Remote Reminiscence Using Immersive Virtual Reality May Be Efficacious for Reducing Anxiety in Patients with Mild Cognitive Impairment Even in COVID-19 Pandemic: A Case Report.

To prevent cognitive decline, non-pharmacological therapies such as reminiscence for mild cognitive impairment (MCI) are required, however, the use of nursing homes was limited due to coronavirus disease 2019 (COVID-19). Therefore, the demand for remote-care is increasing. We hypothesized that immersive virtual reality (iVR) could be used more effectively than conventional reminiscence for anxiety. We first examined the effectiveness and safety of reminiscence using iVR (iVR reminiscence session) in patients with MCI. After COVID-19 imposed restriction on visiting nursing homes, we conducted online iVR reminiscence session (remote iVR reminiscence session) and compared its effectiveness with that of interpersonal iVR reminiscence session (face-to-face iVR reminiscence session). The results of two elderly with MCI suggested that iVR reminiscence could reduce anxiety and the burden of care without serious side effects. The effects of remote iVR reminiscence might be almost as effective as those of face-to-face one.

Short-term meditation modulates EEG activity in subjects with post-traumatic residual disabilities.

OBJECTIVE: Neurophysiological changes related to meditation have recently attracted scientific attention. We aimed to detect changes in electroencephalography (EEG) parameters induced by a meditative intervention in subjects with post-traumatic residual disability (PTRD), which has been confirmed for effectiveness and safety in a previous study. This will allow us to estimate the objective effect of this intervention at the neurophysiological level. METHODS: Ten subjects with PTRD were recruited and underwent psychological assessment and EEG recordings before and after the meditative intervention. Furthermore, 10 additional subjects were recruited as normal controls. Source current density as an EEG parameter was estimated by exact Low Resolution Electromagnetic Tomography (eLORETA). Comparisons of source current density in PTRD subjects after the meditative intervention with normal controls were investigated. Additionally, we compared source current density in PTRD subjects between before and after meditative intervention. Correlations between psychological assessments and source current density were also explored. RESULTS: After meditative intervention, PTRD subjects exhibited increased gamma activity in the left inferior parietal lobule relative to normal controls. In addition, changes of delta activity in the right precuneus correlated with changes in the psychological score on role physical item, one of the quality of life scales reflecting the work or daily difficulty due to physical problems. CONCLUSIONS: These results show that the meditative intervention used in this study produces neurophysiological changes, in particular the modulation of oscillatory activity of the brain. SIGNIFICANCE: Our meditative interventions might induce the neurophysiological changes associated with the improvement of psychological symptoms in the PTRD subjects.

Yokukansan and its ingredients as possible treatment options for schizophrenia.

Schizophrenia is a debilitating psychotic mental disorder that affects almost the entire range of human mental function. The devastating effect of the illness is usually long-lasting and requires lifelong treatment. Despite an evolved psychopharmacological understanding, the overall therapeutic effect of antipsychotics is still not satisfactory. The choice of proper medication presents a clinical dilemma between efficacy and safety. As a result, searching for comparable treatment options with safer profiles is very important. Yokukansan (TJ-54), also called yi-gan san in Chinese, is a traditional herbal medicine with evident therapeutic effect for neuropsychiatric disorders. There are several open-label clinical studies upholding the possibility of using yokukansan to treat schizophrenia or schizophrenia-like psychosis. Evidence from animal studies and neurobiology also sheds light on the antipsychotic implications of yokukansan and its ingredients. Nevertheless, correlations between the experimental environment and clinical settings may be complicated by a number of confounders. Clinical trials with more sophisticated designs are required to fill the gap between the experimental environment and clinical settings.

New possibility of traditional Chinese and Japanese medicine as treatment for behavioral and psychiatric symptoms in dementia.

Yokukansan, one of the Kampo prescriptions, is composed of seven herbaceous plants and was developed in China in the 16th century as a cure for restlessness and agitation in children. Yokukansan has also become a popular drug combination in Japan, especially for the behavioral and psychiatric symptoms of dementia (BPSD). Recent studies have shown that yokukansan might also be quite effective against BPSD occurring in association with other types of dementia, such as Alzheimer's disease, Lewy body disease, Parkinson's disease with dementia, frontotemporal dementia, and vascular dementia. Researchers have intensively investigated yokukansan, focusing on the pharmacological mechanisms against glutamate-mediated excitotoxicity. This traditional Chinese and Japanese medicine holds potential promise for improving BPSD in elderly patients suffering from dementia.

