent a pre-treatment CBT, followed by tDCS or sham treatment, then a post-treatment CBT on two separate days. We found that although patients with severe DPN (Dyck’s grade 2a or 2b) showed comparable general intelligence scores on WAIS-IV as their age- and education-matched healthy counterparts, they nonetheless showed mild cognitive impairment (MCI) on MOCA and working memory deficit on digit-span test of WAIS-IV. Furthermore, patients’ peripheral nerve conduction velocity (NCV) was positively correlated with their VSWM span in the most difficult CBT condition that involved backward-recall with motor interference such that patients with worse NCV also had lower VSWM span. Most importantly, anodal tDCS over the right DLPFC was able to improve low-performing patients’ VSWM span to be on par with the high-performers, thereby eliminating the correlation between NCV and VSWM. In summary, these findings suggest that (1) MCI and severe peripheral neuropathy can coexist with unequal severity in diabetic patients, (2) the positive correlation of VSWM and NCV suggests a link between peripheral and central neuropathies, and (3) anodal tDCS over the right DLPFC can improve DPN patients’ VSWM, particularly for the low-performing patients.

Exploring the contributions of the supplementary eye field to subliminal inhibition using double-pulse transcranial magnetic stimulation

It is widely accepted that the supplementary eye fields (SEF) are involved in the control of voluntary eye movements. However, recent evidence suggests that SEF may also be important for unconscious and involuntary motor processes. Indeed, Sumner et al. ([2007]: Neuron 54:697-711) showed that patients with micro-lesions of the SEF demonstrated an absence of subliminal inhibition as evoked by masked-prime stimuli. Here, we used double-pulse transcranial magnetic stimulation (TMS) in healthy volunteers to investigate the role of SEF in subliminal priming. We applied double-pulse TMS at two time windows in a masked-prime task: the first during an early phase, 20-70 ms after the onset of the mask but before target presentation, during which subliminal inhibition is present; and the second during a late phase, 20-70 ms after target onset, during which the saccade is being prepared. We found no effect of TMS with the early time window of stimulation, whereas a reduction in the benefit of an incompatible subliminal prime stimulus was found when SEF TMS was applied at the late time window. These findings suggest that there is a role for SEF related to the effects of subliminal primes on eye movements, but the results do not support a role in inhibiting the primed tendency. Hum Brain Mapp 38:339-351, 2017. © 2016 Wiley Periodicals, Inc.

The critical role of phase difference in gamma oscillation within the temporoparietal network for binding visual working memory

How does the brain enable us to remember two or more object representations in visual working memory (VWM) without confusing them? This "gluing" process, or feature binding, refers to the ability to join certain features together while keeping them segregated from others. Recent neuroimaging research has reported higher BOLD response in the left temporal and parietal cortex during a binding-VWM task. However, less is known about how the two regions work in synchrony to support such process. In this study, we applied transcranial alternating current stimulation (tACS) over the left temporal and parietal cortex in gamma and theta frequency, with a phase difference of either 0° (in-phase) or 180° (anti-phase) to account for the different ways through which neural synchronization may occur. We found no facilitatory or inhibitory effect from sham, theta, and in-phase gamma stimulation. Importantly, there was an enhancement effect from anti-phase gamma tACS that was binding-specific, and such effect was only apparent in low-performing individuals who had room for improvement. Together, these results demonstrate that binding-VWM is supported by a temporally-precise oscillatory mechanism within the gamma frequency range, and that the advantageous 180°-apart phase relationship also implies a possible temporal driver-to-receiver time-lag between the temporal and parietal cortex.

Theta Oscillation Reveals the Temporal Involvement of Different Attentional Networks in Contingent Reorienting

In the visual world, rapidly reorienting to relevant objects outside the focus of attention is vital for survival. This ability from the interaction between goal-directed and stimulus-driven attentional control is termed contingent reorienting. Neuroimaging studies have demonstrated activations of the ventral and dorsal attentional networks (DANs) which exhibit right hemisphere dominance, but the temporal dynamics of the attentional networks still remain unclear. The present study used event-related potential (ERP) to index the locus of spatial attention and Hilbert-Huang transform (HHT) to acquire the time-frequency information during contingent reorienting. The ERP results showed contingent reorienting induced significant N2pc on both hemispheres. In contrast, our time-frequency analysis found further that, unlike the N2pc, theta oscillation during contingent reorienting differed between hemispheres and experimental sessions. The inter-trial coherence (ITC) of the theta oscillation demonstrated that the two sides of the attentional networks became phase-locked to contingent reorienting at different stages. The left attentional networks were associated with contingent reorienting in the first experimental session whereas the bilateral attentional networks play a more important role in this process in the subsequent session. This phase-locked information suggests a dynamic temporal evolution of the involvement of different attentional networks in contingent reorienting and a potential role of the left ventral network in the first session.

