Walton T. Roth

Clinical application of the P3 component of event-related potentials. II. Dementia, depression and schizophrenia

Patients with dementia, schizophrenia and depression were tested with analogous auditory and visual event-related potential (ERP) paradigms designed to elicit a large P3. The patient groups were compared to age normative predictions derived from a large control sample for a number of ERP and behavioral variables. The results were similar for the auditory and visual paradigms. P3 latency was prolonged two or more S.D.s beyond that predicted by age for less than one-half of the demented patients. This latency prolongation was significant for the group as a whole but would result in too many false negatives if used diagnostically for individuals. Furthermore, increased P3 latency was not specific, as the schizophrenic patients also had later P3s. The amplitude of P3 was reduced in the demented patients, but it was also smaller in other patient groups. The only variable which distinguished the demented patients from both controls and from the other patients was the single trial P3 latency/RT correlation. The demented patients, as a group, had significantly lower P3 latency/RT correlations, but this effect also was not sensitive enough to be diagnostic for individuals. The data from these two paradigms suggest that the P3 amplitude and latency abnormalities observed reflect a common, rather than a diagnostically specific deficit. This study is in contrast to some others which report much more sensitivity and specificity in the use of P3 latency in the diagnosis of dementia. Differences in task demands, patient samples and ERP analysis techniques might explain some of the discrepancy.

Clinical application of the P3 component of event-related potentials. I. Normal aging

Normal adult volunteer subjects ranging in age from 18 to 90 years participated in a study in which analogous auditory and visual paradigms, with infrequently occurring target and non-target events, were used to elicit event-related potentials (ERPs) with a prominent P3 component. Of the 135 subjects participating, 66 completed both auditory and visual paradigms. The amplitude and latency of P3 were analyzed using average ERPs, single trials (adaptive filter) and principal components analysis (PCA). Age regressions were calculated using measures derived from average ERPs and single trials. Single trial measures were better than average ERP measures in demonstrating age-related changes in P3 latency. There was a significant increase in P3 latency with age of 1-1.5 msec/year. The range of normal P3 latency for a given age (1 S.E. of the regression = 40 msec for the visual target stimuli) was much larger than obtained by other investigators. The visual paradigm produced higher P3 latency/age correlations than the auditory paradigm (visual target r = 0.52, non-target r = 0.42; auditory target r = 0.32, non-target r = 0.33). Within individuals, the amplitude and latency of P3 generated by auditory and visual stimuli were highly correlated, though the visual paradigm produced larger and later P3s than the auditory paradigm. There is an apparent change in the scalp topography of P3 with age. In young adults, P3s to target stimuli have a markedly parietal distribution. The distribution of P3 becomes more uniformly distributed from Pz to Fz with age. This may be due to changes in overlapping components such as the slow wave (SW) rather than to changes in the amplitude of P3 per se.

Reduced communication between frontal and temporal lobes during talking in schizophrenia

BACKGROUND Communication between the frontal lobes, where speech and verbal thoughts are generated, and the temporal lobes, where they are perceived, may occur through the action of a corollary discharge. Its dysfunction may underlie failure to recognize inner speech as self-generated and account for auditory hallucinations in schizophrenia. METHODS Electroencephalogram was recorded from 10 healthy adults and 12 patients with schizophrenia (DSM-IV) in two conditions: talking aloud and listening to their own played-back speech. Event-related electroencephalogram coherence to acoustic stimuli presented during both conditions was calculated between frontal and temporal pairs, for delta, theta, alpha, beta, and gamma frequency bands. RESULTS Talking produced greater coherence than listening between frontal-temporal regions in all frequency bands; however, in the lower frequencies (delta and theta), there were significant interactions of group and condition. This finding revealed that patients failed to show an increase in coherence during talking, especially over the speech production and speech reception areas of the left hemisphere, and especially in patients prone to hallucinate. CONCLUSIONS Reduced fronto-temporal functional connectivity may contribute to the misattribution of inner thoughts to external voices in schizophrenia.

Event-related potentials recorded from young and old adults during a memory retrieval task☆

Six healthy old and 8 healthy young subjects each received a series of trials in a memory retrieval task devised by Sternberg (1966). On each trials, the subject received a memory set of 1-4 digits and was then shown a test digit. The subjects task was to press one of two response buttons indicating whether the test digit was a member of the memory set for that trial. Response time (RT) was found to be an increasing, linear function of the number of items held in memory. The slope of the RT function was a composite measure of the time necessary to process each additional item in memory while the intercept was a measure of stimulus encoding and response processes that do not depend on memory set size (see Sternberg 1966, 1969, 1975). We found that the latency of P3 to the test stimulus also increased with increases in memory set size, although the slope of the P3 was less than that for RT. We have suggested that the intercept of the P3 slope reflects the time it takes to encode the test stimulus before the evaluation of the stimulus starts, while the slope reflects the amount of time per digit needed to evaluate the set. We have suggested that the difference between RT and P3 slopes represents the additional time per digit which the subjects waits before making a response, due to low confidence occurring with more difficult task conditions (i.e., when set size = 4). We further suggest that the intercept of the RT-P3 latency slope is a reflection of pure response processes. Time estimates of these processes are made for young and old subjects.

