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To investigate the effects of the Dejian mind-body intervention (DMBI), on depressive symptoms and electroencephalography (EEG) changes in relation to emotional processing in patients with depression. Seventy-five age-, gender-, and education-matched participants with depression were randomly assigned to receive either Cognitive Behavior Therapy (CBT) or DMBI or were placed in a control group. Overall depressive syndrome, specific mood-related symptoms (Hamilton Psychiatric Rating Scale for Depression, Beck Depression Inventory), and EEG data were collected individually during a resting state and during affective image viewing before and after 10 weeks of intervention. After intervention, both the DMBI and CBT groups showed significantly reduced levels of overall depressive syndrome and mood-related symptoms (Ps ≤ 0.002) than the control group. In addition, the DMBI group demonstrated a significantly greater extent of elevation in fronto-posterior EEG theta coherence on the right hemisphere when viewing different mood-induction (neutral, positive, and negative) stimuli than the CBT and control groups (Ps < 0.03). The elevated intra-right fronto-posterior coherence when viewing mood-induction stimuli correlated with improved mood levels after the intervention (Ps < 0.05). Our findings also showed that, only in the DMBI group, there was a significant suppression of theta source activity at the posterior and subcortical brain regions that are known to mediate negative emotional responses and the self-absorbed mode of thinking. The findings of reduced depressive symptoms and elevated frontoposterior coherence suggest that the DMBI can enhance emotional control in depression.
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Terapia Cognitivo-Conductual , Sincronización Cortical/fisiología , Trastorno Depresivo Mayor/fisiopatología , Trastorno Depresivo Mayor/terapia , Regulación Emocional/fisiología , Terapias Mente-Cuerpo , Evaluación de Resultado en la Atención de Salud , Ritmo Teta/fisiología , Adulto , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Psicoterapia de GrupoRESUMEN
BACKGROUND: Some functional magnetic resonance imaging studies have reported altered activations in the frontal cortex during working memory (WM) performance in individuals with mild cognitive impairment (MCI), but the findings have been mixed. The objective of the present study was to utilize near-infrared spectroscopy (NIRS), an alternative imaging technique, to examine neural processing during WM performance in individuals with MCI. METHODS: Twenty-six older adults with MCI (7 males; mean age 69.15 years) were compared with 26 age-, gender-, handedness-, and education-matched older adults with normal cognition (NC; 7 males; mean age 68.87 years). All of the participants undertook an n-back task with a low (i.e., 0-back) and a high (i.e., 2-back) WM load condition while their prefrontal dynamics were recorded by a 16-channel NIRS system. RESULTS: Although behavioral results showed that the two groups had comparable task performance, neuroimaging results showed that the MCI group, unlike the NC group, did not exhibit significantly increased frontal activations bilaterally when WM load increased. Compared to the NC group, the MCI group had similar frontal activations at low load (p > 0.05 on all channels) but reduced activations at high load (p < 0.05 on 4 channels), thus failing to demonstrate WM-related frontal activations (p < 0.05 on 9 channels). In addition, we found a positive correlation between the left WM-related frontal activations and WM ability primarily in the NC group (rs = 0.42, p = 0.035), suggesting a relationship between frontal hypoactivation and WM difficulties. CONCLUSION: The present findings suggest the presence of frontal dysfunction that is dependent on WM load in individuals with MCI.
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Disfunción Cognitiva/diagnóstico por imagen , Lóbulo Frontal/diagnóstico por imagen , Memoria a Corto Plazo , Anciano , Estudios de Casos y Controles , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/psicología , Femenino , Lóbulo Frontal/fisiopatología , Lateralidad Funcional , Neuroimagen Funcional , Humanos , Imagen por Resonancia Magnética , Masculino , Trastornos de la Memoria , Persona de Mediana Edad , Neuroimagen , Espectroscopía Infrarroja Corta , Análisis y Desempeño de TareasRESUMEN
The Chanwuyi Lifestyle Medicine Program (CLMP) was found to enhance the memory and executive functions of older adults with or without subjective memory complaints. The present study investigated whether similar beneficial effects can be extended to mild cognitive impairment (MCI). Twenty-four older adults with MCI were randomly assigned to receive the CLMP (the experimental group) or strategic memory training (SMT; the active control group) for 10 weeks. They were assessed by neuropsychological tests at baseline and post-intervention. Older adults showed similar visual and verbal memory improvements after receiving the CLMP and SMT. Yet, only those who received the CLMP showed distinct improvements in planning/organization, working memory, and attention in terms of accuracy, with greater cognitive gains associated with older age and lower levels of education and baseline cognitive functions. This study provides preliminary evidence for the effects of the CLMP on improving memory, attention, and executive functions in MCI.
