Mismatch negativity (MMN) has gained attention as a biomarker for psychosis and a translational intermediate phenotype in animal models of psychosis, including rodents and non-human primates. MMN has been linked to global functioning (Global Assessment of Functioning [GAF] score) and prognosis (psychosis onset or remission), suggesting that MMN reflects activities beyond auditory processing alone. This review examines the 45-year history of MMN from the perspective of psychiatric researchers and discusses current advances in computational and translational research on MMN, summarizing the current understanding of the MMN generation mechanism. We then address the essential question, "What do we observe through MMN?" Currently, we regard the relationship between global functioning in the real world and MMN as the key to answering this question. As a preliminary investigation, we analyzed the relationship between GAF as an objective variable and MMN, diagnosis, and basic epidemiological factors (age, sex, premorbid intelligence quotient) as explanatory variables (total n = 201, healthy controls: n = 41, patients with psychiatric disorders: n = 160) without assuming diagnostic categories. The relationship between functional outcomes and MMN was confirmed without a case-control design. Finally, we propose that new neurophysiological studies should acknowledge psychophysiological responses such as emotion, intention, and autonomic responses, as well as behavioral differences among participants beyond the dichotomy between healthy controls and patients. Measurements could be conducted in various settings from the participant's perspective. We discuss the potential for research investigating psychosis based on the interaction between individuals and the environment, using MMN as an illustrative model.

Auditory verbal hallucinations (AVH) are experienced by many individuals with schizophrenia (SZ), a neurodevelopmental disease that encumbers the quality of life and psychosocial outcome of those afflicted by it. While many hypotheses attempt to better define the etiology of AVHs in SZ, their neural profile and its moderation by current neuroleptics remains limited. The Mismatch Negativity (MMN) is an event related potential (ERP) measured from electroencephalographic (EEG) activity during the presentation of a deviance detection auditory paradigm. The neural regions and activity underlying the generation of the MMN include the primary auditory cortex and the prefrontal cortex which are regions also found to be activated during the experience of AVHs. Decreased MMN amplitudes have been robustly noted in SZ patients during the presentation of MMN tasks using auditory tones. However, the MMN generation to speech stimuli has not been extensively examined in SZ nor in relation to AVHs. The primary objective of this study was to examine the MMN to five speech-based deviants in SZ patients and healthy controls. Second, we assessed MMN features with AVH characteristics in 19 SZ patients and 21 HC. While AVH features did not correlate with measures of MMN, we found decreased MMN amplitudes to speech-based frequency and vowel change deviants in SZ patients compared to HC potentially reflecting deficiencies in basic speech processing mechanisms.

Assessment of electroencephalographic (EEG) activity in depression has provided insights into neural profiles of the illness. However, there is limited understanding on how symptom severity and risk factors, such as childhood adversity, influence EEG features. Eyes-closed EEG was acquired in N = 28 depressed individuals being treated in a tertiary psychiatric setting. Absolute alpha, beta, theta, and delta power and inter-/intra-hemispheric coherence were examined. Relations between the Montgomery-Åsberg Depression Scale (MADRS) and Adverse Childhood Experience (ACE) Questionnaire and EEG features were assessed. Individuals in the high (MADRS≥30) versus lower (MADRS ≤ 29) symptom severity group exhibited greater overall beta power, and lower Fp-Fp delta and theta coherence. Those with high (≥3) versus lower (≤2) ACE scores exhibited greater T-T beta coherence. Lowest F-F beta coherence was observed in those with high ACE/high depression severity. A negative correlation existed between F-P alpha coherence and symptom severity. Those with higher depression severity exhibit increased beta power, possibly reflecting a hyper-vigilant state Depression severity and ACE history may produce subtle alterations in frontal delta/theta and temporal/frontal beta coherence regions. This is the first study to examine the neural impact of depression severity and ACE-assessed childhood trauma in depressed individuals receiving treatment in a tertiary setting, accounting for the clinical reality of the prevalence of their co-occurrence.

Face recognition is an important cognitive function of the human brain. Post stroke depression (PSD) is a common mental complication after stroke, which has a serious impact on individual physical function recovery and quality of life. This study aims to explore the face perception characteristics of PSD through electrophysiological indicators N170 and VPP, and provide an objective basis for the early evaluation of facial cognitive dysfunction in PSD. 58 patients in the cerebral small vessel disease (CSVD) with depressive symptoms (PSD) and 188 patients in the pure CSVD (NPSD). At the same time, 30 healthy subjects were selected as the healthy controls (HC). The differences of N170 and VPP components between the three groups were compared under the stimulation of inverted faces and upright faces. PSD patients exhibited significantly longer peak latency and lower amplitude of N170 and VPP under both inverted and upright face stimulation compared to HC and NPSD. These results suggest that PSD patients have defects in early face recognition, there are abnormalities in the early perception and structural encoding of face information, and both the "overall mechanism" and "feature mechanism" of face recognition are damaged. These findings provide neuroelectrophysiological evidence for impaired emotionless face recognition in PSD patients.

