The effects of body posture on resting electroencephalographic activity in sleep-deprived subjects.

OBJECTIVE: This study examined the effects of posture on the resting electroencephalographic (EEG) activity of sleep-deprived volunteers. METHODS: EEG data were collected under two conditions at 13 separate time points. Testing was performed while subjects remained in a normal seated position and then repeated while subjects stood upright. RESULTS: Results indicated that delta and theta activity progressively increased as a function of sleep loss, and that standing upright attenuated this effect. CONCLUSIONS: These results suggest that an upright posture increases EEG arousal and may be useful for counteracting fatigue in sleep-deprived individuals.     

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.     

How body position changes visual vertical perception after unilateral vestibular loss

Visual vertical perception, posture and equilibrium are impaired in patients with a unilateral vestibular loss. The present study was designed to investigate whether body position (standing upright, sitting on a chair and lying supine) influences the visual vertical perception in Menière's patients tested before and after a unilateral vestibular neurotomy. Data were compared with sex- and age-matched healthy participants. During the first postoperative month the body position strongly influences the visual vertical perception. The ipsilesional deviation of the visual vertical judgment gradually increased from standing upright to sitting and to lying supine. The present data indicate that visual vertical perception improves when postural control is more demanding. This suggests that postural balance is a key reference for vertical perception, at least up to one month after vestibular loss.     

Body position alters human resting-state: Insights from multi-postural magnetoencephalography

Neuroimaging researchers tacitly assume that body-position scantily affects neural activity. However, whereas participants in most psychological experiments sit upright, many modern neuroimaging techniques (e.g., fMRI) require participants to lie supine. Sparse findings from electroencephalography and positron emission tomography suggest that body position influences cognitive processes and neural activity. Here we leverage multi-postural magnetoencephalography (MEG) to further unravel how physical stance alters baseline brain activity. We present resting-state MEG data from 12 healthy participants in three orthostatic conditions (i.e., lying supine, reclined at 45°, and sitting upright). Our findings demonstrate that upright, compared to reclined or supine, posture increases left-hemisphere high-frequency oscillatory activity over common speech areas. This proof-of-concept experiment establishes the feasibility of using MEG to examine the influence of posture on brain dynamics. We highlight the advantages and methodological challenges inherent to this approach and lay the foundation for future studies to further investigate this important, albeit little-acknowledged, procedural caveat.     

Test-retest reliability of cognitive EEG.

OBJECTIVE: Task-related EEG is sensitive to changes in cognitive state produced by increased task difficulty and by transient impairment. If task-related EEG has high test-retest reliability, it could be used as part of a clinical test to assess changes in cognitive function. The aim of this study was to determine the reliability of the EEG recorded during the performance of a working memory (WM) task and a psychomotor vigilance task (PVT). METHODS: EEG was recorded while subjects rested quietly and while they performed the tasks. Within session (test-retest interval of approximately 1 h) and between session (test-retest interval of approximately 7 days) reliability was calculated for four EEG components: frontal midline theta at Fz, posterior theta at Pz, and slow and fast alpha at Pz. RESULTS: Task-related EEG was highly reliable within and between sessions (r0.9 for all components in WM task, and r0.8 for all components in the PVT). Resting EEG also showed high reliability, although the magnitude of the correlation was somewhat smaller than that of the task-related EEG (r0.7 for all 4 components). CONCLUSIONS: These results suggest that under appropriate conditions, task-related EEG has sufficient retest reliability for use in assessing clinical changes in cognitive status.     

Pharmaco-EEG and Psychometric study of the effect of single doses of temazepam and nitrazepam

A double-blind, daytime, placebo-controlled study was carried out in 12 healthy volunteers to investigate the effects of single doses of 5, 15 and 30 mg temazepam and of 5 and 10 mg nitrazepam on the EEG, psychomotor performance, subjective mental and emotional status, blood pressure and heart rate. Each subject received all 6 treatments in a random sequence at intervals of 1 week. The EEG tracings were evaluated quantitatively by spectral analysis. Psychomotor performance was assessed by means of the tapping test. Subjective mental and emotional status were assessed using the Bond and Lader analogue self-rating scale. Procedures were carried out before and at 1/2, 1, 2, 4, 6, 7, 8 and 9 h after drug administration, with the exception of the tapping test, which was carried out before and, again, after 2 and 7 h. EEG estimates of equipotency, based on magnitude of peak effect, were as follows: 15 mg temazepam approximately 5 mg nitrazepam; and 30 mg temazepam greater than or equal to 10 mg nitrazepam. At these approximately equipotent doses, temazepam had a somewhat earlier onset of action on the EEG, a clearly shorter duration of EEG action, and lesser impairment of psychomotor performance than nitrazepam. Qualitatively, both drugs had similar effects on the subjective mental and emotional states of the subjects. There were no clinically relevant changes in mean or individual sitting and standing blood pressure values. After temazepam, but not after nitrazepam, heart rate increased (maximal mean change 10 bpm) as part of a normal startle response to arousal. The results suggest that temazepam has less hangover potential than nitrazepam.     

