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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Neurosci.</journal-id>
<journal-title>Frontiers in Neuroscience</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Neurosci.</abbrev-journal-title>
<issn pub-type="epub">1662-453X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fnins.2023.1247290</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neuroscience</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Temporal and spectral analyses of EEG microstate reveals neural effects of transcranial photobiomodulation on the resting brain</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Truong</surname>
<given-names>Nghi Cong Dung</given-names>
</name>
<uri xlink:href="https://loop.frontiersin.org/people/1454121/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Xinlong</given-names>
</name>
<uri xlink:href="https://loop.frontiersin.org/people/1179366/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Liu</surname>
<given-names>Hanli</given-names>
</name>
<xref rid="c001" ref-type="corresp"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/60952/overview"/>
</contrib>
</contrib-group>
<aff><institution>Department of Bioengineering, University of Texas at Arlington</institution>, <addr-line>Arlington, TX</addr-line>, <country>United States</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0001"><p>Edited by: Gahangir Hossain, University of North Texas, United States</p></fn>
<fn fn-type="edited-by" id="fn0002"><p>Reviewed by: Ali Jahan, Tabriz University of Medical Sciences, Iran; Luke Tait, Cardiff University, United Kingdom</p></fn>
<corresp id="c001">&#x002A;Correspondence: Hanli Liu, <email>hanli@uta.edu</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>17</day>
<month>10</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>17</volume>
<elocation-id>1247290</elocation-id>
<history>
<date date-type="received">
<day>25</day>
<month>06</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>25</day>
<month>09</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2023 Truong, Wang and Liu.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Truong, Wang and Liu</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec id="sec1001">
<title>Introduction</title>
<p>The quantification of electroencephalography (EEG) microstates is an effective method for analyzing synchronous neural firing and assessing the temporal dynamics of the resting state of the human brain. Transcranial photobiomodulation (tPBM) is a safe and effective modality to improve human cognition. However, it is unclear how prefrontal tPBM neuromodulates EEG microstates both temporally and spectrally.</p>
</sec>
<sec id="sec2001">
<title>Methods</title>
<p>64-channel EEG was recorded from 45 healthy subjects in both 8-min active and sham tPBM sessions, using a 1064-nm laser applied to the right forehead of the subjects. After EEG data preprocessing, time-domain EEG microstate analysis was performed to obtain four microstate classes for both tPBM and sham sessions throughout the pre-, during-, and post-stimulation periods, followed by extraction of the respective microstate parameters. Moreover, frequency-domain analysis was performed by combining multivariate empirical mode decomposition with the Hilbert-Huang transform.</p>
</sec>
<sec id="sec3001">
<title>Results</title>
<p>Statistical analyses revealed that tPBM resulted in (1) a significant increase in the occurrence of microstates A and D and a significant decrease in the contribution of microstate C, (2) a substantial increase in the transition probabilities between microstates A and D, and (3) a substantial increase in the alpha power of microstate D.</p>
</sec>
<sec id="sec4001">
<title>Discussion</title>
<p>These findings confirm the neurophysiological effects of tPBM on EEG microstates of the resting brain, particularly in class D, which represents brain activation across the frontal and parietal regions. This study helps to better understand tPBM-induced dynamic alterations in EEG microstates that may be linked to the tPBM mechanism of action for the enhancement of human cognition.</p>
</sec>
</abstract>
<kwd-group>
<kwd>transcranial photobiomodulation (tPBM)</kwd>
<kwd>electroencephalogram (EEG)</kwd>
<kwd>EEG microstate</kwd>
<kwd>empirical mode decomposition</kwd>
<kwd>Hilbert-Huang transform</kwd>
</kwd-group>
<counts>
<fig-count count="6"/>
<table-count count="0"/>
<equation-count count="4"/>
<ref-count count="73"/>
<page-count count="13"/>
<word-count count="8681"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Neural Technology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1.</label>
<title>Introduction</title>
<p>Over the past decade, photobiomodulation (PBM) has attracted substantial interest as a practical method for treating a variety of pain and/or infections using low-dose red to near-infrared (630&#x2013;1,100&#x2009;nm) light. Examples of PBM applications include pain alleviation (<xref ref-type="bibr" rid="ref17">Fulop et al., 2010</xref>) and wound healing (<xref ref-type="bibr" rid="ref40">Mester et al., 1971</xref>; <xref ref-type="bibr" rid="ref12">Conlan et al., 1996</xref>; <xref ref-type="bibr" rid="ref70">Yasukawa et al., 2007</xref>; <xref ref-type="bibr" rid="ref50">Peplow et al., 2010</xref>). Transcranial PBM (tPBM), which refers to PBM administered to the cerebral cortex, has also been proven to boost human cognition (<xref ref-type="bibr" rid="ref15">Eells et al., 2004</xref>; <xref ref-type="bibr" rid="ref2">Barrett and Gonzalez-Lima, 2013</xref>; <xref ref-type="bibr" rid="ref20">Holmes et al., 2019</xref>; <xref ref-type="bibr" rid="ref62">Truong et al., 2022</xref>) including attentional performance (<xref ref-type="bibr" rid="ref24">Jahan et al., 2019</xref>) and to be a treatment for traumatic brain injury (<xref ref-type="bibr" rid="ref10">Choi et al., 2012</xref>; <xref ref-type="bibr" rid="ref16">Figueiro Longo et al., 2020</xref>), Alzheimer&#x2019;s disease (<xref ref-type="bibr" rid="ref19">Grillo et al., 2013</xref>; <xref ref-type="bibr" rid="ref46">Nizamutdinov et al., 2021</xref>), and Parkinson&#x2019;s disease (<xref ref-type="bibr" rid="ref52">Quirk et al., 2012</xref>; <xref ref-type="bibr" rid="ref37">Liebert et al., 2021</xref>). A recent, comprehensive study by Zhao et al. reported significant enhancements in visual working memory capacity in healthy humans through four experiments using two separate laser wavelengths (850 and 1,064&#x2009;nm) and two stimulation sites (left and right forehead; <xref ref-type="bibr" rid="ref71">Zhao et al., 2022</xref>).</p>
<p>The mechanism underlying tPBM has been proposed to involve cytochrome c oxidase (CCO), a crucial component in mitochondria responsible for energy generation. The photochemical reactions of CCO initiate a cascade of biochemical events, which were believed to enhance cellular energy production, promote neuronal metabolism, and modulate neurovascular coupling (<xref ref-type="bibr" rid="ref54">Rojas et al., 2012</xref>; <xref ref-type="bibr" rid="ref32">Lee et al., 2017</xref>). To better understand the neurophysiological effects of tPBM on the human brain, different imaging modalities have been simultaneously employed, including electroencephalography (EEG; <xref ref-type="bibr" rid="ref64">Wang et al., 2019</xref>; <xref ref-type="bibr" rid="ref18">Ghaderi et al., 2021</xref>; <xref ref-type="bibr" rid="ref56">Shahdadian et al., 2022</xref>), functional magnetic resonance imaging (fMRI; <xref ref-type="bibr" rid="ref63">Vargas et al., 2017</xref>; <xref ref-type="bibr" rid="ref14">Dmochowski et al., 2020</xref>), broadband near-infrared spectroscopy (bbNIRS; <xref ref-type="bibr" rid="ref61">Tian et al., 2016</xref>; <xref ref-type="bibr" rid="ref66">Wang et al., 2017</xref>; <xref ref-type="bibr" rid="ref51">Pruitt et al., 2020</xref>; <xref ref-type="bibr" rid="ref65">Wang et al., 2022a</xref>), and functional near-infrared spectroscopy (fNIRS; <xref ref-type="bibr" rid="ref20">Holmes et al., 2019</xref>; <xref ref-type="bibr" rid="ref62">Truong et al., 2022</xref>).</p>