Relationship between prepulse inhibition of acoustic startle response and schizotypy in healthy Japanese subjects.

Prepulse inhibition (PPI) of the acoustic startle reflex (ASR) is the most common psychophysiological index of sensorimotor gating. Several studies have investigated the relationship of PPI of ASR to schizotypy in Caucasians. However, little has been reported on this relationship in Asians. We investigated a possible relationship between PPI of ASR and schizotypy in 79 healthy Japanese subjects. Schizotypy was assessed by the Schizotypal personality Questionnaire (SPQ). PPI was evaluated at signal-to-noise ratios (SnRs: difference between background noise intensity and prepulse intensity) of +12, +16, and +20 dB. The total SPQ score, cognitive/perceptual score, and interpersonal score correlated negatively with PPI at SnR of +16 and +20 dB. We conclude that PPI is associated with the trait of schizotypy in healthy Asian subjects.

Cortical oscillatory power changes during auditory oddball task revealed by spatially filtered magnetoencephalography.

OBJECTIVE: To investigate the neural sources and associated changes in oscillatory activity involved in auditory attention and memory updating processing using spatially filtered magnetoencephalography. METHODS: We recorded magnetic responses during an auditory oddball task in 12 normal subjects. Synthetic aperture magnetometry (SAM)-permutation analysis was used to visualize the multiple brain regions associated with event-related magnetic fields (ERFs), and event-related oscillations during target detection processing. RESULTS: SAM-permutation results showed the topographical distribution of N1m over the bilateral primary auditory cortex. Post-stimulus delta (1.5-4 Hz) activity sources, likely related to the P300 slow-waveform, were distributed over the right frontocentral and parietal regions. Source locations of theta (4-8 Hz) and alpha (8-13 Hz) event-related synchronization (ERS) were identified over the dorsolateral and medial prefrontal cortex. We visualized bilateral central-Rolandic suppresions for mu (8-15 Hz), beta (15-30 Hz), and low-gamma (30-60 Hz) activities, more dominant in the hemisphere contralateral to the moving hand (button-pressing in response to target stimuli). CONCLUSIONS: Prefrontal theta and alpha ERS, and frontocentral-parietal delta ERS are functionally engaged in auditory attention and memory updating process. SIGNIFICANCE: Spatially filtered MEG is valuable for detection and source localization of task-related changes in the ongoing oscillatory activity during oddball tasks.

Impaired prepulse inhibition and habituation of acoustic startle response in Japanese patients with schizophrenia.

Prepulse inhibition (PPI) and habituation of the acoustic startle reflex (ASR) are considered to be candidate endophenotypes of schizophrenia. However, to our knowledge, only one group has investigated these startle measures in Asian patients with schizophrenia. In the present study, we evaluated these startle measures in 51 Japanese patients with schizophrenia and compared them with those of 55 healthy age- and sex-matched Japanese controls. A human startle response monitoring system was used to deliver acoustic startle stimuli, and record and score the electromyographic activity of the orbicularis oculi muscle. The startle measures examined were mean magnitude of ASR to pulse alone trials in initial block (SR), habituation of ASR during the session (HAB), and PPI at prepulse intensities of 82 dB (PPI82), 86 dB (PPI86), and 90 dB (PPI90) sound pressure level. SR was not significantly different between the patients and controls. Patients displayed significantly reduced HAB and PPI for all prepulse intensities compared to controls. The greatest statistical difference in PPI between patients and controls was found with PPI86. This did not correlate with any clinical variable in each group. Our results indicate that PPI and habituation of ASR are impaired in Asian patients with schizophrenia.

Auditory detection of motion velocity in humans: a magnetoencephalographic study.

