Modafinil improves information processing speed and increases energetic resources for orientation of attention in narcoleptics: Double-blind, placebo-controlled ERP studies with low-resolution brain electromagnetic tomography (LORETA)

Background and purposeRecent neuroimaging studies in narcolepsy discovered significant gray matter loss in the right prefrontal and frontomesial cortex, a critical region for executive processing. In the present study, event-related potential (ERP) low-resolution brain electromagnetic tomography (LORETA) was used to investigate cognition before and after modafinil as compared with placebo.Patients and methodsIn a double-blind, placebo-controlled cross-over design, 15 patients were treated with a 3-week fixed titration scheme of modafinil and placebo. The Epworth Sleepiness Scale (ESS), Maintenance of Wakefulness Test (MWT) and auditory ERPs (odd-ball paradigm) were obtained before and after the 3 weeks of therapy. Latencies, amplitudes and LORETA sources were determined for standard (N1 and P2) and target (N2 and P300) ERP components.ResultsThe ESS score improved significantly from 15.4 (± 4.0) under placebo to 10.2 (± 4.1) under 400 mg modafinil (p = 0.004). In the MWT, latency to sleep increased nonsignificantly after modafinil treatment (11.9 ± 6.9 versus 13.3 ± 7.1 min). In the ERP, N2 and P300 latencies were shortened significantly. While ERP amplitudes showed only minor changes, LORETA revealed increased source strengths: for N1 in the left auditory cortex and for P300 in the medial and right dorsolateral prefrontal cortex.ConclusionLORETA revealed that modafinil improved information processing speed and increased energetic resources in prefrontal cortical regions, which is in agreement with other neuroimaging studies.     

Brain regions activated during an auditory discrimination task in insomniac postmenopausal patients before and after hormone replacement therapy: low-resolution brain electromagnetic tomography applied to event-related potentials

Electrical sources of auditory event-related potentials (ERPs) determined by means of low-resolution brain electromagnetic tomography (LORETA) in 48 unmedicated insomniac postmenopausal patients aged between 46 and 67 years were compared with those obtained in 48 age-matched normal female controls. Subsequently, the patients were included in a double-blind, placebo-controlled, comparative, randomized 3-arm trial phase - Climodien 2/3 [estradiol valerate (EV) 2 mg + the progestin dienogest 3 mg] was compared with EV 2 mg and placebo - followed by an open-label phase in which all of them received Climodien 2/2 (EV 2 mg + dienogest 2 mg). The double-blind and the open-label phase lasted 2 months. ERPs were recorded from 19 EEG leads in a two-tone oddball paradigm and electrical sources of standard N1 and P2 as well as target N2 and P300 components were estimated. In both patients and controls, LORETA revealed an activation of the superior temporal gyrus [auditory cortex, Brodmann areas (BA) 41, 42, 22] for all four components. For standard P2, an additional activation was observed medially parietally in the precuneus (BA 7, 5). For target N2, also a medial frontal source (BA 9, 10, 32) was identified. Finally, for the target P300 component - in addition to the aforementioned sources - activations in the prefrontal cortex (BA 9, 10, 46, 47), the inferior parietal cortex (supramarginal gyrus, BA 40, 39) and the posterior cingulum (BA 31) were found. Thus, patients and controls did not differ in the structural processes engaged in these fundamental aspects of information processing. However, patients demonstrated significantly reduced source strength - for standard ERP components predominantly in the temporal lobe and for target components predominantly in the frontal lobe, indicating reduced energetic resources available for perceptual and cognitive demands of the discrimination task. While, as compared with placebo, estrogen alone had only minor effects on ERP source strength, Climodien generally increased the impressed current density at the ERP peak latencies, predominantly in the temporal lobe, indicating an increased stimulus-induced cortical arousal in the primary and higher-order auditory cortex. Specifically, Climodien enhanced P300 source strength in the left middle temporal gyrus and in the left superior frontal gyrus, brain regions that on the one hand have been shown to be affected by hormone therapy in positron emission tomography and functional magnetic resonance neuroimaging studies and that on the other hand are among those critical for encoding and memory processes.     

