The Journal of Neuroscience, August 13, 2003, 23(19):7407-7411
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Abnormal Neural Synchrony in Schizophrenia
Kevin M. Spencer,
Paul G. Nestor,
Margaret A. Niznikiewicz,
Dean F. Salisbury,
Martha E. Shenton, and
Robert W. McCarley
Department of Psychiatry, Harvard Medical School/Veterans Affairs Boston
Healthcare System, Brockton, Massachusetts 02301
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Abstract
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Schizophrenia has been conceptualized as a failure of cognitive
integration, and abnormalities in neural circuitry (particularly inhibitory
interneurons) have been proposed as a basis for this disorder. We used
measures of phase locking and phase coherence in the scalp-recorded
electroencephalogram to examine the synchronization of neural circuits in
schizophrenia. Compared with matched control subjects, schizophrenia patients
demonstrated: (1) absence of the posterior component of the early visual gamma
band response to Gestalt stimuli; (2) abnormalities in the topography,
latency, and frequency of the anterior component of this response; (3) delayed
onset of phase coherence changes; and (4) the pattern of anterior-posterior
coherence increases in response to Gestalt stimuli found in controls was
replaced by a pattern of interhemispheric coherence decreases in patients.
These findings support the hypothesis that schizophrenia is associated with
impaired neural circuitry demonstrated as a failure of gamma band
synchronization, especially in the 40 Hz range.
Key words: schizophrenia; gamma band EEG; phase synchrony; wavelet analysis; visual perception; inhibitory interneurons
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Introduction
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As early as 1911, Bleuler had described schizophrenia as a "splitting
of the psychic functions" (Bleuler,
1950/1911
), in which various aspects of thought and personality
were disintegrated. In the modern era, it has been proposed that the cognitive
and affective impairments associated with schizophrenia may be related to a
failure to integrate the activity of local and distributed neural circuits
(Friston and Frith, 1995
;
Grunze et al., 1996
;
Selemon and Goldman-Rakic,
1999
; Benes, 2000
;
Lewis and Gonzalez-Burgos,
2000
; Whittington et al.,
2000
). This hypothesis has been supported by postmortem studies
demonstrating abnormalities in the morphology and distribution of certain
cortical neurons in schizophrenia (Selemon
and Goldman-Rakic, 1999
; Benes,
2000
; Lewis and
Gonzalez-Burgos, 2000
;
Whittington et al., 2000
),
particularly inhibitory interneurons. Evidence suggests that interactions
between inhibitory interneurons (subject to NMDA modulation from excitatory
pyramidal cells) are an important substrate of synchronous neural activity in
the upper beta and gamma bands (20 -100 Hz)
(Grunze et al., 1996
;
Whittington et al., 2000
;
McBain and Fisahn, 2001
),
which may play an important role in the formation and selection of neural
representations (Engel et al.,
2001
; Varela et al.,
2001
). Hence, the study of high-frequency synchrony in the
scalp-recorded electroencephalogram (EEG) may shed light on the functional
integrity of neural circuits in schizophrenia and on the relationship between
neural synchrony and thought processes in general.
Phase locking is a highly sensitive measure of neural synchronization in
the EEG (Tallon-Baudry and Bertrand,
1999
). Spectral power has been commonly used as a putative measure
of neural synchrony in the scalp-recorded EEG, but, in fact, this measure is
sensitive only to the amplitude of oscillations and not the phase, so it
cannot directly measure temporal correlations of oscillatory activity. In
contrast, phase locking measures the variance of EEG phase across single
trials independently of amplitude, making it sensitive to small amplitude
oscillations that would not be detected with power measures. Furthermore,
phase locking can be computed between electrode sites (here termed
"phase coherence"), providing a measure of temporally synchronous
interactions in distributed neural networks
(Varela et al., 2001
), which
may also be abnormal in schizophrenia.
We used phase locking and phase coherence to examine whether high-frequency
neural synchronization associated with the perception of visual Gestalts is
abnormal in schizophrenia patients. Previous studies of healthy individuals
have reported enhancements of gamma band power
(Tallon-Baudry and Bertrand,
1999
; Herrmann et al.,
1999
) and phase locking
(Rodriguez et al., 1999
) when
coherent objects are perceived. In this study, schizophrenic (SZ) and matched
normal control (NC) subjects discriminated between illusory square and control
stimuli (Square/No-Square conditions) (Fig.