Mismatch negativity (MMN) event-related potential (ERP) component reduction, indexing N-methyl-D-aspartate receptor (NMDAR)-dependent auditory echoic memory and short-term plasticity, is a well-established biomarker of schizophrenia that is sensitive to psychosis risk among individuals at clinical high-risk (CHR-P). Based on the NMDAR-hypofunction model of schizophrenia, NMDAR-dependent plasticity is predicted to contribute to aberrant neurodevelopmental processes involved in the pathogenesis of schizophrenia during late adolescence or young adulthood, including gray matter loss. Moreover, stress and inflammation disrupt plasticity. Therefore, using data collected during the 8-center North American Prodrome Longitudinal Study (NAPLS-2), we explored relationships between MMN amplitudes and salivary cortisol, gray matter volumes, and inflammatory cytokines. Participants included 303 CHR-P individuals with baseline electroencephalography (EEG) data recorded during an MMN paradigm as well as structural magnetic resonance imaging (MRI) and salivary cortisol, of which a subsample (n = 57) also completed blood draws. More deficient MMN amplitudes were associated with greater salivary cortisol and pro-inflammatory cytokine levels in future CHR-Converters, but not among those who did not convert to psychosis within the next two years. More deficient MMN amplitude was also associated with smaller total gray matter volume across participants regardless of future clinical outcomes, and with subcortical gray matter volumes among future CHR-Converters only. These findings are consistent with the theory that deficient NMDAR-dependent plasticity results in an overabundance of weak synapses that are subject to over-pruning during psychosis onset, contributing to gray matter loss. Further, MMN plasticity mechanisms may interact with stress, cortisol, and neuroinflammatory processes, representing a proximal influence of psychosis.

Artifacts on an electroencephalogram (EEG) - whether physiologic or non-physiologic - can be common and are important to recognize to prevent errors in interpretation. One such EEG artifact is an electroretinogram (ERG) artifact which occurs during photic stimulation. Typically, of a low amplitude, its presence is usually obscured by normal EEG activity over the frontopolar channels but it can appear prominent in very suppressed or EEG recordings showing electrocerebral inactivity. Overall, rarely reported in the literature, the purpose of this case report is to highlight the presence of an ERG artifact in a teenage boy where EEG was obtained after a cerebral anoxic event. It is important that EEG readers identify this to be a non-cerebral waveform in order to provide an accurate assessment of neurologic prognosis.

We aimed to evaluate the occurrence of electroencephalogram (EEG) abnormalities in pediatric patients attending an outpatient psychiatry clinic at a tertiary center. We examined the rates of abnormalities and specific findings based on demographics, specific diagnoses, and clinical severity. This study included pediatric patients who underwent EEG at the outpatient psychiatry clinic. Patient demographics, psychiatric diagnosis, intellectual disability, intelligent quotient (IQ) score, family history of psychiatric disorders, and Clinical Global Impression-Severity (CGI-S) score were obtained through retrospective electronic health record analysis. The rate of EEG abnormalities was calculated, and specific abnormal findings were reviewed. Relationships between the rate of EEG abnormalities and diagnosis, severity, IQ, and age at EEG examination were analyzed. Of 319 patients who underwent EEG, 21.3% (68 patients) of patients exhibited abnormalities, including background abnormalities (14.7%, 47 patients), interictal epileptiform discharges (IEDs) (10.3%, 33 patients), and a slow posterior dominant rhythm (3.8%, 10 patients). The frontal region was the most commonly affected area. Neurodevelopmental disorders (NDDs) had the most frequent abnormalities (29.8%), followed by anxiety (16.7%), sleep (14.3%), mood (11.7%), psychotic (5%), and conduct disorders (0%). Disease severity did not correlate with the rate of EEG abnormalities. Adjusted for age, sex, severity, and family history, patients with EEG abnormalities exhibited lower IQ scores. EEG abnormalities were common in pediatric patients with psychiatric disorders, with background abnormalities detected as frequently as IEDs. Disease severity was not associated with EEG abnormality, while IQ scores showed a negative correlation.

