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de Deus M, Petit C, Schwitzer T. ElectroRetinoGraphy toward an exploration of the therapeutic potential of antidepressants in patients with major depressive disorder: A scoping review of the literature. Neurosci Biobehav Rev 2024; 164:105833. [PMID: 39089420 DOI: 10.1016/j.neubiorev.2024.105833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/07/2024] [Accepted: 07/27/2024] [Indexed: 08/04/2024]
Abstract
Major Depressive Disorder (MDD) is characterized by at least one major depressive episode. It requires medical attention typically involving the prescription of antidepressants. Remission in MDD patients is often difficult to achieve because of the limited effectiveness of these drugs. Nowadays, numerous patients undergo various antidepressant treatments, with subjective changes in their personal experiences being regularly monitored. Therefore, it is essential to find clinical and objective tools that offer a more tailored approach to antidepressant selection. The neurochemistry of the retina being similar to the brain, one promising approach would be to use ElectroRetinoGraphy (ERG) measurements on MDD patients requiring antidepressant treatment. Thus, the aim of this scoping review is to highlight effects of different classes of antidepressants on retinal function evaluated by full-field ERG (ffERG), Pattern ERG (PERG) and multifocal ERG (mfERG) waveforms in MDD patients. These ERG measurements could serve as pivotal indicators in defining patient profiles, facilitating a more objective and personalized approach to therapeutic interventions, thereby advancing precision psychiatry.
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Affiliation(s)
- Marie de Deus
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adulte et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, 1, rue du Docteur Archambault, Laxou 54 520, France
| | - Charlotte Petit
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adulte et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, 1, rue du Docteur Archambault, Laxou 54 520, France
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adulte et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, 1, rue du Docteur Archambault, Laxou 54 520, France.
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Tully J, Pereira AC, Sethi A, Griem J, Cross B, Williams SC, Blair RJ, Murphy D, Blackwood N. Impaired striatal glutamate/GABA regulation in violent offenders with antisocial personality disorder and psychopathy. Mol Psychiatry 2024; 29:1824-1832. [PMID: 38326560 PMCID: PMC11371654 DOI: 10.1038/s41380-024-02437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/09/2024]
Abstract
Men with antisocial personality disorder (ASPD) with or without psychopathy (+/-P) are responsible for most violent crime in society. Development of effective treatments is hindered by poor understanding of the neurochemical underpinnings of the condition. Men with ASPD with and without psychopathy demonstrate impulsive decision-making, associated with striatal abnormalities in functional neuroimaging studies. However, to date, no study has directly examined the potential neurochemical underpinnings of such abnormalities. We therefore investigated striatal glutamate: GABA ratio using Magnetic Resonance Spectroscopy in 30 violent offenders (16 ASPD-P, 14 ASPD + P) and 21 healthy non-offenders. Men with ASPD +/- P had a significant reduction in striatal glutamate : GABA ratio compared to non-offenders. We report, for the first time, striatal Glutamate/GABA dysregulation in ASPD +/- P, and discuss how this may be related to core behavioral abnormalities in the disorders.
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Affiliation(s)
- John Tully
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Jubilee Campus, University of Nottingham, Wollaton Rd, Lenton, Nottingham, NG8 1BB, United Kingdom.
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom.
| | - Andreia C Pereira
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Arjun Sethi
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Julia Griem
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Ben Cross
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Steve Cr Williams
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE58AF, United Kingdom
| | - Robert James Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Nigel Blackwood
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
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Friedel EBN, Tebartz van Elst L, Beringer M, Endres D, Runge K, Maier S, Kornmeier J, Bach M, Domschke K, Heinrich SP, Nickel K. Reduced contrast sensitivity, pattern electroretinogram ratio, and diminished a-wave amplitude in patients with major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01826-8. [PMID: 38805071 DOI: 10.1007/s00406-024-01826-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
The electroretinogram (ERG), a non-invasive electrophysiological tool used in ophthalmology, is increasingly applied to investigate neural correlates of depression. The present study aimed to reconsider previous findings in major depressive disorder (MDD) reporting (1) a diminished contrast sensitivity and (2) a reduced patten ERG (PERG) amplitude ratio, and additionally, to assess (3) the photopic negative response (PhNR) from the flash ERG (fERG), with the RETeval® device, a more practical option for clinical routine use. We examined 30 patients with a MDD and 42 healthy controls (HC), assessing individual contrast sensitivity thresholds with an optotype-based contrast test. Moreover, we compared the PERG ratio, an established method for early glaucoma detection, between both groups. The handheld ERG device was used to measure amplitudes and peak times of the fERG components including a-wave, b-wave and PhNR in both MDD patients and HCs. MDD patients exhibited diminished contrast sensitivity together with a reduced PERG ratio, compared to HC. With the handheld ERG device, we found reduced a-wave amplitudes in MDD, whereas no significant differences were observed in the fERG b-wave or PhNR between patients and controls. The reduced contrast sensitivity and PERG ratio in MDD patients supports the hypothesis that depression is associated with altered visual processing. The findings underscore the PERG's potential as a possible objective marker for depression. The reduced a-wave amplitude recorded with the RETeval® system in MDD patients might open new avenues for using handheld ERG devices as simplified approaches for advancing depression research compared to the PERG.
