Contingent negative variation in acute trauma patients: A prospective exploratory study.

It is still unclear why some individuals completely recover after an acute trauma and others develop a long-lasting post-traumatic stress disorder (PTSD). This study investigates whether the contingent negative variation (CNV) - a slow negative event-related potential - may be associated with the occurrence of PTSD after acute trauma. CNV (auditory 2-stimulus reaction time paradigm) was recorded within one month as well as 6 months after an acute trauma (dangerous or grave physical injuries, witnessing of attempted suicide or murder, robbery, extortion, accidents, heavy illness, death or loss of an important person, hostage-taking) in 39 otherwise healthy adults and compared with CNV recordings in 38 healthy control subjects without potentially traumatizing experience in their history. According to their subsequent clinical course, these subjects were divided into two groups: participants who recovered completely 1 month after the trauma (PTSD- group, n = 31), and those who began to experience PTSD (PTSD+ group, n = 8). Patients from both trauma groups were characterized by a significantly longer reaction time immediately after the trauma. The PTSD+ group demonstrated lower amplitudes of the late CNV component immediately and six months after the trauma compared with the PTSD- and the control group. Whether the lower CNV amplitudes in patients who develop PTSD after the acute trauma, which is already present in the first days after the trauma, may be related to a higher risk for development of PTSD in these subjects, this has to be clarified in further prospective studies.

Prenatal maternal distress seems to be associated with the infant's temperament and motor development: an explorative study.

According to the concept of fetal programming, prenatal distress has long-lasting consequences on the offspring's health later in life. The hypothalamic-pituitary-adrenal axis is considered a mediating system by which maternal distress is transferred to the fetus in intrauterine environment. In this longitudinal explorative study on 30 mother-child-dyads, reported maternal distress and salivary cortisol were collected during pregnancy. Infant temperament, motor and cognitive development were assessed at 16 months. Additionally, infant cortisol levels throughout the day and in reaction to a psycho-social stressor where measured. As expected, infants whose mothers had experienced higher prenatal distress expressed a more difficult temperament and lower fine motor development at 16 months. No association could be shown between prenatal maternal distress and infant salivary cortisol.

Lifestyle intervention in BRCA1/2 mutation carriers: study protocol for a prospective, randomized, controlled clinical feasibility trial (LIBRE-1 study).

BACKGROUND: Women with highly penetrant BRCA mutations have a 55-60% lifetime risk for breast cancer and a 16-59% lifetime risk for ovarian cancer. However, penetrance differs interindividually, indicating that environmental and behavioral factors may modify this risk. These include lifestyle factors such as physical activity status, dietary habits, and body weight. The modification of penetrance by changing lifestyle factors has not thus far been investigated in a randomized trial in BRCA mutation carriers. METHODS: Therefore, we intend to enroll 60 BRCA1/2 mutation carriers in a pilot feasibility study (Lifestyle Intervention Study in Women with Hereditary Breast and Ovarian Cancer (LIBRE) pilot). This multi-center, prospective, controlled trial aims to randomize (1:1) participants into a (1) multi-factorial lifestyle intervention group (IG) versus (2) the control group with usual care (CG). The primary endpoint is feasibility and acceptance of a structured interdisciplinary lifestyle intervention program over 12 months (at least 70% of the patients to complete the 1-year intervention). Furthermore, the effects on physical fitness, BMI, quality of life, and stress coping capacity will be investigated. During the first 3 months, women in the IG will receive structured, individualized and mainly supervised endurance training of ≥18 MET*h/week (MET = metabolic equivalent task) and personal nutritional counseling based on the Mediterranean diet. During the subsequent 9 months, the IG will receive monthly group training sessions and regular telephone contacts for motivation, whereas the CG will only receive usual care (one general counseling on healthy nutrition and benefits of regular physical activity on health status). At randomization and subsequent time points (3, 6, 12 months), cardiopulmonary fitness will be assessed by spiroergometry and nutritional and psychological status by validated questionnaires. DISCUSSION: This pilot study will investigate the optimal strategy to improve physical fitness, nutritional habits, and psychological factors in women at high risk for developing breast or ovarian cancer. The results of this pilot feasibility study will be the basis for a larger prospective randomized trial including clinical events (LIBRE). TRIAL REGISTRATION: ClinicalTrials.gov, NCT02087592.

No deficit in neurocortical information processing in patients with cleft lip and palate.