.Brain morphological biomarkers could contribute to understanding the treatment response in patients with obsessive-compulsive disorder (OCD). Multimodal neuroimaging addresses this issue by providing more comprehensive information regarding neural processes and structures. The present study aims to investigate whether patients responsive to deep Transcranial Magnetic Stimulation (TMS) differ from non-responsive individuals in terms of electrophysiology and brain morphology. Secondly, to test whether multimodal neuroimaging is superior to unimodal neuroimaging in predicting response to deep TMS. Thirty-two OCD patients who underwent thirty sessions of deep TMS treatment were included in the study. Based on a minimum 50% reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores after treatment, patients were grouped as responders (n = 25) and non-responders (n = 7). The baseline resting state qEEG and magnetic resonance imaging (MRI) records of patients were recorded. Independent sample t-test is used to compare the groups. Then, three logistic regression model were calculated for only QEEG markers, only MRI markers, and both QEEG/MRI markers. The predictive values of the three models were compared. OCD patients who responded to deep TMS treatment had increased Alpha-2 power in the left temporal area and increased volume in the left temporal pole, entorhinal area, and parahippocampal gyrus compared to non-responders. The logistic regression model showed better prediction performance when both QEEG and MRI markers were included. This study addresses the gap in the literature regarding new functional and structural neuroimaging markers and highlights the superiority of multimodal neuroimaging to unimodal neuroimaging techniques in predicting treatment response.

Abnormalities in auditory processing are believed to play a major role in autism and attention-deficit hyperactivity disorder (ADHD). Both conditions often co-occur in children, causing difficulties in deciding the most promising intervention. Event-related potentials (ERPs) have been investigated and are showing promise to act as potential biomarkers for both conditions. This study investigated mismatch negativity (MMN) using a passive listening task and P3b in an active auditory go/no-go discrimination task. Recordings were available from 103 children (24 females): 35 with ADHD, 27 autistic, 15 autistic children with co-occurring ADHD, and 26 neurotypical (NT) children. The age range considered was between 4 and 17 years, but varied between groups. The results revealed increases in the MMN and P3b amplitudes with age. Older children with ADHD exhibited smaller P3b amplitudes, while younger autistic children showed reduced MMN amplitudes in response to phoneme changes compared to their NT counterparts. Notably, children diagnosed with autism and ADHD did not follow this pattern; instead, they exhibited more similarities to NT children. The reduced amplitudes of phonetically elicited MMN in children with autism and reduced P3b in children with ADHD suggest that the two respective ERPs can act as potential biomarkers for each condition. However, optimisation and standardisation of the testing protocol, as well as longitudinal studies are required in order to translate these findings into clinical practice.

This study aims to investigate the effects of a neurofeedback system on cognitive skills, as measured by the Wechsler Intelligence Scale for Children-Revised (WISC-R), in a cohort of 100 children aged 8 to 12 who were diagnosed with attention deficit. A randomized single-blind sham control group design was employed, with 50 participants assigned to the experimental group receiving neurofeedback training and 50 participants assigned to the sham group receiving simulated training. Participants were selected through random sampling from individuals seeking assistance at a specialized education center over the course of one year (May 2021-2022). Pre- and post-test WISC-R assessments were administered to both groups to evaluate participants' mental performance. The experimental group underwent a total of 60 sessions of quantitative electroencephalography-based infralow frequency neurofeedback training, with half-hour sessions conducted three days a week over a five-month period. The post-test WISC-R was administered at the end of the sixth month. The results revealed significant differences between the pre- and post-training test scores, specifically in terms of verbal IQ, picture arrangement, performance IQ, and total IQ (p = 0.016, p = 0.001, p < 0.001, and p = 0.002, respectively), when comparing the differences between the two groups. These findings indicate a notable improvement in performance IQ, total IQ, and a reduction in attention deficits among the neurofeedback group based on the WISC-R assessments. Future studies should consider employing larger sample sizes, including appropriate control groups, and conducting long-term follow-ups to further elucidate the clinical significance of these results.

Current research on the effectiveness of neurofeedback (NFB) in children with attention-deficit/hyperactivity disorder (ADHD) is divided. Personalized NFB (pNFB), using pre-recorded individual electroencephalogram (EEG) features, is hypothesized to provide more reliable results. Our paper reviews available evidence on pNFB effectiveness and its methodological quality. Additionally, it explores whether other methodological features implying personalization are related to successful NFB. We conducted a systematic literature review on PubMed, PSYNDEX, PsycInfo and PsycArticles until November, 30, 2023. Studies that focused on pNFB in children with ADHD were selected, deviant studies excluded. Quality ratings by independent raters using Loney's criteria were conducted. Pooled effect sizes for NFB effects and methodological features were calculated. Three of 109 studies included personalization and were reviewed in the full-text. In two studies, theta/beta-NFB was personalized using individual alpha peak frequencies (iAPF), whereas in one study, individual beta rhythms were trained. All three studies demonstrated significant short- and long-term improvements in ADHD symptoms, as assessed by questionnaires and objective performance tests, when compared to standard protocols (SP), sham-NFB, and control conditions. Twelve of 111 studies reported methodological features consistently related to NFB effectiveness. These features, including self-control instructions, feedback animations, timing of feedback presentation, behavioral performance, pre-recorded individual ERP-components and stimulant medication dosage, can be used to personalize NFB and enhance training success. Personalizing NFB with iAPF appears promising based on the existing -albeit small- body of research. Future NFB studies should include iAPF and other personalized features facilitating implementation consistently associated with treatment success.