1A). Several abnormalities were found in the
schizophrenia patients' phase locking and phase coherence responses,
particularly to illusory square stimuli, which presumably engage
synchronization mechanisms that support visual feature binding. These results
provide further evidence for the hypothesis that neural synchronization is
abnormal in schizophrenia.

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Figure 1. Illusory square discrimination task. A, Stimuli. The ratio of
inducer radius to length of square was 0.2. B, Behavioral performance
data (bars indicate SE). C, VEPs at electrode site PO6. D,
Relationship between the Square minus No-Square RT (x-axis) and
occipital phase-locking (y-axis) effects. The greater the RT savings,
the larger the phase-locking effects for NC but not SZ.
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Materials and Methods
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Participants. Inclusion criteria for patients and controls
included: (1) age between 18 and 50 years; (2) right handed; (3) no history of
electroconvulsive treatment; (4) no history of neurological illness; (5) no
history of alcohol or drug dependence, or abuse within the last year, or long
duration (>1 year) of past abuse; (6) no present medication for medical
disorders that would have deleterious EEG, neurological, and/or cognitive
functioning consequences; (7) verbal intelligence quotient above 75; (8) no
alcohol use in the 24 hr before testing; and (9) an ability and desire to
cooperate with our experimental procedures as demonstrated by giving informed
consent (following Harvard Medical School and Veterans Affairs Boston
Healthcare System guidelines).
Fourteen schizophrenia patients [diagnosed according to the Diagnostic and
Statistical Manual of Mental Disorders, fourth edition
(American Psychiatric Association,
1994
)] participated in the study. Two patients' data were
unusable, one because of artifacts, the other because of an excessive error
rate (
50%). The final sample for the SZ group consisted of 12 chronic
medicated male patients (mean ± SD; age, 45 ± 9.2 years; illness
duration, 21 ± 5.1 years). The NC group consisted of 12 healthy males
(age, 47 ± 5.7 years) matched with the SZ group on the basis of age
(F(1,22) = 0.311; NS) and parental socioeconomic status.
Five patients were receiving conventional neuroleptics, six patients received
atypical antipsychotics, and one patient received both types. Mean equivalent
chlorpromazine dosage was 519 ± 539 mg.
Stimuli and experimental procedures. Subjects fixated a central
cross and responded with a button press according to whether an illusory
square (Fig. 1 A) was
present or absent (response hands counterbalanced across subjects). Stimuli
remained on the monitor until 300 msec after a response had been made. If no
response had been made by 2000 msec after stimulus onset, the trial was ended,
and the next trial began (1000 msec intertrial interval). Subjects performed a
practice block and two experimental blocks, each consisting of 45 trials per
condition.
Electrophysiological recording and processing. The EEG was
recorded (0.01-100 Hz; 500 Hz digitization) with tin electrodes at 16 scalp
sites (F3/Fz/F4, C3/Cz/C4, P3/Pz/P4, O1/Oz/O2, P7/P8, PO5/PO6) and the right
mastoid, referenced to the left mastoid. The vertical electrooculogram (EOG)
was recorded at Fp1, and the horizontal EOG was recorded at the outer canthi
of the eyes. Electrode impedances were <5 k
. Error and no-response
trials were excluded from analyses. Independent component analysis
(Makeig et al., 1996
) was used
to identify eye-blink artifacts by their distinct topography and to remove
their contribution to each subject's data. Corrected single-trial epochs were
rereferenced to averaged mastoids. For the SZ and NC groups, there were
averages of 85.5 and 87.5 trials per condition, respectively.