<p>EEG is a widely used and effective measurement tool for noninvasive monitoring of human neurophysiological activity in neuroscience research and clinical applications. In a subset of EEG research, EEG microstate analysis is an established method for investigating brain dynamics in the resting state (<xref ref-type="bibr" rid="ref34">Lehmann et al., 1987</xref>). EEG microstates are defined as global patterns of scalp potential topographies that dynamically alter over time in an ordered manner. Specifically, spontaneous EEG activity during the resting state can be described by a limited number of EEG topographical maps that remain stable for a short period (60&#x2013;120&#x2009;ms). These specific global scalp maps were obtained by spatial clustering of whole scalp topographies without considering the polarity inversion (<xref ref-type="bibr" rid="ref48">Pascual-Marqui et al., 1995</xref>; <xref ref-type="bibr" rid="ref29">Koenig et al., 1999</xref>; <xref ref-type="bibr" rid="ref28">Koenig and Brandeis, 2016</xref>). Briefly, scalp topographies with high spatial correlation independent of polarity were first clustered into one representative topographical map, forming a class of microstates (<xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>). A dynamic train or alteration of the microstates is then found by fitting the template maps (or classes) back to the temporal data.</p>
<p>Recent publications have demonstrated that tPBM enables significant alterations in EEG spectral power across the human cortex (<xref ref-type="bibr" rid="ref72">Zomorrodi et al., 2019</xref>; <xref ref-type="bibr" rid="ref67">Wang et al., 2021</xref>) and in functional connectivity across several resting-state brain networks (<xref ref-type="bibr" rid="ref72">Zomorrodi et al., 2019</xref>; <xref ref-type="bibr" rid="ref18">Ghaderi et al., 2021</xref>; <xref ref-type="bibr" rid="ref56">Shahdadian et al., 2022</xref>). However, previous EEG-based studies have not investigated the influence of tPBM on the temporal dynamics of the human brain. To the best of our knowledge, only a short conference abstract by <xref ref-type="bibr" rid="ref73">Zomorrodi et al. (2021)</xref> has reported the effects of tPBM on the temporal dynamics of the human brain. Therefore, it remains unclear how tPBM dynamically modulates the human brain. Accordingly, this study addressed two key questions: can tPBM modulate EEG microstates and their topographical spectral parameters? If so, which temporal and spectral parameters of microstates would tPBM modulate significantly? We hypothesized that tPBM significantly affects the parameters of certain microstate classes.</p>
<p>This study shared the 64-channel EEG data reported earlier (<xref ref-type="bibr" rid="ref67">Wang et al., 2021</xref>; <xref ref-type="bibr" rid="ref56">Shahdadian et al., 2022</xref>; <xref ref-type="bibr" rid="ref68">Wang et al., 2022b</xref>), comprising 45 healthy subjects undergoing both active and sham 8-min tPBM using a 1,064-nm laser applied to the right forehead. The novelty of this study differs from our prior work on several key analysis methodologies and findings. For the first time, EEG microstate analysis (<xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>) has been applied to investigate brain dynamics under tPBM. Different temporal microstate parameters were extracted and compared to assess the effects of tPBM on temporal dynamics in the human brain. In addition, EEG microstate spectral analysis was performed using multivariate empirical mode decomposition (MEMD; <xref ref-type="bibr" rid="ref31">Lang et al., 2018</xref>) and the Hilbert-Huang transform (HHT; <xref ref-type="bibr" rid="ref21">Huang et al., 1998</xref>; <xref ref-type="bibr" rid="ref22">Huang and Wu, 2008</xref>). This newly developed frequency-domain analysis enabled us to quantify the alteration in the EEG power of microstate classes over different experimental periods for both tPBM and sham sessions. By the end of this study, our statistical results revealed significant changes in the occurrence, contribution, and transition probabilities of different microstate classes as well as alterations in frequency-band-specific microstate power, which affirmed our hypothesis.</p>
</sec>
<sec sec-type="materials|methods" id="sec2">
<label>2.</label>
<title>Materials and methods</title>
<sec id="sec3">
<label>2.1.</label>
<title>Participants</title>
<p>We recruited 49 healthy human subjects (29 males, 19 females, 26 <italic>&#x00B1;</italic> 8.8&#x2009;years of age) from the University of Texas at Arlington local community to participate in this study. Participants had to be satisfied the following criteria: (1) no psychiatric disorder or neurological condition, (2) no severe brain injury, (3) no history of violence or imprisonment, (4) no current intake of any psychotropic medicine, (5) no smoking or excessive alcohol consumption, (6) had not been diagnosed with diabetes, as required by the laser&#x2019;s manufacturer (Cell Gen Therapeutics LLC, Dallas, Texas). Due to observed fatigue or drowsiness during EEG measurements, four subjects were excluded from the dataset, leaving 45 remaining participants in the subsequent data analysis. The experimental protocol was approved by the Institutional Review Board of the University of Texas at Arlington. Prior to all measures, each participant&#x2019;s informed consent was obtained.</p>
</sec>
<sec id="sec4">
<label>2.2.</label>
<title>Experimental procedures</title>
<p>We employed a 1,064-nm continuous-wave (CW) laser with FDA clearance (Model CG-5000 Laser, Cell Gen Therapeutics LLC, Dallas, Texas) for our noninvasive tPBM experiment (<xref rid="fig1" ref-type="fig">Figure 1A</xref>). The laser had a 13.6&#x2009;cm<sup>2</sup> irradiation area, and its power was set at 3.4&#x2009;W. Using this laser&#x2019;s output, a total energy dose of 1,632&#x2009;J was delivered throughout an 8-min tPBM session (3.4&#x2009;W <italic>&#x00D7;</italic> 60&#x2009;s/min <italic>&#x00D7;</italic> 8&#x2009;min&#x2009;=&#x2009;1,632&#x2009;J), resulting in a laser power density of 0.25&#x2009;W/cm<sup>2</sup>. The light was delivered over the right frontopolar region close to the Fp2 site without physical contact (<xref rid="fig1" ref-type="fig">Figure 1B</xref>). For the sham condition, the laser device was also on to ensure subjects heard the device operation sound and were unaware of being in the sham condition. However, the laser strength was reduced to 0.1&#x2009;W for sham stimulation, and a black cap was placed in front of the laser aperture to obstruct the light further. Participants would not be aware of the cap as it was placed after they closed their eyes. Throughout the experiment, participants were required to wear a pair of laser protection goggles.</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p><bold>(A)</bold> A photograph of our 1,064-nm laser used for the study. <bold>(B)</bold> A cartoon showing the EEG setup and the tPBM site on the participant&#x2019;s right forehead. <bold>(C)</bold> Schematic diagram of the experimental protocol. A total of 45 subjects were randomly divided into two groups: active-sham or sham-active stimulation. Each experiment included EEG recordings of a 2-min baseline, an 8-min active or sham tPBM, and a 3-min recovery period. A minimum 1-week waiting period between two visits was required to avoid potential effects from active tPBM.</p>