Relationships between auditory event‐related potentials and mood state,medication, and comorbid psychiatric illness in patients with bipolar disorder

Background: Patients with bipolar disorder (BD) exhibit aberrations in auditory event‐related potentials (ERPs), although the relationships between these measures and mood state at testing, comorbid psychiatric illness, presence of psychotic features, and medication usage are unclear. The purpose of this study was to investigate the relationships between these factors and auditory ERP measures in BD patients. Methods: An auditory ‘oddball’ discrimination task was used to elicit ERPs from 69 patients with type I BD and 52 healthy controls. Patients were placed into subgroups based upon their mood state at testing (euthymic or symptomatic), and ANOVA was used to compare amplitude and peak latency measures from the N100, P200, N200, and P300 ERP components across subgroups. Multiple regression was used to investigate relationships between ERP measures and comorbid psychiatric diagnosis, history of psychotic features, and medication status. Results: Relative to healthy control participants, euthymic and symptomatic BD patients exhibited reduced P300 and P200 amplitude, but ERP measures did not differ among BD patients on the basis of mood status. A history of a comorbid anxiety disorder was associated with reduced N200 peak latency, but prolonged P300 peak latency among BD patients. No other relationships between clinical variables and ERP measures were significant. Conclusions: The results suggest that disrupted auditory attention may be observed in BD patients regardless of their mood state at testing, medication status, or history of psychosis. These results extend previous findings, and provide further evidence for aberrations in the P300 ERP as an endophenotype for BD.     

ERPs associated with and without an "orienting reflex" in patients with schizophrenia.

In this study, we measured traditional late components of the Event Related Potential (ERP: N 100, P 200, N 200 and P 300) in a conventional auditory oddball paradigm, but additionally and simultaneously assessed electrodermal "orienting reflexes (ORs)" in 40 patients with schizophrenia and 40 age and gender matched normal controls. The single epoch ERPs that did and did not evoke an OR, were sub-averaged separately. The control subjects (but not the patient group), revealed delayed P 300 latency in the ERP sub-averages without ORs (ERP-OR), compared with ERP sub-averages with ORs (ERP+OR). Between-group analysis showed reduced N 100, N 200 and P 300 amplitudes (as well as delayed P 300 latency) in the ERP+OR sub-average in patients with schizophrenia. In the ERP-OR sub-average, the patient group also had smaller N 100, N 200 and P 300 amplitudes, but larger P 200 amplitude (compared with normal controls). This study shows the potential to tease out physiologically based OR sub-processes, by simultaneous acquisition and analysis of ERPs and autonomic electrodermal activity. Such ERP sub-averages (based on autonomic responses) highlight that multiple processes overlap across the trial, and their delineation may elucidate more specific patterns of disturbance in schizophrenia, than traditional averaged measures.     

Cognition and event-related potentials in adult-onset non-demented myotonic dystrophy type 1

ObjectiveTo clarify the cognitive and event-related potentials (ERPs) profiles of adult-onset genetically-proven non-demented myotonic dystrophy type 1 (DM1).MethodsFourteen DM1 patients and matched 14 normal controls were enrolled. DM1 patients were compared with normal controls, using a variety of neuropsychological tests; an auditory “oddball” counting paradigm for the ERPs, and low-resolution brain electromagnetic tomography (LORETA). For patients, ERPs and neuropsychological parameters were correlated with CTG repeat size, duration of illness, grip strength, and arterial blood gas analysis.ResultsFrontal lobe dysfunction, prolonged N1 latency, and attenuated N2/P3 amplitudes were observed in DM1. Longer CTG repeat size was associated with fewer categories achieved on Wisconsin Card Sorting Test. Greater grip strength was associated with better scores on color-word “interference” of Stroop test. P3 latency was negatively correlated with PaO₂. LORETA revealed significant hypoactivities at the orbitofrontal and medial temporal lobe, cingulate, and insula. There was no correlation between ERPs and CTG expansion.ConclusionsAdult-onset non-demented DM1 presented frontal lobe dysfunction. Absence of correlations between CTG repeat size and objective ERP parameters suggested CTG expansion in lymphocytes does not directly contribute to cognitive dysfunction.SignificanceCTG expansion in lymphocytes does not directly contribute to cognitive dysfunction of adult-onset non-demented DM1.     

