Brain Topography, Volume 3, Number 3, 1991 381

EEG Laterality in the Era of Structural Brain Imaging

Michael S. Myslobodsky*, Richard Coppola, and Daniel R. Weinberger

Summary: Bilateral EEG recording is a common practice when brain laterality needs to be assessed in cognitive neurophysiology and psychiatry
research. Its precision and validity remain uncertain. With structural brain imaging methods, it is possible to examine EEG electrode placements
according to the 10-20 system and the validity of inferences made on derived data. Frequent sources of placement errors are examined along with
important factors that contribute to EEG imbalance. Examples are mentioned where asymmetries of EEG/ERP caused by cranial and parenchymal
brain asymmetries may be mistaken for cognition-related laterality changes. Because external skull landmarks are not reliable predictors of cranial
and parenchymal brain asymmetries, laterality assessment cannot be guaranteed by the 10-20 system. Consequently, a return, on a case-to-case basis,
to nonstandard montages, assisted by structural brain imaging is seen as an acceptable alternative.

Keywords: EEG laterality; MRI; The 10-20 system; Alpha rhythm.

Introduction if the system of electrode placements in homotopic sites

A decade ago the source of EEG (ERP) asymmetries
was thought to be well understood. Clinical and research
neurophysiologists were lulled into complacency by the
knowledge that the results obtained by manipulation of
the cognitive state, a n d / o r by drug administration could
often be made to agree with the general predictions of
laterality theories. Consequently, asymmetries of EEG
and ERP seen in the resting state and during cognitive
effort were commonly regarded as a sign of cerebral
lateralization or cerebral dominance. Based on this as-
sumption, comparisons of EEG potentials from different
areas have gained in popularity, and they currently ap-
pear to be a popular tool of cognitive neurophysiology,
psychophysiology and research psychiatry, dealing with
normal and aberrant brain laterality.
Such an approach would be appropriate if potentials
derived from the scalp reflected the activity of the brain
spot immediately underneath, and if the anatomy of the
two hemispheres is genuinely identical and/or, at least,
Clinical Brain Disorders Branch, NIMH Neuroscience Center, St.
Elizabeths, Washington, DC and *Psychobiology Research Unit,
Department of Psychology, Tel-Aviv University, Ramat-Aviv, Israel.
Acknowledgements: Supported in part by the Ford Foundation
grant to MSM. Ms H. von Pragh assisted in running the VEP study; Dr.
J. Glicksohn assisted with statistical processing of the data.
Accepted for publication November 6, 1990
Correspondence and reprint requests should be sent to Dr. Richard
Coppola, NIMH Neuroscience Center, St. Elizabeths, Washington, DC
20032. Tel: (202) 373-6222.
Copyright © 1991 Human Sciences Press, Inc.
were unimpeachable. None of these conditions is ful-
filled with the International 10-20 system (Jasper 1958) so
that inferences made about the state of the two bilaterally
compared areas are not justified. This suspicion not-
withstanding, EEG laterality research leaped further for-
ward with commercial availability for computerized
EEG mapping (e.g., Duffy et al. 1979) that has made these
methods popular.
Structural brain imaging now makes it possible to
examine the accuracy of these maps and the cerebral
accuracy of any system of electrode placement in vivo.
For the first time, a systematic study of the nature of
specific relationships between the cranial and cephalic
anatomy and the electrical activity of the brain, with the
aim of determining such relationships, appear within
reach. Elsewhere, we and other groups have dealt with
the issues caused by the inaccuracy of the dominant
system of electrode placement, the International 10-20
system (Coppola et al. 1987; Homan et al. 1987, 1988;
Myslobodsky and Bar-Ziv 1987; Myslobodsky et al. 1990;
Steinmetz et al. 1989). In the present summary, we con-
tinue this analysis to show sources of inaccuracy in
laterality research literature using examples of effects of
skull inhomogeneity and of parenchymal brain asym-
metry in plagiocephaly.
Plagiocephaly, A Ubiquitous Cranial
Deformity
An important, even if ambiguous disclaimer of the
10-20 system was that calvarial landmarks could be suf-
382
ficiently accurate reference points for locating the desired
cerebral sites only in individuals with no cranial deform-
ities (Jasper 1958). This seemed to be a token caution
since cranial deformity was not expected to affect
e v e r y d a y research or clinical practice in the EEG
laboratory. Jasper's report of 1958 did not even specify
what kind or degree of deformity might invalidate the
system. The term deformity is typically used to denote
striking or at the very least noticeable deviation from
normal anatomy. It appears, however, that rather subtle,
normally occurring cranial deformities may conceivably
compromise laterality EEG data.
Binnie et al. (1982) were probably the first to draw
attention to inaccuracies of the 10-20 system in the
presence of inconspicuous lateral skull asymmetries.