Automated contingent reinforcement of correct posture

This study evaluated the effectiveness of a mercury switch as a self-monitoring device to improve the sitting posture of an adult male. The participant in this study was a 31 year old man who was blind, nonambulatory, and who had been classified in the moderate range of intellectual functioning and in the severe range of adaptive functioning due to physical impairments. After determining that music practice and listening to a game show on the television channel of a radio were powerful reinforcers, a multiple baseline across the two reinforcing activities was implemented. The participant wore a mercury switch inside of a baseball cap which activated a Casio keyboard during music practice and a radio during the independent leisure activity of listening to a game show. During the treatment condition, the keyboard and radio were activated automatically by upright sitting posture. Results indicated that the participant's sitting posture increased from an average of almost 0% correct upright posture during baseline to an average of 52% during treatment.     

Middle cerebral artery velocity during upright posture after marijuana smoking.

Marijuana is known to cause symptoms suggestive of orthostatic hypotension such as dizziness and fainting during upright posture. We examined changes in cerebral blood velocity (CBV) and peripheral circulation during upright posture after smoking marijuana in 10 right-handed male subjects with a previous history of exposure to marijuana. The participants were physically and mentally healthy and drug-free for a minimum of 3 months before the experiment. Middle cerebral artery CBV, blood pressure and pulse rate were recorded during reclining position and standing, before and after smoking a high-potency marijuana cigarette or a placebo cigarette administered during 2 separate visits to the laboratory. The participants were questioned about dizziness during the upright position. Six of 10 subjects reported moderate to severe dizziness during standing after marijuana but not placebo. Subjects who experienced severe dizziness during standing showed marked decreases in blood pressure and CBV. Those who reported moderate dizziness showed reduction in CBV but not blood pressure. Subjects who reported mild dizziness after marijuana and after placebo smoking showed minimal changes in blood pressure and CBV. Cerebral ischemia during upright position after marijuana smoking may be caused by hypotension and impaired cerebral autoregulation.     

Posture-dependent modulation of reciprocal inhibition upon initiation of ankle dorsiflexion in man

The present study tested whether soleus H-reflex depression recorded from normal subjects during isotonic ankle dorsiflexion is due to reciprocal inhibition and this might be modulated by varying postures. The soleus H-reflex amplitude of eight healthy adults was investigated at various times prior to and during tibialis anterior discharge while subjects were seated and when standing. Results showed that the amount of soleus H-reflex depression was significantly larger in the standing than that in the sitting posture in spite of the same dorsiflexion movement. Furthermore, the depression upon initiation of dorsiflexion movement appeared earlier in the standing than in the sitting. The results suggest that increasing amounts of reciprocal inhibition are correlated with and dependent upon the preceding postural conditions for voluntary movement, i.e., modulation of reciprocal inhibition seems to be dictated by the difference in functional demand between sitting and standing posture.     

Role of cerebral cortex in human postural control: an EEG study.

OBJECTIVE: It was our primary objective to provide evidence supporting the existence of neural detectors for postural instability that could trigger the compensatory adjustments to avoid falls. METHODS: Twelve young healthy subjects performed self-initiated oscillatory and discrete postural movements in the anterior-posterior (AP) directions with maximal range of motion predominantly at ankle joint. Movements were recorded by the system and included force plate and EMG, and EEG measures from 25 electrode sites. The center of pressure dynamics and stability index were calculated, and EEG potentials both in voltage and frequency domains were extracted by averaging and Morlet wavelet techniques, respectively. RESULTS: The initiation of self-paced postural movement was preceded by slow negative DC shift, similar to movement-related cortical potentials (MRCP) accompanying voluntary limb movement. A burst of gamma activity preceded the initiation of compensatory backward postural movement when balance was in danger. This was evident for both oscillatory and discrete AP postural movements. The spatial distribution of EEG patterns in postural actions approximated that previously observed during the postural perceptual tasks. CONCLUSIONS: The results suggest an important role of the higher cortical structures in regulation of posture equilibrium in dynamic stances. Postural reactions to prevent falls may be triggered by central command mechanisms identified by a burst of EEG gamma activity. SIGNIFICANCE: The results from this study contribute to our understanding of neurophysiological mechanisms underlying the cortical control of human upright posture in normal subjects.     