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Affiliation(s)
- Evelyn B N Friedel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Malina Beringer
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon Maier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Kornmeier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
| | - Michael Bach
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
| | - Sven P Heinrich
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Copa D, Erritzoe D, Giribaldi B, Nutt D, Carhart-Harris R, Tagliazucchi E. Predicting the outcome of psilocybin treatment for depression from baseline fMRI functional connectivity. J Affect Disord 2024; 353:60-69. [PMID: 38423367 DOI: 10.1016/j.jad.2024.02.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Psilocybin is a serotonergic psychedelic drug under assessment as a potential therapy for treatment-resistant and major depression. Heterogeneous treatment responses raise interest in predicting the outcome from baseline data. METHODS A machine learning pipeline was implemented to investigate baseline resting-state functional connectivity measured with functional magnetic resonance imaging (fMRI) as a predictor of symptom severity in psilocybin monotherapy for treatment-resistant depression (16 patients administered two 5 mg capsules followed by 25 mg, separated by one week). Generalizability was tested in a sample of 22 patients who participated in a psilocybin vs. escitalopram trial for moderate-to-severe major depression (two separate doses of 25 mg of psilocybin 3 weeks apart plus 6 weeks of daily placebo vs. two separate doses of 1 mg of psilocybin 3 weeks apart plus 6 weeks of daily oral escitalopram). The analysis was repeated using both samples combined. RESULTS Functional connectivity of visual, default mode and executive networks predicted early symptom improvement, while the salience network predicted responders up to 24 weeks after treatment (accuracy≈0.9). Generalization performance was borderline significant. Consistent results were obtained from the combined sample analysis. Fronto-occipital and fronto-temporal coupling predicted early and late symptom reduction, respectively. LIMITATIONS The number of participants and differences between the two datasets limit the generalizability of the findings, while the lack of a placebo arm limits their specificity. CONCLUSIONS Baseline neurophysiological measurements can predict the outcome of psilocybin treatment for depression. Future research based on larger datasets should strive to assess the generalizability of these predictions.
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Affiliation(s)
- Débora Copa
- Universidad de Buenos Aires, Facultad de Ingeniería, Instituto de Bioingeniería, Buenos Aires, Argentina.
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, United Kingdom
| | - Bruna Giribaldi
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, United Kingdom
| | - David Nutt
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, United Kingdom
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Division of Academic Psychiatry, Imperial College London, London, United Kingdom; Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, USA
| | - Enzo Tagliazucchi
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Física, Ciudad Universitaria, Buenos Aires, Argentina; CONICET - Universidad de Buenos Aires, Instituto de Física Interdisciplinaria y Aplicada (INFINA), Ciudad Universitaria, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
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Friedel EBN, Haldina J, Nickel K, Bach M, Tebartz van Elst L, Heinrich SP. Effect of eccentric fixation on the steady-state pattern electroretinogram. Doc Ophthalmol 2024; 148:87-95. [PMID: 38416305 PMCID: PMC10954955 DOI: 10.1007/s10633-024-09967-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/20/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE The steady-state pattern electroretinogram (ssPERG) is used to assess retinal ganglion cell function in a variety of research contexts and diagnostic applications. In certain groups of patients or study participants, stable central fixation of the stimulus is not guaranteed. The present study aimed at assessing the effects of misfixation on the ssPERG response to checkerboard reversal stimuli. METHODS Using two check sizes (0.8° and 15°), we compared ssPERG responses for several amounts of fixation deviation, ranging from 0° to 19° horizontally and from 0° to 14° diagonally. The stimulus area extended to 15° eccentricity, stimulus reversal rate was 15/s. RESULTS Up to around 7° eccentricity, there was no sizable effect of fixation deviation under most conditions. Effects were somewhat larger for nasal than for temporal deviation, in particular for small checks. Diagonal deviation was associated with a response to luminance onset/offset at 7.5 Hz (subharmonic of the reversal rate), most prominently when the interior of a large check was fixated. CONCLUSION Generally, moderate inaccuracies of fixation do not have a sizable effect on ssPERG amplitude. However, with large checks, the luminance response has to be considered.