On Holo-Hilbert spectral analysis: a full informational spectral representation for nonlinear and non-stationary data

The Holo-Hilbert spectral analysis (HHSA) method is introduced to cure the deficiencies of traditional spectral analysis and to give a full informational representation of nonlinear and non-stationary data. It uses a nested empirical mode decomposition and Hilbert-Huang transform (HHT) approach to identify intrinsic amplitude and frequency modulations often present in nonlinear systems. Comparisons are first made with traditional spectrum analysis, which usually achieved its results through convolutional integral transforms based on additive expansions of an a priori determined basis, mostly under linear and stationary assumptions. Thus, for non-stationary processes, the best one could do historically was to use the time-frequency representations, in which the amplitude (or energy density) variation is still represented in terms of time. For nonlinear processes, the data can have both amplitude and frequency modulations (intra-mode and inter-mode) generated by two different mechanisms: linear additive or nonlinear multiplicative processes. As all existing spectral analysis methods are based on additive expansions, either a priori or adaptive, none of them could possibly represent the multiplicative processes. While the earlier adaptive HHT spectral analysis approach could accommodate the intra-wave nonlinearity quite remarkably, it remained that any inter-wave nonlinear multiplicative mechanisms that include cross-scale coupling and phase-lock modulations were left untreated. To resolve the multiplicative processes issue, additional dimensions in the spectrum result are needed to account for the variations in both the amplitude and frequency modulations simultaneously. HHSA accommodates all the processes: additive and multiplicative, intra-mode and inter-mode, stationary and non-stationary, linear and nonlinear interactions. The Holo prefix in HHSA denotes a multiple dimensional representation with both additive and multiplicative capabilities.

Different forms of prefrontal theta burst stimulation for executive function of medication- resistant depression: Evidence from a randomized sham-controlled study

BACKGROUND

Even during symptomatic remission, many patients with medication resistant depression (MRD) still demonstrate impaired cognitive function, especially executive function (EF). Theta-burst transcranial magnetic stimulation (TBS) modulates cortical excitability and may treat MRD. Evidences from previous studies show that intermittent TBS (iTBS) produces cortical excitatory effects, while continuous TBS (cTBS) produces a reduction of cortical excitability. EF is highly dependent on prefrontal activity, but the effects of different forms of prefrontal TBS on EF remain unknown.

METHODS

60 MRD patients were recruited and randomly assigned to one of four groups. Treatment was determined by the group to which an individual was assigned; A: cTBS 1800pulses/session; B: iTBS 1800pulses/session; C: a combination of cTBS+iTBS, 1800pulses/session for each; and D: sham TBS. Wisconsin Card Sorting Test (WCST) for the performance of EF was evaluated before and after 10 daily treatment sessions

RESULTS

Repeated measures ANOVA, with each WCST index at baseline and 2weeks after TBS as within-subject factors, demonstrated that a statistically significant interaction of TBS groups (G) and antidepressant responses [(R), responses were defined as >50% reduction of depression scores after 2-weeks TBS treatment] on the before-versus-after changes of all WCST indexes (G×R, p<0.05). Responders in Group B, but not in the other groups, showed a significant improvement in WCST performance. Only nonresponders in Group A showed a trend for EF worsening.

CONCLUSIONS

Our findings showed that left prefrontal iTBS, not right prefrontal cTBS, improved EF, and this can be independent from its antidepressant effects.

Predicting Aggressive Tendencies by Visual Attention Bias Associated with Hostile Emotions

The goal of the current study is to clarify the relationship between social information processing (e.g., visual attention to cues of hostility, hostility attribution bias, and facial expression emotion labeling) and aggressive tendencies. Thirty adults were recruited in the eye-tracking study that measured various components in social information processing. Baseline aggressive tendencies were measured using the Buss-Perry Aggression Questionnaire (AQ). Visual attention towards hostile objects was measured as the proportion of eye gaze fixation duration on cues of hostility. Hostility attribution bias was measured with the rating results for emotions of characters in the images. The results show that the eye gaze duration on hostile characters was significantly inversely correlated with the AQ score and less eye contact with an angry face. The eye gaze duration on hostile object was not significantly associated with hostility attribution bias, although hostility attribution bias was significantly positively associated with the AQ score. Our findings suggest that eye gaze fixation time towards non-hostile cues may predict aggressive tendencies.

Abstract WP154: Bihemispheric Modulation of the Motor Cortex by Single-session Transcranial Direct Current Stimulation During Training in Subacute Stroke Patients

Introduction: Non-invasive transcranial direct current stimulation (tDCS) can induce polarity-specific changes in cortical excitability. Compared to unilateral anodal tDCS over the non-dominant motor cortex (M1), dual-hemispheric tDCS to the M1 may further accelerate motor reaction of the target hand and alter excitability of the corticospinal tract (CST). However, the effects and individual variability of bi-hemispheric tDCS to the M1 during motor training remain largely unclear in healthy and stroke subjects.

Purpose: We assessed the hypothesis that bi-hemispheric tDCS during single-session motor training alter inter-hemispheric inhibition, CST excitability and bilateral cortical oscillations.

Methods: We enrolled first-time, unilateral ischemic stroke patients between two and four weeks after stroke and matched healthy controls. They were subjected to two 20 min-sessions of dual-hemispheric tDCS (anode over non-dominant or ipsilesional M1, cathode over dominant or contralesional M1; 2mA for 20 mins) and sham tDCS (2mA for 2 mins) in a randomized crossover design during repetitive extension of the non-dominant or paretic extensor carpi radialis muscle. We compared the post-stimulation changes of motor evoked potentials (MEPs), ipsilateral silent period (iSP), short interval intracoritcal inhibition (SICI), as well as resting and unilateral finger lifting-related cortical oscillations by magnetoencephalography (MEG).

Results: Compared to the sham tDCS, the dual-hemispheric tDCS significantly increased MEP amplitudes and reduced SICI at the anodal-stimulated M1, as well as decreased inter-hemispheric inhibition from the cathodal-stimulated M1 with shortened iSP for about 30 mins in healthy controls (n=8). In contrast, reduced MEP amplitudes were observed at the cathodal-stimulated M1. The tDCS effects on cortical oscillations and in stroke patients are currently under investigation.

Conclusions: Task-concurrent dual tDCS may enhance activity-dependent motor plasticity in subacute stroke.