SUMMARYThe availability of a reliable system to record sleep stage measures easily and automatically in ambulatory settings could be of utility for research and clinical work. The aim of this study was to evaluate a novel wireless system (WS) that does not require skilled preparation for the automatic collection and scoring of human sleep. Twenty-nine healthy adults underwent concurrent sleep measurement via the WS, polysomnography (PSG) and an actigraph (ACT) in a sleep laboratory for one assessment night preceded by an acclimation night. The PSG recordings were scored by two experienced trained technicians from separate laboratories. Each recording was scored by both technicians to Rechtschaffen and Kales (R&K) criteria. The WS and ACT were compared with each of the PSG scores and a consensus PSG score, and the PSG scores were compared with each other. Inter-rater agreement was assessed for each pair over all pooled epochs by percentage agreement, CohenÕs kappa and intraclass correlation coefficient. The WS agreement with each of the two PSG scores for sleep stages was 75.8 and 74.7%, respectively. WS agreement with each of the two PSG scores for sleep ⁄ wakefulness was 92.6 and 91.1%, ACT agreement with PSG was 86.3 and 85.7%. The PSG scorersÕ agreement with each other for sleep stages was 83.2%, and for sleep ⁄ wakefulness was 95.8%. The findings from the current study indicate that the WS may provide an easy to use and accurate complement to other established technologies for measuring sleep in healthy adults. INTRODUC TIONThe ability to investigate the sleep of individuals is of scientific and clinical interest. Sleep patterns have most commonly been examined with polysomnography (PSG), wrist actigraphy and subjective self-report instruments. Each method of measuring sleep has strengths and limitations. PSG is the gold standard assessment methodology for sleep and it provides detailed information on sleep staging, latencies to sleep and specific sleep stages, as well as the number of arousals from sleep.Actigraphy is an alternative to PSG as an objective indirect measurement of sleep and wakefulness (Ancoli-Israel et al., 2003;Paquet et al., 2007). Actigraphy has the advantages that it is less costly and less intrusive than PSG, is relatively easy to use in ambulatory settings, and utilizes automated scoring algorithms that reduce the need for manual interpretation of the recordings. These advantages enable its use for multiple nights in longitudinal studies of sleep ⁄ wakefulness patterns. However, there is no set standard for the collection or scoring of sleep using actigraphy, making interpretation of data from different systems difficult (Acebo and LeBourgeois, 2006). In addition, because actigraphy uses movement as a surrogate for wakefulness, it is limited almost exclusively to the detection of sleep and wakefulness, and its correlation with PSG is moderate. Moreover, actigraphy tends to overestimate total sleep time (TST) in healthy and sleepdisordered subjects because actigraphy is prone to misint...

We propose development of evidence-based methods to guide clinical intervention in neurobehavioral syndromes based on categorization of individuals using both behavioral measures and quantification of the EEG (qEEG). Review of a large number of clinical EEG and qEEG studies suggests that it is plausible to identify a limited set of individual profiles that characterize the majority of the population. Statistical analysis has already been used to document "clusters" of qEEG features seen in populations of psychiatric patients. These clusters are considered here as intermediate phenotypes, based on genetics, and are reliable indices of brain function, not isomorphic with DSM categories, and carry implications for therapeutic intervention. We call for statistical analysis methods to be applied to a broad clinical database of individuals diagnosed with neurobehavioral disorders in order to empirically define clusters of individuals who may be responsive to specific neurophysiologically based treatment interventions, namely administration of psychoactive medication and/or EEG neurofeedback. A tentative set of qEEG profiles is proposed based on clinical observation and experience. Implication for intervention with medication and neurofeedback for individuals with these neurophysiological profiles and specific qEEG patterns is presented.

Org 26576 acts by modulating ionotropic AMPA-type glutamate receptors to enhance glutamatergic neurotransmission. The aim of this Phase 1b study (N=54) was to explore safety, tolerability, pharmacokinetics, and pharmacodynamics of Org 26576 in depressed patients. Part I (N=24) evaluated the maximum tolerated dose (MTD) and optimal titration schedule in a multiple rising dose paradigm (range 100 mg BID to 600 mg BID); Part II (N=30) utilized a parallel groups design (100 mg BID, 400 mg BID, placebo) to examine all endpoints over a 28-day dosing period. Based on the number of moderate intensity adverse events reported at the 600 mg BID dose level, the MTD established in Part I was 450 mg BID. Symptomatic improvement as measured by the Montgomery-Asberg Depression Rating Scale was numerically greater in the Org 26576 groups than in the placebo group in both study parts. In Part II, the 400 mg BID dose was associated with improvements in executive functioning and speed of processing cognitive tests. Org 26576 was also associated with growth hormone increases and cortisol decreases at the end of treatment but did not influence prolactin or brain-derived neurotrophic factor. The quantitative electroencephalogram index Antidepressant Treatment Response at Week 1 was able to significantly predict symptomatic response at endpoint in the active treatment group, as was early improvement in social acuity. Overall, Org 26576 demonstrated good tolerability and pharmacokinetic properties in depressed patients, and pharmacodynamic endpoints suggested that it may show promise in future well-controlled, adequately powered proof of concept trials.

Neurofeedback is an emerging neuroscience-based clinical application, and understanding the underlying principles of neurofeedback allows the therapist to provide referrals or treatment, and provides clients with a framework for understanding the process. The brain's electrical patterns are a form of behavior, modifiable through "operant conditioning," with the excessive brain frequencies reduced, and those with a deficit are increased. The learning curve for EEG has been described (Hardt, 1975).

No abstract