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Cannabis use disorder (CUD) is increasing in the United States, yet, specific neural mechanisms of CUD are not well understood. Disordered substance use is characterized by heightened drug cue incentive salience, which can be measured using the late positive potential (LPP), an event‐related potential (ERP) evoked by motivationally significant stimuli. The drug cue LPP is typically quantified by averaging the slow wave's scalp‐recorded amplitude across its entire time course, which may obscure distinct underlying factors with differential predictive validity; however, no study to date has examined this possibility. In a sample of 105 cannabis users, temporo‐spatial Principal Component Analysis was used to decompose cannabis cue modulation of the LPP into its underlying factors. Acute stress was also inducted to allow for identification of specific cannabis LPP factors sensitive to stress. Factor associations with CUD severity were also explored. Eight factors showed significantly increased amplitudes to cannabis images relative to neutral images. These factors spanned early (~372 ms), middle (~824 ms), and late (>1000 ms) windows across frontal, central, and parietal‐occipital sites. CUD phenotype individual differences were primarily associated with frontal, middle/late latency factor amplitudes. Acute stress effects were limited to one early central and one late frontal factor. Taken together, results suggest that the cannabis LPP can be decomposed into distinct, temporal‐spatial factors with differential responsivity to acute stress and CUD phenotype variability. Future individual difference studies examining drug cue modulation of the LPP should consider (1) frontalcentral poolings in addition to conventional central‐parietal sites, and (2) later LPP time windows. The current study is the first to utilize temporo‐spatial principal component analysis (PCA) to decompose the cannabis cue modulation of the late positive potential (LPP) before and after an acute laboratory stressor. Findings provide insight into potential neurophysiological markers relevant for substance use outcomes. [ABSTRACT FROM AUTHOR]

The article discusses highlights of the Kathleen Mears Memorial Lecture at the 2022 ASET meeting held in Louisville, Kentucky. Topics discussed are telemedicine, telehealth service implementation model, MUSC telestroke network, telehealth intensive care unit (ICU) program, the convenience, affordability and need for virtual urgent care, importance of bringing telepsychiatry and nutrition specialty services in rural areas, telementoring and telehealth electroencephalography (EEG).

Baseline electroencephalography (EEG) alpha power, i.e. that measured prior to stimulus presentation, is a potential objective predictor of task performance. Here we assessed the predictive power of EEG alpha on performance accuracy in a digits-in-noise recognition task, factoring in hearing thresholds and age. EEG alpha power, recorded while participants listened to target digits presented in a noise background, was analysed during two different baseline periods: i) a pre-stimulus baseline (pre-STIM) free from any acoustic stimulus, and ii) a pre-target baseline (pre-TARG) recorded in background noise only. Eighty-five participants with either normal hearing or aided hearing impairment (age range: 55–85 years old, 42 male). Hierarchical multiple regression analyses indicated that i) lower hearing thresholds and, to a lesser extent, higher pre-STIM alpha power were associated with improved performance accuracy ii) alpha power in pre-STIM and pre-TARG were highly correlated across individuals but pre-TARG alpha power was not a significant predictor of performance accuracy. Investigations of baseline EEG alpha power as a predictor of speech-in-noise performance accuracy should control for associations between hearing thresholds and measures of EEG baseline periods. [ABSTRACT FROM AUTHOR]

Tele-electroencephalogram (EEG) has become more pervasive over the last 20 years due to advances in technology, both independent of and driven by personnel shortages. The professionalization of EEG services has both limited growth and controlled the quality of tele-EEG. Growing data on the conditions that benefit from brain monitoring have informed increased critical care EEG and ambulatory EEG utilization. Guidelines that Inarshal responsible use of still-limited resources and changes in broadband and billing practices have also shaped the tele-EEG landscape. It is helpful to characterizethedrivers of tele-EEG to navigate barriers to sustainable growth andto build dynamic systems that anticipate challenges in any of the domains that expand access and enhance quality of these diagnostic services. We explore the historical factors and current trends in tele-EEG in the United States in this review. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted the delivery of care to people with epilepsy (PWE) in multiple ways including limitations on in-person contact and restrictions on neurophysiological procedures. To better study the effect of the pandemic on PWE, members of the American Epilepsy Society were surveyed between April 30 and June 14, 2020. There were 366 initial responses (9% response rate) and 337 respondents remained for analysis after screening out noncompleters and those not directly involved with clinical care; the majority were physicians from the United States. About a third (30%) of respondents stated that they had patients with COVID-19 and reported no significant change in seizure frequency. Conversely, one-third of respondents reported new onset seizures in patients with COVID-19 who had no prior history of seizures. The majority of respondents felt that there were at least some barriers for PWE in receiving appropriate clinical care, neurophysiologic procedures, and elective surgery. Medication shortages were noted by approximately 30% of respondents, with no clear pattern in types of medication involved. Telehealth was overwhelmingly found to have value. Among the limitation of the survey was that it was administered at a single point in time in a rapidly changing pandemic. The survey showed that almost all respondents were affected by the pandemic in a variety of ways. [ABSTRACT FROM AUTHOR]