BACKGROUND: Cleft lip and palate (CLP) represents the most common malformation of the midfacial region worldwide. It can be suggested that the facial stigmatization, the speech impediment, and the long-standing pressure of treatment cause a range of life stressors. Neurocortical information is influenced by physiological and psychological factors and varies significantly in patients suffering from chronic stress, anxiety, depression, or other psychopathological conditions following maladaptation. The aims of the present study were to investigate the neurocortical information processing of patients with CLP using the contingent negative variation (CNV) paradigm and to evaluate secondary psychopathology, anxiety, and depression. MATERIALS AND METHODS: Twenty-five adults with CLP and 25 healthy volunteers, matched in age and gender, were investigated using recordings of the CNV. Initial CNV (iCNV), late CNV (lCNV), and total CNV (tCNV) as well as habituation slope of the iCNV were determined in each subject. Additionally, each participant had to complete the hospital anxiety and depression questionnaire (HADS) and the Symptom Checklist-90-R (SCL-90-R). RESULTS: Individuals with CLP did not differ significantly from healthy subjects according to any of the CNV parameters investigated. No correlations could be revealed between the measured items and the confounding factors age and gender. Additionally, there were no differences between the groups regarding depression and SCL-90-R; however, anxiety showed significant group differences on a subclinical level. CONCLUSIONS: These data suggest that subjects with CLP show normal neurocortical information processing. It seems likely that CLP and its treatment have no impact on psychosocial functioning and neurophysiological mechanisms of attention. CLINICAL RELEVANCE: The specific living conditions of patients with CLP do not result in disease-specific neurophysiological changes.

Disease duration of episodic migraine correlates with modified amplitudes and habituation of contingent negative variation.

Cortical habituation in episodic migraine patients without medication overuse headache (MOH), recorded by contingent negative variation (CNV), is often reduced compared with healthy controls. There is evidence that with longer duration of migraine disease (DOD) amplitudes and habituation of CNV become progressively abnormal. The aim of the study was to examine habituation characteristics of contingent negative variation in episodic migraine patients suffering from short- and long-lasting migraine compared to matched healthy controls. 32 migraine patients without aura and without MOH diagnosed according to the revised ICHD-II criteria and 16 age- and sex-matched healthy controls were included. According to DOD, the total sample of migraine patients was divided into two groups (group a: DOD <121 months, n = 17 subjects, group b: DOD >120 months, n = 15 subjects). Both migraine groups did not differ in the number of days of migraine and the duration of attacks. Overall CNV and initial CNV differed significantly between migraine patients and controls, whereas the former produced more negative amplitudes. In the migraine group lack of or deficient habituation occurred, whilst controls showed habituation. There were middle range correlations between the DOD and overall CNV, initial CNV, and y-intercept. Patients suffering from long-lasting migraine produced higher CNV amplitudes with a higher y-intercept. The results are interpreted as "maladaptive plasticity" with a risen intercept in long-lasting migraine.

Altered information processing in children with focal epilepsies with and without intellectual disability.

The aim of this exploratory study was to investigate the relationship between focal interictal epileptiform discharges (IEDs), intellectual disability and cortical information processing in children with partial epilepsy. Two groups of patients--Group 1 (n = 9 patients) with focal IEDs and normal IQ and Group 2 (n = 10 patients) with focal IEDs and intellectual disability--were compared with 14 healthy control participants. A computerized choice reaction time task (go/no-go paradigm) was performed and event-related potentials (ERPs) were recorded. When an IED occurred during the period between the presentation of the stimulus and the response, the response was defined as a response with IED. Omission errors, commission errors and reaction time were evaluated in temporal relationship to IEDs. The Group 1 patients did not differ from the healthy children in neurophysiological functions and ERP amplitudes. The Group 2 children showed inferior Altered information processing in children with focal epilepsies with and without intellectual disability performances in verbal learning and memory, cognitive flexibility and selective attention, and were characterized by low ERP amplitudes compared with the epilepsy patients with normal IQ and the healthy children. We were not able to identify any significant relationship between IEDs and cognitive functions in either group of patients. Our findings suggest that the impact of IEDs on the overall intellectual abilities of epilepsy patients may not be as significant as previously thought. Moreover, it is likely that abnormalities in cognitive information processing as revealed by lower ERP amplitudes, occurrence of IEDs, and intellectual disabilities may represent common abnormal processes and may not be causally related to each other.