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Disfunción Cognitiva , Función Ejecutiva , Pruebas Neuropsicológicas , Humanos , Disfunción Cognitiva/terapia , Disfunción Cognitiva/rehabilitación , Masculino , Función Ejecutiva/fisiología , Anciano , Femenino , Memoria/fisiología , Estilo de Vida , Atención , Anciano de 80 o más AñosRESUMEN
Objective: Temporal processing is the brain's ability to process rapid successive stimuli, and children with neurodevelopmental disorders showed temporal processing deficits. Empirical evidence suggests that in-person intervention on temporal processing improves various cognitive functions of these children, and the present study aimed to study the effects of temporal processing tele-intervention (TPT) on the cognitive functions of children with neurodevelopmental disorders. Methods: Ninety-five children with neurodevelopmental disorders were recruited and randomly assigned to remotely receive either TPT or conventional language remediation (CLR) in 20 parallel group-based intervention sessions once per week. Their cognitive functions were assessed before and after the intervention. Results: The TPT group demonstrated a specific and significant improvement in working memory (p < .001). While there was an overall significant improvement in sustained attention in terms of processing speed after both types of intervention (p = .006), the positive effects of TPT might be more prominent than that of CLR given the significant pre-post difference after receiving TPT (p = .012) but not CLR (p = .21). Regarding rapid naming accuracy which had marginally significant improvement after the intervention (p = .03), the trend of improvement in TPT (p = .05) also seemed more apparent than that of CLR (p = .18). Finally, the TPT group had significant improvement in word knowledge (p < .001), rapid naming speed (p < .001), sustained attention in terms of accuracy (p < .001), and verbal learning and memory (p < .01) to an extent similar to that of the CLR group. Conclusions: These findings suggest that TPT can be a potential intervention for improving cognitive functions in children with neurodevelopmental disorders. Clinical trial registration number: NCT05428657 at ClinicalTrials.gov (https://clinicaltrials.gov/).
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Objective: The sensory deficit has been considered as one of the core features in children and adolescents with autism spectrum disorder (ASD). The present study aimed to examine the temporal processing of simple and more complex auditory inputs in ASD children and adolescents with an online assessment that can be conducted remotely. Methods: One hundred fifty-eight children and adolescents aged 5-17 years participated in this study, including 79 ASD participants and 79 typically developing (TD) participants. The online assessment consisted of two temporal-order judgment tasks that required repeating the sequence of two pure tones or consonant-vowel (CV) syllabic pairs at varying interstimulus intervals (ISIs). Results: Significantly lower accuracy rates were found in ASD than TD participants in the pure tone and the CV conditions with both short and long ISI. In addition, ASD participants (M = 245.97 ms) showed a significantly higher passing threshold than TD participants (M = 178.84 ms) in the CV task. Receiver operating characteristic analysis found that the age × ISI passing threshold composite yielded a sensitivity of 74.7% and a specificity of 50.6% at the cutoff point of -0.307 in differentiating ASD participants from TD participants. Conclusion: In sum, children and adolescents with ASD showed impaired temporal processing of both simple and more complex auditory stimuli, and the online assessment seems to be sensitive in differentiating individuals with ASD from those with TD.
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Executive dysfunctions have been found to be related to repetitive/disinhibited behaviors and social deficits in autism spectrum disorders (ASDs). This study aims to investigate the potential effect of a Shaolin-medicine-based dietary modification on improving executive functions and behavioral symptoms of ASD and exploring the possible underlying neurophysiological mechanisms. Twenty-four children with ASD were randomly assigned into the experimental (receiving dietary modification for one month) and the control (no modification) groups. Each child was assessed on his/her executive functions, behavioral problems based on parental ratings, and event-related electroencephalography (EEG) activity during a response-monitoring task before and after the one month. The experimental group demonstrated significantly improved mental flexibility and inhibitory control after the diet modification, which continued to have a large effect size within the low-functioning subgroup. Such improvements coincided with positive evaluations by their parents on social communication abilities and flexible inhibitory control of daily behaviors and significantly enhanced event-related EEG activity at the rostral and subgenual anterior cingulate cortex. In contrast, the control group did not show any significant improvements. These positive outcomes of a one-month dietary modification on children with ASD have implicated its potential clinical applicability for patients with executive function deficits.