Postural effects on brain hemodynamics in unilateral cerebral artery occlusive disease: a positron emission tomography study.

To investigate effect of assuming of upright posture on brain hemodynamics in patients with unilateral internal carotid or middle cerebral artery occlusion (MCAO), local tissue oxygen extraction fraction (OEF), and postural changes in regional cerebral blood flow (rCBF) during supine and sitting conditions were examined using positron emission tomography (PET) with (15)O-gas steady-state method and H(2)(15)O autoradiographic method. A total of 22 minor stroke patients at relatively early stages participated. The regions of interest method was used for analyzing levels of perfusion and oxygen metabolic parameters, and postural rCBF change within MCAO group was investigated using statistical parametric mapping. Region of interest analyses showed significant rCBF reduction in the cortical and subcortical regions distal to the artery occlusion in CAO patients during sitting. Regression analyses showed that magnitudes of rCBF reduction in those areas were correlated positively with OEF values and inversely with metabolic rates of oxygen (P < 0.05). Statistical parametric mapping for MCAO patients demonstrated further rCBF reduction by sitting in the occlusion-side MCA territory. The current study suggested that assumption of upright posture could exert an adverse effect on local perfusion in hemodynamically compromised patients with major cerebral vessel occlusion, possibly caused by impairment of local autoregulation.     

The effect of posture on the normal and pathological auditory startle reflex.

The effect of posture on the EMG pattern of the normal auditory startle reflex was investigated. The startle response to an unexpected auditory tone was studied in eleven normal subjects when standing, and in six normal subjects when sitting relaxed or tonically plantar flexing both feet. Reflex EMG activity was recorded in the tibialis anterior and soleus about twice as frequently when standing, than when sitting relaxed. In addition, the median latencies to onset of reflex EMG activity in the tibialis anterior and soleus were about 40 and 60 ms shorter during standing, than when sitting relaxed. No short latency EMG activity was recorded in the calf muscles during tonic plantar flexion of the feet, while sitting. The effect of posture on the EMG pattern of the pathological auditory startle reflex was studied in five patients with hyperekplexia. In three patients the latency to onset of reflex EMG activity in the tibialis anterior was shorter when standing, than when sitting relaxed. The EMG pattern of the reflex response to sound was studied in detail in two of these patients and consisted of up to three successive components. The expression of each EMG component depended on the postural set of the limbs. In particular, a distinct short latency component was found in posturally important muscles following auditory stimulation. This short latency component was not recorded when sitting relaxed. It is concluded that the EMG pattern of the physiological and pathological auditory startle response is not fixed, but may change with the postural stance of the body. This finding supports the theory that the normal startle reflex and the abnormal startle reflex in hyperekplexia have a common brainstem origin.     

Effects of loading and unloading of lower limb joints on the soleus H-reflex in standing humans.

OBJECTIVE: To investigate the effects of loading and unloading of the lower limb joints on the soleus H-reflex in standing humans. METHODS: H-reflexes were elicited in the soleus muscle in subjects standing on a force platform in a water tank under the following loading conditions of the ankle and knee joints: control condition; reduced loads of -10 and -20 N; imposed loads of 10 and 20 N. The joint loading was altered by changing the combinations of buoys and weights attached to the lower limb segments, while total body weight was kept constant. RESULTS: As the ankle- or knee-joint load was reduced, the H-reflex was significantly enhanced compared to that under the control condition. In contrast, the H-reflex was decreased as the ankle- or knee-joint load was increased. In both cases, similar levels of background activity were recorded. CONCLUSIONS: The present results suggest that joint afferents might mediate the suppression of the soleus H-reflex in standing humans. However, the identification of the receptors and/or the mechanisms cannot be addressed under the current experimental set up. SIGNIFICANCE: The results of this study give some basic insights into reflex control in an upright posture.     

Dynamic changes of cerebrospinal fluid shunt flow in patient's daily life

The shunt flow rate will be greatly influenced by the changing posture of the patient. A newly designed method of assessing shunt flow rate by isotope clearance is described and the results of phantom experiments and clinical data are presented. This method makes it possible to assess shunt flow rates in a variety of postures, such as recumbent, or head raised or as posture changes from recumbent to sitting and eventually to upright. As patients changed from the recumbent to the sitting position, shunt flow rates ceased in some cases. In cases with low flow rates in the recumbent position, shunt flow rate increased with any elevation of the upper half of the body. In many cases, flow rates increased as the patient's position changed from recumbent to sitting and then to the upright position. The results suggest that shunt flow rates vary substantially as postures alter in a patient's daily life.     

