Topographic electroencephalogram changes associated with psychomotor vigilance task performance after sleep deprivation

ObjectivesThe psychomotor vigilance task (PVT) is a widely used method for the assessment of vigilance after sleep deprivation (SDEP). However, the neural basis of PVT performance during SDEP has not been fully understood. In particular, no studies have investigated the possible relation between EEG topographical changes after sleep loss and PVT performance. The aim of the present study is to assess the EEG topographic correlates of PVT performance after SDEP.MethodsDuring 40 h of SDEP, 16 healthy male subjects were evaluated in four sessions performed at the same time (11:00 a.m. and 11:00 p.m.) of the first and second day with: (a) subjective sleepiness recordings by means of the Karolinska Sleepiness Scale (KSS); (b) EEG recordings (5 min eyes-open condition); and (c) PVT.ResultsSDEP induced a slowing of PVT reaction times (RTs), higher level of subjective sleepiness and an increase of delta, theta, alpha and beta 1 EEG activity. Only slowest PVT RTs were influenced by circadian factors, with longer RTs in the morning. Both fastest PVT RTs and KSS scores were positively correlated with post-SDEP changes in EEG theta activity, mainly in centro-posterior areas, but not with other EEG frequencies. KSS scores and PVT measures were also positively correlated.ConclusionsThese findings suggest that SDEP differently affects PVT variables, and that an increase in theta activity may be the principal EEG basis of the post-SDEP slowing of fastest PVT RTs. Similar neural mechanisms seem to underlie both performance deterioration to PVT and the increase of subjective sleepiness.     

Extreme sleepiness: quantification of EOG and spectral EEG parameters

Our earlier research has shown considerable increases of and intercorrelations between subjective sleepiness, alpha, theta, and delta power density of the EEG as well as slow rolling eye movements (SEM) during night-time, monotonous work tasks. The purpose of the present methodological study was to establish EEG-EOG criteria for extreme behavioral sleepiness. Medilog tape-recorders were used to record EEG and EOG on 5 males and 5 females during a 45 min visual vigilance test. Performance on the test was also recorded on the tape as well as experimenter-scored dozing off episodes (from TV supervision). The EEG was subjected to computerized spectral analysis in 7.5 s epochs, and the EOG was scored visually for slow eye movements in the same epochs. The epochs immediately preceding a hit, miss and dozing off differed significantly. There was most power density in the alpha, theta and delta bands and most SEM activity before dozing off episodes and least before hits. The power density and the SEM activity were significantly increased one whole minute before dozing off events and missed signals compared to hits. Just prior to the ultimate sleepiness, i.e., the dozing off, the SEM activity and the delta and theta power density were further increased, while alpha power density was at its maximum during the last three epochs before the dozing off. The response patterns of all subjects were rather homogeneous. In conclusion, behavioral sleepiness is systematically reflected in spectral EEG and EOG parameters and the results support attempts to use these variables to indicate sleepiness in active subjects in real life situations.     

EEG spectral power and sleepiness during 24 h of sustained wakefulness in patients with obstructive sleep apnea syndrome.

OBJECTIVE: This study investigated if obstructive sleep apnea syndrome (OSAS) may be associated with higher activity in different frequency bands of the EEG during a sustained wakefulness paradigm. METHODS: Twelve OSA patients and 8 healthy controls were studied with the Karolinska Drowsiness Test (KDT) and subjective ratings of sleepiness (VAS and KSS) conducted every hour during 24 h of sustained wakefulness. RESULTS: The waking EEG activity, mainly in the low (0.5-7.8 Hz) and fast (12.7-29.2 Hz) frequency band, increased as time awake progressed in both groups but more obviously in OSA patients. A similar pattern was observed for rated sleepiness in both groups. Moreover, VAS ratings of alertness were closely related to the awake theta, fast alpha and beta bands in controls but not in OSA patients. CONCLUSIONS: OSAS was associated with a wake-dependent increase in low (0.5-7.8 Hz) and fast (12.7-29.2 Hz) frequency range activity. Variations in behavioural sleepiness measured by VAS ratings closely reflect most of the waking EEG parameters in controls but not in OSA patients. SIGNIFICANCE: In a sustained wakefulness paradigm, higher activity in delta, theta and beta bands associated with OSAS indicates that OSA patients show marked signs of higher sleepiness and stronger efforts than controls to stay awake, even though they tend to underestimate their sleepiness.     