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Sleep disturbance is a common problem associated with depression, and cognitive-behavioral therapy (CBT) is a more common behavioral intervention for sleep problems. The present study compares the effect of a newly developed Chinese Chan-based intervention, namely Dejian mind-body intervention (DMBI), with the CBT on improving sleep problems of patients with depression. Seventy-five participants diagnosed with major depressive disorder were randomly assigned to receive 10 weekly sessions of CBT or DMBI, or placed on a waitlist. Measurements included ratings by psychiatrists who were blinded to the experimental design, and a standardized questionnaire on sleep quantity and quality was obtained before and after the 10-week intervention. Results indicated that both the CBT and DMBI groups demonstrated significantly reduced sleep onset latency and wake time after sleep onset (effect size range = 0.46-1.0, P ≤ 0.05) as compared to nonsignificant changes in the waitlist group (P > 0.1). Furthermore, the DMBI group, but not the CBT or waitlist groups, demonstrated significantly reduced psychiatrist ratings on overall sleep problems (effect size = 1.0, P = 0.00) and improved total sleep time (effect size = 0.8, P = 0.05) after treatment. The present findings suggest that a Chinese Chan-based mind-body intervention has positive effects on improving sleep in individuals with depression.
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Trastorno Depresivo Mayor/complicaciones , Terapias Mente-Cuerpo/métodos , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Adulto , Afecto , Terapia Cognitivo-Conductual/métodos , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sueño , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Resultado del TratamientoRESUMEN
Introduction: This study investigated the effects of transcranial photobiomodulation (tPBM) on improving the frontal lobe cognitive functions and mental health of older adults. Methods: Three older adults with mild cognitive impairment (MCI) of the non-amnestic type received 18-session tPBM stimulation for 9 weeks and were assessed with neuropsychological tests of memory and executive functions and standardized questionnaires on depressive and anxiety symptoms, global cognitive functions, and daily functioning abilities before and after tPBM stimulation. Results: At baseline, their intrusion and/or perseveration errors in a verbal memory test and a fluency test, as measures of the frontal lobe cognitive functions, were in the borderline to severely impaired range at baseline. After tPBM stimulation, the three older adults showed various levels of improvement in their frontal lobe cognitive functions. One older adult's intrusion and perseveration errors improved from the <1st-2nd percentile (moderately to severely impaired range) to the 41st-69th percentile (average range), another older adult's intrusion errors improved from the 11th percentile to the 83rd percentile, and the third older adult's intrusion errors improved from the 5th percentile to the 56th percentile. Moreover, improvements in their anxiety and/or depressive symptoms were also observed. One older adult's depressive and anxiety symptoms improved from the severe range at baseline to the mild range after the intervention. The other two older adults' depressive symptoms improved from the mild range at baseline to the normal range after the intervention. Discussion: These findings provide preliminary support for the potential of tPBM to improve the frontal lobe cognitive functions and mental health of older adults with MCI. Given the small sample size of only three older adults and the absence of a placebo control group, larger randomized controlled studies are needed to confirm its potential.
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Objective: Temporal processing deficits were found among children with attention-deficit/hyperactivity disorder (ADHD). The present study aims to develop an online temporal processing assessment that can be conducted remotely, and the sensitivity of the test was assessed on a group of children with ADHD. Methods: A total of 188 children were recruited, including 94 typically developing (TD) children, and 94 children with ADHD. The online assessment consists of two temporal-order judgment (TOJ) tasks. One task used tone pairs presented with two interstimulus intervals (ISIs) (305ms and 40ms). Another task used pairs of consonant-vowel (CV) syllables with 20 varying ISI levels. Participants were asked to determine the sequence of the sound pairs. Results: The results showed that ADHD children were less accurate (ISI 305ms: M = 83.90%; ISI 40ms: M = 66.28%) than TD children (ISI 305ms: M = 89.36%; ISI 40ms: M = 77.16%) in the tone task. Similarly, ADHD children showed a higher ISI passing threshold (M = 283.64ms) than TD children (M = 199.76ms) and higher accuracy in the CV task. Hierarchical binary logistic regression suggested a model to predict ADHD children using accuracy in ISI 40ms in the tone task and ISI passing threshold in the CV task. Receiver operating characteristic (ROC) analysis yielded a sensitivity of 75.58% and a specificity of 51.11%. Conclusion: ADHD children showed temporal processing deficits of both tones and CVs. The online assessment may be a valid tool for differentiating ADHD children from TD children.
