Changes in EEG Activity and Cognition Related to Physical Activity in Older Adults: A Systematic Review.

Aging is generally associated with a decline in important cognitive functions that can be observed in EEG. Physical activity in older adults should be considered one of the main strategies to promote health and prevent disease in the elderly. The present study aimed to systematically review studies of EEG activity and cognitive function changes associated with physical activity in older adults. Records from PubMed, Scopus, and EBSCO databases were searched and, following the PRISMA guidelines, nine studies were included in the present systematic review. A risk of bias assessment was performed using the National Institute of Health Quality Assessment Tool for Case-control Studies instrument. The studies analyzed used two main strategies to determine the effects of physical activity on cognition and EEG: (1) multiscale entropy and power frequencies; and (2) event-related potentials. In terms of EEG activity, it can be concluded that exercise-induced neuroplasticity underlies improvements in cognitive function in healthy older adults.

State of the art and new directions of Quantitative Electroencephalography use in Differential Diagnosis of ADHD / Estado de la cuestión y uso de la electroencefalografía cuantitativa en el diagnóstico diferencial del TDAH

Advances in technology in recent years have made the use of quantitative electroencephalogram more accessible to clinicians. The incorporation ofnormative databases in QEEG studies and the possibility of detecting different electroencephalographic patterns in patients with a given pathology,despite showing an apparent symptomatology homogeneity, make it an interesting source of information. The relationship of these patterns with apossible response to treatment or with prognostic estimates would justify its inclusion as a routine test in the process of the differential diagnosisof ADHD. In this paper, we present the possible benefits of the use of QEEG in the differential diagnosis of ADHD, the different electroencephalographic patterns associated with ADHD most common in the literature, and a case showcasing the use of the technique in a patient with ADHD. (AU)

El avance de la tecnología en los últimos años ha hecho que el uso del electroencefalograma cuantitativo sea más accesible a los clínicos. La incorporación de bases de datos normativas enlos estudios de QEEG y la posibilidad de detectar diferentes patrones electroencefalográficos en pacientes con una patología determinada, a pesarde mostrar una aparente homogeneidad sintomatológica, hacen que sea una fuente de información interesante. La relación de estos patrones conuna posible respuesta a tratamientos o con estimaciones pronósticas justificarían su inclusión como prueba rutinaria en el proceso de diagnósticodiferencial del TDAH. En este trabajo se presentan los posibles beneficios del uso del QEEG en el diagnóstico diferencial del TDAH, los diferentespatrones electroencefalográficos asociados al TDAH más comunes en la literatura y un caso ilustrativo del uso de la técnica en un paciente con TDAH. (AU)

Exploring Inflammatory Status in Febrile Seizures Associated with Urinary Tract Infections: A Two-Step Cluster Approach.

BACKGROUND: Urinary tract infections (UTIs) are considered common facilitating factors, along with other infections, in triggering febrile seizures (FS). The main purpose of our study was to identify specific inflammatory patterns of UTI cases from other infections in a specific cluster, using a combination of inflammatory biomarkers to differentiate UTIs from other bacterial diseases triggering FS. METHOD: This prospective study included a number of 136 patients with 197 distinct FS events, from patients hospitalized in the Pediatric Clinical Hospital Sibiu, among which 10.2% were diagnosed with UTIs. RESULTS: In one-third of the patients with UTIs (20 cases), the symptoms were limited to fever and FS. Using two-step cluster analysis, a distinct UTI inflammatory pattern has emerged: highest platelet values (PLT), median value 331 × 103/mm3 and intermediate C-reactive protein (CRP), median value 15 mg/dL, platelet distribution width (PDW), median value 9.65%, platelet-large cell ratio (P-LCR), median value 14.45%, mean platelet volume (MPV), median value 8.60 fL and neutrophil-to-lymphocyte values (NLR), median value 3.64. Furthermore, higher PDW (median value 12.25%), P-LCR (median value 28.55%), MPV (median value 10.40 fL), CRP (median value 74.00 mg/dL) and NLR values (median value 4.11) were associated mainly (85.7%) with bacterial lower respiratory infections. UTIs were highly unlikely in these patients with significantly increased CRP values and normal values of platelet indices. CONCLUSIONS: Considering the nonspecific clinical picture of UTIs at an early age, to optimize the management of FS, a fast diagnosis of UTI is mandatory. The analysis of the inflammatory biomarker clusters (rather than individual parameters) correlated with urine leukocyte and nitrite stick evaluation for specific age groups could help in identifying even oligosymptomatic UTIs patients. The study limitation (20 UTI cases) recommends future multicentric trials on larger datasets to validate the model.