Age-related changes in auditory event-related potentials ☆

Twelve elderly and 12 young women were subjects in a reaction-time task designed to elicit middle and late event-related potentials (ERP). The aged subjects differed from the young in respect to the later occurring ERP components: P2 was larger and later; P3 was later and had a different scalp distribution; the slow wave (SW) was smaller. In contrast, no age-related differences were found for N1 amplitude or latency. It is suggested that the diminution in SW amplitude contributes to the change in scalp distribution of P3 amplitude seen with age. The relationship of reaction time and P3 latency of single trials was examined by the adaptive filter technique. There was no difference between the old and young subjects as both groups revealed signficant, positive P3 latency-reaction time correlations.

Selective processing of threat cues in subjects with panic attacks

Abstract Previous research has demonstrated that patients with generalised anxiety disorder, phobias, and obsessive-compulsive disorder show an attentional bias towards threat cues related to their respective disorders. Two studies are presented that used a modified Stroop colour naming task to assess attentional bias in subjects with panic attacks. In Study 1, 24 panic disorder patients and 24 normal controls were presented three cards containing threat words related to physical harm, separation, or social embarrassment. Colour naming times were compared between these cards and control cards containing matched non-threat words. Reaction time differences in the two groups were in opposite directions, patients tending to be slower in colour naming threat words, and controls, faster. In Study 2, 18 non-clinical panickers and 18 controls were presented cards containing physical threat words, neutral control words, or colour words, respectively. Panickers showed greater interference than controls in colour na...

ERPs in schizophrenia: Effects of antipsychotic medication.

Thirty unmedicated schizophrenics were compared to 29 age-matched controls on auditory and visual event-related brain potential (ERP) paradigms. Twenty-one of these patients were tested again after 1 week on placebo and after 4 weeks on antipsychotic medication. Before treatment, N1, N2, and P3 components of the auditory ERP were smaller in the schizophrenics than in the controls. Although visual N2 was smaller in schizophrenics, visual P3 was not. In spite of significant clinical improvement with antipsychotic treatment, amplitudes of auditory and visual N1, N2, and P3 were not significantly changed. Higher blood levels of antipsychotic medication were related to reductions in auditory P3 latency, however. In addition, higher levels of cerebrospinal fluid (CSF) MHPG (methoxyhydroxyphenylglycol) were associated with larger auditory N1s and larger auditory and visual P3s, suggesting an influence of arousal on these components in schizophrenics. In spite of this influence, reduction of the auditory P3 in schizophrenia is an enduring trait of the disease, which is not affected by antipsychotic medication or clinical improvement.

Event-related potentials in schizophrenics ☆

Fifteen schizophrenics and 15 age-matched controls were compared on 3 auditory event-related potential (ERP) paradigms that elicited a variety of components. In one paradigm, tones were given at 0.75, 2.25 and 6.75 sec interstimulus intervals; in another, infrequently occurring targets in a reaction-time task were interspersed with frequent background stimuli; and, in a third, noise bursts or tones were delivered in a random sequence at either 70 or 100 dB SPL. The sensitivity of some of the ERP components in distinguishing schizophrenics from controls depended on the conditions under which the component was elicited. N1 amplitude was smaller in the schizophrenics than in the controls after longer interstimulus intervals. P2 amplitude was smaller in the schizophrenics than in the controls after longer interstimulus intervals. P2 amplitude was smaller in the schizophrenics only at higher stimulus intensities. P2 latency was shorter in schizophrenics except in the paradigm that varied interstimulus intervals. P3 amplitude, however, was much smaller in schizophrenics than controls ragardless of whether P3 was elicited by targets in a task or was elicited by 100 dB SPL stimuli. The loud stimuli also elicited blink reflexes that coincided with N1, but these reflexes did not vary by clinical group. Neither the amplitude of the slow wave following targets nor the sustained potential that accompanies prolonged auditory stimuli differed between schizophrenics and controls.

Auditory event-related potentials in schizophrenia and depression.

Event-related potentials in two auditory target detection paradigms and two auditory paradigms without overt tasks were studied in 22 schizophrenic, 21 depressed, and 28 matched control subjects meeting Research Diagnostic Criteria. In the target detection paradigms, schizophrenics showed a pattern of reduced N120 amplitude and shorter P200 latency to frequently occurring tones, and reduced P300 and Slow Wave amplitude to infrequent target and nontarget tones. This pattern is consistent with impaired selective attention for stimuli. For depressed patients these variables were generally intermediate between those of schizophrenics and controls. In the other paradigms N120 latency was greater for schizophrenics, and P200 amplitude was less for depressed patients.

Psychophysiological assessment: clinical applications for PTSD

Descriptions of anxiety disorders clearly recognize the physiological features of anxiety, yet in most clinical practice and research there is little actual use of physiological measurement. This is unfortunate because a potentially important source of information is thereby unavailable and is likely to result in judgements about emotional experience that are less accurate, complete, and reliable than those that include physiological information. The neglect of physiological measures may result from a variety of concerns regarding test attributes such as reliability, validity, utility, and complexity. Promising results from studies of posttraumatic stress disorder (PTSD) demonstrate that physiological assessment can provide valuable clinical and theoretical insight. Numerous studies have now shown that heightened physiological reactivity to trauma-related cues is highly indicative of a diagnosis of PTSD. Physiological tests have achieved some success in predicting the development and persistence of PTSD, and in predicting and assessing treatment response. Studies of the startle response, aversive conditioning, and brain potentials during cognitive processing have identified several potentially important differences between PTSD patients and controls. This paper provides an overview of psychophysiological findings in PTSD and considers potential clinical applications of psychophysiological assessment for this disorder.