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Affiliation(s)
- Evelyn B N Friedel
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
- Faculty of Biology, University of Freiburg, Freiburg, Germany.
| | - Julia Haldina
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bach
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sven P Heinrich
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Constable PA, Lim JKH, Thompson DA. Retinal electrophysiology in central nervous system disorders. A review of human and mouse studies. Front Neurosci 2023; 17:1215097. [PMID: 37600004 PMCID: PMC10433210 DOI: 10.3389/fnins.2023.1215097] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
The retina and brain share similar neurochemistry and neurodevelopmental origins, with the retina, often viewed as a "window to the brain." With retinal measures of structure and function becoming easier to obtain in clinical populations there is a growing interest in using retinal findings as potential biomarkers for disorders affecting the central nervous system. Functional retinal biomarkers, such as the electroretinogram, show promise in neurological disorders, despite having limitations imposed by the existence of overlapping genetic markers, clinical traits or the effects of medications that may reduce their specificity in some conditions. This narrative review summarizes the principal functional retinal findings in central nervous system disorders and related mouse models and provides a background to the main excitatory and inhibitory retinal neurotransmitters that have been implicated to explain the visual electrophysiological findings. These changes in retinal neurochemistry may contribute to our understanding of these conditions based on the findings of retinal electrophysiological tests such as the flash, pattern, multifocal electroretinograms, and electro-oculogram. It is likely that future applications of signal analysis and machine learning algorithms will offer new insights into the pathophysiology, classification, and progression of these clinical disorders including autism, attention deficit/hyperactivity disorder, bipolar disorder, schizophrenia, depression, Parkinson's, and Alzheimer's disease. New clinical applications of visual electrophysiology to this field may lead to earlier, more accurate diagnoses and better targeted therapeutic interventions benefiting individual patients and clinicians managing these individuals and their families.
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Affiliation(s)
- Paul A. Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Jeremiah K. H. Lim
- Discipline of Optometry, School of Allied Health, University of Western Australia, Perth, WA, Australia
| | - Dorothy A. Thompson
- The Tony Kriss Visual Electrophysiology Unit, Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Xiao X, Zhong D, Liu H, Fan R, Jiang C, Zheng Z, Li Y, Wan L. Role of optical coherence tomography in depression detection: a protocol of systematic review and meta-analysis. BMJ Open 2023; 13:e065549. [PMID: 37423631 DOI: 10.1136/bmjopen-2022-065549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
INTRODUCTION Optical coherence tomography (OCT) is a non-invasive approach for detecting changes in the retinal layers, which may also reflect changes in brain structure and function. As one of the leading causes of disability worldwide, depression has been associated with alteration of brain neuroplasticity. However, the role of OCT measurements in detecting depression remains unknown. This study aims to employ a systematic review and meta-analysis approach to explore ocular biomarkers measured by OCT for detecting depression. METHODS AND ANALYSIS We will search studies describing the relationship between OCT and depression across seven electronic databases, and retrieve articles published from database inception to date. We will also manually search grey literature and reference lists included in the retrieved studies. Two independent reviewers will screen studies, extract data and assess risk of bias. Target outcomes will include peripapillary retinal nerve fibre layer thickness, macular ganglion cell complex thickness and macular volume, as well as other related indicators. Next, we will conduct subgroup analysis and meta-regression to explore study heterogeneity, then perform sensitivity analysis to investigate the robustness of the synthesised results. Meta-analysis will be performed using Review Manager (V.5.4.1) and STATA (V.12.0), and the certainty of evidence will be graded according to the Grading of Recommendations Assessment, Development and Evaluation system. ETHICS AND DISSEMINATION Ethics approval is not necessary because the data used in this systematic review and meta-analysis will be extracted from published studies. Study results will be disseminated by publishing our findings in a peer-reviewed journal.