A Decision-Tree Approach to Assist in Forecasting the Outcomes of the Neonatal Brain Injury.

Neonatal brain injury or neonatal encephalopathy (NE) is a significant morbidity and mortality factor in preterm and full-term newborns. NE has an incidence in the range of 2.5 to 3.5 per 1000 live births carrying a considerable burden for neurological outcomes such as epilepsy, cerebral palsy, cognitive impairments, and hydrocephaly. Many scoring systems based on different risk factor combinations in regression models have been proposed to predict abnormal outcomes. Birthweight, gestational age, Apgar scores, pH, ultrasound and MRI biomarkers, seizures onset, EEG pattern, and seizure duration were the most referred predictors in the literature. Our study proposes a decision-tree approach based on clinical risk factors for abnormal outcomes in newborns with the neurological syndrome to assist in neonatal encephalopathy prognosis as a complementary tool to the acknowledged scoring systems. We retrospectively studied 188 newborns with associated encephalopathy and seizures in the perinatal period. Etiology and abnormal outcomes were assessed through correlations with the risk factors. We computed mean, median, odds ratios values for birth weight, gestational age, 1-min Apgar Score, 5-min Apgar score, seizures onset, and seizures duration monitoring, applying standard statistical methods first. Subsequently, CART (classification and regression trees) and cluster analysis were employed, further adjusting the medians. Out of 188 cases, 84 were associated to abnormal outcomes. The hierarchy on etiology frequencies was dominated by cerebrovascular impairments, metabolic anomalies, and infections. Both preterms and full-terms at risk were bundled in specific categories defined as high-risk 75-100%, intermediate risk 52.9%, and low risk 0-25% after CART algorithm implementation. Cluster analysis illustrated the median values, profiling at a glance the preterm model in high-risk groups and a full-term model in the inter-mediate-risk category. Our study illustrates that, in addition to standard statistics methodologies, decision-tree approaches could provide a first-step tool for the prognosis of the abnormal outcome in newborns with encephalopathy.

Enhancing the Effects of Neurofeedback Training: The Motivational Value of the Reinforcers.

The brain activity that is measured by electroencephalography (EEG) can be modified through operant conditioning, specifically using neurofeedback (NF). NF has been applied to several disorders claiming that a change in the erratic brain activity would be accompanied by a reduction of the symptoms. However, the expected results are not always achieved. Some authors have suggested that the lack of an adequate response may be due to an incorrect application of the operant conditioning principles. A key factor in operant conditioning is the use of reinforcers and their value in modifying behavior, something that is not always sufficiently taken into account. This work aims to clarify the relevance of the motivational value versus the purely informational value of the reinforcer. In this study, 113 subjects were randomly assigned two different reinforcer conditions: a selected reinforcer-the subjects subjectively selected the reinforcers-or an imposed reinforcer-the reinforcers were assigned by the experimenter-and both groups undertook NF sessions to enhance the sensorimotor rhythm (SMR). In addition, the selected reinforcer group was divided into two subgroups: one receiving real NF and the other one sham NF. There were no significant differences between the groups at baseline in terms of SMR amplitude. After the intervention, only those subjects belonging to the selected reinforcer group and receiving real NF increased their SMR. Our results provide evidence for the importance of the motivational value of the reinforcer in Neurofeedback success.

Individual Alpha Peak Frequency, an Important Biomarker for Live Z-Score Training Neurofeedback in Adolescents with Learning Disabilities.

