Modality dependent changes in event-related potentials correlate with specific cognitive functions in nondemented patients with Parkinson's disease

Summary The relationship between event-related potentials (ERPs) and cognitive functioning was studied in patients with Parkinson's Disease (PD) but without dementia. Auditory and visual stimuli were used; 30 subjects participated in the auditory study and 20 in the visual study. Patient groups did not differ with respect to gender, age, education, illness duration, and level of cognitive functioning. Visual stimuli were 2.3 cpd sinusoidal grating patterns randomly presented in an oddball paradigm (oblique vs. vertical spatial orientation). Auditory stimuli were tones presented at 70dB SPL at a rate of 1.1/second, also using the oddball paradigm (1.5K vs. 1K tones). All patients were given neuropsychological tests to measure verbal fluency, memory, visual spatial perception, and abstract reasoning. P300 and N200 abnormalities correlated with a number of these measures, such that longer ERP latencies were related to lower scores on tests of cognitive functioning. Patterns of results suggest that auditory and visual ERPs correlate with different subsets of neuropsychological functions in nondemented PD patients and that N200 may provide a new metric for clinical use.     

Visual event-related potentials under different interstimulus intervals in Parkinson's disease: relation to motor disability, WAIS-R, and regional cerebral blood flow

We have introduced S1-S2 paradigm (task S) as well as oddball paradigm (task O) visual event-related potentials (ERPs) under different interstimulus intervals (ISIs) in Parkinson's disease (PD). ERP measurements were correlated with motor disability, WAIS-R, and regional cerebral blood flow (rCBF). The 'group' influence was characterized by longer latency for P300, N200, and reaction time and decreased P300 amplitude in PD. Both P300 latency and reaction time during task O showed significantly longer latency in longer ISI condition. Our results revealed 'ISI' influence on ERPs during task S and significant correlation between ERPs and rCBF in task S.     

Early sensory information processes are enhanced on visual oddball and S1-S2 tasks in Parkinson's disease: a visual event-related potentials study

To observe sensory and cognitive information processing in Parkinson's disease (PD), 34 PD patients and 26 controls were investigated. A visual oddball paradigm and an S1–S2 paradigm were employed to record the early (P1, N1, P2) and late (N2, P3) event-related potentials (ERPs) at Cz, Pz and Oz. Results showed: (1) enlarged P1 amplitude at all electrode locations on both tasks, (2) shortened N1 latency and enlarged P2 amplitude at Oz on both tasks, (3) enlarged N1 amplitude at Cz during an oddball paradigm, (4) delayed N2 latency and decreased N2, P3 amplitude on both tasks, and (5) delayed P3 latency and reaction time during the S1–S2 paradigm. Abnormal ERP changes were correlated with worsened scores on Wechsler Adult Intelligence Scale-Revised and motor dysfunction scales in PD. We surmise overactive aspects or failed inhibitory modulation of sensory information processing in the early ERP stage and deficient cognitive information processing during the late ERP stage in PD.     

帕金森病患者额叶认知功能和事件相关电位相关性研究

目的:探讨事件相关电位(P300)和额叶认知测试对帕金森病患者认知障碍评价的意义。方法:对31例非痴呆非抑郁帕金森病患者和25例年龄、性别、受教育程度相匹配的正常对照进行P300检测,同时采用词语流畅性、连线测验、Stroop字色干扰测验对病例组和对照组分别进行测试。结果:病例组与对照组比较:额叶认知功能评分较差,P300潜伏期延长(P<0.05),波幅下降;P300潜伏期与额叶认知功能障碍程度呈正相关。结论:非痴呆非抑郁帕金森病患者存在认知功能障碍。这种障碍可能是额叶功能受损后的表现。     

ERPs (N200, P300 and CNV) in alcoholics: relapse risk assessment]

The cognitive event-related potentials were studied in a group of 55 alcoholic patients, paired in age and sex with a group of 18 control subjects, using a protocol oddball (visual and auditory) and a protocol VCN Go/Nogo. The N200 obtained using an auditory oddball paradigm had lower amplitude in alcoholics than in controls. A significant amplitude decrease of visual P300 was also observed in alcoholic male subjects. There was however no difference in auditory P300 between alcoholics and control subjects. Using a Go/Nogo paradigm, a significant difference on the final part of the VCN appears between alcoholic and pilot subjects. In addition, the longitudinal follow-up of the same alcoholic patients showed an electrophysiological profile that allowed dividing them into two different groups. On the initial recording (17 days after weaning), the auditory oddball P300 amplitude was significantly higher at Cz and Pz among patients who relapsed during the 3 months follow-up. The same effect appeared on the CNV protocol, where the amplitude of P300 was higher in patients who subsequently relapsed than for those who remained abstinent. Cognitive ERPs may be clinically useful to improve the prediction of risk of relapse among alcoholic patients.     