Subjective and objective sleepiness in the active individual

Eight subjects were kept awake and active overnight in a sleep lab isolated from environmental time cues. Ambulatory EEG and EOG were continuously recorded and sleepiness ratings carried out every two hours as was a short EEG test session with eyes open for 5 min and closed for 2 min. The EEG was subjected to spectral analysis and the EOG was visually scored for slow rolling eye movements (SEM). Intrusions of SEM and of alpha and theta power density during waking, open-eyed activity strongly differentiated between high and low subjective sleepiness (the differentiation was poorer for closed eyes) and the mean intraindividual correlations between subjective and objective sleepiness were very high. Still, the covariation was curvilinear; physiological indices of sleepiness did not occur reliably until subjective perceptions fell between "sleepy" and "extremely sleepy-fighting sleep"; i.e. physiological changes due to sleepiness are not likely to occur until extreme sleepiness is encountered. The results support the notion that ambulatory EEG/EOG changes may be used to quantify sleepiness.     

Construction and validation of the EEG analogues of the Karolinska sleepiness scale based on the Karolinska drowsiness test

ObjectiveSimple methods of sleepiness assessment are greatly needed for both fundamental research and practical applications. The Karolinska drowsiness test (KDT) was applied to construct physiological alertness scales and to validate them against such well-known instrument of subjective sleepiness assessment as the Karolinska sleepiness scale (KSS).MethodsSeven-min EEG recordings were obtained with 2-h interval from frontal and occipital derivations during the last 32–50 h of 44–61-h wakefulness of 15 healthy study participants. Occipital alpha-theta power difference and frontal and occipital scores on the 2nd principal component of the EEG spectrum were calculated for each one-min interval of 5-min eyes closed section of the record.ResultsTo obtain scores (from 0 to 5) on alertness scales for each of these EEG indexes, all positive one-min values of the index were assigned to 1, and all remaining (negative) values were assigned to 0. Scores on any of the physiological alertness scales were found to be strongly associated with KSS scores.ConclusionPhysiological analogues of KSS were offered by utilising the EEG recordings on eyes closed interval of KDT.SignificanceThe constructed physiological scales can help in improving validity and user-friendliness of the field and laboratory methods of quantification of drowsy state.     

Sleepiness on the job: continuously measured EEG changes in train drivers

Eleven train drivers participated in the study during 1 night and 1 day journey (4.5 h) over the same route. Their EEG, EOG and ECG were recorded on portable tape recorders. The EEG records were subjected to spectral analysis (FFT) and the EOG was scored visually for slow eye movements (SEMs). The results showed that rated sleepiness increased sharply during the night journey. A similar pattern was seen for spectral power density in the alpha band, SEM and, to a lesser extent, also for power in the theta and delta bands. Heart rate was low during the entire night drive. The day journey showed low values without any trend for all variables. The intra-individual correlations were very high between rated sleepiness and, particularly, alpha and theta power density, as well as SEM. Further analyses showed that most of the night time increases in EEG/EOG parameters were confined to the 6 most sleepy subjects. Among these, 4 admitted to dozing off during the night drive and 2 of these 4 subjects failed to act on signals while exhibiting large bursts of alpha activity. It was concluded that EEG and EOG parameters closely reflect variations in sleepiness on the job and that these parameters, together with self-ratings, demonstrate that severe sleepiness may occur in train drivers during night work.     

Association between pupillary unrest index and waking electroencephalogram activity in sleep-deprived healthy adults

ObjectiveIn recent years there has been growing interest in the use of pupillography as an objective and time-saving method to assess the level of sleepiness. The aim of our study was to further elucidate the validity of pupillography by investigating the association of pupillometric variables with subjective sleepiness and waking electroencephalogram (EEG) activity.MethodsThe level of sleepiness of 24 young healthy adults was evaluated during 40 h of sustained wakefulness using pupillography and subjective ratings with the Stanford sleepiness scale and a visual analog scale (VAS). During the assessment of sleepiness by pupillography, waking EEG was simultaneously recorded and subjected to spectral analyses. As a pupillographic measure of sleepiness the pupillary unrest index (PUI) was calculated.ResultsPUI, subjective sleepiness, and power in the δ, θ, α1, β1, and β3 frequency band exhibited significant variations over time. PUI showed a prominent circadian modulation under high homeostatic sleep pressure. At time points of maximum PUI indicating a high level of sleepiness, significant increases were found in subjective sleepiness as well as in δ, θ, α1, and β1 power. Moreover, PUI showed a significant, high intraindividual correlation with subjective sleepiness and with power in the δ, θ, and α1 frequency band.ConclusionThe novel finding of a close association between pupillometric variables and distinct changes in waking EEG activity underscores the validity of pupillography as a time- and cost-efficient objective measure of sleepiness that could ease the diagnostic and therapeutic workup of patients who report excessive daytime sleepiness.     

