Mapping cognitive and emotional networks in neurosurgical patients using resting-state functional magnetic resonance imaging.

Neurosurgery has been at the forefront of a paradigm shift from a localizationist perspective to a network-based approach to brain mapping. Over the last 2 decades, we have seen dramatic improvements in the way we can image the human brain and noninvasively estimate the location of critical functional networks. In certain patients with brain tumors and epilepsy, intraoperative electrical stimulation has revealed direct links between these networks and their function. The focus of these techniques has rightfully been identification and preservation of so-called "eloquent" brain functions (i.e., motor and language), but there is building momentum for more extensive mapping of cognitive and emotional networks. In addition, there is growing interest in mapping these functions in patients with a broad range of neurosurgical diseases. Resting-state functional MRI (rs-fMRI) is a noninvasive imaging modality that is able to measure spontaneous low-frequency blood oxygen level-dependent signal fluctuations at rest to infer neuronal activity. Rs-fMRI may be able to map cognitive and emotional networks for individual patients. In this review, the authors give an overview of the rs-fMRI technique and associated cognitive and emotional resting-state networks, discuss the potential applications of rs-fMRI, and propose future directions for the mapping of cognition and emotion in neurosurgical patients.

The origins of insight in resting-state brain activity.

People can solve problems in more than one way. Two general strategies involve (A) methodical, conscious, search of problem-state transformations, and (B) sudden insight, with abrupt emergence of the solution into consciousness. This study elucidated the influence of initial resting brain-state on subjects' subsequent strategy choices. High-density electroencephalograms (EEGs) were recorded from subjects at rest who were subsequently directed to solve a series of anagrams. Subjects were divided into two groups based on the proportion of anagram solutions derived with self-reported insight versus search. Reaction time and accuracy results were consistent with different cognitive problem-solving strategies used for solving anagrams with versus without insight. Spectral analyses yielded group differences in resting-state EEG supporting hypotheses concerning insight-related attentional diffusion and right-lateralized hemispheric asymmetry. These results reveal a relationship between resting-state brain activity and problem-solving strategy, and, more generally, a dependence of event-related neural computations on the preceding resting state.

The transliminal brain at rest: baseline EEG, unusual experiences, and access to unconscious mental activity.

Transliminality reflects individual differences in the threshold at which unconscious processes or external stimuli enter into consciousness. Individuals high in transliminality possess characteristics such as magical ideation, belief in the paranormal, and creative personality traits, and also report the occurrence of manic/mystic experiences. The goal of the present research was to determine if resting brain activity differs for individuals high versus low in transliminality. We compared baseline EEG recordings (eyes-closed) between individuals high versus low in transliminality, assessed using The Revised Transliminality Scale of Lange et al. (2000). Identifying reliable differences at rest between high- and low-transliminality individuals would support a predisposition for transliminality-related traits. Individuals high in transliminality exhibited lower alpha, beta, and gamma power than individuals low in transliminality over left posterior association cortex and lower high alpha, low beta, and gamma power over the right superior temporal region. In contrast, when compared to individuals low in transliminality, individuals high in transliminality exhibited greater gamma power over the frontal-midline region. These results are consistent with prior research reporting reductions in left temporal/parietal activity, as well as the desynchronization of right temporal activity in schizotypy and related schizophrenia spectrum disorders. Further, differences between high- and low-transliminality groups extend existing theories linking altered hemispheric asymmetries in brain activity to a predisposition toward schizophrenia, paranormal beliefs, and unusual experiences.

Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder.

