Multisensory temporal function and EEG complexity in patients with epilepsy and psychogenic nonepileptic events.

Cognitive and perceptual comorbidities frequently accompany epilepsy and psychogenic nonepileptic events (PNEE). However, and despite the fact that perceptual function is built upon a multisensory foundation, little knowledge exists concerning multisensory function in these populations. Here, we characterized facets of multisensory processing abilities in patients with epilepsy and PNEE, and probed the relationship between individual resting-state EEG complexity and these psychophysical measures in each patient. We prospectively studied a cohort of patients with epilepsy (N=18) and PNEE (N=20) patients who were admitted to Vanderbilt's Epilepsy Monitoring Unit (EMU) and weaned off of anticonvulsant drugs. Unaffected age-matched persons staying with the patients in the EMU (N=15) were also recruited as controls. All participants performed two tests of multisensory function: an audio-visual simultaneity judgment and an audio-visual redundant target task. Further, in the cohort of patients with epilepsy and PNEE we quantified resting state EEG gamma power and complexity. Compared with both patients with epilepsy and control subjects, patients with PNEE exhibited significantly poorer acuity in audiovisual temporal function as evidenced in significantly larger temporal binding windows (i.e., they perceived larger stimulus asynchronies as being presented simultaneously). These differences appeared to be specific for temporal function, as there was no difference among the three groups in a non-temporally based measure of multisensory function - the redundant target task. Further, patients with PNEE exhibited more complex resting state EEG patterns as compared to their patients with epilepsy, and EEG complexity correlated with multisensory temporal performance on a subject-by-subject manner. Taken together, findings seem to indicate that patients with PNEE bind information from audition and vision over larger temporal intervals when compared with control subjects as well as patients with epilepsy. This difference in multisensory function appears to be specific to the temporal domain, and may be a contributing factor to the behavioral and perceptual alterations seen in this population.

Identifying and quantifying multisensory integration: a tutorial review.

We process information from the world through multiple senses, and the brain must decide what information belongs together and what information should be segregated. One challenge in studying such multisensory integration is how to quantify the multisensory interactions, a challenge that is amplified by the host of methods that are now used to measure neural, behavioral, and perceptual responses. Many of the measures that have been developed to quantify multisensory integration (and which have been derived from single unit analyses), have been applied to these different measures without much consideration for the nature of the process being studied. Here, we provide a review focused on the means with which experimenters quantify multisensory processes and integration across a range of commonly used experimental methodologies. We emphasize the most commonly employed measures, including single- and multiunit responses, local field potentials, functional magnetic resonance imaging, and electroencephalography, along with behavioral measures of detection, accuracy, and response times. In each section, we will discuss the different metrics commonly used to quantify multisensory interactions, including the rationale for their use, their advantages, and the drawbacks and caveats associated with them. Also discussed are possible alternatives to the most commonly used metrics.