</caption>
<graphic xlink:href="fnins-17-1247290-g001.tif"/>
</fig>
<p><xref rid="fig1" ref-type="fig">Figure 1C</xref> depicts the experimental protocol. Each subject was assigned a random order for the two study sessions: active tPBM and sham tPBM. In order to prevent any carry-over effects, two visits had to be separated by at least 1 week. Subjects were instructed to sit comfortably with their eyes closed during EEG acquisition. The resting state EEG data were recorded for 2&#x2009;min of pre-stimulation, 8&#x2009;min of active/sham stimulation, and 3&#x2009;min of post-stimulation. We used a Biosemi (64-channel) 10&#x2013;10 EEG equipment to acquire the EEG data (<xref rid="fig1" ref-type="fig">Figure 1B</xref>). The electrical gel was applied to each electrode prior to each EEG measurement in order to boost conductivity and the signal-to-noise ratio of the collected data.</p>
</sec>
<sec id="sec5">
<label>2.3.</label>
<title>EEG data analysis</title>
<sec id="sec6">
<label>2.3.1.</label>
<title>EEG data preprocessing</title>
<p>We employed the EEGLAB toolbox (<xref ref-type="bibr" rid="ref13">Delorme and Makeig, 2004</xref>) to preprocess 64-channel EEG data. Since either 256 or 512&#x2009;Hz was used to acquire the EEG data, the 512&#x2009;Hz data were first down-sampled to 256&#x2009;Hz to ensure consistency. The EEG signals underwent bandpass filtering between 1 and 70&#x2009;Hz using the EEGLAB &#x201C;filtfilt&#x201D; function. Additionally, a notch filter at 60&#x2009;Hz was employed to remove line noise. Re-referencing was performed by subtracting the average voltage signals across all 64 electrodes from each of the EEG time series. The Independent Component Analysis (ICA) technique (<xref ref-type="bibr" rid="ref8">Campos Viola et al., 2009</xref>) was applied to eliminate artifacts caused by eye blinks, eye movements, or jaw clenches. ICA components were manually inspected, and the noisy components corresponding to the noise and artifacts were excluded. Subsequently, the artifact-free EEG time series were split into four temporal segments to better characterize the EEG microstates in response to tPBM/sham stimulation: (1) a 2-min pre-stimulation (Pre) period, (2) the first 4-min temporal segment during active/sham tPBM (Stim1), (3) the last 4-min segment of active/sham tPBM (Stim2), and (4) a 3-min post-stimulation (Post) period.</p>
</sec>
<sec id="sec7">
<label>2.3.2.</label>
<title>EEG microstate analysis in the time domain</title>
<p>The EEG microstate analysis in the time domain was performed following the procedure presented in <xref ref-type="bibr" rid="ref29">Koenig et al. (1999)</xref> and <xref ref-type="bibr" rid="ref41">Michel and Koenig (2018)</xref>. We employed a Matlab-based microstate toolbox (<xref ref-type="bibr" rid="ref27">Koenig, 2017</xref>) compatible with EEGLAB (<xref ref-type="bibr" rid="ref13">Delorme and Makeig, 2004</xref>) to compute EEG microstates. The main steps of the time-domain EEG microstate analysis are depicted by the gray-shaded left column in <xref rid="fig2" ref-type="fig">Figure 2</xref> (i.e., <xref rid="fig2" ref-type="fig">Figures 2A</xref>&#x2013;<xref rid="fig2" ref-type="fig">D</xref>) with 4 steps.</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>A flowchart for EEG microstate analysis. Panels <bold>(A&#x2013;D)</bold> show steps of the time-domain EEG microstate analysis; Panels <bold>(F&#x2013;H)</bold> show steps of the frequency-domain EEG microstate analysis. &#x03B4;: delta band (0.5&#x2013;4&#x2009;Hz); &#x03B8;: theta band (4&#x2013;8&#x2009;Hz); &#x03B1;: alpha band (8&#x2013;13&#x2009;Hz); &#x03B2;: beta band (13&#x2013;30&#x2009;Hz). Panels <bold>(E,I)</bold> represent the process for statistical analysis in the time and frequency domain, respectively.</p>
</caption>
<graphic xlink:href="fnins-17-1247290-g002.tif"/>
</fig>
<p>The principle of microstate analysis consists of finding a set of the most dominant topographical maps representing different crucial brain states and then fitting these maps back to the EEG data. The global field power (GFP) was calculated for each sample time as follows:</p>
<disp-formula id="EQ1">
<label>(1)</label>
<mml:math id="M1">
<mml:mrow>
<mml:mi mathvariant="normal">GFP</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mi>t</mml:mi>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mo>=</mml:mo>
<mml:msqrt>
<mml:mrow>
<mml:mfrac>
<mml:mrow>
<mml:msubsup>
<mml:mstyle displaystyle="true">
<mml:mo>&#x2211;</mml:mo>
</mml:mstyle>
<mml:mrow>
<mml:mi>i</mml:mi>
<mml:mo>=</mml:mo>
<mml:mn>1</mml:mn>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:msubsup>
<mml:msub>
<mml:mi>v</mml:mi>
<mml:mi>i</mml:mi>
</mml:msub>
<mml:msup>
<mml:mrow>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mi>t</mml:mi>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mn>2</mml:mn>
</mml:msup>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:mfrac>
</mml:mrow>
</mml:msqrt>
</mml:mrow>
</mml:math>
</disp-formula>
<p>where <italic>N</italic> is the number of EEG electrodes (N&#x2009;=&#x2009;64 in this study), and <italic>v<sub>i</sub></italic>(<italic>t</italic>) is the voltage of electrode <italic>i</italic> at time <italic>t</italic>. The time-resolved GFP(<italic>t</italic>) reflects the global power alteration of the EEG signal at time <italic>t</italic>; the GFP peaks correspond to the moments of high global neuronal synchronization (<xref ref-type="bibr" rid="ref59">Skrandies, 2007</xref>). It is known that the scalp topographies around the peaks remain quasi-stable (<xref ref-type="bibr" rid="ref35">Lehmann and Skrandies, 1980</xref>; <xref ref-type="bibr" rid="ref58">Skrandies, 1989</xref>; <xref ref-type="bibr" rid="ref30">Koenig et al., 2002</xref>; <xref ref-type="bibr" rid="ref28">Koenig and Brandeis, 2016</xref>; <xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>).</p>
<p>In step 1 (<xref rid="fig2" ref-type="fig">Figure 2A</xref>), we determined the scalp topographical maps at the GFP peaks for each participant within each experimental temporal period for both tPBM and sham sessions separately.</p>
<p>In step 2 (<xref rid="fig2" ref-type="fig">Figure 2B</xref>), we performed two-level clustering to identify global microstates. The first level of clustering was performed to identify the individual-level EEG microstates for each experimental segment (Pre, Stim1, Stim2, and Post), separately for tPBM and sham sessions. All topographical maps acquired per subject per each temporal segment were clustered into 4 maps using the k-means clustering algorithm (<xref ref-type="bibr" rid="ref30">Koenig et al., 2002</xref>; <xref ref-type="bibr" rid="ref44">Murray et al., 2008</xref>). These 4 clustered maps present dominant microstate classes, which have been commonly used and reported in numerous EEG microstates studies. Since the individual microstate classes obtained by the k-means clustering had no particular order and thus were potentially mismatched between participants (<xref ref-type="bibr" rid="ref30">Koenig et al., 2002</xref>; <xref ref-type="bibr" rid="ref27">Koenig, 2017</xref>), the second level of clustering was performed on EEG microstates of all subjects for each experimental period (<xref ref-type="bibr" rid="ref29">Koenig et al., 1999</xref>), separately for the tPBM or sham session. The outcome of this clustering was the group-level microstate classes for each experimental period (Pre, Stim1, Stim2, and Post), separately for the tPBM or sham session. Finally, a permutation-based clustering step was employed to identify the &#x201C;global&#x201D; microstate classes based on the two groups of 4 microstate classes from the tPBM and sham sessions, serving as representative microstates for all experimental periods of both tPBM and sham sessions.</p>