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Children who experience difficulty in learning at mainstream schools usually are provided with remediation classes after school to facilitate their learning. The present study aims to evaluate an innovative eye-tracking training as possible alternative remediation. Our previous findings showed that children who received eye-tracking training demonstrated improved attention and inhibitory control, and the present randomized controlled study aims to evaluate if eye-tracking training can also enhance the learning and memory of children. Fifty-three primary school students with learning difficulty (including autism spectrum disorder, attention-deficit/hyperactivity disorder, specific learning disorder, specific language impairment and borderline intellectual functioning) were recruited and randomly assigned to either the Eye-tracking Training group or the after-school remediation class. They were assessed on their learning and memory using the Hong Kong List Learning Test before and after 8-month training. Twenty weekly parallel sessions of training, 50 min per session, were provided to each group. Children who received the eye-tracking training, not those in the control group, showed a significant improvement in memory as measured by the delayed recall. In addition, the Eye-Tracking Training group showed significantly faster learning than the control group. Also, the two groups showed a significant improvement in their reading abilities. In sum, eye-tracking training may be effective training for enhancing the learning and memory of children with learning difficulties.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno del Espectro Autista , Discapacidades para el Aprendizaje , Trastorno del Espectro Autista/terapia , Niño , Tecnología de Seguimiento Ocular , Humanos , AprendizajeRESUMEN
Neuro-electrophysiological studies on meditative breathing revealed its association with either a relaxed or an attentive state. The present study aimed to investigate whether the Shaolin Dan Tian Breathing (DTB) technique, which consists of the Passive and Active subtypes and can be considered as a relaxation exercise and Qigong, would induce both relaxed and attentive states. Twenty-two adults and 22 age-, gender- and education-matched controls received training on the Shaolin DTB (experimental group) and the progressive muscle relaxation respectively for one month. Eyes-closed resting EEG data before and immediately after each type of breathing were obtained individually at baseline and after one-month training. At baseline, the EEG changes after the Shaolin DTB between both groups were comparable. After one-month training, participants in the experimental, but not the control, group showed enhanced temporal alpha asymmetry (an index of relaxation and positive mood) after performing the Passive DTB for five minutes, and enhanced intra- and inter-hemispheric theta coherence (an index of attention and alertness) after performing the Active DTB. The present findings suggested a positive effect of the Shaolin DTB technique on enhancing human neural activity and connectivity, which may possibly enhance mood state and cognitive functions.
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The present study examined the neuro-electrophysiological activity of the brain associated with the application of a herbal remedy developed by a Shaolin monk based upon the Chan healing principle of clearing the orifices (i.e., the nasal cavities). A repeated-measures design was used. Fourteen normal adults were administered herbal remedy and saline solution intranasally on separate sessions. Two intervals of eyes-closed resting EEG data were obtained individually before and after each administration. Results showed that only the herbal remedy but not the saline solution induced elevation in cordance, an index correlated with cerebral perfusion, in the anterior brain region. In addition, the activity of the anterior cingulate cortex (ACC), as examined by the LORETA analysis, was also increased after the application of the herbal remedy but not saline solution. The present study provided some preliminary evidence suggesting that the herbal nasal drop enhanced the activity of the frontal lobe and ACC. Implications for the potential clinical application of the herbal remedy to treat patients with frontal lobe disorders were discussed.
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The present study evaluated the effectiveness of a short-term mind-body intervention program on improving the depressive mood of an adult community sample. Forty adult volunteers with various degrees of depressive mood were randomly assigned to the experimental group (Dejian Mind-Body Intervention, DMBI) and control group (Cognitive-Behavioral Therapy, CBT). For each group, a total of four 90-min weekly sessions were conducted. Treatment-related changes were measured using the Beck Depression Inventory (BDI-II), an electroencephalographic indicator of positive affect (i.e., prefrontal activation asymmetry), and self-report ratings on physical health. Results indicated that both the DMBI and the CBT group demonstrated significant reduction in depressive mood. However, among individuals with moderate to severe depressive mood at baseline, only those in the DMBI but not the CBT group showed significant reduction in depressive mood. Besides, only the DMBI group demonstrated a significant increase in prefrontal activation asymmetry, suggesting increase in positive affect. While most psychological therapies for depressive mood normally take several months to show treatment effect, the present findings provided initial data suggesting that the DMBI was effective in improving depressive mood of community adults after 1 month of training.