Cerebrovascular accident alters P300 event-related potential characteristics

P300 event-related potentials to counted (target) and uncounted (background) visual stimuli were recorded from subjects who had sustained either a right or a left middle cerebral artery cerebrovascular accident (CVA) and from appropriate normal control subjects. Subjects were asked to count target stimuli and to ignore non-target stimuli. Standard measurements of the amplitude and latency of P300 components as well as intercorrelations among P300 wave forms from 3 brain regions (Fz, Cz, Pz) were collected. Amplitudes of N1-P2 and N2-P3 components as well as overall amplitude of the ERP wave form were reliably reduced by a CVA, but component latencies were not significantly affected. The amplitude reduction associated with a CVA cannot be simply interpreted as evidence for reduced cognitive efficiency because overall amplitudes and intercorrelations between brain regions of CVA patients were reduced for both counted and uncounted stimuli. The intercorrelations between brain regions were particularly reduced if the CVA was localized in the right hemisphere. For CVA patients, reduced component amplitudes may reflect decreased cortical intercommunication associated with damage to subcortical brain structures.     

Electrophysiological basis for the ability of olanzapine to improve verbal memory and functional outcome in patients with schizophrenia: a LORETA analysis of P300

Abnormality of P300 waveforms of event-related potentials (ERPs) has been suggested to represent an aspect of the pathophysiology of schizophrenia. Previous work points to the contribution of altered neural function in discrete brain regions in the left hemisphere to psychotic symptoms and cognitive deficits of schizophrenia. In this study, we sought to determine: 1) if patients with schizophrenia elicit a decreased P300 current source density in brain areas, such as the superior temporal gyrus (STG); 2) if decreased P300 generator density in the left STG is recovered by treatment with the most widely-used antipsychotic drug olanzapine; and 3) if the recovery of P300 source density is associated with improvements of cognitive and functional status. P300 in response to an auditory oddball task, as well as verbal learning memory, psychopathology, and quality of life were evaluated in 16 right-handed patients with schizophrenia before and after treatment with olanzapine for 6 months. ERP data were also obtained from 16 right-handed age and gender-matched normal volunteers. Low resolution electromagnetic tomography (LORETA) analysis was used to obtain current density images of P300. Patients with schizophrenia showed significantly smaller LORETA values in several brain regions in the left side, particularly STG, middle frontal gyrus, and precentral gyrus, compared with control subjects. Six-month treatment with olanzapine significantly increased P300 source density only in the left STG. Positive symptoms, negative symptoms, verbal learning memory, and quality of life were also improved during treatment. Significant correlations were found between the increase in LORETA values of left STG vs. improvements of negative symptoms, as measured by Scale for the Assessment of the Negative Symptoms, and verbal learning memory, as measured by the Japanese Verbal Learning Test. Improvement of quality of life, as evaluated by the Quality of Life Scale, were significantly associated with an increase in LORETA values of middle frontal gyrus, and tended to correlate with that of precentral gyrus. The results of this study suggest that changes in cortical activity, as measured by ERPs, are responsible for the ability of some antipsychotic drugs to improve cognition and functional outcome in patients with schizophrenia.     

Effect of acute deep brain stimulation of the subthalamic nucleus on auditory event-related potentials in Parkinson's disease

ObjectiveThe analysis of long-latency event-related potentials (ERPs) is an important approach in the evaluation of certain cognitive functions, particularly selective attention, and in following their subsequent changes. Auditory P300 has previously been reported to be abnormal in patients with Parkinson's disease (PD). The aim of this study was to investigate whether acute deep brain stimulation (DBS) of the subthalamic nucleus (STN) itself can cause changes in the configuration of ERPs.MethodUsing a standard auditory oddball paradigm, we elicited ERPs in 10 patients with PD (in both DBS-ON and DBS-OFF conditions). The patients acted as their own controls. The N100, P200, N200 and P300 latencies, amplitudes and areas were compared between DBS-ON and DBS-OFF states. The motor reaction times were also recorded and compared between the two states.ResultsComparison of the DBS-ON and DBS-OFF states revealed that neither amplitudes nor areas of the ERP components changed significantly; however, significant changes were observed in the latency of N100 potential when the target stimulus was applied, although there was no significant change in the latency of the P300 potential. No significant changes were noted in the latencies of the other observed ERP components. There was a marked improvement in the reaction time after the DBS electrode was turned ON.ConclusionOur data indicate that DBS might have varied impacts on electrophysiological parameters during the auditory oddball paradigm. Moreover, it may also worsen the orientation response as reflected by the increase in the N100 latency after the DBS electrode is turned ON.     