The effects of asking for verbal ratings of sleepiness on sleepiness and its masking effects on performance.

OBJECTIVE: This study investigated whether verbal rating sleepiness will itself affect sleepiness and performance. METHODS: Thirteen healthy male volunteers (mean age, 26.9 years) performed two 40-min vigilance tests, one of which involved verbal ratings every 4min using the Karolinska sleepiness scale and another of which did not involve any ratings during the test. RESULTS: Repeated rating of sleepiness significantly reduced post-test sleepiness and improved the subjective perception of performance, and also reduced alpha power density (i.e., a physiological indicator of sleepiness). However, performance was not improved by the ratings. CONCLUSIONS: The act of rating affects subjective and EEG measures of sleepiness. Presumably this occurs through the modest stimulation involved in this act. SIGNIFICANCE: Methodologically one should be aware of subtle effects of the rating situation on sleepiness. From a practical point of view, it would be important for safety management since subjective sleepiness and performance are easily dissociated, which might interfere with risk perception.     

Electroencephalography and subjective ratings of sleep deprivation

BACKGROUND AND PURPOSE: Sleep-related vehicle accidents account for many injuries and fatalities each year on monotonous motorways and roads. To effectively prevent such incidents requires greater knowledge of the mechanisms and development of the effects of sleep deprivation. Ten volunteers participated in a laboratory study aimed to analyze the way changes in wakefulness were described in terms of EEG changes and subjective ratings. PATIENTS AND METHODS: For each subject, the study consisted of four testing sessions that varied in length on different days: one session each of 60, 90, and 120 min when sleep-deprived, and one session of 120 min when rested. Changes in wakefulness were analyzed using electroencephalographic recordings and ratings on two different scales, the Karolinska Sleepiness Scale (KSS) and the Category-Ratio Scale (CR-10). RESULTS: The results indicate quite conclusively that significant changes in the perception of sleepiness occur during the first 60-90 min of sedentary, monotonous work. Beyond this time period, subjective and physiological changes remained constant throughout the rest of the 120-min period. CONCLUSION: In general, the subjective rating scales highly and significantly correlated with theta activity in both tired and rested states and with alpha activity in the rested state. Similar results were seen using both subjective rating scales.     

Spectral composition of NREM sleep in healthy subjects with moderately increased daytime sleepiness.

OBJECTIVE: This study addressed the relationship between daytime sleepiness and spectral composition of the preceding NREM sleep.METHODS: Nineteen healthy volunteers (mean age: 36.5 years; SD: 10.1) underwent polysomnography during two consecutive nights and the multiple sleep latency test (MSLT) on the following day. Daytime sleepiness was also assessed by the Epworth sleepiness scale (ESS). The sleep recordings were visually scored according to standard criteria. The quantitative sleep EEG analysis was performed using a fast Fourier transform routine. The sleep parameters were compared between subjects with short and long MSLT sleep latencies (cut-off=10 min) and between subjects with low and high ESS scores (cut-off=6 points).RESULTS: Subjects with short MSLT sleep latencies showed a reduced theta EEG activity. There was no evidence of reduced synchronization of sleep EEG in subjects with high ESS scores.CONCLUSIONS: Moderately increased daytime sleepiness as indicated by MSLT sleep latency less than 10 min is accompanied by decreased power of theta activity during NREM sleep indicating a deficit of sleep EEG synchronization.     