To investigate the cerebral mechanisms of auditory detection of motion velocity in the human brain, neuromagnetic fields elicited by six moving sounds and one stationary sound were investigated with a whole-cortex magnetoencephalography (MEG) system. The stationary sound evoked only one clear response at a latency of 109+/-6 ms (first response, or M100), but the six moving sounds evoked two clear responses: an earlier response at a latency of 116+/-7 ms (M100) and a later response at a latency ranging from 180 to 760 ms (magnetic motion response, or MM). The latency and amplitude of the MM were inversely related to the velocity of the moving sounds (p<0.02). The magnetic source of MM was related to the velocity of the moving sounds (p<0.05). A dynamic neuromagnetic response, MM, was elicited by the moving sounds, which likely encoded the neural processing of auditory detection of motion velocity. A specific neural network that processes the motion velocity in the human brain probably includes the bilateral superior temporal cortices and the brainstem. The left posterior and lateral part of the auditory cortex may play a pivotal role in the auditory detection of motion velocity.

Slow repetitive transcranial magnetic stimulation increases somatosensory high-frequency oscillations in humans.

Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible treatment for psychiatric and neurological disorders characterized by focal brain excitability, such as major depression and action myoclonus. However, the mechanism of modulating excitability by rTMS is unclear. We examined the changes in high frequency oscillations (HFOs) of somatosensory evoked potentials (SEPs) before and after slow rTMS over the right primary somatosensory cortex (0.5 Hz, 50 pulses, 80% motor threshold intensity). The HFOs, which represent a localized activity of intracortical inhibitory interneurons, were significantly increased after slow rTMS, while the SEPs were not changed. Our results suggest that slow rTMS affects cortical excitability by modulating the activity of the intracortical inhibitory interneurons beyond the time of the stimulation and that rTMS may have therapeutic effects on such disorders.

Determination of activation areas in the human auditory cortex by means of synthetic aperture magnetometry.

In this study we applied synthetic aperture magnetometry (SAM) to investigate active cortical areas associated with magnetically recorded transient and steady-state auditory evoked responses. For transient evoked responses, SAM images reveal an activated volume of cortical tissue within the lateral aspect of the superior temporal plane. The volume of cortical activation for steady-state responses was located more medially than that for transient evoked responses. Additionally, SAM also reveals a small overlap of activated areas between transient and steady-state evoked responses, which has not be demonstrated when using equivalent current dipole (ECD) source modeling. Source waveforms from SAM and ECD analyses show comparable temporal information. Results from this study suggest that SAM is a useful technique for imaging cortical structures involved in processing perceptual information.

Magnetoencephalographic study of the cortical activity elicited by human voice.

In an attempt to identify voice-specific neural activities in auditory cortex in humans, we recorded cortical magnetic responses. Volunteers were instructed to listen to vocal and instrumental sounds matched in fundamental-frequency, duration, temporal envelope and average root mean square power. The stimuli were sounds produced by four singers and four musical instruments at each of two fundamental frequencies: 220 Hz (musical note A3) and 261.9 Hz (C3). Two components of the evoked responses were analyzed, one at approximately 100 ms (N1m) and the other 400 ms after the stimulus onset (sustained field, SF). The source locations of equivalent current dipoles for both components were estimated around the Heschl's gyrus in both hemispheres. Compared with the instrumental sound, the source strength of the SF component for the voice was significantly larger.

MEG study of long-term cortical reorganization of sensorimotor areas with respect to using chopsticks.

The movements required to use chopsticks are overlearned and routine in Asians. Most non-Asians, on the other hand, typically have difficulty performing this unfamiliar manual activity, and have to focus their attention on the movements required to use chopsticks adequately. Using magnetoencephalography (MEG) we compared the cortical activation of highly trained Asian chopstick users to the activation of Europeans who only occasionally used chopsticks, while they performed the same tasks with chopsticks or a control task of simple tapping of the same fingers. The data were analyzed using the new method of synthetic aperture magnetometry (SAM). In Europeans there was a significantly higher ratio of spectral power in the higher gamma frequency band (60-80 Hz) over the sensorimotor area compared to the Asian subjects. From these results we conclude that the high gamma band activity in the sensorimotor area may reflect focused attention and functional reorganization of the cortical network with respect to sensorimotor experience.