The cranial deformity they examined - without specify-
ing it - is known as plagiocephaly (from Gr. plagios -
slant), a deformity along the sagittal suture. Occipital
plagiocephaly is characterized by a unilateral occipital
flattening, often with compensatory bulging of the ip-
silateral frontal region and prominence of the ipsilateral
ear (Bjork and Bjork 1964; Simpson and David 1986).
According to Simpson and David (1986) plagiocephaly is
encountered in 10% of the population. However, it must
be more ubiquitous to have been detected in the EEG
laboratory just by bilaterally comparing the length of the
frontal and occipital quadrants, as Binnie et al. (1982)
have done. The latter study obtained right-left quadrant
asymmetries of 10% or more in 70% of placements.
Homan et al. (1987,1988) reported such an asymmetry in
50% of placements. Examining CT images one can easily
confirm that mild slant deformity is present virtually in
almost 50% of normal individuals (Myslobodsky et al.
1987).
The underlying brain configuration associated with
occipital plagiocephaly in most right-handers can be
described as a counterclockwise torque with the left oc-
ciput extending laterally and backward and the wider
right frontal lobe, often protruding forward (Daniel et al.
1990). This is the pattern of cranial asymmetry typical for
the majority of right-handed subjects (Chui and Damasio
1980; Geschwind and Levitsky 1968; LeMay 1977;
LeMay and Kido 1978). In left handers, especially
females with components of left-handedness, a reversed
type of asymmetry is seen (see Myslobodsky and Wein-
berger 1987 for review). Such skull deformity, apart from
interfering with accurate electrode placements, may also
introduce a problem w h e n the source derivation method
or Laplacian operator (Hjorth 1975) is applied. The latter
method assumes that the electrodes spaced for comput-
ing the local current density are equidistant and at right
angles to each other. This assumption is often violated
due to the asymmetry of the cranial vault bones in the
frontal and the sagittal planes.
Myslobodsky, Coppola, and Weinberger
The s h a p e of the c r a n i u m a n d c o r r e s p o n d i n g
p a r e n c h y m a l brain a s y m m e t r y in plagiocephaly is
shown in Figure 1. It is clear that cranial slanting would
introduce an error in electrode placement, at the very
least, causing considerable variation in the interelectrode
distances. In the case of occipital flattening, occipital
electrodes would be located closer to parietal electrodes
homolaterally to the flattened occiput (Myslobodsky et
al. 1989). Since no system of electrode placement re-
quires the quantification of plagiocephaly or recom-
mends that regular circumferential measurements be
supplemented with assessments of the symmetry of the
right and left quadrants of the head - as Binnie et al. (1982)
have done - plagiocephaly remains virtually unrecog-
nized. This is especially regrettable since this cranial
deformity requires consideration of other measurements
that go beyond a simple assessment of the hemicircum-
ference. These inter alia are:
(1) Skull inhomogeneity. Skull thickness is known to
differ between the sides (Lang 1983). It is expected then
that resistance (and therefore current flow) in the
electrode-scalp interface will contribute an error unless
skull variables are used as a standard procedure to nor-
malize experimental EEG/ERP values. The skull and
scalp are known to 'smear' EEG potentials, making the
sources appear deeper in the head than they actually are
(Geisler and Gerstein 1961; Nunez 1981). Given that
calvarial bones are known to increase in width with
advancing years (LeMay 1984) one may expect a more
generalized distribution of EEG/ERP in the elderly. For
example, hyperostosis along with cortical atrophy that
are frequently seen among subjects in the middle to older
groups (Dilhmann 1981) would notably contribute to the
smearing effect and generalized potentials by moving the
generators away from the recording electrode. Since the
delayed ERP components may involve current sources
over relatively widespread areas of the cortex, the finding
of an unusually generalized ERP in dementia should not
be attributed to cognitive changes with advancing years
until brain and skull anatomy is scrutinized.
(2) The basal angle may be another measure to be taken
into consideration in as much as brain parenchyma is
molded by factors affecting the development of the cranial
basis (Moss 1958, 1959). It is an inferior angle created by
two lines: the line from the middle of the sella turcica to
the nasion, and the line from the latter point to the basion
(the anterior point of the foramen magnum). The size of
the basal angle ranges from 121 degrees to 152 degrees.
Values of less than 120 degrees indicate a 'kyphotic' base.
Skulls with an angle greater than 152 degrees are said to
have platybasia (Shapiro and Janzen 1960). The kyphotic
base may be associated with upward motion of the oc-
cipital bone (Moss 1958). With an obtuse basal angle
complicated by plagiocephaly, the homolateral occipital
CT/MRI-assistedElectroencephalography 383