The purpose of this study was the too early identification of Alzheimer's (AD) permits people and their health manages for medication. We have a tendency to plan an approach for categorization of stages in AD and MCI, with regard to Texture with Principal component analysis (PCA) based rule using magnetic resonance imaging (MRI) to recognition of tissues in Alzheimer's Diseases. Alzheimer's is such a dementia that causes issues with memory, thinking and lead. Signs as a rule grow dynamically and self-destruct after some time, getting satisfactorily veritable to meddle with customary tasks. Alzheimer's is actually not an normal portion of aging. The most familiar standard hazard factor is increasing age, and a huge part of persons with Alzheimer's are 65 and increasingly developed. Regardless, Alzheimer's isn't only an ailment of create age. Around 200,000 Americans more energetic than 65 have progressively youthful beginning Alzheimer's sickness (regardless viewed as beginning stage Alzheimer's).Alzheimer's is the 6th driving reason behind death in the United States. Those with Alzheimer's live a run of the mill of eight years after their signs become observable others, to other people, in any case constancy can go from four to 20 years, subordinate upon age and other flourishing conditions. Alzheimer's has no vitality fix, yet solutions for signs are open and research proceeds. Be that as it may, current Alzheimer's medications can't shield Alzheimer's from moving, they can quickly slow the rising of dementia responses and pick up singular fulfillment for those with Alzheimer's and their parental figures. Today, there is an overall action under approach to supervise discover better approaches to manage treat the infection, surrender its beginning, and keep it from developing. It recognized by physical difficulties the brain. Further, proposed having CT, MRI, PET, EEG techniques. Machine making sense of how to be comprehensively used in clinical field. [ABSTRACT FROM AUTHOR]

Background: The development of effective strategies to maintain good mental health of older adults is a public health priority. Mindfulness-based interventions have the potential to improve psychological well-being and cognitive functions of older adults, but little is known about the effect of such interventions when delivered through internet. During the COVID-19 pandemic we evaluated short- and long-term cognitive, psychological, and physiological effects of a mindfulness-based intervention (MBI) delivered via web-based videoconference in healthy older adults., Methods: Fifty older adults participated in an 8-week MBI, which comprised structured 2-h weekly group sessions. A comprehensive evaluation encompassing cognitive (verbal memory, attention and processing speed, executive functions) and psychological assessments (depression and anxiety symptoms, mindfulness, worries, emotion regulation strategies, well-being, interoceptive awareness and sleep) was conducted. Additionally, electroencephalography (EEG) data were recorded before and after the MBI and at the 6-month follow-up (T6). Data were analyzed using an intention-to-treat approach, using linear mixed models adjusted for age. The effect size for time was computed as omega squared., Results: We observed significant improvements from pre-MBI to post-MBI and at the T6 across several measures. These improvements were notable in the areas of verbal memory (California Verbal Learning Test, p ≤ .007), attention and executive functions (Trail Making Test A and BA, p < .050), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness, p = .0002 for self-regulation and p < .05 for noticing, body listening, and trusting dimensions), and rumination (Heidelberg Form for Emotion Regulation Strategies, p = .018). These changes were associated with low to medium effect size. Moreover, we observed significant changes in EEG patterns, with a decrease in alpha1 (p = .004) and an increase in alpha2 (p < .0001) from pre-MBI to T6. Notably, improvements in TMTBA and rumination were correlated with the decrease in alpha1 (p < .050), while improvements in TMTA were linked to the increase in alpha2 (p = .025)., Conclusions: The results of our study show that a web-based MBI in older adults leads to improvements in cognitive and psychological measures, with associated modulations in specific brain rhythms. While these findings are promising, further controlled studies are required to validate these preliminary results., Trial Registration: The trial has been registered with the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT05941143 on July 12, 2023., (© 2024. The Author(s).)