Mismatch negativity (MMN), an auditory prediction error signal, is an enhanced response to unexpected (deviant) stimuli compared to expected (standard) stimuli. There is strong interest in MMN due to reliable findings of reduced MMN in schizophrenia. To interpret reduced MMN in schizophrenia, an enhanced understanding of the factors that influence MMN amplitude could lead to a better understanding of neural mechanisms underpinning the reduction. While several laboratories have observed mismatch responses (MMRs) in rodents, this study assesses how MMR is altered in more complex auditory sequences in rats. Prediction-errors are elicited in relation to "predictive" internal models of regularities. These internal models are updated dynamically when a regularity changes, but human MMN exhibits order effects when two regularities alternate; while deviants in both regularities elicit MMN (ie, the model updates) there is a slower build-up in MMN amplitude over time in the second encountered regularity type. We investigate whether order effects occur in rat MMRs. MMRs were studied to rare ascending and descending frequency deviations in awake, freely moving Wistar rats using wireless telemetry in both separate sequences (one regularity at a time) and in alternating sequences where regularities changed back and forth. The rat MMR did not show order effects, however, substantial MMRs occurred in response to both ascending and descending deviants in the alternating context but to the ascending deviant only when the same regularities were presented separately. The longer-term sequence structure altered prediction-error signalling in rat auditory system revealing a long term context sensitivity in internal models.

The effect of antiseizure medications (ASMs) on cognition varies depending on the type of ASM. We aimed to investigate the effects of ASMs on patients with epilepsy based on the conflicting findings in the literature. Patients diagnosed with epilepsy who were taking ASMs were included. All patients underwent a neuropsychiatric assessment, Beck Depression and Anxiety Inventories, Positive and Negative Syndrome Scale, and general psychopathological tests. The patients were divided into polytherapy and monotherapy groups. Subgroups were categorized according to the type of ASMs, dosage, and duration of monotherapy. Ninety-seven patients were included in this study. The polytherapy group showed a significant decrease in attention, total learning, and interpretation of proverbs compared to the monotherapy group. In the monotherapy group, carbamazepine use had a moderate positive correlation with working memory ( = .669;  = .034), and a strong negative correlation with maintaining attention ( = -.740;  = .014). The duration of levetiracetam monotherapy was negatively correlated with verbal memory (immediate recall  = -.436,  = .038; free recall  = .426,  = .043) and negatively weakly correlated with naming performance ( = -.488,  = .025). The study showed polytherapy may affect verbal and working memory. Carbamazepine may affect working memory and the maintenance of attention in a dose-dependent manner. Levetiracetam may cause impairments in verbal memory and naming, depending on the duration of usage.

Focal seizures (FS) have previously been described before or after infantile spasm (IS) clusters, but FS occurring simultaneously with an IS cluster has been rarely reported in the EEG literature. We present three cases where focal seizures (FS) occurred concurrently during an infantile spasm (IS) cluster on VEEG. On VEEG, onset of IS cluster preceded FS in all three patients; however, patient three was diagnosed with FS prior to the onset of IS. FS duration ranged from 10-90 s and was electrographic-only in two out of the three patients. Unfortunately, the first two patients are now deceased, and for patient two no etiology was ever identified. Currently, patient three is free of spasms as well as seizures but has global developmental delay; no definite etiology has been identified for their presentation. Concurrent FS with IS suggests that the seizure types may be generated in different brain areas with one seizure type potentially triggering the other and is generally reflective of multifocal or diffuse cerebral disease with a poor prognosis as was seen in at least two of our patients. Our three cases of IS where FS occurred concurrently contribute to the limited existing data describing this phenomenon on VEEG.

The aim was to examine the differences in electroencephalography (EEG) findings by visual and automated quantitative analyses between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). EEG data of 20 patients with AD and 24 with DLB/PDD (12 DLB and 12 PDD) were retrospectively analyzed. Based on the awake EEG, the posterior dominant rhythm frequency and proportion of patients who showed intermittent focal and diffuse slow waves (IDS) were visually and automatically compared between the AD and DLB/PDD groups. On visual analysis, patients with DLB/PDD showed a lower PDR frequency than patients with AD. In patients with PDR <8 Hz and occipital slow waves or patients with PDR <8 Hz and IDS, DLB/PDD was highly suspected (PPV 100%) and AD was unlikely (PPV 0%). On automatic analysis, the findings of the PDR were similar to those on visual analysis. Comparisons between visual and automatic analysis showed an overlap in the focal slow wave commonly detected by both methods in 10 of 44 patients, and concordant presence or absence of IDS in 29 of 43 patients. With respect to PDR <8 Hz and the combination of PDR <8 Hz and IDS, PPV and NPV in DLB/PDD and AD were not different between visual and automatic analysis. As the noninvasive, widely available clinical tool of low expense, visual analysis of EEG findings provided highly sufficient information to delineate different brain dysfunction in AD and DLB/PDD, and automatic EEG analysis could support visual analysis especially about PD.

