Impaired early visual processing in disorganised schizophrenia.

Topographic differences in flash/pattern shift VEP data are evaluated in paranoid (n: 38), disorganized (n: 23) and residual (n: 23) schizophrenic subtypes and compared to normal controls. Increased early P1 and a restricted diffusion of the late P2 responses suggest dopaminergic over- and cholinergic underactivity in paranoid and residual schizophrenia. A distinctive pattern N145 reflects well-preserved attentional resources in the paranoid subtype. Latency increase and amplitude decrease of the pattern N145 concur with abnormal antisaccades documented in disorganized behaviour. VEP-data might help differentiate between schizophrenic subtypes.

Facilitation of early and masking of late cortical responses in dementia.

Topographic differences in longlatency SSEP and flash VEP data are compared in 3 different psychiatric patient groups. Differences between schizophrenia and affective disorder are restricted to somatosensory P100 amplitude gradients along the antero-posterior axis. In contrast EP-differences between psychiatric patients and dementia are prominent, encompassing both late and early (< 100 ms) responses. Our flash P 2 and somatosensory P 3 data are in accordance with previous findings. Multi-modal positive responses with a latency of 40-80 ms are significantly increased in dementia. This facilitation suggests cortical dysfunction and/or subcortical gating impairment.

Auditory information processing in schizophrenia.

Early N1P2 and late N2P3 responses generated in an auditory oddball paradigm are topographically compared in three psychiatric patient groups. In schizophrenia N1 and N2 amplitude is comparable with dementia and significantly decreased with respect to affective disorder. In contrast, P3 amplitude does not allow discriminating schizophrenia from affective disorder but is significantly diminished in dementia. The late N2P3 response shows a topographic effect along the fronto-occipital axis. Schizophrenia is characterized by an iCNV and N2 maximum over the frontal planes and a compound P3 lacking distinct frontal and parietal components. The findings are discussed in reference to literature data and current hypotheses/theories concerning information processing. Our findings favour an important dysfunction of automatic processing including early selection in schizophrenia.

Auditory vertex potential in children: a cognitive hypothesis.

In children the early N1P2 response generated by an auditory oddball paradigm is a compound negative potential with distinctive 165-ms temporal and 240-ms frontocentral components. As this configuration differs considerably from the adult response, it may be assumed that neural systems engaged in auditory attentional processes differ with age. It is argued that the auditory vertex potential might index frontal lobe development and matching mechanisms. In combination with EEG spectral data this cognitive parameter could initiate an alternative approach to the evaluation and research of learning and attention deficit disorders.

Sleep and the temporal lobe.

The main interest in the association between sleep and temporal lobe dysfunction is based on the activation of ictal and interictal epileptic phenomena. The clinical semiology of NREM and REM parasomnias may resemble complex partial seizures. The differentiation between epilepsy and dissociated states of wakefulness and sleep is of high diagnostic and therapeutic importance. Systems within temporal lobe structures are also responsible for disturbed sleep or dyssomnia. The limbic brain is connected with different nodal points in the network underlying sleep organisation and participates in both sleepinducing and arousal mechanisms. Experimental amygdala kindling, an animal epilepsy model involving temporal structures, induces disturbed sleep patterns favouring waking and light sleep. In epilepsy unstable disrupted and superficial sleep patterns prevail without overt seizures. Sleep-fragmentation and deprivation may impair daytime functioning and cognitive performance by lowering the seizure-threshold. The recognition of dyssomnia and of excessive sleepfragmentation and sleepiness has obvious implications for behavioural and drug treatment.

Psychological and neurophysiological dysfunctioning during wakefulness in narcolepsy.

Memory complaints and altered states of consciousness with automatic behaviour of narcoleptic patients indicate cognitive dysfunctioning. Although more problems arise while performing attention tasks than memory tasks, the neuropsychological test inquiry doesn't indicate one particular neuropsychological function as consistently impaired. They often perform well because they compensate impaired wakefulness by an increased willingness to respond. Neurophysiological research indicates that the sometimes occurring cognitive dysfunction is associated with a waxing and waning between wakefulness and sleep. The increased psychopathology is partly a reflection of, partly a reaction to the symptoms. The impact of hypersomnia on psychosocial functioning is more important than that of epilepsy in epileptics. In severe cases smoking and driving should better be dissuaded.

Electrical brain activity in preterm infants at risk for intracranial hemorrhage.

We studied the effect of preterm birth on electroencephalographic background activity in 20 infants < 32 weeks' gestation. Six infants developed periventricular-intraventricular hemorrhage during the study period. Four-channel 24-h cassette recordings were obtained on day 1, 3-5 and 7-9. For each of the 24-h recordings, the percentage of the time showing stage I (continuous activity), stage II (mixed activity) and stage III (discontinuous activity) epochs was calculated. In infants without periventricular-intraventricular hemorrhage, a positive linear relationship between gestational age and continuous activity and a negative linear relationship between gestational age and discontinuous activity existed in the first day recordings; in infants with periventricular-intraventricular hemorrhage, such relationships were not found. To determine if the changes in continuous and discontinuous activities during the first week of extrauterine life were different from the expected changes during a corresponding time in utero, we calculated the expected amounts of stage I and III changes for each infant. The actual changes were not significantly different from the expected values in both study groups. However, during the onset and/or extension of periventricular-intraventricular hemorrhage, depression of the electroencephalographic background activity was found.