The $4.7 billion acquisition of Smithfield Foods by China's Shuanghui International (now WH Group) marks the largest Chinese takeover of a US company in history. Using electroencephalography along with an incentive compatible willingness‐to‐pay (WTP) elicitation mechanism, our study provides neural based evidence that the Shuanghui–Smithfield acquisition lowered consumers' preference for the Smithfield brand, but increased it for the Chinese brand. Consumers' neural preference for American brands increased after learning about the acquisition, implying a positive spillover effect to US brands in the US market. We also find that, after learning that an item is a product of the United States, consumers' neural preference decreased although their willingness‐to‐pay increased, consistent with some empirical reports that many US consumers prefer to purchase cheaper products made abroad rather than products of the United States with higher prices. [ABSTRACT FROM AUTHOR]

Development of reading skills has been shown to be tightly linked to phonological processing skills and to some extent to speech perception abilities. Although speech perception is also known to play a role in reading development, it is not clear which processes underlie this connection. Using event-related potentials (ERPs) we investigated the speech processing mechanisms for common and uncommon sound contrasts (/ba/-/da/-/ga/ and /ata/-/at: a/) with respect to the native language of school-age children in Finland and the US. In addition, a comprehensive behavioral test battery of reading and phonological processing was administered. ERPs revealed that the children could discriminate between the speech sound contrasts (place of articulation and phoneme length) regardless of their native language. No differences emerged between the Finnish and US children in their change detection responses. The brain responses to the phoneme length contrast, however, correlated robustly with reading scores in the US children, with larger responses being linked to poorer reading skills. Finnish children also showed correlations between the reading and phonological measures and ERP responses, but the pattern of results was not as clear as for the US children. The results indicate that speech perception is linked to reading skills and this link is more robust for uncommon speech sound contrasts. [ABSTRACT FROM AUTHOR]

Status epilepticus is a potentially life-threatening medical emergency associated with poor functional outcomes. Improving our ability to accurately predict functional outcomes is beneficial to optimizing treatment strategies. Currently, there are four published status epilepticus scores in adults: STESS (Status Epilepticus Severity Score), EMSE (Epidemiology-Based Mortality Score in Status Epilepticus), END-IT (Encephalitis-Nonconvulsive-Diazepam resistance-Imaging-Tracheal intubation), and recently published ACD (Age-level of Consciousness-Duration of status epilepticus) score. The only available scale in the pediatric population is PEDSS (Pediatric CPC scale-EEG (normal vs abnormal)-Drug refractoriness-critical Sickness-Semiology). While these scores are useful research tools, currently there is little evidence to suggest their utility during real-time clinical care. Except for EMSE, none of the scores incorporate EEG findings for prognostication. Adding EEG features improves prognostic accuracy, as has been shown with the EMSE scale with and without the EEG component. Acute symptomatic seizures (AsyS) and early epileptiform abnormalities, especially nonconvulsive seizures, and periodic discharges, markedly increase the risk for subsequent unprovoked seizures. However, many of these patients may not need lifelong anti-seizure medications (ASMs). Continuous EEG monitoring shows that the majority of ASyS are nonconvulsive and can identify epileptic patterns. Dedicated specialty clinics for these patients, known as Post Acute Symptomatic Seizure (PASS) clinics, already exist in the United States. Post Acute Symptomatic Seizure clinics are ideal for both long-term clinical care and answering important research questions related to epileptogenesis, duration of ASM treatment required, and evolution of EEG findings. This topic was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. [ABSTRACT FROM AUTHOR]

The study of cognitive processes underlying Internet users’ fast impression formation is important to understand how people behave in an information-overloaded environment. Here we study how Internet users form fast website impression by investigating which evaluative dimension, i.e., usefulness and enjoyment, is automatically activated when people are required to rapidly evaluate website logos. To capture the transient processes in website impression formation, we have applied dense-array (128 and 256 channels) electroencephalography (EEG) to conduct experiments in two cultures (USA and Taiwan). The results of the EEG analysis showed that usefulness and enjoyment evaluations were consistently performed quickly (450–800 ms) in both cultural groups. More importantly, the results showed that enjoyment evaluation could be automatically performed. No clear evidence was found that usefulness evaluation was performed when usefulness evaluation goal was irrelevant. The finding suggests that people can form rapid website impression, and enjoyment is a critical component in the impression formation process. [ABSTRACT FROM AUTHOR]