Data analysis. The complex Morlet wavelet transform (six-cycle
length) (Torrence and Compo,
1998
) was applied to the 20-60 Hz frequency range of the EEG in
the -200 to +300 msec period relative to stimulus onset. Wavelet frequencies
were centered at 20.3, 22.1, 24.1, 26.3, 28.7, 31.2, 34.1, 37.2, 40.5, 44.2,
48.2, 52.6, and 57.3 Hz. Phase locking was computed as one minus the circular
variance of phases at each time point, wavelet frequency, and electrode
(Tallon-Baudry and Bertrand,
1999
). Phase coherence was computed as one minus the circular
variance of the phase differences between pairs of electrodes at each time
point and wavelet frequency (Lachaux et
al., 1999
). Every unique pair of the 16 scalp electrodes (120
pairs) was used in this analysis. Prestimulus baseline levels (-200 to -50
msec) were subtracted from each time-frequency map.
The occipital component of the visual evoked gamma band response was
measured as the average phase-locking value within the 80 -120 msec and 31-44
Hz ranges. Analysis of the fronto-central component was based on peak values
at midline and right hemisphere sites where it was maximal, with latency and
frequency ranges selected to avoid overlap with the visual-evoked potentials
(VEPs). The latency range was 80 -160 msec for both groups and conditions,
except for NC subjects in the Square condition, in which it was 80 -110 msec.
Frequency ranges for both groups were 34 -58 (Square) and 28 -58 Hz
(No-Square).
For phase coherence analyses of the Square and No-Square conditions, values
were compared with the mean prestimulus baseline in two-tailed paired
t tests at each time-frequency element (0 -300 msec period) for each
group. In the Square versus No-Square comparison, t tests were
computed between values for the respective conditions. Significance values
were corrected for the number of frequency bins (n = 4;
Fig. 3), resulting in a
statistical criterion of p = 0.0125 (t = ± 2.98). A
temporal threshold was applied to the statistical maps such that any period of
coherence change above the t threshold had to be at least one cycle
in duration at that particular frequency. Coherence changes were summed within
each frequency bin across four time bins
(Fig. 4).

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Figure 3. Phase coherence results. The distributions of the number of coherence
changes (increases and decreases) are plotted across frequency bins in each
stimulus condition and the Square minus No-Square comparison. Note the
different y-axis scales for each row of plots.
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Figure 4. Phase coherence changes in the 37-44 Hz frequency bin plotted in space and
time. Circles indicate electrode positions, with frontal sites at top and
occipital sites at bottom. Red lines mark coherence increases between
electrode sites, and blue lines mark coherence decreases.
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VEP amplitudes were measured at sites O1/O2, P7/P8, and PO5/PO6. Latency
ranges for the P1 were 76 -126 msec (NC) and 78 -138 msec (SZ), and for the
N1, 126 -212 msec (NC) and 138 -212 msec (SZ).
Phase locking and VEP amplitude were statistically analyzed using ANOVA
with the design group (SZ/NC) X stimulus (Square/No-Square) X site (relevant
electrode sites). Effects on group level coherence changes were analyzed using
the
2 goodness-of-fit test, comparing the
distributions of coherence changes across frequency bins.
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Results
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Behavioral performance
NC and SZ subjects had similar median reaction time (RT) and error rate
patterns (Fig. 1B). In
general, subjects made more errors (F(1,22) = 4.99;
p < 0.05) and had shorter RTs (F(1,22) = 9.92;
p < 0.01) on Square than No-Square trials. This shorter RT for
Squares also was present within the SZ group (F(1,11) =
7.61; p < 0.05) but not within the NC group
(F(1,11) = 2.32; NS). Whereas the SZ patients' low overall
error rate (3.9%) indicated that they did not have any particular difficulties
with the task, they did make more errors (F(1,22) = 5.97;
p < 0.05) and had longer RTs (F(1,22) = 9.06;
p < 0.01) than the NC group.
VEPs
The most notable group difference in the VEPs
(Fig. 1C) was that the
P1 component was larger in amplitude for NC than SZ subjects across stimulus
conditions (F(1,22) = 6.22; p < 0.05). There
was a trend for N1 component amplitude to be larger in the NC than the SZ
group (F(1,22) = 3.11; p = 0.09), and across all
subjects, the N1 was significantly larger for Square than No-Square stimuli
(F(1,22) = 8.66; p < 0.01).