Learning disabilities (LDs) have an estimated prevalence between 5% and 9% in the pediatric population and are associated with difficulties in reading, arithmetic, and writing. Previous electroencephalography (EEG) research has reported a lag in alpha-band development in specific LD phenotypes, which seems to offer a possible explanation for differences in EEG maturation. In this study, 40 adolescents aged 10-15 years with LDs underwent 10 sessions of Live Z-Score Training Neurofeedback (LZT-NF) Training to improve their cognition and behavior. Based on the individual alpha peak frequency (i-APF) values from the spectrogram, a group with normal i-APF (ni-APF) and a group with low i-APF (li-APF) were compared in a pre-and-post-LZT-NF intervention. There were no statistical differences in age, gender, or the distribution of LDs between the groups. The li-APF group showed a higher theta absolute power in P4 (p = 0.016) at baseline and higher Hi-Beta absolute power in F3 (p = 0.007) post-treatment compared with the ni-APF group. In both groups, extreme waves (absolute Z-score of ≥1.5) were more likely to move toward the normative values, with better results in the ni-APF group. Conversely, the waves within the normal range at baseline were more likely to move out of the range after treatment in the li-APF group. Our results provide evidence of a viable biomarker for identifying optimal responders for the LZT-NF technique based on the i-APF metric reflecting the patient's neurophysiological individuality.

Effects of quantitative electroencephalogram normalization using 4-channel live z-score training neurofeedback for children with learning disabilities: Preliminary data / Efectos de normalización del electroencefalograma cuantitativo utilizando neurorretroalimentación de puntuaciones Z de 4 canales en tiempo real para niños con trastornos de aprendizaje: datos preliminares

Children with learning disabilities (LD) can have difficulties in reading at word level, text comprehension, writing or arithmetic. Several studies have shown the efficacy of neurofeedback (NF) in improving learning skills through brainwave operant conditioning in children with LD. The aim of this work was to show the efficacy of live z-score NF training (LZT) for quantitative electroencephalogram (QEEG) normalization in school children with LD. Twenty-eight children aged 10-15 years with LD participated. Ten 30-min sessions of QEEG-guided LZT using patient's highly preferred feedback were applied. After 10 sessions of QEEGguided LZT, participants showed statistically significant improvements in QEEG normalization and a statistically significant small to medium improvement in the Cognitive and Emotional Checklist. The results suggest that LZT-NF produces a tendency towards normalization of brain waves in children with LD, and might be advised as a therapeutic alternative or coadjuvant along with cognitive interventions

Los niños con trastornos de aprendizaje (TA) pueden manifestar dificultades en la lectura a nivel de palabra, comprensión de textos, escritura o matemáticas. Algunos estudios han mostrado la eficacia de la neurorretroalimentación (NR) en la mejora de las habilidades de aprendizaje a través del condicionamiento operante de las ondas cerebrales en niños con TA. El objetivo de este trabajo fue mostrar datos preliminares de la eficacia de la neurorretroalimentación de puntuaciones z en tiempo real (LZT) para la normalización del electroencefalograma cuantitativo (QEEG) en escolares con TA. Participaron 28 niños de entre 10-15 años de edad con TA. Se aplicaron diez sesiones de 30 minutos de LZT guiado por QEEG utilizando retroalimentación de alta preferencia de los sujetos. Tras 10 sesiones de LZT guiado por QEEG, los participantes mostraron mejoras estadísticamente significativas en la normalización del QEEG y una mejora de pequeña a media estadísticamente significativa en la "Lista de comprobación cognitiva y emocional". Los resultados sugieren que LZT-NR produce una tendencia hacia la normalización de las ondas cerebrales en niños con TA, y podría suponer una alternativa terapéutica o coadyuvante junto con la intervención cognitiva

Are cognitive interventions effective in Alzheimer's disease? A controlled meta-analysis of the effects of bias.