Elective admission to the epilepsy monitoring unit (EMU) is an essential service provided by epilepsy centers, particularly for those with drug-resistant epilepsy. Given previously characterized racial and socioeconomic healthcare disparities in the management of epilepsy, we sought to understand access and utilization of this service in New Jersey (NJ). We examined epilepsy hospitalizations in NJ between 2014 and 2016 using state inpatient and emergency department (ED) databases. We stratified admissions by race/ethnicity and primary payer and used these to estimate and compare (1) admission rates per capita in NJ, as well as (2) admission rates per number of ED visits for each group. Patients without insurance underwent elective EMU admission at the lowest rates across all racial/ethnic groups and payer types studied. Black patients with Medicaid and private insurance were admitted at disproportionately low rates relative to their number of ED visits. Hispanic/Latino and Asian/Pacific Islanders with private insurance, Hispanic/Latinos with Medicaid, and Asian/Pacific Islanders with Medicare were also admitted at low rates per capita within each respective payer category. Future studies should focus on addressing causal factors driving healthcare disparities in epilepsy, particularly for patients without adequate health insurance coverage and those who have been historically underserved by the healthcare system., Competing Interests: Declaration of Competing Interest Dr. Zhang has received honorariums from Lundbeck Biopharmaceuticals, Board Vitals, and Fieve Clinical Research. He collaborates with Headache Science Incorporated without receiving financial support. He has ownership interest in Cymbeline LLC. The other authors do not have competing interests to declare., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: African American English (AAE) has never been examined through neurophysiological methods in investigations of dual-language variety processing. This study examines whether contrastive and non-contrastive morphosyntactic features in sentences with and without AAE constructions elicit differing neural and/or behavioral responses in bidialectal speakers of AAE and Mainstream American English (MAE), compared to monodialectal MAE speakers. We compared electroencephalographic (EEG) and behavioral (grammatical acceptability judgment) data to determine whether two dialects are processed similarly to distinct languages, as seen in studies of bilingual codeswitching where the P600 event related potential (ERP) has been elicited when processing a switch between language varieties., Methods: Bidialectal AAE-MAE speakers (n = 15) and monodialectal MAE speakers (n = 12) listened to sentences in four conditions, while EEG was recorded to evaluate time-locked brain responses to grammatical differences between sentence types. The maintained verb form in the present progressive tense sentences (e.g., The black cat lap/s the milk) was the morphosyntactic feature of interest for comparing P600 responses as an indicator of error detection. Following each trial, responses and reaction times to a grammatical acceptability judgment task were collected and compared., Results: Findings indicate distinct neurophysiological profiles between bidialectal and monodialectal speakers. Monodialectal speakers demonstrated a P600 response within 500-800ms following presentation of an AAE morphosyntax feature, indicating error detection; this response was not seen in the bidialectal group. Control sentences with non-contrasting grammar revealed no differences in ERP responses between groups. Behaviorally, bidialectal speakers showed greater acceptance of known dialectal variation and error (non-contrastive) sentence types compared to the monodialectal group., Conclusions: ERP and behavioral responses are presented as preliminary evidence of dual-language representation in bidialectal speakers. Increased consideration of AAE language processing would enhance equity in the study of language at large, improving the work of clinicians, researchers, educators and policymakers alike., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2022. Published by Elsevier Inc.)

The electroneurodiagnostics of the future will unfold from key factors that contribute to the growth and maturation of specialized diagnostic technologies in health care. Our unique business portfolio is the collection of services that make up electroneurodiagnostic technology. More than 100 years after Hans Berger first described EEG, electroencephalography may recapture the attention and imagination of research fourfold. And the attention that our profession directs toward education, professional growth, utilization of the technology, relating to the transdisciplinary team, and research will be our stake in the ground to become the pre-eminent diagnostic technology in the future. There is clear strategic direction for the American Society of Electroneurodiagnostic Technologists, Inc. (ASET) because the society is fundamentally interlaced with the architecture of electroneurodiagnostic technology and neuroscience. [ABSTRACT FROM AUTHOR]