Figure 1. CT and MR images of skull with a slant deformity (plagiocephaly), A: fop view of the 3D skull image produced
with Elscint 2400. The calvarial vault is 'removed' fo show that the long axes of the temporal bone pyramids are not
orthogonal to the nasion-inion line. Arrows denote aluminum bars attached to the skull. They emphasize the degree of
its obliquity. B: view from the bottom demonstrates the deformity of skull basis. Mastoids' perimeter (M] and M2) was
thresholded to show the asymmetry of their size. C, D: T]-weighted 7 mm MR images (Gyrex 5000, 0.5T) illustrating
parenchymal asymmetries associated with plagiocephaly, The pyramidal bones (seen as triangularly shaped void) are
of different size indicating that the right pyramidal ridge is slightly above the left one in the horizontal plane. Small circular
hyperintensities at the preauricular points and at T3, T4 sites (arrows in C,D) are lipid markers (capsules) affixed to the scalp.
They permit notice that electrodes at T3 would not be coplanar with MR images (C) and that consistent with a slant
deformity along the sagiftal line the right marker is imaged in front of the left one (D).

electrode will be positioned somewhat lower with regard
to the occipital pole thereby contributing to reduced EEG
potential values at occiput a n d / o r to the enhanced
parieto-occipital differences of the signal.
(3) Head shape was long categorized as either frontipe-
tal, mesopetal, or occipitopetal (Minkin 1925). In fron-
tipetal subjects the occipital pole is high up and the
cerebellum is shifted frontally. In contrast, in skulls of
the occipitopetal shape the occipital pole lies lower in
relation to the Frankfurt horizontal plane. Unusually
high variance in the distance of the occipital lobe from
the internal inion (endion) reported elsewhere (Mys-
lobodsky and Bar-Ziv 1989) may be associated with the
fact that individuals with frontipetal, mesopetal and oc-
cipitopetal heads were not distinguished in that sample.
They are encountered with about equal frequency in the
normal population (Minkin 1925). In the study by Mys-
lobodsky and Bar-Ziv (1989), the occipital lobe distance
from the inion was assessed using lateral radiographs.
Such an approach is acceptable assuming that both oc-
cipital lobes are on the same horizontal plane. However,
this may be a risky assumption. In plagiocephaly, the
frontipetal and occipitopetal hemisphere configurations
may coexist in the same skull. The possibility of such
384 Myslobodsky,Coppola, and Weinberger

IRLS LS

Figure 2. A: Tl-weighted coronal MR image (Gyrex 5000, 0.5 T) through the caudal portion of the temporal lobes, roughly
corresponding to the central line in the 10-20 system. Note that the right lateral sulcus runs steeper in the caudal temporal
lobe and is imaged above its left counterpart. B: Noninteractively thresholded MR images of several 5 mm cuts through
the temporal lobes are stacked to show the variation of the lateral sulcus level in the coronal plane.