Event-related potentials during auditory oddball, and combined auditory oddball-visual paradigms

The purpose of the current study was to investigate the properties of a new modification of the classical auditory oddball paradigm (auditory oddball paradigm combined with passive visual stimulation, AERPs + VEPs) and compare the scalp topography obtained with the new paradigm and the classical auditory oddball paradigm (AERPs) in healthy humans. The responses to bimodal stimulation, and to the classical oddball paradigm were similar to those reported in other studies in terms of location, amplitudes, and latencies of P1, N1, P2, N2, and P300. The new modification of the oddball paradigm produced P300 at fronto-central locations in contrast to centro-parietal locations during the classical oddball paradigm. The amplitudes and latencies of P300 were also significantly larger during the new than the classical paradigm. Furthermore, the amplitudes of N1 and P2, but not N2 were significantly higher and differed in location during the new paradigm in response to both target and standard stimuli. The latencies of all three waves were significantly longer and the latency of P2 differed in location between the new and the classical paradigms in response to only the standard stimuli. The results of this study suggest that the new modification of the classical oddball paradigm produces different neural responses to the classical oddball paradigm. Therefore, this modification can be used to investigate dysfunctions in sensory and cognitive processing in clinical samples.     

EVENT-RELATED POTENTIALS DURING AUDITORY ODDBALL,AND COMBINED AUDITORY ODDBALL–VISUAL PARADIGMS

The purpose of the current study was to investigate the properties of a new modification of the classical auditory oddball paradigm (auditory oddball paradigm combined with passive visual stimulation, AERPs+VEPs) and compare the scalp topography obtained with the new paradigm and the classical auditory oddball paradigm (AERPs) in healthy humans. The responses to bimodal stimulation, and to the classical oddball paradigm were similar to those reported in other studies in terms of location, amplitudes, and latencies of P1, N1, P2, N2, and P300. The new modification of the oddball paradigm produced P300 at fronto-central locations in contrast to centro-parietal locations during the classical oddball paradigm. The amplitudes and latencies of P300 were also significantly larger during the new than the classical paradigm. Furthermore, the amplitudes of N1 and P2, but not N2 were significantly higher and differed in location during the new paradigm in response to both target and standard stimuli. The latencies of all three waves were significantly longer and the latency of P2 differed in location between the new and the classical paradigms in response to only the standard stimuli. The results of this study suggest that the new modification of the classical oddball paradigm produces different neural responses to the classical oddball paradigm. Therefore, this modification can be used to investigate dysfunctions in sensory and cognitive processing in clinical samples.     

Effect of interstimulus interval on visual P300 in Parkinson's disease

OBJECTIVE: Visual event related potentials (ERPs) were studied during an oddball paradigm, to testify whether cognitive slowing in Parkinson's disease exists and to investigate whether cognitive information processing can be influenced by different interstimulus intervals (ISIs) of an oddball task in patients with Parkinson's disease and normal subjects. METHODS: ERPs and reaction time were measured in 38 non-demented patients with Parkinson's disease and 24 healthy elderly subjects. A visual oddball paradigm was employed to evoke ERPs, at three different interstimulus (ISI) intervals: ISI(S), 1600 ms; ISI(M), 3100 ms; and ISI(L), 5100 ms. The effect of ISIs on ERPs and reaction time was investigated. RESULTS: Compared with the normal subjects, P300 latency at Cz and Pz was significantly delayed after rare target stimuli in patients with Parkinson's disease only at ISI(L). Reaction time was prolonged in patients at all the three ISIs, compared with the normal controls. There was also significantly delayed N200 and reduced P300 amplitude at Cz and/or Pz to rare non-target stimuli in patients at the three ISIs, compared with the normal controls. During rare target visual stimulation, P300 latency and reaction time in the patients with Parkinson's disease and reaction time in the normal subjects were gradually prolonged as the ISI increased. CONCLUSION: Prolonged N200 latency to rare non-target stimuli might indicate that automatic cognitive processing was slowed in Parkinson's disease. Cognitive processing reflected by P300 latency to rare target stimuli was influenced by longer ISI in patients with Parkinson's disease.     