Ellen Grass was a remarkable woman, whose efforts on behalf of neurophysiology, epilepsy, and physiological technology contributed importantly to the development of neuroscience in the United States during the middle third of the 20th century. She initially provided an important link between a remarkable group of Harvard physiologists and her husband, Albert, a brilliant engineer whose innovative equipment played a critical role in accelerating advances in neurophysiology and, later, EEG and epilepsy. Mr. Grass herself observed and personally facilitated much of the clinical and basic neuroscience research during this period, when the modern framework for a scientific understanding of epilepsy and EEG was established. She also supported the development of professional societies relevant to these areas, including ASET, the American EEG Society, the American Epilepsy Society, and the Epilepsy Foundation of America. [ABSTRACT FROM AUTHOR]

Purpose: The study purpose was to evaluate sleep structure during ketogenic diet (KD) treatment in children with therapy-resistant epilepsy and to correlate possible alterations with changes in clinical effects on seizure reduction, seizure severity, quality of life (QOL), and behavior. Methods: Eighteen children were examined with ambulatory polysomnographic recordings initially and after 3 months of KD treatment. Eleven children continued with the KD and were also evaluated after 12 months. Sleep parameters were estimated. Seizure frequency was recorded in a diary and seizure severity in the National Health Seizure Severity Scale (NHS3). QOL was assessed with a visual analogue scale. Child behavior checklist and Ponsford and Kinsella's rating scale of attentional behavior were used. Results: KD induced a significant decrease in total sleep (p = 0.05) and total night sleep (p = 0.006). Slow wave sleep was preserved, rapid eye movement (REM) sleep increased (p = 0.01), sleep stage 2 decreased (p = 0.004), and sleep stage 1 was unchanged. Eleven children continued with the KD and were also evaluated after 12 months. They showed a significant decrease in daytime sleep (p = 0.01) and a further increase in REM sleep (p = 0.06). Seizure frequency (p = 0.001, p = 0.003), seizure severity (p < 0.001, p = 0.005) and QOL (p < 0.001, p = 0.005) were significantly improved at 3 and 12 months. Attentional behavior was also improved, significantly so at 3 months (p = 0.003). There was a significant correlation between increased REM sleep and improvement in QOL (Spearman r = 0.6, p = 0.01) at 3 months. Conclusion: KD decreases sleep and improves sleep quality in children with therapy-resistant epilepsy. The improvement in sleep quality, with increased REM sleep, seems to contribute to the improvement in QOL. [ABSTRACT FROM AUTHOR]

Purpose: To determine the electrophysiological pattern and propose a clinical relevance of a deficient glutamate transport in the developing brain. Methods: (a) Surface EEG-video monitoring in freely moving pups; (b) intracortical multiple unit activity (MUA) and local field potential recordings in 5- to 7-day-old rats after pharmacological inhibition of the glutamate transporters by DL-TBOA. Results: Glutamate transporters inhibition alters the background cortical electrical activity inducing a dominant and persistent pattern of bilateral recurrent paroxysmal bursts alternating with periods of hypoactivity and also partial seizures. Intracortical local field recordings show that paroxysmal bursts are associated with multiunits and gamma oscillations separated by periods of silence. This cortical activity involves the activation of ionotropic glutamate receptors and was not observed after kainate and pilocarpine administration. Conclusions: We show that a dysfunction of glutamate transporters in immature rats leads to a singular cortical activity that is reminiscent of a “suppression-burst” pattern. We propose that an early deficiency of glutamate transport may underlie some early onset epilepsies. [ABSTRACT FROM AUTHOR]

Purpose: Brain malformations are a common cause of intractable epilepsy and cognitive dysfunction in children. Prenatal exposure to the teratogen methylazoxymethanol (MAM) is a rodent model of brain malformation featuring loss of lamination, clusters of displaced hippocampal cells, and pharmaco-resistance to antiepileptic drugs. In a normotopic hippocampus, expression of postsynaptic glutamate receptors and the transporters regulating neurotransmitter reuptake are critical factors modulating excitation and synaptic communication. Alterations in this system can have profound effects on overall excitability, cognitive function, and seizure thresholds. Methods: Immunohistochemical techniques were used to analyze the expression of N-methyl-d-aspartate (NMDA) and α-amino-3-hydroxy-5 methylisoxazole-4-proprionic acid (AMPA) receptor subunits in rats exposed to MAM in utero (25 mg/kg, intraperitoneal injection). We also examined the expression of several glutamate transporters (EAAC1, vGLUT1, and vGLUT2). A video-electroencephalographic (video-EEG) system was used for long-term monitoring of adult MAM-exposed rats. Results: Heterotopic hippocampal neurons exhibited striking reductions in GluR1 and EAAC1 expression; vGlut2 expression was prominent in these regions. Spontaneous electrographic seizures were verified in two animals. Conclusions: We conclude that glutamate receptor subunit and transporter expression are altered in animals exposed to MAM in utero. Further studies in the MAM model may provide greater insight into the potential disruptions in excitatory synaptic neurotransmission that can occur in a malformed brain. [ABSTRACT FROM AUTHOR]