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Affiliation(s)
- Xili Xiao
- Department of Ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Liu
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Rong Fan
- Department of Rehabilitation Medicine, Nanbu County People's Hospital, Nanchong, China
| | - Chengzhi Jiang
- Department of Rehabilitation Medicine, Sichuan Science City Hospital, Mianyang, China
| | - Zhong Zheng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Wan
- School of sports medicine and health, Chengdu Sport University, Chengdu, China
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Zhang S, She S, Qiu Y, Li Z, Wu X, Hu H, Zheng W, Huang R, Wu H. Multi-modal MRI measures reveal sensory abnormalities in major depressive disorder patients: A surface-based study. Neuroimage Clin 2023; 39:103468. [PMID: 37473494 PMCID: PMC10372163 DOI: 10.1016/j.nicl.2023.103468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/17/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Multi-modal magnetic resonance imaging (MRI) measures are supposed to be able to capture different brain neurobiological aspects of major depressive disorder (MDD). A fusion analysis of structural and functional modalities may better reveal the disease biomarker specific to the MDD disease. METHODS We recruited 30 MDD patients and 30 matched healthy controls (HC). For each subject, we acquired high-resolution brain structural images and resting-state fMRI (rs-fMRI) data using a 3 T MRI scanner. We first extracted the brain morphometric measures, including the cortical volume (CV), cortical thickness (CT), and surface area (SA), for each subject from the structural images, and then detected the structural clusters showing significant between-group differences in each measure using the surface-based morphology (SBM) analysis. By taking the identified structural clusters as seeds, we performed seed-based functional connectivity (FC) analyses to determine the regions with abnormal FC in the patients. Based on a logistic regression model, we performed a classification analysis by selecting these structural and functional cluster-wise measures as features to distinguish the MDD patients from the HC. RESULTS The MDD patients showed significantly lower CV in a cluster involving the right superior temporal gyrus (STG) and middle temporal gyrus (MTG), and lower SA in three clusters involving the bilateral STG, temporal pole gyrus, and entorhinal cortex, and the left inferior temporal gyrus, and fusiform gyrus, than the controls. No significant difference in CT was detected between the two groups. By taking the above-detected clusters as seeds to perform the seed-based FC analysis, we found that the MDD patients showed significantly lower FC between STG/MTG (CV's cluster) and two clusters located in the bilateral visual cortices than the controls. The logistic regression model based on the structural and functional features reached a classification accuracy of 86.7% (p < 0.001) between MDD and controls. CONCLUSION The present study showed sensory abnormalities in MDD patients using the multi-modal MRI analysis. This finding may act as a disease biomarker distinguishing MDD patients from healthy individuals.
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Affiliation(s)
- Shufei Zhang
- School of Psychology, Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Shenglin She
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou 510370, China
| | - Yidan Qiu
- School of Psychology, Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Zezhi Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou 510370, China
| | - Xiaoyan Wu
- School of Psychology, Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Huiqing Hu
- School of Psychology, Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou 510370, China
| | - Ruiwang Huang
- School of Psychology, Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China.
| | - Huawang Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou 510370, China.
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Structural and functional retinal alterations in patients with paranoid schizophrenia. Transl Psychiatry 2022; 12:402. [PMID: 36151078 PMCID: PMC9508100 DOI: 10.1038/s41398-022-02167-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/21/2022] Open
Abstract
Ophthalmological methods have increasingly raised the interest of neuropsychiatric specialists. While the integrity of the retinal cell functions can be evaluated with the electroretinogram (ERG), optical coherence tomography (OCT) allows a structural investigation of retinal layer thicknesses. Previous studies indicate possible functional and structural retinal alterations in patients with schizophrenia. Twenty-five patients with paranoid schizophrenia and 25 healthy controls (HC) matched for age, sex, and smoking status participated in this study. Both, ERG and OCT were applied to obtain further insights into functional and structural retinal alterations. A significantly reduced a-wave amplitude and thickness of the corresponding para- and perifoveal outer nuclear layer (ONL) was detected in patients with paranoid schizophrenia with a positive correlation between both measurement parameters. Amplitude and peak time of the photopic negative response (PhNR) and thickness of the parafoveal ganglion cell layer (GCL) were decreased in patients with schizophrenia compared to HC. Our results show both structural and functional retinal differences between patients with paranoid schizophrenia and HC. We therefore recommend the comprehensive assessment of the visual system of patients with schizophrenia, especially to further investigate the effect of antipsychotic medication, the duration of illness, or other factors such as inflammatory or neurodegenerative processes. Moreover, longitudinal studies are required to investigate whether the functional alterations precede the structural changes.