cranial deformity in a normal sample adds to the neces-
sity that EEG studies be paralleled by structural brain
imaging.
(4) Sulcal variance. The necessity to take into account
the contribution of variation in sulca! patterns seems
intuitively obvious. The symmetry of EEG potentials
depends significantly upon dipole orientation. In a
regular bilateral EEG comparison one cannot recognize
asymmetries contributed by either radial or tangential
dipole variations because the depth of sulci and the sulcal
pattern are much too variable (e.g., Connolly 1950) to
afford accurate EEG analysis without an individual
anatomical map. ! t should be recalled that the anatomi-
cal substantiation of the 10-20 system has been worked
out predominantly for the major sulci. Jasper (1958)
alluded to the precision of placement within +1 cm from
such landmarks as the Central and Sylvian fissures. It is
doubtful that this magnitude of error is acceptable for
bilateral EEG analysis of the retroinsular cortex (Habib et
aE 1984; Geschwind and Lewitsky 1968). Figure 2 shows
a coronal MR image through the temporal lobe to
demonstrate that the lateral ends of the lateral sulcus
appear on different levels. Given that in the majority of
cases (79%) the right lateral sulcus is located superior to
its counterpart on the left (Habib et al. 1984), there is a
possibility that electrodes located along the coronal line
will record from dissimilar dipoles. Thus, T4 will appear
under the sulcus when T3 will be precisely opposite to
its lateral end or even slightly above it. Information on
sulcal variance might apparently become imperative in
individuals with increased sulcal depth and width, such
as encountered among the elderly and psychotic patients
with brain a~ophies (e.~., Weinberger et al. 1980).
(5) Neural packing density. Ingraham et al. (1986; 1991)
n o t e d that larger brain size was associated with
decreased CT density in frontal white, frontal gray, and
corona radiata. A similar finding was also reported by
Pearlson et al. (1989). Given asymmetry of brain size in
plagiocephaly, it would be interesting to explore whether
the difference in the "neural packing density' could con-
tribute to imbalanced spread of activity and neuronal
synchronization within the cortex due to the operation of
nonsynaptic, i.e., direct or ephaptic influences from one
cell to another. Such a process may not play a significant
role in the normal propagation of activity, but might be
relevant in pathological conditions, facilitating synaptic
transmission and synchronization in abnormally active
cells in the subliminal fringe. Alternatively, a narrowing
of extracellular spaces could augment the efficacy of
ephaptic interaction between neurons, with larger areas
of membranes intimately opposed to each other due to
changes in the extracellular ionic environment (e.g., K+
accumulation during activity). Ephaptic transmission is
typically discussed in relation to mechanisms of epilep-
togenesis, especially in immature neural tissue (Jasper
1969; Purpura 1969; Schwartzcroin 1984). However, it
could conceivably operate in cases of psychopathology
with occasions of epileptiform EEG potentials (e.g.,
schizophrenia).
(6) The irregularity of skull sutures, too, may distort
potentials because the current tends to follow a lower
resistance path (Nunez 1981). Plain skull X-rays show
that individuals with plagiocephaly have narrowing or
complete obliteration of sutures unilaterally. The asym-
metry of sutural closure is so frequent that it is of value
in establishing prevalence of benign plagiocephaly
CT/MRI-assistedElectroencephalography
retrospectively on a dry skull (Kreiborg and Bjork 1981;
Zivanovic 1983). There is often a shift of the posterior
part of the sagittal suture to the affected side (Kreiborg
and Bjork 1981). Total coronal and parieto-occipital
a s y m m e t r y in s u t u r e closure w a s encountered by
Zivanovic (1983) in skulls of European origin in 66.8 %
(n=147) of males and in 80.9% (n=72) of females. It is not
clear whether there is any systematic bias in laterality of
sutural closure. If it occurs, a significant scalp current,
due to generators that are rather far from the recording
point on one side, may be expected (Kaznelson and
Nunez 1981). According to Rush and Driscoll (1968), the
current density at the scalp relative to the cortex imme-
diately underneath a suture may be three times that for a
nonsutured bone. It is conceivable that with a detailed
EEG laterality analysis, notably in infancy, a conduc-
tivity imbalance may cause a detectable EEG symmetry.
(7) Asymmetries of the mastoid prominence were men-
tioned elsewhere (Myslobodsky and Bar-Ziv 1989; Mys-