<p>In step 3 (<xref rid="fig2" ref-type="fig">Figure 2C</xref>), the global microstate classes were fitted back to each subject&#x2019;s temporal EEG data to assign a label of one microstate class to every EEG data instant. The assigned microstate class was chosen as the one that had the highest spatial correlation with the scalp topography of the corresponding EEG data instant (<xref ref-type="bibr" rid="ref7">Brodbeck et al., 2012</xref>; <xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>). The spatial correlation was computed using Pearson&#x2019;s correlation coefficient (<xref ref-type="bibr" rid="ref5">Brandeis et al., 1992</xref>) defined as follows:</p>
<disp-formula id="EQ2">
<label>(2)</label>
<mml:math id="M2">
<mml:mrow>
<mml:mi>C</mml:mi>
<mml:mo>=</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:msubsup>
<mml:mstyle displaystyle="true">
<mml:mo>&#x2211;</mml:mo>
</mml:mstyle>
<mml:mrow>
<mml:mi>i</mml:mi>
<mml:mo>=</mml:mo>
<mml:mn>1</mml:mn>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:msubsup>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:msub>
<mml:mi>u</mml:mi>
<mml:mi>i</mml:mi>
</mml:msub>
<mml:mo>&#x00B7;</mml:mo>
<mml:msub>
<mml:mi>v</mml:mi>
<mml:mi>i</mml:mi>
</mml:msub>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:msqrt>
<mml:mrow>
<mml:msubsup>
<mml:mstyle displaystyle="true">
<mml:mo>&#x2211;</mml:mo>
</mml:mstyle>
<mml:mrow>
<mml:mi>i</mml:mi>
<mml:mo>=</mml:mo>
<mml:mn>1</mml:mn>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:msubsup>
<mml:msubsup>
<mml:mi>u</mml:mi>
<mml:mi>i</mml:mi>
<mml:mn>2</mml:mn>
</mml:msubsup>
</mml:mrow>
</mml:msqrt>
<mml:mo>&#x00B7;</mml:mo>
<mml:msqrt>
<mml:mrow>
<mml:msubsup>
<mml:mstyle displaystyle="true">
<mml:mo>&#x2211;</mml:mo>
</mml:mstyle>
<mml:mrow>
<mml:mi>i</mml:mi>
<mml:mo>=</mml:mo>
<mml:mn>1</mml:mn>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:msubsup>
<mml:msubsup>
<mml:mi>v</mml:mi>
<mml:mi>i</mml:mi>
<mml:mn>2</mml:mn>
</mml:msubsup>
</mml:mrow>
</mml:msqrt>
</mml:mrow>
</mml:mfrac>
</mml:mrow>
</mml:math>
</disp-formula>
<p>where <italic>N</italic> is the number of electrodes, <italic>u<sub>i</sub></italic> and <italic>v<sub>i</sub></italic> are the voltage of electrode <italic>i</italic> of the two topographical maps. At the end of Step 3, the labeled microstate time series for all subjects were obtained in both tPBM and sham sessions (<xref rid="fig2" ref-type="fig">Figure 2C</xref>).</p>
<p>In Step 4 (<xref rid="fig2" ref-type="fig">Figure 2D</xref>), the resulting microstate time series were used to compute four temporal microstate parameters as follows:</p>
<list list-type="bullet">
<list-item>
<p>Duration: the average duration that the microstate class is continuously presented (in ms). The microstate duration reflects the average time that the brain sustains synchronized activities.</p>
</list-item>
<list-item>
<p>Occurrence: the number of occurrences of a microstate class divided by the total duration (in s) of the analyzed EEG data. The occurrence parameter reveals how frequently a microstate class occurs over time (<xref ref-type="bibr" rid="ref25">Khanna et al., 2014</xref>; <xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>).</p>
</list-item>
<list-item>
<p>Contribution: the proportion of the total occurrence duration of one microstate over the whole analysis time. The contribution parameter indicates the time coverage of each microstate class relative to other classes (<xref ref-type="bibr" rid="ref33">Lehmann et al., 2005</xref>).</p>
</list-item>
<list-item>
<p>Transition probability: proportion of the number of transitions from one microstate class to another over the number of all transitions occurring during the analysis period (<xref ref-type="bibr" rid="ref33">Lehmann et al., 2005</xref>; <xref ref-type="bibr" rid="ref26">Khanna et al., 2015</xref>).</p>
</list-item>
</list>
</sec>
<sec id="sec8">
<label>2.3.3.</label>
<title>EEG microstate analysis in the frequency domain</title>
<p>In parallel, we performed EEG microstate analysis in the frequency domain, following the framework proposed in <xref ref-type="bibr" rid="ref36">Li et al. (2021)</xref>. Because conventional time-frequency spectral analysis that employs Fourier or wavelet transform usually fails to analyze EEG signals with a short temporal length [60&#x2013;120&#x2009;ms for the case of EEG microstates (<xref ref-type="bibr" rid="ref48">Pascual-Marqui et al., 1995</xref>; <xref ref-type="bibr" rid="ref38">Mandic et al., 2013</xref>)], many studies have employed the Hilbert transform in microstate analysis because of its feasibility in analyzing short-length signals (<xref ref-type="bibr" rid="ref38">Mandic et al., 2013</xref>; <xref ref-type="bibr" rid="ref43">Milz et al., 2017</xref>; <xref ref-type="bibr" rid="ref11">Comsa et al., 2019</xref>). Thus, following the methodology proposed in <xref ref-type="bibr" rid="ref57">Shi et al. (2020)</xref> and <xref ref-type="bibr" rid="ref36">Li et al. (2021)</xref>, we performed a spectral analysis of EEG microstates (<xref ref-type="bibr" rid="ref57">Shi et al., 2020</xref>) by employing a multivariate empirical mode decomposition (MEMD) algorithm incorporated with the Hilbert-Huang transform (HHT; <xref ref-type="bibr" rid="ref21">Huang et al., 1998</xref>; <xref ref-type="bibr" rid="ref22">Huang and Wu, 2008</xref>). The procedure of EEG microstate analysis in the frequency domain is depicted by the yellow-shaded right column in <xref rid="fig2" ref-type="fig">Figure 2</xref> (i.e., <xref rid="fig2" ref-type="fig">Figures 2F</xref>&#x2013;<xref rid="fig2" ref-type="fig">H</xref>) in 3 steps, as briefly described below. Detailed mathematical expressions are provided in <xref ref-type="supplementary-material" rid="SM1">Supplementary material</xref>.</p>
<p>First, MEMD was performed to decompose N-channel EEG signals into a set of intrinsic mode functions (IMFs) that represent different oscillatory levels embedded in the original signals. MEMD is an extended method of EMD, the latter of which is a data decomposition method for non-linear and non-stationary signals (<xref ref-type="bibr" rid="ref21">Huang et al., 1998</xref>). EMD enables any complicated dataset to be expressed in a finite number of IMFs. MEMD was developed by taking signal projections along different directions in <italic>N</italic>-dimensional spaces, a generalization of EMD (<xref ref-type="bibr" rid="ref53">Rehman and Mandic, 2010</xref>). This step is illustrated in <xref rid="fig2" ref-type="fig">Figure 2F</xref>.</p>