Effects of caffeine on electrophysiological and neuropsychological indices after sleep deprivation

Caffeine is regarded as a central nervous system (CNS) stimulant. The goal of this study was to analyze electrophysiological, motor, cognitive and behavioral changes produced by caffeine ingestion after sleep deprivation. Ten subjects were evaluated after sleep deprivation, comparing the ingestion of either 400 mg of caffeine or placebo, in a double-blind randomized study. The variables analyzed were: quantitative EEG, the event-related potential (ERP-P300) and cognitive responses. The most significant quantitative EEG results, which were characterized by moment x treatment interactions, were seen in alpha and theta relative power variables. A significant decrease in relative alpha and theta was observed in the caffeine group after sleep deprivation. In relation to caffeine stimulant effects, there were no significant differences in the other parameters.     

Computerized EEG frequency analysis: sensitivity and specificity in patients with focal lesions

We performed computerized EEG frequency analysis (C-EEGFA) in 69 controls and 20 patients with focal brain lesions and focally abnormal conventional EEGs. Individual channel EEG frequency analysis variables that were helpful in differentiating the 2 groups were absolute delta and theta band power, relative delta, theta, and alpha band powers, and median-power frequency. High-frequency beta band power (20 to 32 Hz) was not useful. Changes in EEG with age were seen only after age 50 and generally consisted of an increase in anterior alpha power, with no significant increase in slowing. Correlations of C-EEGFA variables with posterior alpha power were more significant than correlations with age. Calculating normative C-EEGFA data for 5 subsets of controls, each with a different amount of posterior alpha power, increased the sensitivity of the EEG frequency analysis test without altering the specificity. Even with this correction 2 of 20 patients with focal lesions and focally abnormal conventional EEGs had normal C-EEGFA studies. If these obvious focal lesions produced normal results, more subtle diseases might not be detected. A significant clinical utility of C-EEGFA remains to be proven.     

Alpha modulation of type 1 and type 2 hippocampal theta in the freely moving rat

In order to determine the brain sites involved in the noradrenergic modulation of hippocampal theta, the alpha2 agonist detomidine was infused into one of three brain sites in the freely moving animal: hippocampus, median raphe nucleus (MRN), or locus coeruleus (LC). Bilateral hippocampal recording electrodes were implanted in 45 animals. Infusions of detomidine into the hippocampus produced an attenuation of type 1 (movement) theta. Detomidine infused into the MRN produced a release of type 2 (immobility) theta, although having no effect on type 1 theta. No significant changes were noted in the hippocampal EEG activity following infusions of detomidine into the LC. Infusions of Xylocaine into each of the above brain sites were ineffective in eliciting changes in hippocampal EEG activity. No behavioral effects were noted following infusions of detomidine or Xylocaine. The present results suggest that the attenuation of type 1 theta occurs at the hippocampus, while the release of type 2 theta occurs at the MRN.     

Diurnal variations in alpha power density and subjective sleepiness while performing repeated vigilance tasks.

OBJECTIVE: Diurnal variations in EEG activity and subjectively rated sleepiness while performing repeated vigilance tasks were examined. METHODS: Nine diurnally active healthy males underwent repeated vigilance tasks at 08:00, 11:00, 14:00, 17:00 and 20:00 h. An electroencephalogram (EEG) was taken while the subjects performed the tasks with their eyes open. The alpha power spectra (8.6-13.3 Hz) of EEG was integrated. Subjectively rated sleepiness, reaction time and oral temperature were also measured. RESULTS: Significant diurnal variations were found for alpha power, subjectively rated sleepiness and oral temperature. The alpha power was significantly smaller at 08:00 than at 11:00, 14:00, 17:00 and 20:00 h. The subjectively rated sleepiness was significantly larger at 08:00 than at 11:00, 17:00 and 20:00 h. The diurnal variation in alpha power did not correspond to that in subjectively rated sleepiness. On the other hand, repeated vigilance tasks increased the alpha power, subjectively rated sleepiness and reaction time at each time of day. The increase in alpha power was significantly greater at 14:00 than at 08:00 and 20:00 h. CONCLUSIONS: The diurnal variation was found in alpha power while performing vigilance tasks. Furthermore, the increase in alpha power with repetition of the task depended on the time of day.     

EEG theta rhythm in infants and preschool children.