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Baykara S, Yıldırım H, Kazğan A, Tabara MF, Keleş DD, Gürok MG, Atmaca M. Retinal Changes in Panic Disorder Patients. Psychiatry Res Neuroimaging 2022; 324:111496. [PMID: 35690017 DOI: 10.1016/j.pscychresns.2022.111496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
AIM Optical coherence tomography (OCT) is a novel method that allows high resolution cross-sectional imaging of biological tissues. It was suggested that changes in the cranial structure or functions would be reflected in the retina. OCT has been an important method in the diagnosis and follow-up of diseases via morphometric or quantitative retinal measurements. Panic disorder (PD) is an anxiety disorder, where free radicals, inflammatory processes and neurotransmitter transmission disorders play a role in the etiology. The present study aimed to demonstrate neurodegeneration in PD by the comparison of PD patient and control OCT data. MATERIAL AND METHOD The study group included 21 PD patients who met the study criteria. The control group included 21 healthy individuals without any known psychiatric or organic disease, including eye disease, and gender-matched to the patient group. All participants underwent detailed psychiatric and eye examinations. Central macular thickness (CMT), macular volume (MV), mean and retinal nerve fiber layer thickness (RNFL), ganglion cell layer thickness (GCLT), and central choroidal thickness (CCT) were measured in both eyes of all participants with OCT. A sociodemographic data form, Clinical Global Impression Scale (CGIS), and Panic Disorder Severity Scale (PDSS) were administered to the participants. RESULTS In the study, it was determined that the CMT values of the PD patients were lower when compared to the controls in the OCT examination. There was a statistically significant difference between the CMT of the PD patient group and the control group; the CMT was lower in the patient group. There were no significant differences between the groups based on GCLT, RNFL superior, RNFL inferior, RNFL nasal, RNFL temporal, and CCT. There was no significant correlation between CGIS, PDSS scores and OCT measurements. CONCLUSION This is the first study in the literature where patients with a PD diagnosis were analyzed based on the OCT method. OCT, which is a simple, noninvasive and relatively inexpensive method that the patient could easily adapt to during imaging, could be employed as a supplementary method in the diagnosis and follow-up of PD patients.
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Affiliation(s)
- Sema Baykara
- Fırat University, Faculty of Medicine, Department of Psychiatry, Elazig, Turkey.
| | - Hakan Yıldırım
- Fırat University, Faculty of Medicine, Department of Ophthalmology, Elazig, Turkey
| | - Aslı Kazğan
- Fırat University, Faculty of Medicine, Department of Psychiatry, Elazig, Turkey
| | | | | | - Mehmet Gürkan Gürok
- Fırat University, Faculty of Medicine, Department of Psychiatry, Elazig, Turkey
| | - Murad Atmaca
- Fırat University, Faculty of Medicine, Department of Psychiatry, Elazig, Turkey
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11
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Schwitzer T, Le Cam S, Cosker E, Vinsard H, Leguay A, Angioi-Duprez K, Laprevote V, Ranta R, Schwan R, Dorr VL. Retinal electroretinogram features can detect depression state and treatment response in adults: A machine learning approach. J Affect Disord 2022; 306:208-214. [PMID: 35301040 DOI: 10.1016/j.jad.2022.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/05/2022] [Accepted: 03/10/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a major public health problem. The retina is a relevant site to indirectly study brain functioning. Alterations in retinal processing were demonstrated in MDD with the pattern electroretinogram (PERG). Here, the relevance of signal processing and machine learning tools applied on PERG was studied. METHODS PERG - whose stimulation is reversible checkerboards - was performed according to the International Society for Clinical Electrophysiology of Vision (ISCEV) standards in 24 MDD patients and 29 controls at the inclusion. PERG was recorded every 4 weeks for 3 months in patients. Amplitude and implicit time of P50 and N95 were evaluated. Then, time/frequency features were extracted from the PERG time series based on wavelet analysis. A statistical model has been learned in this feature space and a metric aiming at quantifying the state of the MDD patient has been derived, based on minimum covariance determinant (MCD) mahalanobis distance. RESULTS MDD patients showed significant increase in P50 and N95 implicit time (p = 0,006 and p = 0,0004, respectively, Mann-Whitney U test) at the inclusion. The proposed metric extracted from the raw PERG provided discrimination between patients and controls at the inclusion (p = 0,0001). At the end of the follow-up at week 12, the difference between the metrics extracted on controls and patients was not significant (p = 0,07), reflecting the efficacy of the treatment. CONCLUSIONS Signal processing and machine learning tools applied on PERG could help clinical decision in the diagnosis and the follow-up of MDD in measuring treatment response.
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Affiliation(s)
- Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1254, IADI, Université de Lorraine, Nancy, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France.