ERPs changes during neuroleptic treatment in schizophrenia--a vulnerability marker in schizophrenia]

P300 amplitude reduction and P300 latency prolongation are consistent findings in schizophrenia, but it is unclear if these abnormalities were the effect of current or past neuroleptic treatment or were present at the onset of illness. We previously recorded ERPs in drug free schizophrenic patients (45 neuroleptic-naive and 56 previously treated with neuroleptics). In that study, P300 amplitude reduction was observed in both the neuroleptic-naive and the previously treated patients. However, both N200 and P300 latencies were prolonged only in the previously treated schizophrenic patients. In this study, we investigated ERPs in 60 drug free schizophrenic patients before and after neuroleptic treatment was begun. According to DSM-IV, schizophrenia subtype classification, 26 cases were paranoid type, 14 were disorganized, 2 catatonic and 18 undifferentiated. Twenty six of the patients were neuroleptic-naive and 34 had been previously treated. Sixty gender- and age-matched healthy controls were also investigated. ERPs were recorded during an auditory oddball task. The scalp EEGs were recorded from AgAgCl electrodes at 16 sites according to the international 10-20 system. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Before treatment, all schizophrenic patients displayed larger N200 amplitudes than the controls; however, increases in N200 amplitudes were not observed after neuroleptic treatment was begun. Both N200 and P300 latencies in the patients before treatment were prolonged only in those previously treated. Neuroleptic-naive patients demonstrated prolongation of both N200 and P300 latencies only after treatment. P300 amplitudes in patients were increased by neuroleptic treatment; but patients had smaller P300 amplitudes than the controls even after treatment. The change in P300 amplitudes (Pz) and the change in total BPRS scores by neuroleptic treatment were positively correlated in the patients whose duration of illness was six months or less (mean: 2.4 months). However, no correlation was observed for patients whose duration of illness was over six months (mean: 49.7 months). There were no significant differences in ERPs changes among subtypes. These results suggested that the P300 amplitude should be considered a vulnerability marker in schizophrenia and that both N200 and P300 latencies might be markers for neuroleptic exposure.     

Contribution of auditory P300 test to the diagnosis of mild cognitive impairment in Parkinson’s disease

Abnormalities in auditory P300 test have been observed in patients with Parkinson’s disease (PD). We aimed to investigate whether or not additional electrophysiological tests assist in making the clinical diagnosis of mild cognitive impairment in Parkinson’s disease (PD-MCI), and we evaluated P300 changes in patients with non-demented PD and analyzed the correlation between the cognitive features and P300 changes. Twenty patients with PD who had been diagnosed with mild cognitive impairment (PD-MCI group) according to the Movement Disorder Society (MDS) 2012 PD-MCI level II criteria, 21 patients with PD without cognitive impairment (PD-Normal group), and 20 control subjects (control group) who were neurologically normal were examined by the standard auditory oddball paradigm. The N100, P200, N200, and P300 latencies and N100-P200, P200-N200, and N200-P300 amplitudes were measured and analyzed. P300 latencies recorded from Fz, Cz, and Pz and N200 latency recorded from Fz were significantly longer in the PD-MCI group than in the PD-Normal and the control group (respectively p < 0.001, p = 0.041). P300 amplitude recorded from Fz was significantly lower in PD-MCI group than those in the other groups (p = 0.038). While P300 was obtained in all patients in the PD-Normal and the control group, it was lost in 35% of PD-MCI patients. The results show that P300 provides a diagnostic tool for detecting PDMCI. We suggest that P300 prolongation and loss of P300 potential could be used as supportive parameter in the diagnosis of PD-MCI.     

Modifications of cognitive and motor tasks affect the occurrence of event-related potentials in the human cortex

This study concerns the question of how task modification affects the frequency occurrence of event-related potentials (ERP) inside the active cortical areas. In 13 candidates for epilepsy surgery, 156 sites in the temporal (74), frontal (73), and parietal (9) cortices were recorded by means of depth and subdural electrodes. Four modifications of the somatosensory evoked P3-like potentials were performed; (i) an oddball paradigm with silent counting of target stimuli (P3c); (ii) an oddball paradigm with a hand movement in response to target stimuli (P3m); (iii) an S1-S2 paradigm, ERP in the P300 time window after the S2 stimulus, with silent counting of target stimuli (S2c), and (iv) an S1-S2 paradigm with a hand movement in response to target stimuli (S2m). In comparing the oddball paradigms with the S1-S2 (contingent negative variation, CNV) paradigms, four regions emerge that are significantly linked with the oddball P3; the prefrontal cortex, the cingulate, the amygdalo-hippocampal complex, and the lateral temporal cortex. A prominent role of the cingulate and the fronto-orbital cortex in the cognitive processing of movement was supported when tasks with identical cognitive loads but different required responses were compared. Even relatively simple cognitive tasks activate many cortical regions. The investigated areas were activated in all tests; however, small regions in each field were active or inactive in relation to the nature of the task. The study indicates a variable and task-dependent internal organization of a highly complex and widely distributed system of active cortical areas.     