Normal emotion regulation in adults with cleft lip and palate: an exploratory study.

INTRODUCTION: Cleft lip and palate (CLP) represent the most common congenital malformations of the midfacial region. Although these patients show differences in their facial appearance, we hypothesize that CLP-affected individuals do not show an alteration in their emotion regulation abilities compared to unaffected individuals. This is because of the strong biological basis of facial emotion and expression that is inherent and receives little influence from external factors. MATERIAL AND METHODS: The present study evaluated various aspects of emotion regulation in 25 adults with CLP and an equally sized control group of unaffected volunteers. The study was divided into three parts. First, we investigated emotion regulation strategies. Here, each participant was asked to complete the Emotion Regulation Questionnaire (ERQ) and Ambivalence over Emotional Expressiveness Questionnaire G 18 (AEQ-G18). Second, we examined the recognition of facially expressed basic emotions (FEEL test). Third, we evaluated the expression of an emotion induced by an odor sample. RESULTS: Habitual emotion regulation, measured by ERQ and AEQ-G18, was not different between CLP and controls subjects for all of the sub-scales. Recognition of facially expressed basic emotions was also the same for both groups. Facial emotion encoding did not differ for both groups. CONCLUSIONS: To summarize, the findings suggest that individuals with an orofacial cleft show undisturbed emotion regulation and recognition. This may be explained by the strong biological basis of facial emotion recognition and regulation as well as by the healthy emotional resilience and social functioning of CLP patients.

Does an aerobic endurance programme have an influence on information processing in migraineurs?

BACKGROUND: Migraine is a disorder of central information processing which is characterized by a reduced habituation of event-related potentials. There might be positive effects of aerobic exercise on brain function and pain. The aim of this study was to investigate the influence of exercise on information processing and clinical course of migraine. METHODS: 33 patients completed a ten-week aerobic exercise programme. To examine the influence of the treatment on information processing and attention, Trail Making Test (TMT) A and B, d2-Letter Cancellation Test (LCT) and recordings of the Contingent Negative Variation (CNV) were performed before and after the training. RESULTS: Patients showed a significant reduction of the migraine attack frequency, the iCNV-amplitude and the processing time for TMT-A and TMT-B after treatment. Moreover, there was a significant increase of the habituation and positive changes in parameters of attention (d2-LCT) after the training. CONCLUSIONS: This study demonstrates that aerobic exercise programme influences central information processing and leads to clinical effects on the migraine symptomatology. The results can be interpreted in terms of an improvement of a dysfunctional information processing and a stimulus selection under aerobic exercise.

Children with a cleft lip and palate: an exploratory study of the role of the parent-child interaction.

INTRODUCTION: Having a child with an orofacial cleft may be associated with a specific pattern of parenting. In order to investigate the parenting style, the present study assessed parent-child interactions during a problem-solving task performed under pressure. MATERIAL AND METHODS: Parent-child interactions were video recorded for 15 families with a child with a cleft lip and palate (CLP), which were then compared to 20 healthy families and 20 families with a child suffering from migraines. The children had to solve a puzzle within a specified time with either their mother or father. RESULTS: In families with a child with CLP, mothers tried to support their children more often and children demonstrated more autonomous behaviour towards both parents than children in healthy and migraine-affected families. Moreover, the children with CLP relied less on their fathers for help and interrupted their fathers less frequently. CONCLUSIONS: Autonomous behaviour among children with CLP which is supported by their parents may represent psychosocial compensatory mechanisms in the family environment.

Developmental changes of neuronal networks associated with strategic social decision-making.

OBJECTIVES: One of the important prerequisites for successful social interaction is the willingness of each individual to cooperate socially. Using the ultimatum game, several studies have demonstrated that the process of decision-making to cooperate or to defeat in interaction with a partner is associated with activation of the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), anterior insula (AI), and inferior frontal cortex (IFC). This study investigates developmental changes in this neuronal network. METHODS: 15 healthy children (8-12 years), 15 adolescents (13-18 years) and 15 young adults (19-28 years) were investigated using the ultimatum game. Neuronal networks representing decision-making based on strategic thinking were characterized using functional MRI. RESULTS: In all age groups, the process of decision-making in reaction to unfair offers was associated with hemodynamic changes in similar regions. Compared with children, however, healthy adults and adolescents revealed greater activation in the IFC and the fusiform gyrus, as well as the nucleus accumbens. In contrast, healthy children displayed more activation in the AI, the dorsal part of the ACC, and the DLPFC. There were no differences in brain activations between adults and adolescents. CONCLUSION: The neuronal mechanisms underlying strategic social decision making are already developed by the age of eight. Decision-making based on strategic thinking is associated with age-dependent involvement of different brain regions. Neuronal networks underlying theory of mind and reward anticipation are more activated in adults and adolescents with regard to the increasing perspective taking with age. In relation to emotional reactivity and respective compensatory coping in younger ages, children have higher activations in a neuronal network associated with emotional processing and executive control.