P300 event-related potential in epileptic children and adolescents

P300 is a manifestation of activity in a limited capacity system "whose use in the service of different tasks is under relative control by instruction". It is accepted as an objective correlate of mental processing involved in the allocation of attentional resources when immediate memory is engaged. The aim of this study was to evaluate cognitive function in epileptic children and adolescents. We applied the "auditory oddball" paradigm to elicit event-related potentials (ERPs) according to the IFCN recommendation standards. ERPs were studied in fifteen patients with generalized epileptic seizures at matched age (8-18 years) (mean 13.8 +/- 2.4 y). 50 neurologically normal children were used as a control group. ERP were averaged with a Multiliner (Toennies, Germany) equipment. The method included two different tones for frequent and for rare stimuli generated at random. The tones were presented binaurally through headphones. ERPs were recorded at Fz, Cz and Pz according to the International 10-20 system. ERPs for target and non-target stimuli were averaged separately. The major positive peak between 250 and 500 ms for the rare tones was regarded as the cognitive evoked potential (P300). Latency values were obtained from the intersection of extrapolated lines from the ascending and descending slopes of each peak. The latencies of the N1, P2, N2 and P300 waves were determined for each subject, as well as peak to peak amplitudes of N1-P2, P2-N2, N2-P300. Auditory event related potential may be helpful procedures used in objective evaluation of cognitive function in patients with epilepsy.     

Auditory event-related potentials in obstructive sleep apnea: effects of treatment with nasal continuous positive airway pressure.

Event-related potentials (ERPs) were recorded in 47 patients with obstructive sleep apnea (OSA) syndrome prior to and after 6 weeks of treatment with continuous positive airway pressure (CPAP). Compared with a control group, the OSA patients showed ERP abnormalities: lengthened P3 latencies and decreased N2-P3 amplitudes. After 6 weeks of CPAP treatment, there was a highly significant improvement in the abnormal ERPs: the P3 and N2 latencies were shortened, but remained longer than in controls, and the N2-P3 and N1-P2 amplitudes were increased. No correlations could be established with various sleep variables. ERPs may be used as an electrophysiological marker of brain dysfunction; treatment of OSA with CPAP is probably responsible for functional brain modifications. On the other hand, possible relationships between the ERP abnormalities and the neuropsychological disorders observed in OSA remain to be established.     

N200 latency and P300 amplitude in depressed mood post-traumatic brain injury patients

In order to examine the independent and combined effects of depressive symptoms and traumatic brain injury on event-related potential (ERP) components, we classified traumatic brain injury (TBI) patients as depressed and non-depressed mood according to their scores on the Zung Self-rating Depression Scale (SDS). Non-depressed mood post-traumatic brain injury patients (NondepTBI, n=9), depressed mood post-traumatic brain injury patients (DepTBI, n=26), and normal healthy control subjects (HC, n=10) were assessed for N100, N200, and P300 latencies and amplitudes by the auditory "oddball paradigm". DepTBI subjects had significantly prolonged N200 latency and low P300 amplitude compared with the NondepTBI and HC groups. A longer P300 latency in the NondepTBI and DepTBI than in the HC groups was found. A prolongation of N200 latency accompanied by low P300 amplitude may be a characteristic of post-traumatic brain injury patients with depressed mood. Prolonged P300 latency may be more closely associated with TBI than with depression, as it was significantly greater in both the DepTBI and NondepTBI, than in the HC group.     