<p>Next, HHT was performed on each of IMFs to estimate the time-frequency Hilbert spectra of all EEG channels and to facilitate the sharp identification of imbedded structures. In addition, the EEG microstate sequences obtained by time-domain analysis (<xref rid="fig2" ref-type="fig">Figure 2C</xref>) were imported to generate the segmented Hilbert spectra for each EEG microstate (<xref rid="fig2" ref-type="fig">Figure 2G</xref>). Given that the Hilbert spectrum is written as <italic>H<sup>n</sup></italic>(&#x03C9;, <italic>t</italic>) for the EEG data from the <italic>n</italic>th channel in the frequency <italic>&#x03C9;</italic> at time <italic>t</italic>, the power for microstate <italic>m</italic> at the <italic>n</italic>th channel in the frequency band (<italic>&#x003C;fb&#x003E;</italic>) would be equal to:</p>
<disp-formula id="EQ3">
<label>(3)</label>
<mml:math id="M3">
<mml:mrow>
<mml:msubsup>
<mml:mi>P</mml:mi>
<mml:mrow>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>f</mml:mi>
<mml:mi>b</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>n</mml:mi>
</mml:mrow>
</mml:msubsup>
<mml:mo>=</mml:mo>
<mml:mfrac>
<mml:mn>1</mml:mn>
<mml:mrow>
<mml:mi>&#x0394;</mml:mi>
<mml:mi>&#x03C9;</mml:mi>
</mml:mrow>
</mml:mfrac>
<mml:mfrac>
<mml:mn>1</mml:mn>
<mml:mrow>
<mml:msub>
<mml:mi>L</mml:mi>
<mml:mi>m</mml:mi>
</mml:msub>
</mml:mrow>
</mml:mfrac>
<mml:mstyle displaystyle="true">
<mml:mrow>
<mml:munder>
<mml:mo>&#x222C;</mml:mo>
<mml:mrow>
<mml:mi>&#x0394;</mml:mi>
<mml:mi>&#x03C9;</mml:mi>
<mml:msub>
<mml:mi>L</mml:mi>
<mml:mi>m</mml:mi>
</mml:msub>
</mml:mrow>
</mml:munder>
<mml:mrow>
<mml:msup>
<mml:mi>H</mml:mi>
<mml:mi>n</mml:mi>
</mml:msup>
<mml:msup>
<mml:mrow>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>&#x03C9;</mml:mi>
<mml:mi mathvariant="normal">,</mml:mi>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mn>2</mml:mn>
</mml:msup>
<mml:mi>d</mml:mi>
<mml:mi>t</mml:mi>
<mml:mi>d</mml:mi>
<mml:mi>&#x03C9;</mml:mi>
</mml:mrow>
</mml:mrow>
</mml:mstyle>
</mml:mrow>
</mml:math>
</disp-formula>
<p>where <italic>L<sub>m</sub></italic> is the total temporal length of the microstate <italic>m</italic>, and &#x2206;&#x03C9; is the range of the frequency band <italic>&#x003C;fb&#x003E;</italic>. Specifically, <italic>&#x003C;fb&#x2009;&#x003E;</italic> covers delta band (&#x03B4;: 0.5&#x2013;4&#x2009;Hz), theta band (&#x03B8;: 4&#x2013;8&#x2009;Hz), alpha band (&#x03B1;: 8&#x2013;13&#x2009;Hz), and beta band (&#x03B2;: 13&#x2013;30&#x2009;Hz). This step is depictured and marked in <xref rid="fig2" ref-type="fig">Figure 2H</xref>.</p>
<p>Finally, the percentage changes of the power for microstate <italic>m</italic> during tPBM/sham and post-tPBM/sham periods with respect to the pre-stimulation (baseline) power were defined as follows:</p>
<disp-formula id="EQ4">
<label>(4)</label>
<mml:math id="M4">
<mml:mrow>
<mml:mi>&#x0394;</mml:mi>
<mml:msubsup>
<mml:mi>P</mml:mi>
<mml:mrow>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>s</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>g</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
<mml:mo>,</mml:mo>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>f</mml:mi>
<mml:mi>b</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>n</mml:mi>
</mml:mrow>
</mml:msubsup>
<mml:mo>=</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:msubsup>
<mml:mi>P</mml:mi>
<mml:mrow>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>s</mml:mi>
<mml:mi>e</mml:mi>
<mml:mi>g</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
<mml:mo>,</mml:mo>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>f</mml:mi>
<mml:mi>b</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>n</mml:mi>
</mml:mrow>
</mml:msubsup>
<mml:mo>&#x2212;</mml:mo>
<mml:msubsup>
<mml:mi>P</mml:mi>
<mml:mrow>
<mml:mi>p</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>e</mml:mi>
<mml:mo>,</mml:mo>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>f</mml:mi>
<mml:mi>b</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>n</mml:mi>
</mml:mrow>
</mml:msubsup>
</mml:mrow>
<mml:mrow>
<mml:msubsup>
<mml:mi>P</mml:mi>
<mml:mrow>
<mml:mi>p</mml:mi>
<mml:mi>r</mml:mi>
<mml:mi>e</mml:mi>
<mml:mo>,</mml:mo>
<mml:mrow>
<mml:mo>&#x2329;</mml:mo>
<mml:mrow>
<mml:mi>f</mml:mi>
<mml:mi>b</mml:mi>
</mml:mrow>
<mml:mo>&#x232A;</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>m</mml:mi>
<mml:mi>n</mml:mi>
</mml:mrow>
</mml:msubsup>
</mml:mrow>
</mml:mfrac>
<mml:mo>&#x00D7;</mml:mo>
<mml:mn>100</mml:mn>
<mml:mi>%</mml:mi>
</mml:mrow>
</mml:math>
</disp-formula>
<p>where <italic>&#x003C;seg&#x003E;</italic> covers three temporal segments (Stim1, Stim2, and Post). These percentage changes were calculated for both tPBM and sham sessions.</p>
</sec>
<sec id="sec9">
<label>2.3.4.</label>
<title>Statistical analysis</title>
<p>For the time-domain microstate analysis (<xref rid="fig2" ref-type="fig">Figure 2E</xref>), we performed a one-way repeated-measures ANOVA on the microstate temporal results of the two experimental sessions (tPBM and sham) to test the period effects (Pre, Stim1, Stim2, Post). We verified the normality and homoscedasticity characteristics of the data to ensure that ANOVA usage was appropriate. Post-hoc pairwise comparisons were further carried out using Tukey&#x2019;s adjustment for multiple variable comparisons to assess significant differences across 4 experimental periods (Pre, Stim1, Stim2, Post).</p>
<p>For the frequency-domain microstate analysis (<xref rid="fig2" ref-type="fig">Figure 2I</xref>), we employed the cluster-based permutation test (CBPT; <xref ref-type="bibr" rid="ref39">Maris and Oostenveld, 2007</xref>; <xref ref-type="bibr" rid="ref47">Oostenveld et al., 2011</xref>; <xref ref-type="bibr" rid="ref49">Pellegrino et al., 2016</xref>; <xref ref-type="bibr" rid="ref3">Benavides-Varela and Gervain, 2017</xref>) to compare the normalized frequency-specific power of four microstate classes between tPBM and sham sessions. This analysis enabled us to assess the significant differences in microstate power between tPBM and sham sessions across these four microstate classes.</p>
</sec>
</sec>
</sec>
<sec sec-type="results" id="sec10">
<label>3.</label>
<title>Results</title>
<sec id="sec11">
<label>3.1.</label>
<title>Alterations of EEG microstate topographies induced by tPBM</title>
<p>The four most dominant EEG microstate classes (A, B, C, and D) were identified under different conditions, and the respective microstate topographies are presented in <xref rid="fig3" ref-type="fig">Figure 3</xref>. Specifically, <xref rid="fig3" ref-type="fig">Figure 3A</xref> shows four microstate topographies derived from all the temporal segments and two tPBM/sham sessions. <xref rid="fig3" ref-type="fig">Figures 3B</xref>,<xref rid="fig3" ref-type="fig">C</xref> illustrate the time-dependent topographies under sham and tPBM interventions across all four microstate classes. These figures clearly display that microstate A exhibited a left occipital to right frontal polarity orientation, while microstate B presented a right occipital to left frontal orientation. Microstates C and D revealed roughly symmetric occipital to frontal and central to frontal polarity patterns, respectively.</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>EEG microstate topographies of 4 microstate classes. <bold>(A)</bold> Global microstate topographies obtained from both tPBM and sham sessions during four experimental periods (Pre, Stim1, Stim2, and Post). <bold>(B)</bold> Microstate topographies during the four temporal segments under Sham session. <bold>(C)</bold> Microstate topographies during the four temporal segments under active tPBM session.</p>
</caption>
<graphic xlink:href="fnins-17-1247290-g003.tif"/>
