Dysfunctional Alpha Modulation as a Mechanism of Working Memory Impairment in Serious Mental Illness

Abstract

BackgroundPeople with psychosis and mood disorders experience disruptions in working memory; however, the underlying mechanism remains unknown. We focused on 2 potential mechanisms: first, poor attentional engagement should be associated with elevated levels of prestimulus alpha-band activity within the electroencephalogram (EEG), whereas impaired working memory encoding should be associated with reduced poststimulus alpha suppression. MethodsWe collected EEG data from 68 people with schizophrenia, 43 people with bipolar disorder with a history of psychosis, 53 people with major depressive disorder, and 90 healthy comparison subjects while they completed a spatial working memory task. We quantified attention lapsing, memory precision, and memory capacity from the behavioral responses, and we quantified alpha using traditional wavelet analysis as well as a novel approach for isolating oscillatory alpha power from aperiodic elements of the EEG signal. ResultsWe found that 1) greater prestimulus alpha power estimated using traditional wavelet analysis predicted behavioral errors; 2) poststimulus alpha suppression was reduced in the patient groups; and 3) reduced suppression was associated with a lower likelihood of memory storage. However, we also observed that the prestimulus alpha was larger among healthy control participants than patients, and single-trial analyses showed that it was the aperiodic elements of the prestimulus EEG—not oscillatory alpha—that predicted behavioral errors. DiscussionThese results suggest that working memory impairments in serious mental illness primarily reflect an impairment in the poststimulus encoding processes rather than reduced attentional engagement prior to stimulus onset.