Phase-locking data
For both the NC and SZ groups, visual stimuli evoked an early phase-locking
response in the 24-48 Hz range that began as early as 80 msec and did not
overlap with the low-frequency VEP at frontal, central, and occipital sites
(Fig. 2A). Previous
studies have differentiated this early evoked gamma band response into
anterior and posterior components
(Tallon-Baudry et al., 1997
),
and in this study, different effects on the response were indeed found at
occipital and fronto-central sites.

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Figure 2. Group average time-frequency maps of phase locking. A, Midline
frontal (Fz), central (Cz), and occipital (Oz) sites. The early evoked gamma
band response (circled in yellow) can be distinguished from the low-frequency
VEP. B, Square minus No-Square difference map at the left occipital
site (O1).
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The most striking difference between the SZ and NC groups was in the
occipital component of the response (group X stimulus;
F(1,22) = 7.29; p < 0.05). In the NC group
data, Square stimuli evoked this response maximally at the left occipital
site, but there was no response to the No-Square stimuli
(F(1,11) = 10.2; p < 0.01). For the SZ
subjects, however, neither stimulus evoked the response
(F(1,11) = 0.515; NS). These group differences are
highlighted in Figure
2B. To try to determine the functional significance of
the occipital phase-locking response, we computed nonparametric Spearman's
correlation coefficients between the Square minus No-Square differences
in phase synchrony and RT across subjects in the NC group. This correlation
was negative and statistically significant (
= -0.677; p <
0.05; two-tailed), indicating that the larger the response, the larger the RT
advantage for Square compared with No-Square stimuli
(Fig. 1D). No such
correlation was found for the SZ group. These data suggest that the occipital
phase-locking response may reflect a feature-binding mechanism in visual
cortex that underlies more efficient task performance for healthy individuals,
but not persons with schizophrenia.
The fronto-central component of the early evoked gamma band response was
abnormal in topography, latency, and frequency for the SZ group. Whereas for
both groups this response was larger for No-Square than Square stimuli (NC:
F(1,11) = 5.70; p < 0.05; SZ:
F(1,11) = 5.19; p < 0.05), it was larger at
central than frontal electrode sites for SZ (group X site;
F(1,22) = 10.0; p < 0.01; SZ:
F(1,11) = 24.5; p < 0.001) but not NC subjects
(F(1,11) = 0.00695; NS). The latency of the fronto-central
response to Square stimuli was longer for SZ than NC subjects (116.9 vs 99.2
msec; group X stimulus; F(1,22) = 5.66; p <
0.05; group: F(1,22) = 24.1; p < 0.0001), but
there was no difference for No-Square stimuli (117.3 vs 119.1 msec;
F(1,22) = 0.046; NS). Last, the frequency of the response
to No-Square stimuli was lower for SZ than NC subjects at central sites (35.3
vs 42.4 Hz; group X stimulus X site; F(1,22) = 5.08;
p < 0.05; group: F(1,22) = 4.45; p
< 0.05), but there was no difference for Square stimuli (44.4 vs 41.5 Hz;
F(1,22) = 1.04; NS).
In summary, the early evoked gamma band response differed between the SZ
and NC groups in several ways, being absent for the occipital component and
abnormal in topography, latency, and frequency for the fronto-central
component. These results support the hypothesis that gamma band
synchronization is abnormal in schizophrenia. The different patterns observed
for the VEPs and phase-locking responses indicate that the latter are not
artifacts of the low-frequency VEPs.
To test for potential confounds with medication, we computed
Spearman's
correlations between antipsychotic medication dosage in
chlorpromazine equivalents and the four effects listed above. None of the
correlations approached significance. Next, we analyzed whether any of the
above effects were related to error rate, age, illness duration, or SZ
symptoms as measured by the Positive and Negative Symptom Scale (PANSS)
(Kay et al., 1987
). Whereas
there were no correlations for errors, age, or illness duration, the frequency
of the No-Square response at central sites correlated negatively with major
categories of the PANSS: total symptoms (-0.72; p < 0.01),
positive symptoms (-0.58; p < 0.05), negative symptoms (-0.62;
p < 0.05), and general symptoms (-0.68; p < 0.05).