lobodsky et al. 1989; Tulasne and Tessier 1981). Mastoids
often differ in size a n d / o r pneumaticity. The more
pneumatic mastoid would be less conductive compared
to its more 'sclerotic' counterpart. Connecting the two
bony masses to create a joined mastoid reference may
conceivably create significant current flow between them
which will act at reducing actual laterality values (Nunez
1981, 1988).
A more subtle source of laterality errors may be in an
intrinsic imbalance of the sternomastoid muscles in cases
of plagiocephaly which is often evidenced by asymmetric
mastoids. Therefore, every time a subject is asked to
focus on a centrally located target, the imbalanced tensile
forces may impose right-left EEG asymmetries. Kreiborg
et al. (1985) observed marked asymmetry in activity of
the sternomastoid muscles on the two sides in a patient
with plagiocephaly. The muscle on the affected (flat-
tened) side exhibited about twice the activity of the left.
When the head was directed homolaterally to the flatten-
ing, the EMG appeared to be symmetrical. Given that
the s t e r n o m a s t o i d muscle is p r o b a b l y controlled
homolaterally (Mastaglia et al. 1986) one may expect
enhanced reactivity of the hemisphere homolateral to
the flattened occiput when attention to centrally located
stimuli is imposed.
Components of Alpha Asymmetry
The foregoing raises a number of questions regarding
the validity of EEG techniques. One of these is this: If
parenchymal and cranial asymmetries do matter for
EEG/ERP studies of brain laterality, could the mag-
nitude of error be figured on the basis of structural brain
imaging? In our exploratory studies in the past we
showed that alpha or alpha afterdischarge of VEP, which
385
is known to be the evoked counterpart of the alpha
rhythm (Lansing and Barlow 1972), covaries in a
predicatble w a y with skull thickness and parenchymal
brain asymmetry (Myslobodsky et al. 1989a, b). A
preliminary study aimed at distinguishing between the
relative contribution of these factors is presented below.
The sensory alpha afterdischarge (AD) of VEP was
collected in ten subjects, in three successive sessions
separated by one to three weeks. Examining AD data
session-by-session we noted a well-recognized tendency
of AD amplitude to increase with repeated trials. There
was a trend, however, toward a more pronounced incre-
m e n t of AD at O1, so that a small a l p h a AD
predominance at 0 2 seen in the first session disappeared
in the third session (Figure 3). A two-way Analysis of
Variance conducted on the data (recording sites x ses-
sion) confirmed a significant interaction between record-
ing sites a n d s e s s i o n s [F(2,16)=8,22; p < 0.01,
Greenhouse-Geisser corrected]. Consequently, a rever-
sal of alpha balance was expected to occur in the third
session. This course is shown clearly in Figure 3a where
the AD voltage is documented to increase at O1 in the
third session. Figure 3b demonstrates that this effect was
contributed by eight of the ten subjects. In eight of them
AD asymmetry was altered toward greater negative
values in the third session. We compared AD values with
thickness of the occipital bone at O1 and 0 2 for each
recording session separately. Figure 4 depicts significant
session differences in regression trends. Thus, an inverse
association between alpha AD and bone thickness, statis-
tically significant in the first session (r= -.65, p<0.04)
approached zero value (r=-.05, ns) in the third (Figure 3a).
Hence, although in keeping with Leisnner et al. (1970)
and our earlier report (Myslobodsky et al. 1989), alpha
AD was reduced homolaterally to thicker occipital bone,
that was possible to confirm only for the first session.
This suggests that the weight of the bone factor may differ
depending upon alpha amplitude.
An explanation that attempts to deal with this paradox
suggests that the impedance of tissue under the record-
ing electrodes is not the only factor governing the degree
of attenuation of EEG potentials. Given that cortical
generators project activity via volume conduction to dis-
tances away from the recording sites (Abrahams and
Ajmone-Marsan 1958; Jame et al. 1968; Morrell and Mor-
rell 1965) such distant generators - if recruited in a
synchronous activity - may act as a factor changing the
cortex/scalp attenuation ratio of the EEG from trial to
trial. Cooper et al. (1965) suggested that "the charac-
teristic fluctuations in normal alpha rhythms are probab-
ly due mainly to changes in the area involved in
synchronous discharge rather than to variations in local
amplitude" (page 225). After more rigorous estimates
years later, Nunez (1981) arrived at a similar conclusion,
 386 Myslobodsky, Coppola, and Weinberger