EEG phase synchrony differences across visual perception conditions may depend on recording and analysis methods.

OBJECTIVE: (1) To investigate the neural synchrony hypothesis by examining if there was more synchrony for upright than inverted Mooney faces, replicating a previous study; (2) to investigate whether inverted stimuli evoke neural synchrony by comparing them to a new scrambled control condition, less likely to produce face perception. METHODS: Multichannel EEG was recorded via nose reference while participants viewed upright, inverted, and scrambled Mooney face stimuli. Gamma-range spectral power and inter-electrode phase synchrony were calculated via a wavelet-based method for upright stimuli perceived as faces and inverted/scrambled stimuli perceived as non-faces. RESULTS: When the frequency of interest was selected from the upright condition exhibiting maximal spectral power responses (as in the previous study) greater phase synchrony was found in the upright than inverted/scrambled conditions. However, substantial synchrony was present in all conditions, suggesting that choosing the frequency of interest from the upright condition only may have been biased. In addition, artifacts related to nose reference contamination by micro-saccades were found to be differentially present across experimental conditions in the raw EEG. When frequency of interest was selected instead from each experimental condition and the data were transformed to a laplacian 'reference free' derivation, the between-condition phase synchrony differences disappeared. Spectral power differences were robust to the change in reference, but not the combined changes in reference and frequency selection criteria. CONCLUSIONS: Synchrony differences between face/non-face perceptions depend upon frequency selection and recording reference. Optimal selection of these parameters abolishes differential synchrony between conditions. SIGNIFICANCE: Neural synchrony is present not just for face percepts for upright stimuli, but also for non-face percepts achieved for inverted/scrambled Mooney stimuli.     

Continuous observations of daytime EEG patterns in normal subjects under restrained conditions while sitting in armchair or on stool. Part 1. Sleep state

While stabilizing both behavioral and environmental factors as far as possible, continuous EEG observations were made on the level of consciousness of 32 normal healthy subjects aged 19-23. The experiment started at 11 p.m. by obtaining the sleep record for each subject. After spontaneous awakening in the morning, each subject was requested to maintain the same posture while sitting in an armchair or on a stool until the end of the experiment, and was asked not to fall asleep in the daytime. The behaviors of each subject were continuously video-recorded throughout the period of the experiment. From inspection of the EEG records, simultaneous video monitoring and recording of the subjects' daytime behavior, and the subsequent data analysis, the following conclusions were drawn: 1) The subjects had a strong tendency to fall asleep in the restrained armchair-sitting posture during the daytime. The EEG and video records of the subjects showed that sleep accounted for about 25-55% (average 37.6%) of the daytime period. 2) In 23 recordings of the subjects sitting in an armchair, 109 sleep blocks were observed, in comparison with 42 sleep blocks while sitting on a stool. On the basis of their characteristics, the sleep blocks could be divided into five categories. All the five types of sleep blocks were observed in the armchair-sitting posture, but only NREM-REM and SOREMP types of a short duration were observed in the stool-sitting posture. SOREMPs were observed in the daytime in both postures. 3) The REM cycle found in nocturnal sleep did not appear in the daytime. However, another rhythm, a 4-hour waking-sleep cycle after spontaneous awakening, was observed.     

Assisting people with multiple disabilities actively correct abnormal standing posture with a Nintendo Wii Balance Board through controlling environmental stimulation

The latest researches adopted software technology turning the Nintendo Wii Balance Board into a high performance change of standing posture (CSP) detector, and assessed whether two persons with multiple disabilities would be able to control environmental stimulation using body swing (changing standing posture). This study extends Wii Balance Board functionality for standing posture correction (i.e., actively adjust abnormal standing posture) to assessed whether two persons with multiple disabilities would be able to actively correct their standing posture by controlling their favorite stimulation on/off using a Wii Balance Board with a newly developed standing posture correcting program (SPCP). The study was performed according to an ABAB design, in which A represented baseline and B represented intervention phases. Data showed that both participants significantly increased time duration of maintaining correct standing posture (TDMCSP) to activate the control system to produce environmental stimulation during the intervention phases. Practical and developmental implications of the findings were discussed.     