Deployment-related stress disorder in german soldiers: utilization of psychiatric and psychotherapeutic treatment.

INTRODUCTION: Military missions abroad carry a high risk of psychological traumatization. In this study, we examined the reasons for increased utilization of the treatments offered to soldiers by the German armed forces' psychiatric services. METHOD: We analyzed trends in initial contacts with psychiatrists and psychotherapists among German soldiers participating in missions to Afghanistan and the Balkans. To this end, we evaluated existing data from the psychiatric services of all German Armed Forces Military Hospitals with respect to sociodemographic factors (sex, area of mission) and the underlying psychiatric disorders over an 18-month period (January 2010 to June 2011). RESULTS: 615 soldiers made an initial contact with the psychiatric and psychotherapeutic services during the study period. The total number of first contacts did not change significantly (p = 0.195), but there was a notable rise in the number of first contacts by female soldiers with deployment-related stress (p = 0.003). Mission-specific statistics revealed a significant increase in the number of first contacts only for soldiers deployed to the Balkans (p = 0.017). 91% of soldiers making a first contact were given the diagnosis of a stress reaction (ICD-10: F 43); the second most common diagnosis (8.9%) was an affective disorder (ICD-10: F 32.0, F 32.1). CONCLUSION: Despite psychological prevention efforts, military missions abroad often lead to mental disorders. Our findings indicate that the mild observed increase in incidence is both sex-specific and deployment-area-specific.

Stress-coping and cortisol analysis in patients with non-syndromic cleft lip and palate: an explorative study.

BACKGROUND: Non-syndromic clefts of the orofacial region occur in approximately 1 per 500 to 2,500 live births, depending on geographical area and ethnicity. It can be supposed that the disruption of the normal facial structure and the long-standing pressure of treatment from birth to adulthood bring about a range of life stressors which may lead to a long-lasting impact on affected subjects throughout their lives. Therefore, the present study aimed to assess different aspects of psychosocial stress in affected individuals. METHODS: The study was divided into two parts: first, the Trier Social Stress Test which involves uncontrollability and high levels of social-evaluative stress under real conditions and second, the query of various aspects of coping with psychosocial stress. The test group consisted of 30 affected adult subjects, and an equally sized control group of unaffected volunteers. Cortisol dysregulation was determined by saliva samples before and after stress induction. Meanwhile, participants were asked to complete the SVF 120 stress-coping questionnaire. RESULTS: The analysis of saliva samples showed a similar baseline concentration as well as a similar increase in cortisol levels after stress induction for both groups. Subsequently, the decline in cortisol concentrations was significantly faster in the CLP group (course: p<0.001; groups: p = 0.102; interaction: p = 0.167). The evaluation of the stress-coping questionnaire revealed a significantly shorter rumination about a stressful event in individuals with CLP-related malformations (p = 0.03). CONCLUSION: We conclude that adults with CLP have significantly better stress-coping strategies than their healthy peers. TRIAL REGISTRATION: German Clinical Trials Organization DRKS00003466.

Time-dependent post-imperative negative variation indicates adaptation and problem solving in migraine patients.

According to the Seligman theory of learned helplessness, depression is caused by a repetitive experience of loss of control resulting in internal, stable and global attributional styles for negative events. In depressed patients and healthy controls experiencing such events, an increased amplitude of the post-imperative negative variation (PINV) has been described. The aim of the study was to investigate a possible correlation between migraine, depression, learned helplessness and PINV. 24 patients suffering from migraine without aura and 24 healthy controls were exposed to a situation of loss of control whilst the contingent negative variation (CNV) from C3, C4 and Cz were recorded. Before conducting the experiment, the subjects were asked to answer the Beck Depression Inventory (BDI) and the German attributional style questionnaire (GASQ). Amplitudes of total CNV, early and late component and PINV were calculated in eight blocks of four recordings each. The results confirm findings of a pronounced PINV in situations of loss of control, though high amplitudes were not correlated with low values in the GASQ and therefore with learned helplessness. High PINV in migraine patients correlated with high scores in the BDI and the list of the complaints questionnaire. However, this was not the case in healthy controls. In this experimental situation, PINV in migraine patients can be interpreted as an expectancy potential in order to avoid failure and helplessness.