This study aimed to investigate the characteristics of resting-state electroencephalography (EEG) activity and brain networks in patients with mild traumatic brain injury (mTBI) and their association with neurocognitive function (NCF). We analyzed 26 patients with subacute mTBI and 21 healthy controls. The subacute mTBI group (9 females, 17 males) had a mean age of 29.9 ± 9.9 years, and the healthy controls (11 females, 10 males) had a mean age of 29.7 ± 11.5 years. Current source density, lagged phase synchronization, and resting-state network activity were analyzed using exact low-resolution electromagnetic tomography (eLORETA) with 60 s resting-state EEG data. In addition, a correlation analysis was performed between these EEG parameters and NCF in patients with mTBI. We used the statistical nonparametric mapping method in eLORETA to correct for multiple comparisons. There were no significant differences in EEG parameters between the patients with mTBI and healthy controls. However, in patients with mTBI, correlation analysis revealed negative correlations between theta activity in the anterior cingulate cortex and verbal short-term memory and between activity in the memory perception network and verbal memory. Our findings suggest that resting-state EEG may be clinically useful in investigating the mechanism of NCF decline in patients with mTBI.

Electroencephalographic neurofeedback (EEG NF) or its effects on event-related potentials (ERPs) in quantitative EEG have not yet been systematically studied in cancer patients. The aim of this study was to investigate the emotional arousal and valence effects on the event-related P300 in a visual oddball paradigm by an individualized EEG alpha and theta/beta NF intervention in cancer patients and survivors (= 18, age between 31 and 73 years). . ERPs to low and high arousal target stimuli with either emotional positive or negative content and depressive state were obtained in cancer patients before and after a five-week NF intervention in a waitlist paradigm, following the consensus on the reporting and experimental design of clinical and cognitive-behavioral NF studies (CRED-nf checklist). . Overall, P300 amplitudes decreased significantly (< .05) from pre to post therapy. Effects concerning high arousal stimuli with negative and positive valences were on the border to significance. Moreover, patients achieved significant relief of depressive symptoms (< .05). Especially younger participants (<55 yrs.) benefited. . P300 observations could reflect a therapeutic effect on brain activity level. EEG NF alleviates depressive symptoms in cancer patients. . Based on these findings, further studies are needed to investigate the effects on event-related potentials by NF therapy.

Holmes tremor (HT) is a rare motor disorder characterized by high-amplitude and low-frequency resting, intentional, and postural tremors. HT typically arises from disruptions in neural pathways, including the dopaminergic system. Its causes include cerebrovascular incidents, neoplasms, demyelination, and infections. Diagnosis involves thorough clinical, neurophysiological, and neuroimaging assessments. Our report details the clinical profile, neuroimaging and EEG results and levodopa treatment response of an HT patient after cerebral arteriovenous malformation (AVM) surgery. A female patient who underwent AVM surgery developed head tremor and dystonia. Neuroimaging revealed left thalamus involvement. Video electroencephalography (EEG) revealed high-amplitude, low-frequency tremors. The patient responded well to levodopa treatment. Involuntary rhythmic or non-rhythmic movements are a primary clinical feature of HT. A differential diagnosis of epilepsy and HT can be achieved through neurophysiological monitoring, avoiding the overuse of antiepileptic drugs. Symptoms can be alleviated with levodopa intervention.

Previous studies has shown that conventional neurofeedback and cognitive rehabilitation can improve psychological outcomes in people with opioid use disorders. However, the effectiveness of LORETA Z-score neurofeedback (LZNFB) and attention bias modification training on quality of life and inhibitory control of these people has not been investigated yet. LZNFB targets deeper brain structures with higher precision, compared to conventional neurofeedback that typically focuses on surface EEG activity. The present study aims to compare the effect of these two methods on quality of life and response inhibition in men with opioid use disorders under methadone maintenance therapy (MMT). In this randomized controlled clinical trial with a pre-test, post-test, follow-up design, 30 men with opioid use disorders under MMT were randomly assigned into three groups of LZNFB, attention bias modification training, and control (MMT alone). The LZNFB and Cognitive Rehabilitation groups received 20 and 15 sessions of treatment, respectively. The Persian versions WHO Quality of Life-BREEF questionnaire and the Go/No-Go test were completed by the participants before, immediately after, and one month after interventions. The collected data were analyzed in SPSS v.22 software. Both intervention groups showed a significant improvement in quality-of-life score and a significant reduction in response time at the post-test phase ( < .05), where LZNFB group showed more improvement in quality of life and more reduction in response inhibition. After one month, the increase in quality of life continued in both groups, while the decrease in response time continued only in the LZNFB group. Both LZNFB and attention bias modification training are effective in improving quality of life and response inhibition of men with OUD under MMT, however, LZNFB is more effective.