Auditory information processing in sleep: late cortical potentials in an oddball paradigm.

Information processing of auditory stimuli in sleeping healthy volunteers is studied by means of an oddball paradigm. Latencies of the early (N1P2) complex are affected by NREM sleep depth and show a progressive slowing. The amplitude of the early N1 component depends on stimulus type and probability and is increased following deviant stimuli. In strict comparison with waking, late responses (N2-P3) complex only follows deviant stimuli. Both latencies and amplitude increase more in NREM than in REM sleep. Thus the early response is mainly affected by vigilance, the late response mainly depends on stimulus type. Results are discussed in terms of comparison processing, context updating and orienting response patterning hypotheses put forward in cognitive psychophysiology.

Auditory information processing in sleep: habituation to repetitive stimuli.

Habituation to evoked responses is obvious in waking but still controversial in sleep. Single-response analysis proves short-term habituation of auditory evoked potentials in stage 2 NREM sleep. The data are discussed referring to the two-system hypothesis of sensory processing in sleep and to DC instability and sleep maintenance mechanisms in stage 2 NREM. It is suggested that information processing might continue in sleep.

Aging of core and optional sleep.

Two consecutive 24-hr ambulatory recordings of 14 healthy elderly persons (7 women, 7 men, ages 88-102) and of 19 healthy young adults (10 women, 9 men, ages 25-35) were evaluated. In addition to the classical sleep parameter analysis, sleep structure was also analyzed in terms of a proposed distinction between "core" and "optional" sleep (Horne 1989). Core sleep is the essential part of the sleep and is mainly slow wave sleep. This type of sleep is composed of stages 3 and 4 on non-REM sleep (NREM 3-4). Core sleep is obtained during the first three sleep cycles and the remainder of the night sleep is considered optional sleep. Optional sleep is more altered than core sleep. However, in both optional and core sleep, NREM sleep and REM are reduced. There is also an increase in drowsiness and in the time spent awake after sleep onset; however, the extent of these effects are more obvious in elderly men. Aging effects of slow wave sleep probably represent an amplification of the changes as observed in awake electroencephalic (EEG) patterns in healthy seniors. The decrease in slow wave sleep (stages NREM 3-4) is gender related and prevails in elderly men. REM sleep diminishes with increasing age. In the elderly, most REM sleep occurs at the beginning of the night. This contrasts to younger persons where the duration of REM sleep is longer at the end of the night. Furthermore, a decrease in REM sleep latency is particularly obvious in elderly men and probably secondary to the curtailment of slow wave sleep. The ultradian NREM-REM cycle rhythm (as defined by the periodic occurrence of REM sleep) shows a monophasic trend suggesting a diminished adaptive function of aged sleep. The informative value of true, continuous ambulatory recordings in the assessment of sleep-wakefulness patterns in normal and pathological aging is stressed.

Ambulatory monitoring of sleep-wakefulness patterns in healthy elderly males and females (greater than 88 years): the "Senieur" protocol.

OBJECTIVE: The study was designed to investigate sleep-wake patterns in healthy elderly men and women (greater than 88 years) using ambulatory recording techniques. DESIGN: Cross-sectional observations on 2 consecutive days. METHODS: Two consecutive 24-hour recordings were made. Each 30-second period of the recording was scored as characteristic of wakefulness, REM, and non-REM sleep (stages 1-4). SETTING: Interviews and recordings were done in the home of the elderly, not interfering with the habitual routine. PARTICIPANTS: Among eligible members of the "Senieur" protocol, screened for wellness, seven females (88-102 years) and seven males (88-98 years) volunteered to participate. MAIN OUTCOME MEASURES: Organization of sleep, sleep structure, and daytime mapping. RESULTS: There was no difference between the first and second night recording. Important gender differences were observed: males had significantly less total sleep, shorter REM latency, more transitions to wake from REM, less NREM 3 sleep, and virtually no NREM 4. Daytime napping, REM amount, and distribution did not show sex differences. Although the variability in the amount of napping was considerable, it occupied less than 10 percent of the total sleep time in both women and men. Daytime napping was unrelated to sleep characteristics. CONCLUSIONS: Ambulatory sleep-wake recordings allow an objective and critical evaluation of sleep function in normal aging. Interesting findings include a shift of REM sleep to the first part of the sleep period an increased cycle variability, and non-correlation of night-time sleep with daytime napping. In contrast to earlier findings in elderly persons, a polygraphic and subjective first-night effect was lacking.

Long-term EEG monitoring in the early premature: developmental and chronobiological aspects.

Long-term cassette EEG monitoring in the neonatal intensive care unit has established prognostic criteria regarding the developmental outcome by quantifying seizure activity. The clinical significance of the organization of continuous and discontinuous EEG patterns in the early premature is still an open question. This report presents quantified EEG data from repeated 24 h records during the first week of life in premature infants (conceptional age less than 32 weeks) with and without ultrasound evidence of intracerebral hemorrhage. The repartition and evolution of EEG background activity is not a reliable parameter regarding pathology. The continuity index is rather a maturational variable and its ultradian fluctuation is an early expression of the "basic rest activity cycle" (BRAC) rhythm.