Does inert gas narcosis have an influence on perception of pain?

The effect of an increased nitrogen partial pressure under hyperbaric conditions is known as nitrogen narcosis (NN). At an ambient pressure of about 4 bar, reduced cognitive performance as well as euphoric effects are reported. We examined the effect of NN on pain perception. 22 subjects completed an experimental (50 meters = 6 bar) and a simulated control dive (0 m = 1 bar) in a hyperbaric chamber. Before and during each dive a standardized cold pressure test was performed. The intensity of pain perceived was assessed with the help of a visual analogue scale; additionally, subjects assessed the subjective effect of NN. The study showed that the perceived pain intensity is significantly reduced under nitrogen narcosis conditions (F1.21 = 5.167, p < 0.034) when compared to the perceived pain intensity under the control dive conditions (F1.21 = 0.836, p = 0.371). A connection between perceived pain intensity and subjects experience of the NN was not found under the experimental dive condition (r = 0.287, p = 0.195). We could show that even relatively moderate hyperbaric conditions may have an influence on the perception of pain. The results are highly relevant since nitrogen narcosis occurs in divers as well as in medical personnel or construction workers, working under hyperbaric conditions.

Behavioural treatment increases activity in the cognitive neuronal networks in children with attention deficit/hyperactivity disorder.

Response cost and token approach (RCT) within the scope of a summer camp training is an effective treatment program for attention deficit hyperactivity disorder (ADHD). It is likely that intensive RCT training influences networks responsible for ADHD symptoms. Functional magnetic resonance imaging (fMRI) was carried out in 12 children with ADHD before and after the RCT program and in 12 healthy control children twice. For fMRI, a Go/No-go paradigm was used to investigate the influence of RCT training on attention and impulsivity. The No-go condition revealed only weak activation in the dorsal part of the anterior cingulate cortex (ACC), parietal and dorsolateral prefrontal cortex (DLPFC) before the training in children with ADHD compared to healthy children. However, this activation in these brain regions was significantly more pronounced after the training. This increase in hemodynamic response cannot be attributed merely to repetition of the measurement since the effect was not observed in healthy children. The increase in hemodynamic response in the ACC and right DLPFC was significantly associated with a reduction in response time variability and clinical symptoms in ADHD patients. After the RCT training, the children with ADHD demonstrated more pronounced activation of cortical structures which are typically related to response monitoring and self-control. It seems likely that children with ADHD learned more cognitive control in a continuous performance task as was revealed by both neuropsychological outcome and fMRI.

Cortical habituation deficit in tinnitus sufferers: contingent negative variation as an indicator of duration of the disease.

Cortical attention and habituation parameters are altered in patients suffering from tinnitus. The aim of the study was to quantify cortical attention and habituation parameters in tinnitus patients by recording the contingent negative variation (CNV) response and to correlate amplitudes of different CNV parameters with duration of disease. Twenty patients suffering from tinnitus (median: 44 years) and twenty age- and sex-matched healthy controls (median: 41 years) were tested by a CNV paradigm. We recorded overall CNV, initial CNV, and terminal CNV and calculated habituation slopes. All CNV parameters were Spearman-correlated with individual duration of disease. Highly significant between groups differences emerged in total (tinnitus: -8.4 uV vs. controls: -3.8 uV), initial (-11.2 vs. -6.0 uV), and terminal CNV (-11.9 vs. -6.5 uV) demonstrating higher negative amplitudes in tinnitus patients. Habituation differed in total and terminal CNV, indicating missing habituation in tinnitus patients. Overall CNV (ϱ = -.365) and initial CNV (ϱ = -.529) showed a medium Spearman correlation with duration of disease. We conclude that the correlation between duration of tinnitus and the initial CNV amplitudes indicates an altered state of cortical excitability that can also be observed in more negative CNV-amplitudes in tinnitus patients. We assume that this state indicates a chronicity process in tinnitus disease.

The impact of a multimodal Summer Camp Training on neuropsychological functioning in children and adolescents with ADHD: an exploratory study.