UNLABELLED: [Correction Notice: An Erratum for this article was reported in Vol 30(5) of Neuropsychology (see record 2016-25217-001). In the article the first sentence of the third paragraph of the Source of bias subsection in the Statistical Analysis subsection of the Correlational Meta-Analysis section should read "For the control condition bias, three comparison groups were differentiated: (a) a structured cognitive intervention, (b) a placebo control condition, and (c) a pharma control condition without cognitive intervention or no treatment at all."] OBJECTIVE: There is limited evidence about the efficacy of cognitive interventions for Alzheimer's disease (AD). However, aside from the methodological quality of the studies analyzed, the methodology used in previous meta-analyses is itself a risk of bias as different types of effect sizes (ESs) were calculated and combined. This study aimed at examining the results of nonpharmacological interventions for AD with an adequate control of statistical methods and to demonstrate a different approach to meta-analysis. METHOD: ESs were calculated with the independent groups pre/post design. Average ESs for separate outcomes were calculated and moderator analyses were performed so as to offer an overview of the effects of bias. RESULTS: Eighty-seven outcomes from 19 studies (n = 812) were meta-analyzed. ESs were small on average for cognitive and functional outcomes after intervention. Moderator analyses showed no effect of control of bias, although ESs were different from zero only in some circumstances (e.g., memory outcomes in randomized studies). Cognitive interventions showed no more efficacy than placebo interventions, and functional ESs were consistently low across conditions. CONCLUSIONS: cognitive interventions delivered may not be effective in AD probably due to the fact that the assumptions behind the cognitive interventions might be inadequate. Future directions include a change in the type of intervention as well as the use of outcomes other than standardized tests. Additional studies with larger sample sizes and different designs are needed to increase the power of both primary studies and meta-analyses. (PsycINFO Database Record

Deterioro cognitivo asociado a radioterapia en tumores cerebrales / No disponible

Introducción: Existe un limitado conocimiento acerca de la influencia sobre las funciones cognitivas de los tratamientos para los tumores cerebrales basados en la radioterapia (RT). Objetivo: Realizar una revisión actualizada de los trabajos desarrollados en los últimos años acerca de los efectos de la RT sobre la cognición en los tumores cerebrales. Método: Mediante el software EndNote X5 se extrajeron los artículos que contenían “radiotherapy” y “cognition” tanto en su título, como en palabras claves, abstracts o contenidos en los años 2009-2011. Asimismo, se realizó una búsqueda ampliada a través de las referencias de los artículos extraídos. Se descartaron aquellos artículos en los que no se reflejase la relación entre RT y el desarrollo de alteraciones cognitivas o no se centraran en tumores cerebrales. Resultados: 14 artículos fueron seleccionados: 7 originales, 6 revisiones y 1 artículo de opinión. Los hallazgos se centraron en 3 aspectos: a) alteraciones cognitivas debidas a la RT; b) factores de riesgo para el desarrollo de deterioro cognitivo inducido por la RT; c) tiempo transcurrido desde la aplicación de la RT hasta la aparición de las alteraciones cognitivas. Conclusiones: Los nuevos estudios confirman hallazgos de las últimas décadas, principalmente que las funciones más comúnmente afectadas son la atención, la memoria y el aprendizaje, la psicomotricidad y las funciones ejecutivas; que existen algunos factores de riesgo identificables para el desarrollo de deterioro cognitivo asociado a la RT; así como que las alteraciones en la función cognitiva tras la RT suelen aparecer de manera evidente después un largo período de tiempo (AU)

Introduction: There is limited knowledge about the influence on cognitive functions of the treatments for brain tumors based on radiotherapy (RT). Objective: To review the works conducted in recent years about the effects of RT on cognition in brain tumors. Method: Using EndNote software X5, articles containing “radiotherapy” and “cognition” in its title, keywords, abstracts or main text in the years 2009-2011 were extracted. Also, an extensive search through the references of articles taken was done. Those works that did not reflect the relationship between RT and the development of cognitive impairment or did not focus on brain tumors were disregarded. Results: 14 articles were selected: 7 originals, 6 reviews, and 1 opinion article. The findings focused on three aspects: a) cognitive impairment due to the RT, b) risk factors for cognitive impairment induced by RT c) time from the application of RT to the onset of cognitive impairment. Conclusions: The new studies confirm findings of recent decades, namely that the functions most commonly affected are attention, memory and learning, psychomotor and executive functions; that there are identifiable risk factors for cognitive impairment associated to RT; and that alterations in cognitive function after RT usually occur after a long period of time (AU)