Longer Auditory and Visual P300 Latencies in Patients with Narcolepsy

Sangal, R. Bart; Jm, Sangal; Belisle, Cynthia

doi:10.1177/155005949903000111

Cited by 19 publications

(6 citation statements)

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“…For instance, the latent period of P300 was generally longer for the patients than for the healthy controls (Fig. 3 ), as has been reported in other studies [ 49 , 50 ]. Furthermore, in several patients, the SSVEP was not apparently evoked as in the healthy controls (Fig.…”

Section: Discussionsupporting

confidence: 84%

Detecting number processing and mental calculation in patients with disorders of consciousness using a hybrid brain-computer interface system

Pan

et al. 2015

BMC Neurol

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BackgroundFor patients with disorders of consciousness such as coma, a vegetative state or a minimally conscious state, one challenge is to detect and assess the residual cognitive functions in their brains. Number processing and mental calculation are important brain functions but are difficult to detect in patients with disorders of consciousness using motor response-based clinical assessment scales such as the Coma Recovery Scale-Revised due to the patients’ motor impairments and inability to provide sufficient motor responses for number- and calculation-based communication.MethodsIn this study, we presented a hybrid brain-computer interface that combines P300 and steady state visual evoked potentials to detect number processing and mental calculation in Han Chinese patients with disorders of consciousness. Eleven patients with disorders of consciousness who were in a vegetative state (n = 6) or in a minimally conscious state (n = 3) or who emerged from a minimally conscious state (n = 2) participated in the brain-computer interface-based experiment. During the experiment, the patients with disorders of consciousness were instructed to perform three tasks, i.e., number recognition, number comparison, and mental calculation, including addition and subtraction. In each experimental trial, an arithmetic problem was first presented. Next, two number buttons, only one of which was the correct answer to the problem, flickered at different frequencies to evoke steady state visual evoked potentials, while the frames of the two buttons flashed in a random order to evoke P300 potentials. The patients needed to focus on the target number button (the correct answer). Finally, the brain-computer interface system detected P300 and steady state visual evoked potentials to determine the button to which the patients attended, further presenting the results as feedback.ResultsTwo of the six patients who were in a vegetative state, one of the three patients who were in a minimally conscious state, and the two patients that emerged from a minimally conscious state achieved accuracies significantly greater than the chance level. Furthermore, P300 potentials and steady state visual evoked potentials were observed in the electroencephalography signals from the five patients.ConclusionsNumber processing and arithmetic abilities as well as command following were demonstrated in the five patients. Furthermore, our results suggested that through brain-computer interface systems, many cognitive experiments may be conducted in patients with disorders of consciousness, although they cannot provide sufficient behavioral responses.

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Section: Discussionsupporting

confidence: 84%

Detecting number processing and mental calculation in patients with disorders of consciousness using a hybrid brain-computer interface system

Pan

et al. 2015

BMC Neurol

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“…Furthermore, Pauli Test performance was correlated with modafinil effects on decreased y and d power, and these correlations were particularly localized to the frontal and anterior cingulate cortices. In addition, among narcolepsy patients, who exhibit a prolonged auditory and visual P300 latency (Sangal et al, 1999a), a relatively shorter P300 latency was associated with clinical response to modafinil (at either 200 or 400 mg/day), using a measure of daytime sleepiness (Sangal et al, 1999b). A shorter auditory P300 latency was also associated with remediation of fatigue in patients with multiple sclerosis in response to 4 weeks of modafinil 100 mg/day (Nagels et al, 2007).…”

Section: Modafinil Effects On Cognition and Brain Function In Clinicamentioning

confidence: 98%

Modafinil: A Review of Neurochemical Actions and Effects on Cognition

Minzenberg

Carter

2007

Neuropsychopharmacol

615

519

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Modafinil (2-[(Diphenylmethyl) sulfinyl] acetamide, Provigil) is an FDA-approved medication with wake-promoting properties. Pre-clinical studies of modafinil suggest a complex profile of neurochemical and behavioral effects, distinct from those of amphetamine. In addition, modafinil shows initial promise for a variety of off-label indications in psychiatry, including treatment-resistant depression, attention-deficit/hyperactivity disorder, and schizophrenia. Cognitive dysfunction may be a particularly important emerging treatment target for modafinil, across these and other neuropsychiatric disorders. We aimed to comprehensively review the empirical literature on neurochemical actions of modafinil, and effects on cognition in animal models, healthy adult humans, and clinical populations. We searched PubMed with the search term 'modafinil' and reviewed all English-language articles for neurochemical, neurophysiological, cognitive, or information-processing experimental measures. We additionally summarized the pharmacokinetic profile of modafinil and clinical efficacy in psychiatric patients. Modafinil exhibits robust effects on catecholamines, serotonin, glutamate, gamma amino-butyric acid, orexin, and histamine systems in the brain. Many of these effects may be secondary to catecholamine effects, with some selectivity for cortical over subcortical sites of action. In addition, modafinil (at well-tolerated doses) improves function in several cognitive domains, including working memory and episodic memory, and other processes dependent on prefrontal cortex and cognitive control. These effects are observed in rodents, healthy adults, and across several psychiatric disorders. Furthermore, modafinil appears to be well-tolerated, with a low rate of adverse events and a low liability to abuse. Modafinil has a number of neurochemical actions in the brain, which may be related to primary effects on catecholaminergic systems. These effects are in general advantageous for cognitive processes. Overall, modafinil is an excellent candidate agent for remediation of cognitive dysfunction in neuropsychiatric disorders.

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“…Although P300 latencies were found to be normal in earlier studies [3,96,116], recent investigations using larger samples of narcoleptic patients reported prolonged P300 latencies to visual as well as auditory stimuli, while amplitudes were unimpaired. Changes in P300 latency were unrelated to sleepiness [115,117]. A study by Naumann et al [90] which focussed on P300 and mismatch negativity (MMN) as indicators of attentional processing revealed increased P300 amplitudes in narcoleptics compared to controls, in particular at frontal recording sites.…”

Section: Information Processing As Indicated By Event-related Potentialsmentioning

confidence: 98%

Narcolepsy: Pathophysiology and Neuropsychological Changes

Naumann

Daum

2003

Behavioural Neurology

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Narcolepsy is now recognized as a distinctive disorder with specific pathophysiology and neurochemical abnormalities. Findings on the role of the neuropeptide hypocretin are opening new avenues of research and new strategies for therapy. Recently, neuropsychological and electrophysiological studies have provided evidence for reduced memory performance on standard memory tests in addition to subjective complaints of forgetfulness which may be related to changes in attentional processing. Further studies are, however, necessary to clarify the neuropsychological profile in narcolepsy. This review focuses on the recent advances in understanding narcolepsy.

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Longer Auditory and Visual P300 Latencies in Patients with Narcolepsy

Cited by 19 publications

References 20 publications

Detecting number processing and mental calculation in patients with disorders of consciousness using a hybrid brain-computer interface system

Detecting number processing and mental calculation in patients with disorders of consciousness using a hybrid brain-computer interface system

Modafinil: A Review of Neurochemical Actions and Effects on Cognition

Narcolepsy: Pathophysiology and Neuropsychological Changes

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