P300 event-related potentials and cognitive function in social phobia

The aim of the study was to investigate abnormalities of event-related potentials (ERPs) in social phobia patients indicating deficits in speed and amount of perceptual and cognitive resources as well as relationships between ERPs and cognitive functioning. ERPs were recorded from 19 EEG leads in a two-tone oddball paradigm in medication-free patients with DSM-IV social phobia (n=25) and in age- and sex-matched healthy controls (HC). Neuropsychological test performance was administered. Compared with the HC group, patients with social phobia showed reductions in N1 at temporal leads, N2 and P300 amplitudes, predominantly centroparietally, and longer P300 latencies. The observed P300 latency prolongation was associated with reduced Non-Verbal Learning Test (NVLT) but not the Wisconsin Card Sorting Test (WCST) scores. The reduction in N1 amplitude indicates an impairment in perceptual processing. The reduced P300 amplitudes may reflect reduced cognitive resources for the evaluation of relevant information. The increased P300 latency, indicating longer stimulus evaluation time, was correlated to deficits in learning processes as measured by the Non-Verbal Learning Test but not to executive function as measured by the Wisconsin Card Sorting Test. It may therefore be concluded that social phobia patients show deficits in cognitive information processing as reflected by ERPs.     

N200 latency and P300 amplitude in depressed mood post-traumatic brain injury patients

In order to examine the independent and combined effects of depressive symptoms and traumatic brain injury on event-related potential (ERP) components, we classified traumatic brain injury (TBI) patients as depressed and non-depressed mood according to their scores on the Zung Self-rating Depression Scale (SDS). Non-depressed mood post-traumatic brain injury patients (NondepTBI, n = 9), depressed mood post-traumatic brain injury patients (DepTBI, n = 26), and normal healthy control subjects (HC, n = 10) were assessed for N100, N200, and P300 latencies and amplitudes by the auditory “oddball paradigm”. DepTBI subjects had significantly prolonged N200 latency and low P300 amplitude compared with the NondepTBI and HC groups. A longer P300 latency in the NondepTBI and DepTBI than in the HC groups was found. A prolongation of N200 latency accompanied by low P300 amplitude may be a characteristic of post-traumatic brain injury patients with depressed mood. Prolonged P300 latency may be more closely associated with TBI than with depression, as it was significantly greater in both the DepTBI and NondepTBI, than in the HC group.     

Auditory event-related potential changes in chronic occupational exposure to organophosphate pesticides

ObjectiveTo determine whether chronic occupational exposure to organophosphates (OP) pesticides leads to cognitive impairment using event-related potentials (ERPs).MethodsERPs of 38 vegetable farmers applying OP pesticides and 35 controls were recorded using an auditory oddball paradigm. The N1, P2, N2 and P300 ERP components and the number of counting errors were compared between the groups.ResultsThe farmers made significantly more counting errors than controls in the oddball task. The mixed model ANOVA of component latencies revealed a significant component × group interaction, suggesting farmers had a greater delay in later ERP components. Intergroup comparisons of individual components showed significant delays in N2 and P300 latencies. Subsequent ANCOVA showed significant P300 delay even after adjusting for the latency of the preceding component, N2. Intergroup differences of P300 amplitudes were not significant, although there was limited evidence of a difference in scalp topography.ConclusionOur findings indicate that chronic low-level occupational exposure to OP pesticides is associated with progressively increasing delay in successive ERP components, particularly P300.SignificanceChronic exposure to OP pesticides may delay the neurophysiological processes underlying early stages of selective attention and late stages of sensory information processing that include stimulus evaluation and updating of working memory.     

Trait and state aspects of P300 amplitude reduction in schizophrenia: a retrospective longitudinal study.