This study aimed to analyze the frequency of unexpected subclinical spikes (USCS) in pediatric patients who underwent high-density electroencephalogram (HD-EEG). Of the 4481 successful HD-EEG studies, 18.5% (829) were abnormal, and 49.7% of these abnormal studies showed SCS, of which 64.1% were USCS. USCS were found to be correlated with attention/concentration deficits and executive dysfunction, often accompanied by the dual psychiatric diagnosis of ADHD. MRI revealed abnormal findings in 32.6% of the subjects with USCS, such as abnormal signal or signal hyperintensity in brain parenchyma, temporal or arachnoid cysts, and vascular malformations. Moreover, the USCS group who received neuropsychiatric testing scored lower than the population mean on Full-Scale Intelligence Quotient, Working Memory Index, and Processing Speed Index. This study highlights the potential of USCS as biomarkers that can lead to changes in clinical management and outcomes, provide valuable information about pathophysiological mechanisms, and suggest potential treatment pathways.

Evaluate the diagnostic yield of 24-h video-EEG monitoring in a group of children admitted in our epilepsy monitoring unit (EMU). 232 children who underwent 24-h video-EEG monitoring was analysed. We divided each patient's monitoring duration into the first 1, 2, 4, 8, 16 h, relative to the whole 24 h monitoring period. The detection of the first interictal epileptiform discharges (IEDs), epileptic seizures (ES), and psychogenic non-epileptic seizures (PNES) were analysed relative to the different monitoring time subdivision. Our findings revealed that: (1) there was no significant difference in the prevalence of detecting initial IEDs between the first 4-h and 24-h monitoring periods (73.7% vs 81%); (2) clinical events detection rate was statistically similar between the first 8-h and 24-h monitoring periods (15.5% vs 19.3%); (4) an 8-h monitoring was sufficient to capture IEDs, ES and PNES in focal epilepsy children; (5) a 1-h monitoring was sufficient to capture IEDs, ES and PNES in generalized epilepsy children; and (6) IEDs were detected within the first 1-h of monitoring in 96.7% self-limited focal epilepsies (SeLFEs) patient. Our study suggests that a 4-h monitoring has more value in increasing the detection rate of IEDs compared to the traditional shorter routine EEG. And in the case of SeLFEs, a 1-h of monitoring might be sufficient in detecting IEDs. A 24-h VEEG monitoring can detect clinical events in 19.3% of patients. Overall, the yield of IEDs and clinical events detection is adequate in children in children undergoing 24-h video-EEG monitoring.

Although there are many treatment options available for depression, a large portion of patients with depression are diagnosed with treatment-resistant depression (TRD), which is characterized by an inadequate response to antidepressant treatment. Identifying the TRD population is crucial in terms of saving time and resources in depression treatment. Recently several studies employed various methods on EEG datasets for automatic depression detection or treatment outcome prediction. However, no previous study has used the deep learning (DL) approach and EEG signals for detecting treatment resistance. Method: 77 patients with TRD, 43 patients with non-TRD, and 40 healthy controls were compared using GoogleNet convolutional neural network and DL on EEG data. Additionally, Class Activation Maps (CAMs) acquired from the TRD and non-TRD groups were used to obtain distinctive regions for classification. GoogleNet classified the healthy controls and non-TRD group with 88.43%, the healthy controls and TRD subjects with 89.73%, and the TRD and non-TRD group with 90.05% accuracy. The external validation accuracy for the TRD-non-TRD classification was 73.33%. Finally, the CAM analysis revealed that the TRD group contained dominant features in class detection of deep learning architecture in almost all electrodes. Limitations: Our study is limited by the moderate sample size of clinical groups and the retrospective nature of the study. These findings suggest that EEG-based deep learning can be used to classify treatment resistance in depression and may in the future prove to be a useful tool in psychiatry practice to identify patients who need more vigorous intervention.

Deficits in problem-solving may be related to vulnerability to suicidal behavior. We aimed to identify the electroencephalographic (EEG) power spectrum associated with the performance of the Raven as a reasoning/problem-solving task among individuals with recent suicide attempts. : This study with the case-control method, consisted of 61 participants who were assigned to three groups: Suicide attempt + Major Depressive Disorder (SA + MDD), Major Depressive Disorder (MDD), and Healthy Control (HC). All participants underwent clinical evaluations and problem-solving abilities. Subsequently, EEG signals were recorded while performing the Raven task. : The SA + MDD and MDD groups were significantly different from the HC group in terms of anxiety, reasons for life, and hopelessness. Regarding brain oscillations in performing the raven task, increased theta, gamma, and betha power extending over the frontal areas, including anterior prefrontal cortex, dlPFC, pre-SMA, inferior frontal cortex, and medial prefrontal cortex, was significant in SA + MDD compared with other groups. The alpha wave was more prominent in the left frontal, particularly in dlPFC in SA + MDD. Compared to the MDD group, the SA + MDD group had a shorter reaction time, while their response accuracy did not differ significantly. : Suicidal patients have more frontal activity in planning and executive function than the two other groups. Nevertheless, it seems that reduced activity in the left frontal region, which plays a crucial role in managing emotional distress, can contribute to suicidal tendencies among vulnerable individuals. The small sample size and chosen difficult trials for the Raven task were the most limitations of the study.

