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Electroencephalography of the Trail Making Test

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Electroencephalography of the Trail Making Test Electroencephalography of the Trail Making Test by Zhongmin Lin A thesis submitted in conformity with the requirements for the degree of Master of Science Department of Medical Biophysics University of Toronto © Copyright by Zhongmin Lin 2021 Electroencephalography of the Trail Making Zhongmin Lin Master of Science Department of Medical Biophysics University of Toronto 2021 Abstract The Trail Making Test (TMT) is a neuropsychological test consisting of Parts A and B, which involve linking numbers and numbers alternating with letters, respectively. The temporal dynamics of TMT-related behavioural and neural changes remain to be characterized. Sixteen healthy young adults underwent TMT performance with electroencephalography (EEG) recording using tablet technology to capture enhanced performance metrics such as the speed of linking movements, and linking and non-linking periods - the time spent executing and preparing movements, respectively. Seconds per link (SPL) was also employed to evaluate TMT performance. A strong effect of TMT Part A and B was found for SPL values, whereas a strong effect of linking and non-linking periods was found in multiple EEG frequency bands, as well as effects consistent with previous studies of TMT-related brain activity performed by functional magnetic resonance imaging. ii Acknowledgments I would like to indicate my wholehearted appreciation to all the people who have helped me to conduct this research. First, I would like to thank the members of my supervisory committee, Dr. Bradley McIntosh, Dr. Tom Schweizer, and Dr. Fa-Hsuan Lin, for their constructive criticisms, advice, and guidance. I want to especially express my sincere gratitude to my supervisor Dr. Simon Graham for his research guidance and advice over the entirety of this thesis, for unparalleled support, kindness, and encouragement, and for this unique and wonderful experience. In addition, I must thank Dr. Dan Nemrodov for his guidance, as well as Dr. Nathan Churchill for his crucial and timely data analysis support. Last but not least, I am grateful to my family and my girlfriend for their continual support and encouragement, and patience. A special thanks to Fred, Benson, Nicole, Anton, and Lucy for being the best lab mates in the world. iii Table of Contents Acknowledgments.......................................................................................................................... iii Table of Contents ........................................................................................................................... iv List of Tables ................................................................................................................................. vi List of Figures ............................................................................................................................... vii List of Abbreviations ..................................................................................................................... ix Chapter 1 ..........................................................................................................................................1 1 Introduction .................................................................................................................................1 1.1 Electroencephalography (EEG) ...........................................................................................1 1.1.1 EEG Oscillations ......................................................................................................3 1.1.2 Event-related potentials (ERPs) ...............................................................................7 1.1.3 Time-Frequency Analysis ........................................................................................9 1.1.4 Task Partial Least Squares (PLS) ..........................................................................12 1.2 Trail Making Test (TMT) ..................................................................................................15 1.2.1 Behavioural studies ................................................................................................18 1.2.2 Lesion studies.........................................................................................................20 1.2.3 Neuroimaging studies ............................................................................................23 1.3 Tablet Technology .............................................................................................................28 1.4 Application of Tablet Technology in TMT .......................................................................33 1.5 Hypotheses and Thesis Outline ..........................................................................................35 Chapter 2 ........................................................................................................................................37 2 EEG Brain Activity during the Trail Making Test....................................................................37 2.1 Introduction ........................................................................................................................37 2.2 Methods..............................................................................................................................40 2.2.1 Participants .............................................................................................................40 2.2.2 TMT Design ...........................................................................................................40 iv 2.2.3 Tablet Technology .................................................................................................42 2.2.4 EEG Recording ......................................................................................................43 2.2.5 Tablet Data Analysis ..............................................................................................44 2.2.6 EEG Data Analysis ................................................................................................46 2.3 Results ................................................................................................................................49 2.3.1 TMT Performance ..................................................................................................49 2.3.2 EEG Time-Frequency Power .................................................................................52 2.4 Discussion ..........................................................................................................................56 2.4.1 Behaviour ...............................................................................................................56 2.4.2 Brain Activity.........................................................................................................60 Chapter 3 ........................................................................................................................................68 3 Conclusion ................................................................................................................................68 3.1 Summary ............................................................................................................................68 3.2 Limitations .........................................................................................................................69 3.3 Future Directions ...............................................................................................................70 3.3.1 Simultaneous EEG-fMRI of TMT Performance ....................................................71 3.3.2 TMT Performance in Aging and Patient Populations ............................................75 3.4 Improvements to the Tablet Technology ...........................................................................76 3.5 Final Remarks ....................................................................................................................77 Bibliography ..................................................................................................................................78 v List of Tables Table 2.1 Behavioural metrics for participants (n = 16) performing the tablet TMT*. ................ 50 vi List of Figures Figure 1.1 Time-locked, non-time-locked and phase-locked properties of EEG signals. .............. 8 Figure 1.2 Example of paper-based Trail Making Test (TMT). Left = TMT-A, Right = TMT-B. ....................................................................................................................................................... 16 Figure 1.3 Tablet prototype 2 (A) with a stylus (B) and a video camera (C) to enable visual feedback of stimulus response and hand position (D). ................................................................. 30 Figure 2.1 Task design for the EEG experiment. See text for details. Fix = fixation, TMT = Trail Making Test. ................................................................................................................................. 40 Figure 2.2 The experimental setup inside (left) and outside (right) the acoustically shielded room. (A) Touch-sensitive tablet, (B) Stylus, (C) Video camera, (D) Visual feedback of stimulus response and hand position, (E) EEG cap and electrodes, (F) Stimulus/response computer, (G) EEG recording computer. ............................................................................................................. 42 Figure 2.3 Speed time course of
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