BACKGROUND: The P300 component of the auditory event-related brain potential (ERP) is consistently reduced in schizophrenia. Longitudinal data are examined to determine whether P300 amplitude is a trait marker of schizophrenia or a state marker tracking clinical fluctuations over time. METHODS: Schizophrenic men (DSM-III-R) (n = 36) received ERP and the Brief Psychiatric Rating Scale (BPRS) assessments on multiple occasions, at varying intervals, under varying medication states. Automatically elicited auditory P3a and effortfully elicited auditory and visual P3b amplitudes were assessed. Brief Psychiatric Rating Scale scores were regressed on P300 amplitude within patients using both multiple regression models and nonparametric analyses of individual patient slopes. Event related brain potentials in patients were compared to ERPs from 34 age-matched control men, and stability of P300 over time was estimated with intraclass correlations. RESULTS: P300 amplitude, regardless of elicitation method or sensory modality, tracked BPRS Total and positive symptom scores over time, decreasing with symptom exacerbations and increasing with improvements. In addition, effortful auditory and visual P3b amplitudes tracked negative symptoms, and automatic auditory P3a tracked depression-anxiety symptoms. When analyses were limited to unmedicated occasions, auditory P3a and P3b persisted in tracking BPRS Total scores, with additional tracking of positive symptoms by P3b and mood symptoms by P3a. Mean auditory and visual P3bs, averaged over all measurement occasions for each individual, were inversely related to mean negative symptoms. Auditory P3a and P3b, but not visual P3b, amplitudes were smaller in patients than control subjects, even when patients were least symptomatic. P300 amplitudes showed high test-retest reliability in control subjects and patients and moderate stability over time in patients. CONCLUSIONS: Auditory, and possibly visual, P300 amplitudes track fluctuations in clinical state, but only auditory P300 amplitude is a trait marker of schizophrenia.     

Cognitive impairments in patients with first episode psychosis: The relationship between neurophysiological and neuropsychological assessments

Cognitive deficits in schizophrenia have been widely reported. Neurophysiological and neuropsychological assessments have been conducted to study these impairments. Event-related potentials (ERPs) are relevant markers of cognitive deficits in schizophrenia, and reductions in specific ERP components have been found. The MATRICS Consensus Cognitive Battery (MCCB) was developed to obtain a consensus battery for the assessment of cognitive deficits in schizophrenia. Here, we aimed to study modulations of several ERP components in first episode psychosis (FEP). We also examined neuropsychological deficits using the MCCB, and correlations between ERP and MCCB impairments. Thirty-eight FEP patients were compared to thirty-eight healthy controls. The following ERP components were examined: P1, N1, MMN, P2, early-P3 and late-P3. We used an auditory three-stimulus oddball paradigm, with standard (60%), target (20%) and distractor (20%) stimuli. FEP patients showed significantly lower amplitudes of P2, early-P3 and late-P3 components. FEP patients also showed significant deficits in all the MCCB cognitive domains. Finally, correlational analyses found strong associations between amplitudes of P2, early-P3 and late-P3 components and MCCB tests for attention and speed of processing. These findings indicate that deficits in late auditory ERP components are present in FEP, whereas early components are preserved. These reductions in late ERP components were related to attentional deficits in FEP as assessed by MCCB. These findings indicate that MCCB is a valid battery for studying cognitive impairments in the initial stages of schizophrenia, and highlight the utility of converging neurophysiological and neuropsychological measures to examine attentional impairments in schizophrenia.     

Effects of hormone replacement therapy on perceptual and cognitive event-related potentials in menopausal insomnia

The influence of a combined estrogen-progestin regimen (Climodien, Lafamme) on auditory event-related potentials (ERPs) was investigated in a double-blind, placebo-controlled, comparative, randomized 3-arm trial phase (Climodien 2/3=estradiol valerate 2 mg+the progestin dienogest 3 mg, EV=estradiol valerate 2 mg, and placebo), followed by an open-label phase in which all patients received Climodien 2/2 (estradiol valerate 2 mg+dienogest 2 mg). Both the double-blind and the open-label phase lasted 2 months. ERPs were recorded from 19 EEG leads in a two-tone odd-ball paradigm in 49 patients aged between 46 and 67 yr with the diagnosis of insomnia (G 47.0) related to postmenopausal syndrome (N 95.1). Climodien reduced standard N1 and target P300 latencies as compared to placebo, while EV did not affect N1 latency but similarly reduced P300 latency. Climodien increased N1, P2 and P300 amplitudes dose-dependently, predominantly at frontal leads. Estrogen alone had only minor effects on ERP amplitudes. The shortening of standard N1 latency and enhancement of N1 and P2 amplitudes indicates a positive effect of Climodien on perceptual processing, most likely due to vigilance improvements also observed in EEG mapping. Concerning target P300, it seems that estradiol is responsible for the improvement in stimulus evaluation time, as reflected by the shortening of the peak latency, while dienogest seems to account for the improvement in cognitive information processing capacity, whereby 3 mg induced a more pronounced augmentation of P300 amplitudes than 2 mg. Based on the spatial distribution of this increase, it can be speculated that Climodien mainly affects the more frontally distributed P3a subcomponent, which is associated with attention and orientation. Furthermore, the observed changes in ERP-components are consistent with recent studies showing significant positive effects of hormone replacement therapy on cholinergic functions. Thus, Climodien seems to be of interest in preventing cognitive decline and treating cognitive disorders in postmenopausal women. Indeed, there is increasing evidence of beneficial effects of estrogen in dementia. Our present findings suggest that the estrogen effects may be augmented by dienogest.     