ALPHA AD iNDEX
30

AD,,,,PL,T°,~ ~ V~ 20
10

10
subjects
~ #1
0 --~ #2
2
-~- #3

-10 -~- #4
-~- #6

0 -~- #6
-- Session 1 | -20
0 ~,- #Q

_1
~- ~ession 2

01 02 ~-- Session 2 1 2 3 -~- #10

-30

SCALP ELECTRODES SESSION #

Figure 3. a: Changes of alpha-afterdischarge (AD) amplitude (in uV) a t O1 and 0 2 as a function of three retest sessions
(denoted by numbers) c o n d u c t e d with an interval of one to three weeks in t e n subjest (group average), b: Individual
values of alpha AD asymmetry index [(R)L)/(R+L)*100] as a function of test sessions. Note a trend toward the reversal or
an increase of negative value of the index. In this and the next figure, each point is based on two within-session retests.
The techniques of the study were detailed elsewhere (Myslobodsky et al. 1989).

that w h e n the generators are all in phase and dipoles are
aligned in parallel, the time-averaged potential is propor-
tional to the total n u m b e r of generators near the
electrode. This hypothesis implies that alpha imbalance
may be, inter alia, associated with asymmetries of the
spatial distribution of EEG potentials.
Further, according to the solid angle principle, fleshed
out by Gloor (1985), the larger the area of cortex occupied
by electrical activity, the less the ratio between cortical
versus scalp EEG amplitude. The solid angle principle
implies that the limit of the spatial distribution of alpha
would be set by the anatomical size of the area. It is of
interest that this corollary of Cooper's hypothesis was
virtually unnoticed by students of brain laterality and
consequently has remained unexplored in a search for
the nature of alpha asymmetries. The problem is that it

ALPHA AD INDEX
A L P H A AD INDEX
30:-

I
o
20 20 2
• , +

10

I
Pearson's r
-10 ~ + _10 J ~ -F * • Pearson's r
-~ -.65
,26
-20 + -~-- -,37
-+- .54
-~- -.05
-30 _ _ I I _ ~ i ~ J* -~-- ,43
-30 ~ I 1 I
-15 -10 -5 0 5 10 15
-30 -20 -10 0 10 20
BONE THICKNESS INDEX
OCCIPITAL WIDTH INDEX
X & Y indice=: I(r-lJ/(r-I)]xl00 x & Y Indices: Jr-II/(r÷l).tOO