This study examined the combined effects of methylphenidate (MPD) and response cost and token strategy (RCT), administered in an intensive ADHD Summer Camp Training (ASCT) format, on neuropsychological functions. Forty children with ADHD were randomly assigned to either the ASCT treatment (MPD plus RCT) or a control group (MPD plus a 1-hour session of standardized parental education/counselling [SPC]). This latter group was structured to be similar to the more typical current treatment. The ASCT treatment was administered for 2½ weeks and included RCT, consisting of elements of social skill training, attention training, and sports participation. RCT was systematically applied in all daily situations and activities. Executive functions and state of regulation using the Test for Attention Performance (TAP) and the Trail-Making Test (TMT) were assessed before training and at a 6-month follow-up. Participants receiving the ASCT improved specific neuropsychological functions in attention regulation and inhibitory control tasks at the 6-month follow-up. No changes occurred for participants assigned to the control condition. The data suggest that an intensive multimodal summer camp treatment program including strategies of instrumental learning can lead to substantial and enduring improvements in neuropsychological functioning of children and adolescents with ADHD.

Neuropsychological deficits in scuba divers: an exploratory investigation.

OBJECTIVE: To investigate whether divers with varying levels of experience and without a history of reported decompression sickness (DCS) show neuropsychometric alterations possibly as a result of so-called repetitive "silent" paradoxical gas embolisms. METHODS: Using reaction time as a psychometric measure, 17 experienced military divers (ED, logging between 150 and 1,200 diving hours) and eight very experienced military divers (VED, logging between 2,800 and 9,800 diving hours) with no decompression sickness (DCS) in their medical histories were compared to 23 healthy controls without any diving history, matched as closely as possible with respect to age for the two diving groups. Motor reaction time, decision reaction time and error rates were measured during completion of both simple and complex reaction time tasks. RESULTS: Compared to their control group, VED showed significantly higher motor reaction times on both tasks and significantly higher decision reaction times in the complex task. ED were not found to be different from their respective controls. No changes in performance quality in terms of increased errors were observed in any of the tasks for either diving group. CONCLUSIONS: The findings support the proposed possibility that minimal cerebral lesions occur after diving even without DCS. Further studies with this highly selective population of very experienced divers using more elaborate neurocognitive and neuromotor tasks seem warranted.

Behavioural treatment programme contributes to normalization of contingent negative variation in children with migraine.

BACKGROUND: Migraine is a disorder of central information processing which may be characterized by increased amplitudes and reduced habituation of evoked and event-related potentials. In this pilot study, special behavioural training of habituation to aversive stimuli (MIPAS-Family = Migraine Patient Seminar for Families) was developed and proven effective in children suffering from migraine without aura. METHODS: 13 children with migraine participated in the MIPAS-Family programme and 13 other children with migraine were treated with biofeedback. The influence of both treatments on abnormal cortical information processing in migraine was assessed using recordings of the contingent negative variation (CNV), an event-related slow cortical potential. RESULTS: Both MIPAS training and biofeedback caused an equal reduction of migraine frequency and severity. However, MIPAS treatment was associated with a significant increase in iCNV habituation. Changes in the clinical course of migraine correlated positively with normalization of habituation: the greater the reduction in headache frequency, the greater the increase in CNV habituation was. These effects were not observed in the biofeedback group. CONCLUSIONS: This study demonstrates that the specific treatment programme which was evolved from knowledge of pathogenetic mechanisms of migraine influences central information processing and leads to a clinical effect.

Component-specific self-regulation of slow cortical potentials and its effect on behavior: an exploratory study.

In the present study, the possibility of component-specific self-regulation of the contingent negative variation (CNV) and the functional significance of the iCNV (initial or early CNV component) and tCNV (terminal or late CNV component) were investigated in twenty-four healthy volunteers. The subjects were able to achieve control over a particular CNV component within four sessions. Regulation of the tCNV was more successful than for the iCNV. Specific control over iCNV was associated with strategies mainly related to the pre-stimulus interval or the warning stimulus (S1), while regulation of the tCNV was assigned to activities during the whole interstimulus interval or around the imperative stimulus (S2). It can be concluded that component-specific regulation of the CNV can be used in studies of the psychophysiological meaning of this potential, representing different stages of information processing. The role of cortical pre-activation in the generation of the iCNV and the phasic performance-directed activation of the tCNV can be hypothesized.