</fig>
</sec>
<sec id="sec12">
<label>3.2.</label>
<title>Alterations of EEG microstate parameters induced by tPBM</title>
<p>As mentioned in Section 2, the labeled microstate time series were obtained by fitting the global microstate classes to each subject&#x2019;s EEG data (<xref rid="fig2" ref-type="fig">Figure 2C</xref>). By using the microstate sequences, we computed several key temporal microstate parameters of the four experimental periods (Pre, Stim1, Stim2, and Post) for the tPBM and sham sessions. One-way repeated-measures ANOVA (rmANOVA) enabled us to reveal significant tPBM-induced changes in two key microstate temporal parameters throughout different experimental periods or segments for both tPBM and sham sessions.</p>
<p><xref rid="fig4" ref-type="fig">Figures 4A</xref>,<xref rid="fig4" ref-type="fig">B</xref> depict the occurrence (per sec) and contribution (in %) of the four microstate classes throughout the different experimental periods (Pre, Stim1, Stim2, and Post) of the tPBM and sham sessions. The post-hoc rmANOVA tests along with Tukey&#x2019;s method revealed a significant increase in the occurrence of microstates A and D and a significant decrease in the contribution of microstate C during the tPBM session. Specifically, the occurrence of microstate A gradually increased during the tPBM stimulation, leading to a significant difference between the Pre and Stim2 periods (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.022). During the Post period, the occurrence of microstate A decreased significantly compared with that during Stim2 (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.049). The occurrence of microstate D also increased notably during Stim1 of the tPBM session (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.038 compared to Pre).</p>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>Statistical comparisons of the microstate <bold>(A)</bold> occurrence (1/s) and <bold>(B)</bold> contribution (%) parameters among four temporal segments (Pre, Stim1, Stim2, and Post) for each of the four microstate classes, A, B, C, and D. These comparisons are made independently for the active and sham sessions. Statistical results were obtained by one-way repeated measures ANOVA and the <italic>post hoc</italic> pairwise comparisons with Tukey correction. Significant differences between a period pair are marked as &#x201C;&#x2217;&#x201D; for <italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 after Tukey correction.</p>
</caption>
<graphic xlink:href="fnins-17-1247290-g004.tif"/>
</fig>
<p>For the contribution parameter, the <italic>post hoc</italic> rmANOVA results showed that the contribution of microstate C of the tPBM session was significantly decreased during Stim2 compared to the baseline (Pre; <italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.045). Regarding the sham condition, the rmANOVA analysis revealed significant differences in the contribution parameter of microstate B across four periods (p<sub>rmANOVA</sub>&#x2009;=&#x2009;0.038). However, the <italic>post hoc</italic> test did not identify any significant differences for six pairs of periods. The smallest <italic>p<sub>Tukey</sub></italic> value for this case was 0.125 between the Pre and Stim1 periods. For other microstates, the statistical analysis did not reveal any significant differences across the four periods of both experimental sessions.</p>
</sec>
<sec id="sec13">
<label>3.3.</label>
<title>Alterations in transition probabilities among microstate classes induced by tPBM</title>
<p>Further analysis of the transition probabilities between different microstate classes revealed several significant differences induced by tPBM. <xref rid="fig5" ref-type="fig">Figure 5</xref> shows the transition probabilities among the four microstate classes. Statistical results showed that the transition between microstates A and D increased significantly during the active stimulation period, whereas the transition between microstates B and C declined significantly. Specifically, the <italic>post hoc</italic> Tukey&#x2019;s test revealed significant increases in the transition probabilities from microstate A to D between the Pre and Stim 2 periods (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.01) and Stim1 and Stim2 periods (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.013). The transition from microstate D to A also significantly increased between Stim1 and Stim2 (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.041). In contrast, the transition probabilities from microstate B to C significantly decreased (<italic>p<sub>Tukey</sub></italic>&#x2009;&#x003C;&#x2009;0.05, when comparing the Pre and Stim2 periods). Similarly, a significant drop in the transition probabilities from microstate C to B was also observed (<italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.01 for Pre and Stim2 periods and <italic>p<sub>Tukey</sub></italic>&#x2009;=&#x2009;0.04 for Stim1 and Stim2 periods). For the sham session, the statistical analysis did not reveal any significant differences in the transition probabilities across the four temporal periods.</p>
<fig position="float" id="fig5">
<label>Figure 5</label>
<caption>
<p>Transition probabilities between each pair of the four microstate classes and respective statistical comparisons under separate active and sham conditions. Statistical results were obtained by one-way repeated measures ANOVA and <italic>post hoc</italic> pairwise comparisons with Tukey&#x2019;s correction. Significant differences between respective pairs are marked as &#x201C;&#x002A;&#x201D; for <italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, after Tukey&#x2019;s correction.</p>
</caption>
<graphic xlink:href="fnins-17-1247290-g005.tif"/>
</fig>
</sec>
<sec id="sec14">
<label>3.4.</label>
<title>Influences of tPBM on EEG microstate topographical power</title>
<p>As mentioned in section 2, we performed EEG microstate analysis in the frequency domain and calculated the percentage changes in power for each microstate across the delta (0.5&#x2013;4&#x2009;Hz), theta (4&#x2013;8&#x2009;Hz), alpha (8&#x2013;13&#x2009;Hz), and beta (13&#x2013;30&#x2009;Hz) frequency bands using <xref ref-type="disp-formula" rid="EQ4">Eq. (4)</xref>. Accordingly, <xref rid="fig6" ref-type="fig">Figures 6A</xref>,<xref rid="fig6" ref-type="fig">B</xref> show the baseline-normalized changes in microstate power across the delta band (<xref rid="fig6" ref-type="fig">Figure 6A</xref>) and alpha band (<xref rid="fig6" ref-type="fig">Figure 6B</xref>) for the four microstate classes during the tPBM and post-tPBM periods. The topographical maps also highlight channels whose cluster-associated <italic>p</italic>-values were below 0.05.</p>
<fig position="float" id="fig6">
<label>Figure 6</label>
<caption>
<p>Topographic maps of group-averaged (<italic>n</italic>&#x2009;=&#x2009;45), baseline-normalized changes in microstate power in four microstate classes during tPBM/sham and post-tPBM/sham periods in the <bold>(A)</bold> delta band and <bold>(B)</bold> alpha band. Stars/crosses indicate clusters of electrodes with significant differences between the conditions (&#x201C;&#x002A;&#x201D; for <italic>p</italic><sub>cluster</sub> <italic>&#x003C;</italic> 0.01 and &#x201C;x&#x201D; for <italic>p</italic><sub>cluster</sub> <italic>&#x003C;</italic> 0.05). The purple color of the stars/crosses in <bold>(A)</bold> indicates that the normalized delta powers in the tPBM session were significantly lower than those in the sham session. The red color of the crosses in <bold>(B)</bold> indicates that the normalized alpha powers of the tPBM session were significantly higher than those in the sham session.</p>