| | - Steven Le Cam
- Université de Lorraine, CNRS, CRAN, F-54000 Nancy, France
| | - Eve Cosker
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France
| | - Heloise Vinsard
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Ambre Leguay
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Karine Angioi-Duprez
- Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France; Service d'Ophtalmologie, CHRU Nancy, Nancy, France
| | - Vincent Laprevote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Radu Ranta
- Université de Lorraine, CNRS, CRAN, F-54000 Nancy, France
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1254, IADI, Université de Lorraine, Nancy, France; Faculté de Médecine, Université de Lorraine, Vandœuvre-lès-Nancy, France
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12
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Cokunlu Y, Mirza E, Caliskan AM, Inanli I, Cicek IE, Ozcimen M, Eren I. Ganglion cell complex thickness changes in patients with different states of bipolar disorder. Eye (Lond) 2022; 36:1034-1041. [PMID: 33976400 PMCID: PMC9046408 DOI: 10.1038/s41433-021-01580-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/11/2021] [Accepted: 04/23/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Neuroimaging studies in patients with bipolar disorder have suggested that a neuropathological process may be effective in this disease. Neurodegenerative changes in the retina can be followed by optical coherence tomography, a non-invasive imaging method that allows in vivo visualization of the retinal layers. The aim of this study was to investigate the possible differences in optical coherence tomography parameters during euthymic, manic, and depressive episodes in patients diagnosed with bipolar disorder. METHODS A total of 150 patients with bipolar disorder were included in the study, divided into three groups (50 patients in a euthymic state, 50 patients in a manic state, and 50 patients in a depressive state) and compared with 50 healthy controls. Ganglion cell complex thickness was measured with automated macular segmentation software of spectral-domain optical coherence tomography. RESULTS Ganglion cell complex thicknesses were thicker in all quadrants in patient groups than the control group but the differences were significant in perifoveal superior and perifoveal inferior quadrants (p < 0.001, p < 0.001). There were no differences in ganglion cell complex thickness among the patient groups (p > 0.05). CONCLUSION The evaluation of ganglion cell complex thickness by spectral-domain optical coherence tomography may give a clue for monitoring neurodegenerative changes in patients with bipolar disorder.
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Affiliation(s)
- Yusuf Cokunlu
- Clinic of Psychiatry, Konya Numune State Hospital, Konya, Turkey
| | - Enver Mirza
- grid.411124.30000 0004 1769 6008Department of Ophthalmology, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Ali Metehan Caliskan
- grid.415453.20000 0004 0419 2409Department of Psychiatry, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey
| | - Ikbal Inanli
- grid.415453.20000 0004 0419 2409Department of Psychiatry, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey
| | - Ismet Esra Cicek
- grid.415453.20000 0004 0419 2409Department of Psychiatry, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey
| | - Muammer Ozcimen
- grid.415453.20000 0004 0419 2409Department of Ophthalmology, University of Health Sciences, Konya Education and Research Hospital, Konya, Turkey
| | - Ibrahim Eren
- grid.411082.e0000 0001 0720 3140Department of Psychiatry, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
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13
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Combined influence of medication and symptom severity on visual processing in bipolar disorder. J Psychiatr Res 2022; 147:135-141. [PMID: 35032946 DOI: 10.1016/j.jpsychires.2022.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/18/2021] [Accepted: 01/03/2022] [Indexed: 12/16/2022]
Abstract
Previous studies have reported visual impairments in patients with bipolar disorder (BPD), but unclear were whether clinical variables would be associated with those disturbances. Here, we investigate the relationship between visual functioning, in terms of color discrimination, and the impact of BPD duration, mood state, and the patients' medication. Forty-five participants (25-45 years old) were recruited for this study. Color discrimination was performed using the Cambridge Colour Test. Serial multiple mediations were run to investigate the assumption of association between color discrimination and the clinical variables. Our findings showed that, compared with healthy controls, BPD patients' performance was worse for the Protan, Deutan, and Tritan vectors, revealing deterioration of color discrimination. In addition, the mediation analyses revealed a strong direct (p < .001) and moderate-to-high indirect effects (p < .01) of medication and symptom severity on color discrimination. Overall, both longer the duration of the disease and greater the symptom severity of BPD patients resulted in worse performance. It highlights the importance of examining the wider clinical context of an affective disorder to understand how it affects visual processing in this population.
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14
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Chen S, Zhong H, Mei G. Stable abnormalities of contrast discrimination sensitivity in subthreshold depression: A longitudinal study. Psych J 2022; 11:194-204. [PMID: 35168295 DOI: 10.1002/pchj.525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 12/11/2022]
Abstract
Subthreshold depression (StD), as a subclinical state, is highly prevalent and increases the risk for developing major depressive disorder (MDD). Although several studies have reported deficits of contrast sensitivity in MDD patients, it is unclear whether individuals with StD could demonstrate deficits of contrast sensitivity and whether the deficits could remain stable over time. Here we used a contrast discrimination task (a suprathreshold task) and a contrast detection task (a near-threshold task) to compare contrast sensitivity of the StD group with that of matched non-depressed controls. For each task, a spatial four-alternative forced-choice method and a psychophysical QUEST procedure were used to measure contrast discrimination threshold or contrast detection threshold. Participants performed an initial assessment and a follow-up assessment 4 months later. Compared to the non-depressed controls, individuals with StD demonstrated reduced contrast discrimination sensitivity, not only at the initial assessment but also at the follow-up assessment, indicating a stable abnormality. Contrast discrimination thresholds at the initial assessment did not predict changes of depression symptom severity over time. For contrast detection sensitivity, there was no significant difference between the StD group and non-depressed controls. We concluded that contrast discrimination testing might provide a trait-dependent biomarker for depression.