Concussion is a common brain injury. The American Academy of Neurology provides a definition of concussion: "Concussion is a traumatically, or biomechanically, induced alteration of brain function. Emphasis is placed on a pathophysiological process, or functional disruption, as opposed to anatomic, structural, or tissue injury.". The incidence of mild traumatic brain injury (mTBI) is estimated at 200 per 100 000. The Centers for Disease Control and Prevention (CDC) estimates 3.8 million sport and recreational mTBIs occurring in the United States each year. A more recent CDC assessment estimates 2.5 million concussion injuries in high school sports alone. The controlled environment and opportunity for direct surveillance and observation has made the sports arena the scientific "wet lab" for the study of mTBI natural history, short- and long-term consequences and opportunities to intervene. Quantitative EEG methods have been utilized in the assessment and management of mTBI and lends to provide a cost-effective procedure that has the sensitivities needed to identify pathology where routine visual inspection of the EEG has failed.

Purpose: We evaluate outcome of in-home diagnostic ambulatory video-EEG monitoring (AVEM) performed on a nationwide cohort of patients over one calendar year, and we compare our findings with outcomes of inpatient adult and pediatric VEM performed during the same year at two academic epilepsy centers., Methods: This is a retrospective cohort study. We obtained AVEM outcome data from an independent ambulatory-EEG testing facility. Inpatient VEM data from a 4-bed adult epilepsy center and an 8-bed pediatric epilepsy center were also included. Primary outcome measure was composite percentage of VEM records with epileptiform activity on EEG tracings or at least one video-recorded pushbutton event. We assessed patient-reported symptoms documented in AVEM event diaries., Results: Of 9221 AVEM recordings performed across 28 states, 62.5% attained primary outcome. At least one patient-activated pushbutton event was captured on video in 54% of AVEM recordings (53.6% in adults, 56.1% in children). Epileptiform activity was reported in 1657 (18.0%) AVEM recordings (1473 [88.9%] only interictal, 9 [0.5%] only ictal, 175 [10.6%] both interictal and ictal). Most common patient-reported symptomatology during AVEM pushbutton events was behavioral/autonomic/emotional in adults and children. Compared to AVEM, inpatient VEM captured more confirmed representative events in adult and pediatric samples., Conclusions: AVEM is useful for non-urgent diagnostic evaluation of events., (Copyright © 2019 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Night-shift workers are at high risk of drowsiness-related motor vehicle crashes as a result of circadian disruption and sleep restriction. However, the impact of actual night-shift work on measures of drowsiness and driving performance while operating a real motor vehicle remains unknown. Sixteen night-shift workers completed two 2-h daytime driving sessions on a closed driving track at the Liberty Mutual Research Institute for Safety: (i) a postsleep baseline driving session after an average of 7.6 ± 2.4 h sleep the previous night with no night-shift work, and (ii) a postnight-shift driving session following night-shift work. Physiological measures of drowsiness were collected, including infrared reflectance oculography, electroencephalography, and electrooculography. Driving performance measures included lane excursions, near-crash events, and drives terminated because of failure to maintain control of the vehicle. Eleven near-crashes occurred in 6 of 16 postnight-shift drives (37.5%), and 7 of 16 postnight-shift drives (43.8%) were terminated early for safety reasons, compared with zero near-crashes or early drive terminations during 16 postsleep drives (Fishers exact: P = 0.0088 and P = 0.0034, respectively). Participants had a significantly higher rate of lane excursions, average Johns Drowsiness Scale, blink duration, and number of slow eye movements during postnight-shift drives compared with postsleep drives (3.09/min vs. 1.49/min; 1.71 vs. 0.97; 125 ms vs. 100 ms; 35.8 vs. 19.1; respectively, P < 0.05 for all). Night-shift work increases driver drowsiness, degrading driving performance and increasing the risk of near-crash drive events. With more than 9.5 million Americans working overnight or rotating shifts and one-third of United States commutes exceeding 30 min, these results have implications for traffic and occupational safety.