Using electroencephalography (EEG) to examine the simple mismatch negativity (MMN), a marker of auditory cortex function, has been of great interest in the exploration of biomarkers for psychotic illness. Despite many studies reporting MMN deficits in chronic schizophrenia, there are inconsistent reports of MMN reductions in the early phases of psychotic illness, suggesting the MMN elicited by traditional paradigms may not be a sensitive enough measure of vulnerability to be used as a biomarker. Recently, a more computationally complex measure of auditory cortex function (the complex mismatch negativity; cMMN) has been hypothesized to provide a more sensitive marker of illness vulnerability. The current study employed a novel dual rule paradigm, in which two pattern rules are established and violated, to examine the cMMN in 14 individuals with early phase psychosis (EPP, < 5 years illness) and 15 healthy controls (HC). Relationships between cMMN waveforms, symptom severity, and measures of functioning were explored. We found reductions of cMMN amplitudes at the site of maximal amplitude in EPP (= .017) with large effect sizes (= 0.96). This study is an early step in the exploration of the cMMN as a biomarker for psychosis. Our results provide evidence that the dual rule cMMN paradigm shows promise as a method for cMMN elicitation that captures more subtle neurofunctional changes in the early stages of illness.

Over the past decade, there has been extensive research on the mismatch negativity (MMN) and its promise as a biomarker of illness in people with schizophrenia (SZ). Nevertheless, when attempting to assess the early stages of illness progression, the utility of MMN has been inconsistent. Recently, researchers have been investigating a more advanced MMN paradigm (the complex MMN [cMMN]) which is believed to index higher-order cognitive processing and has been suggested to be a more effective indicator of the early phases of SZ. The cMMN is defined as a paradigm that relies on alterations within a pre-established pattern of stimuli. In this meta-analysis, we investigated cMMN deficits in individuals with SZ, including an analysis involving those in the first 5 years of illness. Our search also included individuals with bipolar disorder who experience psychosis; however, no related papers were found and thus, no findings are reported. Our findings indicate a small/moderate effect (d = 0.47), suggesting that individuals with SZ exhibit reduced cMMN amplitudes compared to individuals without SZ. Interestingly, this effect seems to be more pronounced in individuals within the first 5 years of their illness (d = 0.58), suggesting that cMMN might be a more sensitive biomarker in the early phases of SZ compared to traditional paradigms.

EEG is an effective tool due to its ability to capture and interpret the changes in brain activity under different situations. Quantitative EEG (qEEG) can be essential in evaluating and treating children's learning problems. Fifty school-going children with difficulty in learning were studied. Analysis of the difference between pre-intervention and postintervention EEG power ratio of frequency bands, including Theta to Beta and Theta to Alpha, while eyes-closed, eyes-open, hyperventilation, writing, and reading conditions and the values for relative powers were calculated. The study correlated postintervention theta/beta ratio (TBR) and theta/alpha ratio (TAR) values with behavioral measures. The findings suggested that there was a significant difference in pre-intervention and postintervention relative TAR and TBR power values. A significant increase of TAR and TBR power values was observed in eyes-closed (resting), hyperventilation, writing, and reading task conditions, indicative of a state of arousal at FP1FP2, T3T4, and O1O2 scalp locations. During eye open conditions, the TAR and TBR were significantly low at all 3 scalp locations, indicating a relaxed, conscious, and aware state of mind. Postintervention TAR and TBR values were significantly correlated with behavioral measures during 5 task conditions on several scalp locations. These quantitative electroencephalogram findings in children with learning problems indicate that with the increased complexity of the cognitive tasks, TAR and TBR increase, while postintervention, children could attain a relaxed and conscious state of mind during eyes-open condition.