Particularly notable in view of our hypothesis about neural synchrony are the
correlations with specific items, such as delusions (-0.68; p <
0.05), conceptual disorganization (-0.66; p < 0.05), and poor
attention (-0.83; p < 0.001). Thus, the lower the frequency of the
early evoked gamma band response, the greater the degree of SZ symptoms.
Phase coherence data
Next, we examined phase coherence, which is indicative of coupling between
distant brain regions (Varela et al.,
2001
). Periods of coherence change relative to the baseline
(coherence increases and decreases) were computed between each pair of
electrodes for each group using a statistical parametric mapping method (see
Materials and Methods). The number of coherence changes for each group and
condition are presented in Figure
3. It can be seen that the NC group had far more coherence
increases than the SZ group, particularly in the 20 -26 Hz bin. Inspection of
the coherence time-frequency maps revealed that this effect was because of the
presence of the VEP in this frequency range, so subsequent analyses focused on
the higher frequency bins.
Three main differences between the groups were observed
(Fig. 3). First, the NC group
had more coherence increases than the SZ group overall (249 vs 91) and in both
the Square (
2(1) = 89.5; p <
0.0001) and the No-Square (
2(1) = 8.99;
p < 0.01) conditions. Second, the NC and SZ groups had different
frequency band distributions of coherence decreases in the Square condition
(
2(2) = 113; p < 0.0001); the
SZ distribution peaked at 37-44 Hz, and the NC distribution peaked at 48-57
Hz. Third, in the Square minus No-Square comparison, coherence changes were
mainly decreases in coherence for the SZ group. The frequency band
distribution of coherence decreases differed between groups
(
2(2) = 115; p < 0.0001): SZ
coherence decreases showed a peak at 37-44 Hz
(
2(2) = 17.0, p < 0.001),
where there were significantly more coherence decreases than the NC group
(
2(1) = 30.9; p < 0.0001),
especially in the Square condition (Fig.
3). In summary, the phase coherence data point to abnormalities of
coherence in long-distance neural synchronization in schizophrenia.
The spatio-temporal distributions of coherence changes in the 37-44 Hz bin
(Fig. 4) revealed several
patterns. For the NC group, coherence changes began in the 0 -75 msec interval
and were concentrated in the 75-150 msec interval, coinciding with the early
evoked gamma band response, and showed a roughly similar pattern of
anterior-posterior coherence increases in the Square and No-Square conditions.
Consequently, there were few differences in coherence in the Square minus
No-Square comparison. For the SZ group, the onset of coherence changes was
delayed, not beginning until after 75 msec. In the Square condition, the
number of coherence changes (mainly decreases) was largest in the 225-300 msec
interval and involved mostly interhemispheric interactions between posterior
sites. In contrast, in the No-Square condition, the coherence changes were
predominantly anterior-posterior increases in the 75-150 and 150 -225 msec
intervals, more in agreement in latency and directionality with those in the
NC data. In the Square minus No-Square comparison, the SZ subjects displayed a
consistent pattern of interhemispheric coherence decreases between posterior
sites across the 0-300 msec period, in contrast to the NC group. The
electrodes most often involved in these coherence decreases were P7 and P8,
which lie over posterior temporal visual areas. Thus, phase coherence changes
generally had a delayed onset for SZ compared with NC subjects and differed
maximally between the groups in the Square condition, in which the SZ pattern
consisted of coherence decreases between posterior sites, contrasting with the
NC pattern of coherence increases along the anterior-posterior axis.
These results demonstrate that long-range neural synchronization in the
upper beta and gamma bands of the EEG is impaired in schizophrenia,
particularly in the 40 Hz range. As in the phase-locking data, the illusory
square stimuli were especially associated with a lack of coherence. It should
be noted that while possible effects of volume conduction cannot be ruled out
from these data, the calculation of phase coherence relative to the
prestimulus baseline reduces such a confound by eliminating any overall level
of coherence. Also, volume conduction would be expected to bias the spatial
distribution of coherence patterns to adjacent electrodes, but this pattern
was not observed (cf. Rodriguez et al.,
1999
).