Event-related potential and EEG measures in Parkinson's disease without and with dementia

Nondemented Parkinson's disease (PD) patients showed increased amplitude of event-related potential component P3. We recorded 18-channel spontaneous eyes-closed resting EEG and auditory oddball event-related potentials in 29 PD patients and 11 age-matched controls. Combining Mini-Mental State Examination score and oddball P3 counting performance, 15 patients were intellectually normal, 7 moderately, and 7 severely demented. P3 and N1 amplitude and latency, mean amplitude of 1,024 ms post-stimulus (separate after rare and after frequent stimuli), and resting EEG total power for 40 s were computed, and linearly regressed for age, sex, and L-dopa dosage. In nondemented PD patients, increased P3 amplitude was confirmed, but N1 amplitude and mean amplitude after rare and frequent stimuli were also increased as well as - most important - resting EEG total power. With increasing dementia, amplitude and power decreased, and P3 latency increased. Task demands cannot explain increased P3 amplitude, since similarly increased EEG total power was found during no-task resting. Prospective studies must determine whether P3 amplitude and EEG power in nondemented PD patients can serve as predictors of dementia.     

The modulation of late component event related potentials by pre-stimulus EEG theta activity in ADHD

Electroencephalography (EEG) and Event Related Potentials (ERPs) studies in ADHD have generally been studied separately. This study examined these measures simultaneously in 54 adolescent unmedicated ADHD males and age and gender matched normal controls during an auditory oddball paradigm. Compared with controls, ADHD patients showed increased pre-stimulus EEG Theta activity and post-stimulus reduced N200 amplitude, increased P200 amplitude and delayed N200 and P300 latencies evoked to target stimuli. Moreover, Theta activity was negatively correlated with N200 amplitude and positively correlated with P200, N200 and P300 latency in ADHD. There were no correlations in the control group. Pre-stimulus preparatory state increases in Theta activity in ADHD may underlie some of the reported disturbances in information processing reflected in ADHD.     

Cognition in Parkinson disease: An event-related potential perspective

Auditory event-related potentials (ERP) elicited in a target detection stimulus paradigm and pattern-shift visual ERPs were studied in 20 male patients with idiopathic Parkinson disease (PD) and 20 age-matched normal controls. Patients showed significantly increased latencies for both the P200 and P300 components of the auditory ERP. Patients and controls showed no significant differences in latency of the visual ERP but patients showed significantly decreased amplitude. Only one of five neuropsychological measures, the Symbol Digit Modalities test (SDMT), showed a significant negative correlation with P300 latency. The significant association between the two measures that showed impairments in the PD patients (P300 latency and SDMT scores) suggested that these measures reflect a common, disrupted aspect of cognitive function in PD.     

Visual event-related potentials in progressive supranuclear palsy, corticobasal degeneration, striatonigral degeneration, and Parkinson's disease

To determine whether there are characteristic changes in event-related potentials (ERPs) in parkinsonian syndromes we studied 8 patients with progressive supranuclear palsy (PSP), 10 patients with corticobasal degeneration (CBD), 9 patients with striatonigral degeneration (SND), and 16 patients with idiopathic Parkinson's disease (PD) with a mean duration of illness shorter than 5 years in each group. A visual oddball paradigm was employed to elicit P300. P300 to the rare target and rare nontarget stimuli and reaction time (RT) to rare target stimuli in each group were compared with those in the corresponding age-matched normal control group and to each other after age correction. The correlation of P300 and RT to motor disability score was also studied. In PSP P300 amplitude was markedly reduced while in CBD P300 latency was prolonged. P300 amplitude to rare nontargets in SND and PD was attenuated. The mean RT in the PSP and the CBD group was significantly longer than in the other two groups. The mean RT in PD and P300 amplitude to rare nontargets in both CBD and PD showed significant correlation with the severity of motor disability. Simultaneous measurement of P300 and RT may yield useful supplementary information in facilitating diagnosis of parkinsonian syndromes in addition to clinical criteria. Received: 6 April 1999, Received in revised form: 5 August 1999, Accepted: 12 January 2000     

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.     

