Despite the critical role of working memory (WM) in neuropsychiatric conditions, there remains a dearth of available WM-targeted interventions. Gamma and theta oscillations as measured with electroencephalography (EEG) or magnetoencephalography (MEG) reflect the neural underpinnings of WM. The WM processes that fluctuate in conjunction with WM demands are closely correlated with WM test performance, and their EEG signatures are abnormal in several clinical populations. Novel interventions such as transcranial magnetic stimulation (TMS) have been shown to modulate these oscillations and subsequently improve WM performance and clinical symptoms. Systematically identifying pathological WM-related gamma/theta oscillatory patterns with EEG/MEG and developing ways to target them with interventions such as TMS is an active area of clinical research. Results hold promise for enhancing the outcomes of our patients with WM deficits and for moving the field of clinical neuropsychology towards a mechanism-based approach.
Prior research in working memory (WM) has been hampered by measurement variability and a lack of integration of neural and clinical markers. This study sought to examine whether a multi-level composite of WM with neural, cognitive, and behavioral levels could predict childhood affective symptomatology in seventeen children and adolescents receiving outpatient mental health services. WM-related theta/gamma oscillations at the F3 electrode were measured via electroencephalography (EEG) recording during a spatial WM task. Other measures included a neuropsychological measure of WM, parent questionnaire assessing WM, and self-reported affective symptoms. Gamma power and theta-gamma coupling, but not theta power, predicted high WM demands performance (i.e., 16-19% of variance). Two composite scores were created consisting of gamma power or theta-gamma coupling, clinical WM measure performance, and parent-reported WM symptoms. These multi-level composite score predicted self-reported depressive (22-32% of variance) symptoms, while only the gamma-version of the composite predicted anxious symptoms (39% of variance compared to 12% of variance). A WM composite score consisting of neural, cognitive, and behavioral levels predicted the severity of childhood affective symptomatology. WM, like other EFs, is highly complex and may be most appropriately measured in clinical and research settings with a combination of neural, cognitive, and behavioral measures.
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