Effects of risperidone on event-related potentials in schizophrenic patients

In order to examine the effects of risperidone on cognitive impairment in schizophrenia, event-related potentials (ERPs) were recorded before and after switching from conventional neuroleptics to risperidone in schizophrenic patients. ERPs were recorded during two auditory discrimination tasks (an oddball task and a distraction task) in 10 medicated schizophrenic patients during conventional neuroleptic and risperidone treatments. The amplitudes and latencies of N 100 and P300 component were measured in ERPs for target stimuli in the oddball task and in ERPs for target and novel stimuli in the distraction task. Although N 100 amplitude and latency and P 300 amplitude did not change significantly after switching the drug compared to that during conventional neuroleptic treatment, P 300 latency for target stimuli shortened significantly during risperidone treatment in both tasks, accompanied by the shortening of the reaction time in the distraction task. The P 300 latency change did not correlate with the change of the severity of psychopathology. These findings suggest that risperidone may speed the information processing in schizophrenic patients, contributing to the improvement of cognitive functions.     

Event-related potentials to intranasal trigeminal stimuli change in relation to stimulus concentration and stimulus duration.

Few data are available on the relation of EEG-derived trigeminal event-related potentials (ERPs) to stimulus duration or stimulus concentration. Thus, the aim of this study was to analyze the relation between ERP components and both stimulus duration and stimulus concentration. Twenty healthy young subjects participated. Trigeminal ERPs were recorded after stimulation with CO(2). Five concentrations (45 to 65% volume per volume CO(2)) and five stimulus durations (100 to 300 msec) were used. Trigeminal ERPs were quantified in terms of amplitudes and latencies of its major peaks N(410) (termed N1) and P(622) (termed P3). The relation between stimulus duration, concentration, and amplitudes or latencies of trigeminal ERP components could be described as a model of power, following the formula p = b + k.I g1.D(g2). A linear relationship was found between stimulus concentration, amplitude N1, and amplitude P3, and between stimulus duration and amplitude P3 respectively. Furthermore, a linear relationship was seen between intensity ratings, and stimulus duration and concentration. These data confirm that the different ERP components encode different stimulus characteristics. Specifically, later components of the trigeminal ERP encode not only stimulus concentration but, other than earlier ERP components, also encode stimulus duration. Thus, they reflect the integration of stimuli over relatively long periods of time.     

Predictors of course in obsessive-compulsive disorder

Event-related potentials (ERPs) have been widely examined in schizophrenic patients. However, although neuroleptic medication could be a potentially confounding variable, studies with unmedicated patients are relatively scarce. The present work was undertaken to determine whether ERP abnormalities persist in stabilized schizophrenic patients after drug withdrawal. In addition, ERP amplitudes and latencies were compared with clinical ratings (the Positive and Negative Syndrome Scale, PANSS) by means of Spearman rank order correlation coefficients. The P300 and N200 responses to rare tones and the P200 and N100 responses to frequent tones were recorded in 20 clinically stabilized drug-free schizophrenic patients and 19 age-matched control subjects during a two-tone discrimination task. Major findings were that the schizophrenic patients had reduced P300, N200 and N100 amplitudes and an increased P300 latency. The P300 amplitude was negatively correlated with age in patients. The P200 latency was negatively correlated with the PANSS positive syndrome score. The ERP abnormalities shown in this study appear to be enduring traits of the disorder as they persist in stabilized patients even after drug withdrawal.