Mismatch negativity (MMN) is automatically elicited by incoming sound deviation compared to the neural representation of preceding homogenous sounds stored in the brain's auditory sensory memory. This study aimed to assess time-functional deviation sensitivity in auditory sensory memory associated with a temporal window of integration (TWI) of 160-170 msec in patients with schizophrenia. To this end, we measured the magnetic counterpart of the MMN (MMNm) in 20 patients with schizophrenia on medication and 20 healthy age-matched adults as a control group responding to an omitted tone segment incorporated into a complex sound of 176 ms duration corresponding to the TWI duration. Overall, the magnitude of the MMNm was smaller in the patients with schizophrenia than in the healthy control group. The peak latency of the MMNm was prolonged in the latter omitted segments for both groups, but to a greater extent in patients with schizophrenia. These results indicate that deviation detection is impaired in the later part of the TWI, corresponding to the duration of auditory sensory memory in patients with schizophrenia. Thus, the specific impairment of MMN in response to duration deviants (duration MMN), as previously reported, might result from a damaged mechanism in the later part of the TWI of sensory memory, suggesting that a decline in sensory memory causes distorted perception or disturbances in cognitive function in patients with schizophrenia.

Chronic pain is a percept due to an imbalance in the activity between sensory-discriminative, motivational-affective, and descending pain-inhibitory brain regions. Evidence suggests that electroencephalography (EEG) infraslow fluctuation neurofeedback (ISF-NF) training can improve clinical outcomes. It is unknown whether such training can induce EEG activity and functional connectivity (FC) changes. A secondary data analysis of a feasibility clinical trial was conducted to determine whether EEG ISF-NF training can significantly alter EEG activity and FC between the targeted cortical regions in people with chronic painful knee osteoarthritis (OA). A parallel, two-arm, double-blind, randomized, sham-controlled clinical trial was conducted. People with chronic knee pain associated with OA were randomized to receive sham NF training or source-localized ratio ISF-NF training protocol to down-train ISF bands at the somatosensory (SSC), dorsal anterior cingulate (dACC), and uptrain pregenual anterior cingulate cortices (pgACC). Resting state EEG was recorded at baseline and immediate post-training. The source localization mapping demonstrated a reduction ( = .04) in the ISF band activity at the left dorsolateral prefrontal cortex (LdlPFC) in the active NF group. Region of interest analysis yielded significant differences for ISF ( = .008), slow ( = .007), beta ( = .043), and gamma ( = .012) band activities at LdlPFC, dACC, and bilateral SSC. The FC between pgACC and left SSC in the delta band was negatively correlated with pain bothersomeness in the ISF-NF group. The EEG ISF-NF training can modulate EEG activity and connectivity in individuals with chronic painful knee osteoarthritis, and the observed EEG changes correlate with clinical pain measures.

To perform spectral analysis on previously recorded electroencephalograms (EEGs) containing hypsarrhythmia in an initial recording and to assess changes in spectral power (µV) in a follow-up recording after a period of 10-25 days. Fifty participants, aged 2-39 months, with hypsarrhythmia in an initial recording (R1), were compared with regard to their spectral findings in a later recording (R2). Typically, anticonvulsant therapy was initiated or modified after R1. Average delta, theta, alpha, and beta power was derived from approximately 3 min of artifact-free EEG data recorded from 19 electrode derivations. Group and individual changes in delta power between R1 and R2 formed the main analyses. Delta accounted for 84% of the total power. In group comparisons, median delta power decreased statistically significantly between R1 and R2 in all 19 derivations, for example, from 3940 µV in R1 to 1722 µV in R2, Cz derivation. When assessing individual participants, delta power decreases in R2 were >50% in 60% of the participants, but <25% in 24% of the participants. Spectral analysis may be used as an additional tool for providing a potential biomarker in the assessment of short-term changes in hypsarrhythmia, including the effects of treatment.

Infrequent stimulus deviations from repetitive sequences elicit mismatch negativity (MMN) even passively, making MMN practical for clinical applications. Auditory MMN is typically elicited by a change in one (or more) physical stimulus parameters (eg, pitch, duration). This lower-order simple MMN (sMMN) is impaired in long-term schizophrenia. However, sMMN contains activity from release from stimulus adaptation, clouding its face validity as purely deviance-related. More importantly, it is unreliably reduced in samples of first-episode psychosis, limiting its utility as a biomarker. Complex pattern-deviant MMN (cMMN) tasks, which elicit early and late responses, are based on higher-order abstractions and better isolate deviance detection. Their abstract nature may increase the sensitivity to processing deficits in early psychosis. However, both the early and late cMMNs are small, limiting separation between healthy and psychotic samples. In 29 healthy individuals, we tested a new dual-rule cMMN paradigm to assess additivity of deviance. Sounds alternated lateralization between left and right, and low and high pitches, creating a left-low, right-high alternating pattern. Deviants were a repeated left-low, violating lateralization and pitch patterns. Early and late cMMNs on the dual-rule task were significantly larger than those on the one-rule extra tone cMMN task ( < .05). Further, the dual-rule early cMMN was not significantly smaller than pitch or duration sMMNs ( > .48, .28, respectively). These results demonstrate additivity for cMMN pattern-violating rules. This increase in cMMN amplitude should increase group difference effect size, making it a prime candidate for a biomarker of disease presence at first psychotic episode, and perhaps even prior to the emergence of psychosis.