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There has been increasing empirical evidence for the enhancing effects of Dejian Mind-Body Intervention (DMBI), a traditional Chinese Shaolin healing approach, on human frontal brain activity/functions, including patients with autism who are well documented to have frontal lobe problems. This study aims to compare the effects of DMBI with a conventional behavioural/cognitive intervention (CI) on enhancing the executive functions and memory of a nine-year-old boy with low-functioning autism (KY) and to explore possible underlying neural mechanism using EEG theta cordance. At post-one-month DMBI, KY's inhibitory control, cognitive flexibility, and memory functioning have significantly improved from "severely-to-moderately impaired" to "within-normal" range. This improvement was not observed from previous 12-month CI. Furthermore, KY showed increased cordance gradually extending from the anterior to the posterior brain region, suggesting possible neural mechanism underlying his cognitive improvement. These findings have implicated potential applicability of DMBI as a rehabilitation program for patients with severe frontal lobe and/or memory disorders.
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Disinhibition is a common sign among children with attention-deficit/hyperactivity disorder (ADHD). The present study examined the effect of computerized eye-tracking training to improve inhibitory control in ADHD children. Thirty-two ADHD children (mean age = 8.4 years) were recruited. Half of the participants underwent 240 min of eye-tracking training over two weeks (i.e., experimental group), while the other half did not receive any training (i.e., control group). After training, the experimental group exhibited significant improvements in neuropsychological tests of inhibition, such as faster reaction time in the incongruent condition of the Flanker test, more unique designs in the Category Fluency and Five-Point Tests, and a faster completion time in Trail 2 of the Children's Color Trail Test. The control group did not show significant changes in any of these tests. Our findings support the use of eye-tracking training to improve the inhibitory control of ADHD children.
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Abnormal saccadic eye movements, such as longer anti-saccade latency and lower pro-saccade accuracy, are common in children with attention-deficit/hyperactivity disorder (ADHD). The present study aimed to investigate the effectiveness of computerized eye-tracking training on improving saccadic eye movements in children with ADHD. Eighteen children with ADHD (mean age = 8.8 years, 10 males) were recruited and assigned to either the experimental (n = 9) or control group (n = 9). The experimental group underwent an accumulated 240 min of eye-tracking training within two weeks, whereas the control group engaged in web game playing for the same amount of time. Saccadic performances were assessed using the anti- and pro-saccade tasks before and after training. Compared to the baseline, only the children who underwent the eye-tracking training showed significant improvements in saccade latency and accuracy in the anti- and pro-saccade tasks, respectively. In contrast, the control group exhibited no significant changes. These preliminary findings support the use of eye-tracking training as a safe non-pharmacological intervention for improving the saccadic eye movements of children with ADHD.
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This is a randomized controlled trial that aimed to evaluate the effect of the Seven-star Needle Stimulation treatment on children with Autistic Spectrum Disorders (ASD). Thirty-two children with ASD were assigned randomly into the treatment and control groups. Children in the treatment group underwent 30 sessions of stimulation over 6 weeks, while children in the control group were on a waiting list and did not receive treatment during this period of time. Intervention consisted of a treatment regime comprising of 30 sessions of Seven-star Needle Stimulation, delivered over 6 weeks. Each session lasted 5 to 10 min, children in the treatment group were stimulated at the front and back sides of their body and the head by using Seven-star Needles. The change in the children's behavior was evaluated using parents' report and neurophysiological changes were measured by quantitative EEG (qEEG). Results showed that the treatment group demonstrated significant improvement in language and social interaction, but not in stereotyped behavior or motor function, compared to the control group. qEEG spectral amplitudes in the treatment, but not in the control group, were also reduced significantly. The results suggested that Seven-star Needle Stimulation might be an effective intervention to improve language and social functioning of children with ASD.