</caption>
<graphic xlink:href="fnins-17-1247290-g006.tif"/>
</fig>
<p>CBPT revealed significant differences in normalized power between the tPBM and sham sessions across multiple microstates. Specifically, within the delta band, the results revealed significantly lower normalized powers during and after tPBM compared to the sham session across all four microstate classes. In contrast, in the alpha band, the microstate powers of class D exhibited significant augmentation during the active tPBM session (Stim 1 and Stim 2) compared to the sham session. This augmentation, prominently observed in the central to the left-parietal region during Stim1 and in the mid-frontal to the left-parietal region during Stim2, underscores the distinctive impact of tPBM on microstate D in the alpha band.</p>
</sec>
</sec>
<sec sec-type="discussions" id="sec15">
<label>4.</label>
<title>Discussion</title>
<sec id="sec16">
<label>4.1.</label>
<title>Effects of tPBM on EEG microstate classes and respective brain networks</title>
<p>Regarding EEG microstate classes, several simultaneous EEG-fMRI studies have investigated correlations between EEG microstates and fMRI resting states (<xref ref-type="bibr" rid="ref60">Smith et al., 2009</xref>; <xref ref-type="bibr" rid="ref6">Britz et al., 2010</xref>; <xref ref-type="bibr" rid="ref45">Musso et al., 2010</xref>). Accordingly, microstate A is related to the activation of the bilateral superior and middle temporal lobes; microstate B is associated with the activation of the bilateral occipital cortex (<xref ref-type="bibr" rid="ref60">Smith et al., 2009</xref>; <xref ref-type="bibr" rid="ref6">Britz et al., 2010</xref>; <xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>). In addition, microstate C is linked to the dorsal anterior cingulate cortex, bilateral inferior frontal cortices, and right insular area, while microstate D is correlated with activation in the right-lateralized dorsal and ventral areas of the frontal and parietal cortices (<xref ref-type="bibr" rid="ref60">Smith et al., 2009</xref>; <xref ref-type="bibr" rid="ref6">Britz et al., 2010</xref>). Compared with prior publications in the literature, the four EEG microstate classes identified in this study are in good agreement with previous findings (<xref ref-type="bibr" rid="ref30">Koenig et al., 2002</xref>; <xref ref-type="bibr" rid="ref41">Michel and Koenig, 2018</xref>).</p>
<p>As shown in section 3, the statistical analysis of the temporal and spectral characteristics of these four microstates revealed that tPBM mainly modulated microstates A and D. This set of modulations implies that tPBM has the ability to alter or stimulate the resting human brain in the frontal, temporal, and parietal cortices. A recent human study (<xref ref-type="bibr" rid="ref14">Dmochowski et al., 2020</xref>) that employed BOLD-fMRI to assess tPBM-induced hemodynamic activity found increases in resting-state functional connectivity in seed regions in the frontal, temporal, and parietal cortices. Another report from our own group developed a combined analysis of Singular Value Decomposition and eLORETA (<xref ref-type="bibr" rid="ref68">Wang et al., 2022b</xref>), which revealed a tPBM-induced enhancement in alpha power in the frontal&#x2013;parietal network. Thus, our findings derived from the EEG microstate analysis supplemented prior findings in brain regions stimulated by tPBM.</p>
</sec>
<sec id="sec17">
<label>4.2.</label>
<title>Effects of tPBM on EEG microstate classes and respective brain networks</title>
<p>As presented in sections 3.2 and 3.3, the results showed significant increases in (i) the occurrence of microstates A and D and (ii) the transition between microstates A and D during the stimulation period of the active tPBM session. These findings imply that tPBM promotes brain activity in microstates A and D, as well as more frequent transitions between them, all of which can also be considered potential indicators of active neuromodulation effects of tPBM. Previous studies on the functional significance of EEG microstates (<xref ref-type="bibr" rid="ref6">Britz et al., 2010</xref>; <xref ref-type="bibr" rid="ref42">Milz et al., 2016</xref>; <xref ref-type="bibr" rid="ref55">Seitzman et al., 2017</xref>) have suggested that microstate A is associated with the auditory network, while microstate D is related to the dorsal attention network (DAN). A recent study using resting-state fMRI (<xref ref-type="bibr" rid="ref1">Argil&#x00E9;s et al., 2022</xref>) also reported an alteration in the functional connectivity of the DAN after red light exposure. Moreover, several papers have reported significant enhancement of attention and memory induced by tPBM (<xref ref-type="bibr" rid="ref2">Barrett and Gonzalez-Lima, 2013</xref>; <xref ref-type="bibr" rid="ref23">Hwang et al., 2016</xref>; <xref ref-type="bibr" rid="ref63">Vargas et al., 2017</xref>; <xref ref-type="bibr" rid="ref24">Jahan et al., 2019</xref>). In particular, Zhao et al. recently demonstrated that right-forehead tPBM with a 1,064-nm laser significantly enhances visual working memory capacity based on neuropsychological measurements of occipitoparietal contralateral delay activity (CDA; <xref ref-type="bibr" rid="ref71">Zhao et al., 2022</xref>), which is well accepted as a robust neural correlate of visual working memory. Thus, we speculate that the tPBM-promoted increase in activity in microstates A and D may be a potential mechanism for brain function enhancement.</p>
</sec>
<sec id="sec18">
<label>4.3.</label>
<title>Alterations by tPBM in EEG microstate topographical delta and alpha powers</title>
<p>In addition to the time-domain EEG microstate analysis, we assessed the spectral information of microstate classes throughout the different experimental periods of both tPBM and sham sessions. To the best of our knowledge, only a few studies have focused on frequency-domain analysis of EEG microstates (<xref ref-type="bibr" rid="ref36">Li et al., 2021</xref>). By combining the MEMD and HHT methods (<xref ref-type="bibr" rid="ref9">Cho et al., 2017</xref>; <xref ref-type="bibr" rid="ref69">Yang and Ren, 2019</xref>), we could overcome the tribulation due to the short-length signals of EEG microstates and estimate the frequency-specific power of different microstate classes. Accordingly, microstate spectral analysis revealed significant differences in the normalized power between the tPBM and sham sessions. Specifically, we observed that active tPBM induced significant reductions in normalized delta power in three microstates (A, B, and D). This aligns with prior findings (<xref ref-type="bibr" rid="ref24">Jahan et al., 2019</xref>; <xref ref-type="bibr" rid="ref67">Wang et al., 2021</xref>; <xref ref-type="bibr" rid="ref56">Shahdadian et al., 2022</xref>) that have also reported a decrease in delta power during and after tPBM. For instance, a previous study demonstrated a significant decline in delta power in the tPBM group, as opposed to a notable increase in delta power in the sham group (<xref ref-type="bibr" rid="ref24">Jahan et al., 2019</xref>). These observations resonate with previous EEG studies that have inferred a connection between the increase of slow wave oscillations and an individual&#x2019;s proclivity for rest and sleep. Thus, tPBM emerges as a potential mitigator of neuronal fatigue through its capacity to augment cellular energy production and promote neuronal metabolism.</p>