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Affiliation(s)
- Shiyu Chen
- School of Psychology, Guizhou Normal University, Guiyang, China.,Department of Education, Guiyang Ninth High School, Guiyang, China
| | - Han Zhong
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Gaoxing Mei
- School of Psychology, Guizhou Normal University, Guiyang, China
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15
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Complete evaluation of retinal function in Major Depressive Disorder: From central slowdown to hyperactive periphery. J Affect Disord 2021; 295:453-462. [PMID: 34507226 DOI: 10.1016/j.jad.2021.08.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/30/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Developing easy-to-access biomarkers is crucial in Major Depressive Disorder. The retina has already been suggested as relevant. However, there is a need for a global and local assessment of whole retinal function using a reproducible, standardized protocol allowing for comparison across studies. Our aim is to assess whole retinal function in patients with actual unipolar Major Depressive Episode (MDE) using pattern, flash and multifocal electroretinogram (ERG) according to the International Society for Clinical Electrophysiology of Vision standardized protocols. METHODS We assessed retinal function in 14 males and females with MDE, diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, and in age- and sex-matched healthy controls. RESULTS Comparing the patients with the controls, we observed the following using multifocal ERG: a significant increase in N1 peak time in ring 3 and a decrease in P1 amplitude in ring 2; using pattern ERG: a significant increase in P50 peak time; using flash ERG: a decrease in a- and b-wave peak time and an increase in the b-wave amplitude in dark-adapted 3.0, a decrease in a- and b-wave peak time and an increase in both wave amplitudes in light-adapted 3.0, and a decrease in the b-wave peak time in light-adapted flicker. LIMITATIONS Sample size. Contribution of pharmacological treatments to the outcomes cannot be formally excluded. CONCLUSIONS Patients with MDE exhibit delayed signaling in the central retina and hyperreactivity to light in the periphery. Central retinal function may be a marker of psychomotor retardation and cognitive impairment in MDE.
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16
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Friedel EBN, Tebartz van Elst L, Schmelz C, Ebert D, Maier S, Endres D, Runge K, Domschke K, Bubl E, Kornmeier J, Bach M, Heinrich SP, Nickel K. Replication of Reduced Pattern Electroretinogram Amplitudes in Depression With Improved Recording Parameters. Front Med (Lausanne) 2021; 8:732222. [PMID: 34778295 PMCID: PMC8585854 DOI: 10.3389/fmed.2021.732222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The retina has gained increasing attention in non-ophthalmological research in recent years. The pattern electroretinogram (PERG), a method to evaluate retinal ganglion cell function, has been used to identify objective correlates of the essentially subjective state of depression. A reduction in the PERG contrast gain was demonstrated in patients with depression compared to healthy controls with normalization after remission. PERG responses are not only modulated by stimulus contrast, but also by check size and stimulation frequency. Therefore, the rationale was to evaluate potentially more feasible procedures for PERG recordings in daily diagnostics in psychiatry. Methods: Twenty-four participants (12 patients with major depression (MDD) and 12 age- and sex-matched healthy controls) were examined in this pilot study. We investigated PERG amplitudes for two steady-state pattern reversal frequencies (12.5/18.75 rps) and four sizes of a checkerboard stimulus (0.8°, 1.6°, 3.2°, and 16°) to optimize the PERG recordings in MDD patients. Results: Smaller PERG amplitudes in MDD patients were observed for all parameters, whereby the extent of the reduction appeared to be stimulus-specific. The most pronounced decline in the PERG of MDD patients was observed at the higher stimulation frequency and the finest pattern, whilst responses for the largest check size were less affected. Following the PERG ratio protocol for early glaucoma, where similar stimulus dependent modulations have been reported, we calculated PERG ratios (0.8°/16°) for all participants. At the higher frequency (18.75 rps), significantly reduced ratios were observed in MDD patients. Conclusion: The “normalization” of the PERG responses—via building a ratio—appears to be a very promising approach with regard to the development of an objective biomarker of the depressive state, facilitating inter-individual assessments of PERG recordings in patients with psychiatric disorders.