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Trastorno Autístico/terapia , Trastornos del Desarrollo del Lenguaje/terapia , Medicina Tradicional China/métodos , Agujas , Estimulación Física/métodos , Puntos de Acupuntura , Trastorno Autístico/fisiopatología , Niño , Conducta Infantil , Preescolar , Electroencefalografía , Femenino , Humanos , Trastornos del Desarrollo del Lenguaje/fisiopatología , Masculino , Medicina Tradicional China/instrumentación , Estimulación Física/instrumentación , Conducta Social , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
The present study examined quantitative electroencephalographic (QEEG) profile for children with autistic spectrum disorder (ASD). Five-minute QEEG data were obtained from 90 normal controls (NCs) and 66 children with ASD. Spectrum analyses revealed that ASD children showed significantly less relative alpha and more relative delta than NC. Specifically, 26% of ASD children and 2% of NCs showed 1.5 SDs of relative alpha below the normative mean. Children with this QEEG profile had 17 times the risk of having ASD than those without such a profile. Sensitivity and specificity of relative alpha were 91% and 73%, respectively. Split-half cross-validation yielded a sensitivity of 76%.
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Mapeo Encefálico , Trastornos Generalizados del Desarrollo Infantil/fisiopatología , Electroencefalografía , Adolescente , Niño , Femenino , Humanos , Masculino , Oportunidad Relativa , Análisis EspectralRESUMEN
Previous studies have shown that immunological factors are involved in the pathogenesis of autism spectrum disorders (ASDs). However, this research has been conducted almost exclusively in Western contexts, and only a handful of studies on immune measures have been conducted in Asian populations, such as Chinese populations. The present study examined whether immunological abnormalities are associated with cognitive deficits and problem behaviors in Chinese children with ASD and whether these children show different immunological profiles. Thirteen typically developing (TD) children and 22 children with ASD, aged 6-17 years, participated voluntarily in the study. Executive functions and short-term memory were measured using neuropsychological tests, and behavioral measures were assessed using parent ratings. The children were also assessed on immunological measures, specifically, the levels of cytokines and chemokines in the blood serum. Children with ASD showed greater deficits in cognitive functions, as well as altered levels of immunological measures, including CCL2, CCL5, and CXCL9 levels, compared to TD children, and the cognitive functions and associated behavioral deficits of children with ASD were significantly associated with different immunological measures. The children were further sub-classified into ASD with only autistic features (ASD-only) or ASD comorbid with attention deficit hyperactivity disorder (ASD + ADHD). The comorbidity results showed that there were no differences between the two groups of ASD children in any of the cognitive or behavioral measures. However, the results pertaining to immunological measures showed that the children with ASD-only and ASD + ADHD exhibited distinct cytokine and chemokine profiles and that abnormal immunologic function was associated with cognitive functions and inattention/hyperactivity symptoms. These results support the notion that altered immune functions may play a role in the selective cognitive and behavioral symptoms of ASD.
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OBJECTIVE: Deficits in cognitive flexibility have been suggested to underlie the repetitive and stereotyped behavior in individuals with autism spectrum disorders (ASD). Because cognitive flexibility is primarily mediated by the frontal lobe, where structural and functional abnormalities have been extensively found in these individuals, it is conceivable that their deficits in cognitive flexibility are related to abnormal activations of the frontal lobe. The present study investigates cognitive flexibility and its underlying neurophysiological activities as indicated by theta oscillations in children with ASD. METHOD: Twenty-five children with high-functioning ASD and 25 IQ- and age-matched typically developing (TD) children were subjected to neuropsychological assessments on cognitive flexibility and electroencephalography recordings. RESULTS: The children with ASD performed significantly worse than the TD children across the tasks of cognitive flexibility, including the modified Wisconsin Card Sorting Test (WCST). These children also demonstrated a reduced increase of the theta power localized in multiple brain regions, including various sectors of the frontal lobe at the late stage (i.e., 600 ms-900 ms poststimulus interval) but not the early stage (i.e., 250 ms-550 ms poststimulus interval) of the performance of the modified WCST. The suppressed late frontal theta activities were further shown to be significantly correlated with a poorer performance on the cognitive flexibility measures. CONCLUSION: Our findings suggest that abnormal activations of multiple cortical regions, especially the frontal lobe, form the neural basis of the cognitive flexibility deficits in children with ASD. In addition, we found an EEG marker of cognitive flexibility which could be used to monitor treatment outcomes objectively.