Figure 4. The family of least square lines represent hemisphere asymmetry of alpha-afferdischarge values at O1 and 02
in three sessions (denoted by numbers) plotted against asymmetry indices of (a) occipital bonethickness and (b) occipital
width (an average of AD values of ten subjects). The techniques of the study were detailed elsewhere (Myslobodsky et
al. 1989).
CT/MRI-assistedElectroencephalography
was impossible to identify a recognizable anatomical
border of the alpha-generating area. Also, although
anatomical asymmetries of the brain hemispheres were
already described (for review see Connolly 1950) they
had to be virtually rediscovered with the advent of struc-
tural brain imaging (e.g., LeMay and Kido, 1978). Today,
it is widely recognized that especially pronounced dif-
ferences in brain width and length can be found in the
occipital area, the putative site of alpha origin. Thus, the
occipital lobe was found to be more often longer and
wider on the left side, notably in right-handed males
(LeMay and Kido 1978). In view of the right-left asym-
metry of the occipital area mentioned above we com-
pared alpha AD values with the right and left occipital
width derived from the CT. A significant positive cor-
relation between AD and width asymmetry was found
(r=.55, p<0.05). Moreover, there was a significant session
difference in this correlation; small in the first session, the
correlation values became stronger in the second and
third sessions. Yet, it was only in the second session that
the r value reached statistical significance (p<0.05). We
therefore entertain the possibility that the magnitude and
degree of asymmetry of potentials recorded from the two
hemispheres are determined by local skull resistance
when the amplitude and the spatiotemporal synchrony
of these potentials are small as is the case in the first
session: increased power of beta activity has long been
related to high level autonomic arousal and anxiety
(Lindsley 1960; Volavka et al. 1967). Given that the
majority of our subjects had somewhat thicker left occipi-
tal bone (median asymmetry index was -3.05), alpha AD
asymmetry favored the right side. In other words, as
more activity sweeps around the cortical palisades to
form equivalent dipoles in the pyramidal neurons - as is
apparently the case in the second-third sessions - the
attenuation becomes increasingly dependent on the area
occupied by alpha. It may be further proposed that with
an increasing active area on one side, the latter's contribu-
tion eventually becomes sufficient to 'outweigh' that per-
taining to skull asymmetry. Given that the median
occipital width asymmetry index was -7.8, the weight of
bone thickness may have become negligible with alpha
build up in the second-third sessions. These results and
their interpretations are in satisfactory agreement with a
computer simulation by Nunez (1989) of the interaction
between skull thickness and the area of active cortex. His
Figure 5 shows a family of curves, representing changes
of three different skull resistivities as a function of dipole
layer size. Note that an increase in local resistivity causes
a much larger drop in the ratio of cortical/scalp potential
when the dipole area is small.
A question that remains is the one we initially set out
to answer: If the gradual build up of EEG alpha is as-
sociated with the generalization of the rhythm, w h y then
387
is this process not reflected in the higher and more sig-
nificant dependence u p o n a s y m m e t r y of the hemi-
spheres in the third session. The answer to this may
require a recollection that although the left temporo-oc-
cipital diameter is greater than the right in the right
handed population, this is by and large true when meas-
urements are taken close to the occipital poles. The width
ratios of the hemispheres differ from one brain segment
to another as one progresses either anteriorly a n d / o r
dorsally, from subventricular to supraventricular cuts
(Myslobodsky et al. 1991). It is possible then that as alpha
spreads it may occupy areas of different size thereby
causing changes of cortex/scalp attenuation ratios on the
right and left sides.
The individual analyses of the data is consistent with
this explanation. Figure 3b demonstrates individual
alpha AD asymmetry indices plotted as a function of
sessions. Two subjects who are absent from the graph
showed an opposite trend, i.e., a predominance of alpha
AD at 0 2 with repeated trials; both had a 'reversed'
pattern of occipital width asymmetry (i.e., right occipital
width predominance). Further, three subjects had AD
predominance at O1 in the first session with a subsequent
rise of negative index values. It appeared that all of them
had a thicker right occipital bone that determined the
negative asymmetry index in the first session. Sub-
sequent increment of their alpha AD over the left hemi-
sphere was consistent with the principle that lateral AD
imbalance is an increasing function of the degree of
asymmetry of the alpha-generating field.
To summarize, bilateral EEG potentials may not be-