Intérêt de l’appui antérieur en station assise pour le redressement et la tenue de tête du sujet atteint d’infirmité motrice cérébrale ou polyhandicapé

Because of their brain damage, patients with cerebral palsy or severely disabled have abnormal postural and antigravity regulation. This results in a postural and movement disorder. In the sitting position, excessive muscle contractions combined with the difficulty in maintaining an upright posture and the balance against gravity disrupt body alignments. Over the months and years, orthopedic disorders develop. Depending on the severity of the primary motor disorder and secondary deformities, the sitting posture becomes difficult or impossible. Sitting corrective devices allow relaxation of the patient and improve the quality of his body's alignments. The difficulty is to facilitate motor skills of the patient without deteriorating his posture, particularly in patients with severe cerebral palsy. Active trunk extension is facilitated by the organization of anterior support. The improved posture control and grasp in turn enables better surrounding interaction and functional performance. After a postural analysis, we will propose the use of support at different levels, depending on the patient's capabilities, the functional project and situation. We will focus here on this application in the different sitting positions: on the floor with straight legs, kneeling, or sitting with legs dangling.     

Gender and age differences in psychomotor vigilance performance under differential sleep pressure conditions

The effects of sleep pressure and circadian phase on neurobehavioral function can be sensitively measured with the psychomotor vigilance task (PVT). We compared PVT performance in 16 young (8 men and 8 women, 20-31 years) and 16 elderly healthy subjects (8 men and 8 women, 57-74 years) during a 40-h sleep deprivation (SD, high sleep pressure) and a 40-h multiple nap protocol (NAP, low sleep pressure) under dim light and constant posture conditions in a balanced crossover design. Independent of age and sleep pressure conditions, women exhibited significantly slower reaction times (RTs) than men. This effect became more apparent with increasing time elapsed into both the 40-h NAP and SD protocol. However, women tended to have fewer premature key presses than men. Independent of gender, the elderly showed slower RTs than the young in the NAP protocol during the biological day (8-24 h) but not during the biological night (24-8 h). In the SD protocol, they had also significantly slower RTs but only during the first 16 h under low to moderate levels of sleep pressure conditions. The relative PVT performance decline after SD was significantly less pronounced in the elderly than in the young, so that both age groups exhibited similar performance decrements after 16 h into the SD protocol. Thus, nighttime- and sleep pressure-related RT slowing in the young "makes them old", or the elderly are less susceptible to circadian and wake-dependent PVT performance decrements. We interpret the gender effect as a different strategy in women when performing the PVT, although the instructions to be 'as fast as possible' were identical. Not only sleepiness and circadian phase, but also age and gender are major factors that may contribute to attentional failures in extended work shifts and during nighttime work shifts.     

Effects of modafinil on sustained attention performance and quality of life in OSA patients with residual sleepiness while being treated with nCPAP

BACKGROUND: Some patients with obstructive sleep apnea/hypopnea syndrome (OSA/HS) who are regular users of nasal continuous positive airway pressure (nCPAP) therapy continue to experience daytime sleepiness that impairs performance and quality of life. A randomized, double-blind, placebo-controlled, parallel-group study was conducted to determine the effect of modafinil on sustained attention performance and functional quality of life in OSA/HS patients with residual daytime sleepiness, who were regular users of nCPAP therapy. METHODS: Seventy-seven patients received modafinil (200 mg/day, week 1; 400 mg/day, weeks 2-4) and 80 patients received matching placebo once daily for 4 weeks. Sustained attention performance on the psychomotor vigilance task (PVT) and functional status and quality of life using the Functional Outcomes of Sleep Questionnaire (FOSQ) were measured. RESULTS: The frequency of lapses of attention during PVT performance was significantly decreased, and both the median and slowest reaction times were significantly improved in patients receiving nCPAP plus modafinil compared with those receiving nCPAP plus placebo (P=0.010 for the number of lapses [transformed], P=0.023 for the median reaction time, and P=0.014 for the reciprocal of the 10% slowest reaction times). Treatment with nCPAP plus modafinil significantly improved the FOSQ total score (weeks 1 and 4), the vigilance subscale score (weeks 1 and 4), and the activity level subscale score (week 4) compared with treatment with nCPAP plus placebo (all P<0.05). CONCLUSIONS: Consistent with previous results for objective and subjective measures of sleepiness, modafinil used adjunctively improved performance on a test of behavioral alertness and reduced functional impairments in patients with OSA/HS who were regular users of nCPAP therapy but still experiencing sleepiness.