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Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and a variant of autism spectrum disorder (ASD). The FXS population is quite heterogeneous with respect to comorbidities, which implies the need for a personalized medicine approach, relying on biomarkers or endophenotypes to guide treatment. There is evidence that quantitative electroencephalography (EEG) endophenotype-guided treatments can support increased clinical benefit by considering the patient’s neurophysiological profile. We describe a case series of 11 children diagnosed with FXS, aged one to 14 years, mean 4.6 years. Case data are based on longitudinal clinically-observed reports by attending physicians for comorbid symptoms including awake and asleep EEG profiles. We tabulate the comorbid EEG symptoms in this case series, and relate them to the literature on EEG endophenotypes and associated treatment options. The two most common endophenotypes in the data were diffuse slow oscillations and epileptiform EEG, which have been associated with attention and epilepsy respectively. This observation agrees with reported prevalence of comorbid behavioral symptoms for FXS. In this sample of FXS children, attention problems were found in 37% (4 of 11), and epileptic seizures in 45% (5 of 11). Attention problems were found to associate with the epilepsy endophenotype. From the synthesis of this case series and literature review, we argue that the evidence-based personalized treatment approach, exemplified by neurofeedback, could benefit FXS children by focusing on observable, specific characteristics of comorbid disease symptoms.

It is known that periods of intense social interaction result in shared patterns in collaborators' physiological signals. However, applied quantitative research on collaboration is hindered due to scarcity of objective metrics of teamwork effectiveness. Indeed, especially in the domain of productive, ecologically-valid activity such as programming, there is a lack of evidence for the most effective, affordable and reliable measures of collaboration quality. In this study we investigate synchrony in physiological signals between collaborating computer science students performing pair-programming exercises in a class room environment. We recorded electrocardiography over the course of a 60 minute programming session, using lightweight physiological sensors. We employ correlation of heart-rate variability features to study social psychophysiological compliance of the collaborating students. We found evident physiological compliance in collaborating dyads' heart-rate variability signals. Furthermore, dyads' self-reported workload was associated with the physiological compliance. Our results show viability of a novel approach to field measurement using lightweight devices in an uncontrolled environment, and suggest that self-reported collaboration quality can be assessed via physiological signals.

Motivated by the link between play and learning, proposed in literature to have a neurobiological basis, we study the electroencephalogram and associated psychophysiology of “learning game” players. Forty-five players were tested for topic comprehension by a questionnaire administered before and after solo playing of the game Peacemaker (Impact Games 2007), during which electroencephalography and other physiological signals were measured. Play lasted for one hour, with a break at half time. We used the Bloom taxonomy to distinguish levels of difficulty in demonstrated learning—with the first five levels assigned to fixed questions—and “gain” scores to measure actual value of demonstrated learning. We present the analysis of the physiological signals recorded during game play and their relationship to learning scores. Main effects related to biomarkers of vigilance and motivation—including decreased delta power and relatively balanced fronto-hemispheric alpha power—predicted learning at the analysed Bloom levels. Results suggest multiple physiological dispositions that support on-task learning styles, and highlight the utility of the psychophysiological method for interpreting game-based learning evaluations.

Purple urine bag syndrome (PUBS) is a unique disease entity characterized by an alarming purple discoloration of the urine secondary to recurrent urinary tract infections with indigo- and indirubin-producing bacteria. It is usually associated with prolonged urinary catheterization and chronic debilitated states. We hereby present a concise review of this rare phenomenon with historic perspectives, epidemiology, emphasizing on current concepts of etiology, pathogenesis, relevant clinical associations, treatment modalities, prognosis, and future directions in PUBS. In addition, we highlight an interesting occurrence of this intriguing phenomenon in a 39-year-old gentleman at our institution.