INTRODUCTION: Studies investigating the neurocognitive effects of posttraumatic stress disorder (PTSD) routinely find "deficits" in various cognitive domains. However, the rate of cognitive impairment in individuals with PTSD remains unclear, as studies have focused on null hypothesis testing (NHT) and inferring patterns of impairment rather than empirically determining the rate of cognitive impairment in this sample. METHOD: This study examined rates of cognitive impairment using a domain-specific approach in non-treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn service members and veterans with (n = 92) and without (n = 79) PTSD and without substance abuse/dependence who passed a performance validity measure and were matched on age, education, estimated IQ, and ethnicity. Chi-square analyses were used to compare the rate of cognitive impairment across groups based on normative scores using three cutoffs (-1, -1.5, and -2 SDs). NHT was also used to compare performances across groups. RESULTS: Individuals with PTSD showed higher rates of impairment in memory (-1-SD cutoff) than controls, but equivalent rates of impairment in attention, processing speed, and executive functioning; no significant differences were found on NHT. Impairment in any domain was also more prevalent in PTSD (-1-, -1.5-, and -2-SD cutoffs). No differences were found on NHT or rates of impairment in individuals with PTSD with (n = 34) and without (n = 58) depression. CONCLUSIONS: Patients with PTSD were more likely to meet criteria for memory impairment and to show impairment in any domain than controls. Patients with PTSD and comorbid depression were no more likely to be impaired in any cognitive domain or to have lower scores on individual cognitive tasks than patients with PTSD alone. Clinicians noting cognitive impairment in individuals with PTSD should exercise caution before ascribing that impairment to another etiology if deficits are limited to memory.

P50: A candidate ERP biomarker of prodromal Alzheimer's disease.

INTRODUCTION: Reductions of cerebrospinal fluid (CSF) amyloid-beta (Aß42) and elevated phosphorylated-tau (p-Tau) reflect in vivo Alzheimer's disease (AD) pathology and show utility in predicting conversion from mild cognitive impairment (MCI) to dementia. We investigated the P50 event-related potential component as a noninvasive biomarker of AD pathology in non-demented elderly. METHODS: 36 MCI patients were stratified into amyloid positive (MCI-AD, n=17) and negative (MCI-Other, n=19) groups using CSF levels of Aß42. All amyloid positive patients were also p-Tau positive. P50s were elicited with an auditory oddball paradigm. RESULTS: MCI-AD patients yielded larger P50s than MCI-Other. The best amyloid-status predictor model showed 94.7% sensitivity, 94.1% specificity and 94.4% total accuracy. DISCUSSION: P50 predicted amyloid status in MCI patients, thereby showing a relationship with AD pathology versus MCI from another etiology. The P50 may have clinical utility for inexpensive pre-screening and assessment of Alzheimer's pathology.

Semantic richness and the activation of concepts in semantic memory: evidence from event-related potentials.

Semantic richness refers to the amount of semantic information associated with a concept. Reaction-time (RT) studies have shown that words referring to rich concepts elicit faster responses than those referring to impoverished ones, suggesting that richer concepts are activated more quickly. In a recent functional neuroimaging study, richer concepts evoked less neural activity, which was interpreted as faster activation. The interpretations of these findings appear to conflict with event-related potential (ERP) studies showing no evidence that speed of concept activation is influenced by typical semantic variables. Resolution of this apparent contradiction is important because the interpretation of 40 years of semantic-memory RT studies depends on whether factors such as semantic richness influence the duration of initial concept activation or later decision and response processes. Consistent with previous studies of the effects of semantic factors on ERP, the present study shows that richness influences the magnitude, but not the latency, of the P2 and N400 ERP components (which are early relative to behavioral responses), suggesting that effects of richness on RT reflect temporal effects on downstream decision or response mechanisms rather than on upstream concept activation.

EEG neurofeedback: a brief overview and an example of peak alpha frequency training for cognitive enhancement in the elderly.

Neurofeedback (NF) is an electroencephalographic (EEG) biofeedback technique for training individuals to alter their brain activity via operant conditioning. Research has shown that NF helps reduce symptoms of several neurological and psychiatric disorders, with ongoing research currently investigating applications to other disorders and to the enhancement of non-disordered cognition. The present article briefly reviews the fundamentals and current status of NF therapy and research and illustrates the basic approach with an interim report on a pilot study aimed at developing a new NF protocol for improving cognitive function in the elderly. EEG peak alpha frequency (PAF) has been shown to correlate positively with cognitive performance and to correlate negatively with age after childhood. The present pilot study used a double-blind controlled design to investigate whether training older individuals to increase PAF would result in improved cognitive performance. The results suggested that PAF NF improved cognitive processing speed and executive function, but that it had no clear effect on memory. In sum, the results suggest that the PAF NF protocol is a promising technique for improving selected cognitive functions.