<p>Microstate spectral analysis also unveiled that tPBM significantly enhanced normalized alpha power topographies in microstate D during the active tPBM period. In particular, enhanced powers occurred in the central to left-parietal region during Stim1 and in the mid-frontal to left-parietal region during Stim2. This latter finding underscores the importance of both alpha power and microstate D. Because microstate D is closely associated with brain activity in the dorsal and ventral areas of the frontal and parietal cortices (<xref ref-type="bibr" rid="ref60">Smith et al., 2009</xref>; <xref ref-type="bibr" rid="ref6">Britz et al., 2010</xref>), our results imply that right-prefrontal tPBM facilitates significant promotion of EEG activity in microstate D across the frontal and parietal regions in alpha rhythm. Overall, both time-domain and frequency-domain EEG microstate analyses presented us with the same key microstate class, namely, class D, which was most significantly modulated by the right-forehead tPBM with a 1,064-nm laser compared to other EEG microstate classes.</p>
<p>It is worth noting that although the local stimulation site experienced a slight increase in skin temperature due to light absorption, the changes in microstate parameters observed in this study were not a result of the thermal effect caused by light. Studies on the effects of tPBM on brain temperature, conducted through a computational model (<xref ref-type="bibr" rid="ref4">Bhattacharya and Dutta, 2019</xref>) and magnetic resonance thermometry (<xref ref-type="bibr" rid="ref14">Dmochowski et al., 2020</xref>), revealed no significant difference in temperature between tPBM and sham conditions. Additionally, a recent EEG study comparing tPBM and thermal stimulation found notable differences in the alterations of EEG power topography between the two types of stimulation (<xref ref-type="bibr" rid="ref67">Wang et al., 2021</xref>).</p>
</sec>
<sec id="sec19">
<label>4.4.</label>
<title>Limitations and future work</title>
<p>While this study has enabled us to obtain several new findings, several limitations exist. First, in Session 4.2, we attempted to elucidate the impact of tPBM on microstate parameters by considering the roles of microstates suggested by previous studies in the literature. However, the specific function of microstates may vary depending on the circumstances in which the EEG data was collected. Second, we took the ICA-based artifact correction approach, which could create an author-made artifact and thus affect the validity of the study. Third, we chose to adopt four microstate classes, as mostly employed in prior EEG microstate studies. Nevertheless, we acknowledge that integrating formal criteria to determine the optimal number of microstates holds the potential to bolster the robustness of the analysis. Last, it is possible that tPBM may affect the occurrence of artifacts since some of them are related to brain behaviors.</p>
<p>To overcome the limitations, further work includes (1) to conducting source localization analysis that can provide a more comprehensive explanation of the changes in microstate parameters throughout the tPBM session and further insights into its effects; (2) to perform artifact rejections to minimize potential confounds introduced by artifact correction methods; (3) to introduce a more systematic procedure for microstate selection to characterize more comprehensively/accurately the microstate patterns present in the EEG data; and (4) to investigate tPBM-induced artifacts on EEG microstates.</p>
</sec>
</sec>
<sec sec-type="conclusions" id="sec20">
<label>5.</label>
<title>Conclusion</title>
<p>In this study, 64-channel EEG data were recorded from 45 healthy subjects under both active and sham 8-min tPBM with a 1,064-nm laser delivered on the right forehead of the subjects. Both time- and frequency-domain analyses were employed to identify and investigate tPBM-induced alterations in the dynamic EEG microstates in the human brain. Four global microstate classes for both the tPBM and sham sessions throughout the different experimental periods (i.e., pre-, during, and post-stimulation) were first identified using conventional EEG microstate analysis. Various temporal microstate parameters were then extracted and statistically analyzed to assess the effects of tPBM on temporal brain dynamics. Moreover, spectral analysis was also performed to investigate the variation in EEG power of microstate classes over the respective periods of tPBM and sham sessions. Statistical analyses revealed that tPBM resulted in (1) a significant increase in the occurrence of microstates A and D and a significant decrease in the contribution of microstate C; (2) a substantial increase in the transition probabilities between microstates A and D; and (3) a substantial increase in the alpha power of microstate D. These findings not only were consistent with our previous reports on tPBM-induced alterations in EEG power, but also confirmed the neurophysiological effects of tPBM on EEG microstates, particularly in class D, which reflects brain activation across the frontal and parietal regions. Future efforts should include investigations of the relationships between cognition-evoked functional improvement and alterations of EEG microstates in response to tPBM for a better understanding of the underlying mechanism between them.</p>
</sec>
<sec sec-type="data-availability" id="sec21">
<title>Data availability statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec sec-type="ethics-statement" id="sec22">
<title>Ethics statement</title>
<p>The studies involving humans were approved by the Institutional Review Board of the University of Texas at Arlington, Arlington, TX, USA. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.</p>
</sec>
<sec sec-type="author-contributions" id="sec23">
<title>Author contributions</title>
<p>NT analyzed the data, interpreted the results, and prepared the manuscript. XW assisted with data collection, discussed the results, and reviewed the manuscript. HL initiated and supervised the study, discussed and interpreted the results, as well as reviewed and revised the manuscript. All authors contributed to the article and approved the submitted version.</p>
</sec>
</body>
<back>
<sec sec-type="funding-information" id="sec24">
<title>Funding</title>
<p>This work was supported in part by the National Institute of Mental Health of the National Institutes of Health under the BRAIN Initiative (RF1MH114285).</p>
</sec>
<ack>
<p>The authors acknowledge Hashini Wanniarachchi for her assistance with data acquisition.</p>
</ack>
<sec sec-type="COI-statement" id="sec25">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="sec100" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec sec-type="supplementary-material" id="sec26">
<title>Supplementary material</title>
<p>The Supplementary material for this article can be found online at: <ext-link xlink:href="https://www.frontiersin.org/articles/10.3389/fnins.2023.1247290/full#supplementary-material" ext-link-type="uri">https://www.frontiersin.org/articles/10.3389/fnins.2023.1247290/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Data_Sheet_1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document" xmlns:xlink="http://www.w3.org/1999/xlink"/>
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