 |
Discussion
|
|---|
We found that schizophrenia was associated with abnormal phase-locking and
phase coherence responses to visual stimuli in a Gestalt perception task,
supporting the hypothesis that abnormal neural circuit function may be an
underlying cause of schizophrenia. The patients' phase-locking and coherence
patterns were particularly abnormal in the Square condition, in which the
perception of the illusory object presumably engages feature-binding
mechanisms that rely on neural synchrony
(Engel et al., 2001
). The
correlation between the RT and phase-locking effects for the NC subjects
suggests that they performed the task using an early perceptual mechanism
involving temporal coding in occipital cortex. The ability of the SZ patients
to perform the Gestalt detection task, albeit less efficiently than the NC
subjects, could be the result of a phase-locking effect that was not
detectable in the scalp EEG, or the patients might have performed the task
using some later stage of analysis.
Earlier studies have documented SZ abnormalities in measures of gamma band
power or amplitude in the EEG (Kwon et
al., 1999
; Haig et al.,
2000
; Kissler et al.,
2000
; Gordon et al.,
2001
; Green et al.,
2003
). Also, in our laboratory, we previously examined
stimulus-driven phase locking in the EEG to steady-state auditory stimulation.
Abnormal phase locking to 40 Hz click trains was found in the average
steady-state auditory-evoked responses of schizophrenia patients
(Kwon et al., 1999
). Compared
with matched healthy controls, the patients' steady-state responses were
slower to phase lock with the stimulus trains and never reached the same
degree of maximal phase locking. Those findings were consistent with the
hypothesis that neural synchrony is abnormal in schizophrenia. The results of
the present study confirm and extend these observations using a method with
greater sensitivity to neural synchronization and with a task that engages
feature-binding processes. We note that the power of the early gamma band
response did not differ between conditions or subject groups, which highlights
the sensitivity of the phase-locking method.
Several recent studies have demonstrated that a critical neural substrate
of high-frequency oscillatory activity in the cortex lies in interactions
between inhibitory interneurons, mediated both by GABAA synapses
and gap junctions (Whittington et al.,
2000
; McBain and Fisahn,
2001
). Because abnormalities in inhibitory interneurons have been
documented in postmortem studies of SZ brains, synchronous neural activity
could be disturbed in schizophrenia through the dysfunction of inhibitory
interneuron networks, as well as through impaired connections from
interneurons to pyramidal cells (Volk et
al., 2002
). Also, given the evidence for NMDA receptor
dysregulation in schizophrenia (Javitt and
Zukin, 1991
; Tsai and Coyle,
2002
), another possibility is that abnormalities in pyramidal
cells (Lewis and Gonzalez-Burgos,
2000
) could impair the NMDA-mediated glutamate projections from
pyramidal cells to interneurons, which play a key role in regulating
interneuron activity (Grunze et al.,
1996
).
The phase coherence data are consistent with a growing body of functional
(Fletcher et al., 1999
;
Meyer-Lindenberg et al., 2001
)
and anatomical (Kubicki et al.,
2002
) studies pointing to impairments in the connectivity of
distributed cortical networks in schizophrenia. The present data demonstrate
that functional connectivity between brain regions is abnormal at the
millisecond time scale in schizophrenia and suggest that interhemispheric
interactions may be particularly affected. In conclusion, we suggest that in
schizophrenia, the synchronization of gamma band neural activity is abnormal,
and this abnormality is implicated in some of the symptoms and signs of this
disorder. These data also suggest that neural synchrony in the 40 Hz range of
the EEG may be important in normal brain function.
 |
Footnotes
|
|---|
Received Mar. 10, 2003;
revised Jun. 23, 2003;
accepted Jun. 24, 2003.
This study was supported by National Institute of Mental Health Grant 40799
to R.W.M., Fellowship 13022 to K.M.S., and Training Grant 016259. The Wavelet
software was provided by C. Torrence and G. Compo (available at
http://paos.colorado.edu/research/wavelets/).
Correspondence should be addressed to Dr. Robert W. McCarley, Harvard
Medical School/Veterans Affairs Boston Healthcare System, Psychiatry 116A, 940
Belmont Street, Brockton, MA 02301. E-mail:
robert_mccarley{at}hms.harvard.edu.
Copyright © 2003 Society for Neuroscience
0270-6474/03/237407-05$15.00/0
 |
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