OBJECTIVE: To study behavioral correlates of theta oscillations in infants and preschool children. METHODS: EEG was recorded during baseline (visual attention) and two test conditions--exploration of toys and attention to 'social' stimulation. Age specific frequency boundaries of theta and mu rhythms were assessed using narrow bin analysis of EEG spectra. RESULTS: Theta spectral power increased whereas mu power decreased under test conditions in both age groups. In preschoolers theta rhythm increased predominantly over anterior regions during exploratory behavior and over posterior regions during attention to social stimulation. Theta frequency range changed with age from 3.6 to 5.6 Hz in infants to 4-8 Hz in children, and mu range from 6.4-8.4 Hz to 8.4-10.4 Hz. CONCLUSIONS: In early life, theta oscillations are strongly related to behavioral states with substantial attentional and emotional load. The scalp distribution of theta spectral power depends on age and behavioral condition and may reflect engagement of different brain networks in control of behavior. SIGNIFICANCE: The findings contribute to the scanty knowledge about the developmental course of theta rhythm. Data on behavioral correlates of theta rhythm in early life may improve our understanding of cognitive and mental processes in healthy and neuropsychiatrically diseased children.     

Neurophysiological correlates of residual inhibition in tinnitus: Hints for trait-like EEG power spectra

ObjectiveTo investigate oscillatory brain activity changes following acoustic stimulation in tinnitus and whether these changes are associated with behavioral measures of tinnitus loudness. Moreover, differences in ongoing brain activity between individuals with and without residual inhibition (RI) are examined (responders vs. non-responders).MethodsThree different types of noise stimuli were administered for acoustic stimulation in 45 tinnitus patients. Subjects resting state brain activity was recorded before and after stimulation via EEG alongside with subjective measurements of tinnitus loudness.ResultsDelta, theta and gamma band power increased, whereas alpha and beta power decreased from pre to post stimulation. Acoustic stimulation responders exhibited reduced gamma and a trend for enhanced alpha activity with the latter localized in the right inferior temporal gyrus. Post stimulation, individuals experiencing RI showed higher theta, alpha and beta power with a peak power difference in the alpha band localized in the right superior temporal gyrus. Neither correlations with behavioral tinnitus measures nor stimulus-specific changes in EEG activity were present.ConclusionsOur observations might be indicative of trait-specific forms of oscillatory signatures in different subsets of the tinnitus population related to acoustic tinnitus suppression.SignificanceResults and insights are not only useful to understand basic neural mechanisms behind RI but are also valuable for general neural models of tinnitus.     

An integrative approach to determine the best behavioral and biological markers of methylphenidate

AIMS: To distinguish the most sensitive markers of methylphenidate (MPH) effects on behavior and underlying biology using an integrated cognitive and brain function test battery. METHODS: A randomized placebo-controlled trial with 32 healthy adult males. Subjects were tested on MPH doses across 18 sessions with subjective mood, objective behavioral and biological endpoints. From a computerized battery of tests, behavioral measures were cognitive performance scores, while biological measures of brain function included electroencephalographs (EEG) and event-related potentials (ERPs) with complementary measures of autonomic arousal. Using mixed modeling analyses; we determined which measures were most affected by MPH dose and correlation analyses determined the associations among them. RESULTS: MPH dose had the most pronounced effect on cognitive performance (sustained attention/vigilance), baseline autonomic arousal (heart rate, blood pressure) and baseline brain activity (EEG theta power). The faster reaction time, reduced errors, increased autonomic arousal and reductions in theta showed strong to moderate inter-correlations. MPH least affected subjective mood measures and early sensory ERP components. DISCUSSION: These findings suggest that MPH increases cortical and autonomic arousal, facilitating vigilance. The combination of behavioral and biological measures may provide an objective set of markers of MPH response. INTEGRATIVE SIGNIFICANCE: This approach has provided additional insight into the mechanism of the stimulant medication, MPH, which would not be achieved by using such measures in isolation.     