have as a simple code since the dependence of the
laterality index on some cephalic and parenchymal vari-
ables appeared to change as function of time. As a result,
various cranial and cephalic asymmetries may
masquerade as EEG/ERP imbalances that develop due
to 'dynamic' (functional) mechanisms.
Conclusions
One conclusion that can be drawn from the above is
that techniques of structural brain imaging provide suf-
ficiently reliable information to warrant individualized
montages that may or may not be derived from the 10-20
system. The other is that the tendency to increase the size
of a sample would aid in reducing the between-subject
variance, but help little in controlling the between-hemi-
sphere within-subject variance. The fact that some com-
mercially available computerized EEG brain mapping
systems advertise 'normative data banks' and encourage
research neurophysiologists to share their data to foster
the growth of the database, demonstrates the lack of
awareness that these two goals are altogether different.
The 'bank' could hardly minimize the error margin of the
388
brain laterality student or rather it could reduce variance
at a cost of inflating the likelihood of the type II error, i.e.,
the error of losing information that may have determined
the goal of a project. These goals may be better served by
categorizing (and/or normalizing) the data on the basis
of individual anatomical variables.
To the best of our knowledge, Leisnner's and Cooper's
findings were not discussed in cognitive neurophysiol-
ogy. Exciting development in the area of brain duality
may have mesmerized most of us into a belief that pos-
sible errors introduced by skull anisotropy can be
reduced by comparing a change in potentials occurring
in the course of retests, after the "baseline" EEG laterality
has been established. However, the foregoing test-retest
dynamics of alpha AD may serve as a caution of what
may be the operative difference between the CT/MRI-as-
sisted EEG and that of regular practice. They suggest that
vagaries of alpha laterality, to a significant extent, repre-
sent imbalanced EEG attenuation values at the scalp
consequent to changes of spatial synchrony of neuronal
activity.
A corollary to this suggestion is that EEG changes in
the course of any trial that involves habituation - as is the
case in any study that requires repeated testings - could
potentially mask a change imposed by an intervening
variable (e.g., a drug, a task administered consequent to
several baseline trials, etc.). A number of findings in
cognitive neurophysiology and psychopharmacology
may need to be scrutinized to rule out the possibility that
anatomical symmetry of the generating circuits and skull
inhomogeneity (i.e., bone- and brain asymmetry-weight-
ing) has not been m i s t a k e n for ' f u n c t i o n - r e l a t e d '
EEG/ERP changes. A typical example of a possible in-
terpretative error is a reversal of EEG power from wake-
fulness to non-REM sleep, as indexed by delayed VEP
components (Myslobodsky et al. 1976). This effect was
associated with a relative increase of EEG synchroniza-
tion over the left hemisphere as sleep progressed and
c o n c e i v e d as a c h a n g e of h e m i s p h e r e r e a c t i v i t y
('hemisphere dominance') in NREM sleep. Clearly, how-
ever, that EEG asymmetry reversal in sleep may be just a
reflection of the relative decrement of potentials' attenua-
tion at the scalp (i.e., not an increase of their amplitude
in the left hemisphere) with a gradual increase of spatial
synchronization. With the advantage of hindsight, one
may suspect that a laterality reversal of P3 amplitude
observed in schizophrenic patients with increased dose
of neuroleptics (Myslobodsky et al. 1983) may, too, be a
combination of a build up of neuroleptic-induced
synchronization in the presence of reversed brain asym-
metry in schizophrenia. Further, the reliability of alpha
lateralization measures in normal individuals and
psychotic patients under the retest conditions was shown
to be notably low in the frontal leads (Merrin et al. 1988).
Myslobodsky, Coppola, and Weinberger
Frontal lobe and bone asymmetries may mirror those of
the occipital lobe and the parietal and occipital bones
(Lang 1983). Consequently, frontally derived alpha may
be more noticeably affected by changing EEG power -
being either bone or brain area weighted - than laterality
measures derived from the more symmetrical, central,
parietal or temporal leads. In summary, although EEG
laterality should not be dismissed lightly on account of
the fact that its roots reach down into the anatomical
structure of the skull and the brain, the faint asymmetries
we measure can be proven to be relevant with full aware-
ness of all components of EEG laterality. While this may
seem to be a costly way of running an EEG study, it is
obviously within the resources of anyone who already
has regular access to CT/MRI data. If anything, review-
ing structural brain images helps to realize that EEG
brain laterality does not reside on the surface of our
electrodes.
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