Simultaneously evoked primary and cognitive visual evoked potentials distinguish younger and older patients with Parkinson's disease

Summary While it is known that both primary visual processes and visuocognitive responses are affected in Parkinson's Disease (PD), their relationship is not known. It is known that both of these measures can be affected by age per se. Our aims were to determine if in non-demented PD patients visual cognitive event-related potential (ERP) changes simply reflect abnormal primary visual processing and to determine the effects of age and disease on their relationship. In order to do so, we introduce a new normalizing procedure for visual ERPs. In addition to the latencies and amplitudes of P100, N140, P200, N200 and P300 components, the P300-P100 latency difference (termed central processing time —CPT) were measured. In order to avoid confounding factors of absolute amplitude differences due to say, generally low voltage recordings or poor primary visual responses, P300 responses normalized to P100 responses were also evaluated (P300/P100 amplitude ratio). Visual ERPs were obtained in an oddball paradigm in 20 non-demented patients with PD and 20 normal age-matched subjects. The stimuli were horizontal sinusoidal gratings differing only in spatial frequency (0.5 and 1 cycle/degree). While simple ERP latency criteria did not distinguish non-demented PD patients as a group from controls, when younger PD patients were compared to older PD patients and controls CPT acceleratedly increased in younger PD patients. The amplitudes of both N200 and P300 provided significant distinction between patient and control groups. The surprising result emerging from this study is that an individually normalized P300 amplitude provides significant distinction of younger PD patients from age matched normals.     

Markers from event-related potential subcomponents and reaction time for information processing dysfunction in schizophrenia

Event-related potentials (ERPs) can serve as markers for cognitive processing stages. Identification of those ERPs altered in schizophrenia offer information about cognitive dysfunction. Auditory evoked potentials (AEPs) were elicited within an oddball paradigm in 35 schizophrenic patients and compared with 35 healthy controls. N100 and P200, as well as N200, frontal P300 and parietal P300 subcomponents, were separated using dipole source analysis. The amplitudes of the N100 and the parietal P300 measured in schizophrenics were diminished. The input-related processing stages (N100 and P200) were not altered, whereas later, the deviant and task-related processes (N200, frontal P300, parietal P300 and reaction time) were significantly prolonged in schizophrenia. Received: 28 September 1998 / Accepted: 1 October 1998     

The impact of bilateral subthalamic deep brain stimulation on long-latency event-related potentials

The analysis of long-latency event-related potentials (ERPs) is of importance in the evaluation of certain cognitive functions and in following their subsequent changes. The aim of the present study was to investigate whether deep brain stimulation (DBS) itself can cause changes in the configuration of the ERPs. Using a standard oddball auditory paradigm, we elicited auditory cognitive ERPs in 23 Parkinson's disease patients (in both DBS-ON and DBS-OFF conditions) and in 14 healthy controls. The P200 and P300 amplitudes and latencies, the motor reaction times and the accuracy of button pressing were compared between the DBS-ON and DBS-OFF states and subsequently correlated with the applied stimulation voltage and disease duration. Comparison of the DBS-ON and DBS-OFF conditions revealed that neither the amplitude nor the latency of the examined ERP components changed significantly. However, the behavioral and attentional aspects (e.g. the accuracy of the button pressing responses to the target signal) definitely improved after the DBS was turned on. Positive correlations were demonstrated between the P300 amplitudes over the central and frontal regions and the optimal stimulation voltage and between the disease duration and P300 latencies over the Cz and Fz sites. In conclusion, our data indicate that DBS may have different impacts on various electrophysiological parameters during the oddball paradigm.     

No decrement in visual P300 amplitude during extended performance of the oddball task

Research indicates that in visual sustained attention paradigms, the amplitude of the P300 component of the event-related potential invoked by target (critical) stimuli shows a decrement in amplitude. This amplitude decrement parallels decrements in vigilance performance that result from the difficult discrimination that is typically required between the infrequent targets and the frequent nontargets (neutral stimuli). In contrast, target stimulus P300 does not appear to show a decrement across large numbers of trials during performance of the "oddball" paradigm, in which targets and nontargets are highly discriminable. The present study measured target and nontarget P300 amplitude during performance of a visual oddball paradigm extended over an interval of some 3 1/2 hours, a period well in excess of the 3/4 hour intervals employed in previous research. The results indicated no decrement in P300 amplitude as a function of time for either targets or nontargets. The only significant relationship between P300 and behavioral data was an inverse correlation across oddball runs between average nontarget P300 amplitude and total number of targets missed.