Electroencephalogram and evoked potential parameters examined in Chinese mild head injury patients for forensic medicine

Objective To evaluate the usefulness of quantitative electroencephalogram （QEEG）, flash visual evoked potential （F-VEP） and auditory brainstem responses （ABR） as indicators of general neurological status. Methods Comparison was conducted on healthy controls （N=30） and patients with brain concussion （N=60） within 24 h after traumatic brain injury. Follow-up study of patient group was completed with the same standard paradigm 3 months later. All participants were recorded in multi-modality related potential testing in both early and late concussion at the same clinical setting. Glasgow coma scale, CT scanning, and physical examinations of neuro-psychological function, optic and auditory nervous system were performed before electroencephalogram （EEG） and evoked potential （EEG-EP） testing. Any participants showed abnormal changes of clinical examinations were excluded from the study. Average power of frequency spectrum and power ratios were selected for QEEG testing, and latency and amplitude of F-VEP and ABR were recorded. Results Between patients and normal controls, the results indicated： （1） Highly significance （P 〈 0.01） in average power of α1 and power ratios of θ/α1, 0/α2, α1/α2 of EEG recording; （2） N70-P 100 amplitude of F-VEP in significant difference at early brain concussion; and （3） apparent prolongation of Ⅰ～Ⅲ inter-peak latency of ABR appeared in some individuals at early stage after concussion. The follow-up study showed that some patients with concussion were also afflicted with characteristic changes of EEG components for both increments of α1 average power and θ/α2 power ratio after 3 months recording. Conclusion EEG testing has been shown to be more effective and sensitive than evoked potential tests alone on detecting functional state of patients with mild traumatic brain injury （MTBI）. Increments of α1 average power and θ/α2 power ratio are the sensitive EEG parameters to determining early concussion and evaluating outcome of postconcussion symptoms （PCS）. Follow-up study associated with persistent PCS may be consistent with the postulate of substantial biological, rather than psychological origin. The study suggests that combination of EEG and EP parameters can contribute to the evaluation of brain function as a whole for clinical and forensic applications.     

Effects of stimulant medications on children with attention-deficit/hyperactivity disorder and excessive beta activity in their EEG.

OBJECTIVE: This study investigated the effects of stimulant medications on the Electroencephalography (EEG) of children with the combined type of attention-deficit/hyperactivity disorder (ADHD) together with excessive beta activity in their EEG. METHODS: Twenty ADHD and 20 control subjects participated in this study. EEG was recorded from 21 sites during an eyes-closed resting condition and Fourier transformed to provide estimates for total power and absolute and relative power in the delta, theta, alpha and beta bands, and for the theta/alpha and theta/beta ratios. Subjects were placed on a 6-month trial of a stimulant medication and a second EEG was recorded at the end of the trial. RESULTS: The unmedicated ADHD group had greater absolute and relative beta, less absolute and relative alpha, a higher theta/alpha and a lower theta/beta ratio than the control group. In the frontal regions the ADHD group had an increase in total power, absolute theta, absolute and relative beta and the theta/beta ratio, with greater relative delta, relative theta, and absolute and relative alpha in posterior regions. With medication use, absolute beta activity and frontal total power decreased, although these changes represented a reduction in power, not a normalisation. CONCLUSIONS: These results indicate that ADHD children with excessive beta activity in their EEG are probably not hypoaroused as previously suggested, and that beta activity in these children is probably only associated with the impulsivity and/or hyperactivity aspects of the disorder, but may not necessarily be associated with inattention. SIGNIFICANCE: This study is the first to investigate effects of stimulant medications on the EEG of ADHD children with excessive beta activity in their EEG.     

Task-related EEG and ERP changes without performance impairment following a single dose of phenytoin.

OBJECTIVES: The acute effects of a single, low dose of phenytoin on behavioral and neurophysiological measures of cognitive function were examined in healthy adults.METHODS: Electroencephalograms (EEGs) were recorded from 7 healthy volunteers while they performed spatial working memory tasks and while they rested quietly. Behavioral measures, EEG power spectra, and event-related potentials (ERPs) were compared between separate sessions in which subjects ingested either 10mg/kg of phenytoin or placebo.RESULTS: Peak serum levels of phenytoin were in the low therapeutic range. Although participants reported subjective effects of the drug, task accuracy and response time were not affected. In the resting EEG, phenytoin decreased power in the alpha band. In the task-related EEG, the frontal midline theta signal was enhanced in response to increased task difficulty following placebo but not following phenytoin. An attention-related augmentation of the N160 ERP to matching stimuli was also reduced by phenytoin.CONCLUSIONS: Neurophysiological measures displayed sensitivity to subtle alterations in attentional processing even in response to a dose of phenytoin too low to produce behavioral impairment. Such results indicate that EEG and ERP measures can provide information about the neurocognitive side effects of medications that cannot be inferred from cognitive task performance measures alone.