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Affiliation(s)
- Evelyn B N Friedel
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Eye Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Céline Schmelz
- Pfalzklinikum-Clinic for Psychiatry and Neurology, Klingenmünster, Germany
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon Maier
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Emanuel Bubl
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Kornmeier
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
| | - Michael Bach
- Eye Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sven P Heinrich
- Eye Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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17
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Cosker E, Moulard M, Schmitt S, Angioi-Duprez K, Baumann C, Laprévote V, Schwan R, Schwitzer T. Portable light therapy in the treatment of unipolar non-seasonal major depressive disorder: study protocol for the LUMIDEP randomised controlled trial. BMJ Open 2021; 11:e049331. [PMID: 34244279 PMCID: PMC8273483 DOI: 10.1136/bmjopen-2021-049331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Major depressive disorder (MDD) affects more than 264 million people worldwide and is associated with an impaired quality of life as well as a higher risk of mortality. Current routine treatments demonstrate limited effectiveness. Light therapy (LT) on its own or in combination with antidepressant treatments could be an effective treatment, but the use of conventional LT devices use is restrictive. Portable LT devices allow patients to continue with their day-to-day activities and therefore encourage better treatment compliance. They have not been evaluated in MDD. METHODS AND ANALYSIS The study is a single-centre, double-blind, randomised controlled trial assessing the efficacy of LT delivered via a portable device in addition to usual care (medical care and drug treatment) for inpatients and outpatients with unipolar non-seasonal MDD. Over the course of 8 weeks, patients use the device daily for 30 min at medium intensity as soon as possible after waking up and preferably between 07:00 and 09:00. All patients continue their usual care with their referring physician. N=50 patients with MDD are included. The primary outcome measure is depressive symptom severity assessed using the Montgomery-Åsberg Depression Rating Scale between baseline and the eighth week. Secondary outcome measures are sleep quality assessed using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale and anxiety level assessed on the Hamilton Anxiety Rating Scale, between baseline and week 8. Further parameters relating to cognitive function are measured at baseline and after the intervention. An ancillary study aims to evaluate the impact of MDD on the retina and to follow its progression. Main limitations include risk of discontinuation or non-adherence and bias in patient selection. ETHICS AND DISSEMINATION The study protocol was approved by Ile de France X's Ethics Committee (protocol number 34-2018). Findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03685942.
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Affiliation(s)
- Eve Cosker
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
- U1114, INSERM, 67085 Strasbourg, Alsace, France
| | - Marie Moulard
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
| | - Samuel Schmitt
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
| | - Karine Angioi-Duprez
- Département d'Ophtalmologie, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Cédric Baumann
- Unité ESPRI-BioBase, Platforme PARC, CHRU de Nancy, Nancy, Lorraine, France
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
- U1114, INSERM, 67085 Strasbourg, Alsace, France
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
- U1114, INSERM, 67085 Strasbourg, Alsace, France
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
- U1114, INSERM, 67085 Strasbourg, Alsace, France
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18
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Liu Y, Tong Y, Huang L, Chen J, Yan S, Yang F. Factors related to retinal nerve fiber layer thickness in bipolar disorder patients and major depression patients. BMC Psychiatry 2021; 21:301. [PMID: 34112131 PMCID: PMC8191183 DOI: 10.1186/s12888-021-03270-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/28/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We analyzed the correlation of the clinical data with retinal nerve fiber layer (RNFL) thickness and macular thickness in bipolar disorder patients and major depression patients. The aim of this study is to explore factors that affect RNFL thickness in bipolar disorder patients and major depression patients, with a view to providing a new diagnostic strategy. METHODS Eighty-two bipolar disorder patients, 35 major depression patients and 274 people who were age and gender matched with the patients were enrolled. Demographic information and metabolic profile of all participants were collected. Best-corrected visual acuity of each eye, intraocular pressure (IOP), fundus examination was performed. RNFL and macular thickness were measured by optical coherence tomography (OCT). Correlations between RNFL and macular thickness and other data were analyzed. RESULTS RNFL and macula lutea in bipolar dipolar patients and major depression patients are thinner than normal people. Triglyceride and UA levels are the highest in the bipolar disorder group, while alanine aminotransferase (ALT) and glutamic oxalacetic transaminase (AST) levels in the depression group are the highest. Age onset and ALT are positively while uric acid (UA) is negatively correlated with RNFL thickness in bipolar dipolar patients. Cholesterol level is positively correlated with RNFL thickness while the duration of illness is correlated with RNFL thickness of left eye in major depression patients. CONCLUSIONS RNFL and macula lutea in bipolar dipolar patients and major depression patients are thinner than normal people. In bipolar disorder patients, age-onset and ALT are potential protective factors in the progress of RNFL thinning, while UA is the pathological factor.
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Affiliation(s)
- Yanhong Liu
- grid.11135.370000 0001 2256 9319Department of Psychiatry, Peking University Huilongguan Clinical Medical School, Nandian Road, Changping District, Beijing, 100096 China ,grid.414351.60000 0004 0530 7044Department of Psychiatry, Beijing Huilongguan Hospital, Beijing, China
| | - Yongsheng Tong
- grid.11135.370000 0001 2256 9319Department of Psychiatry, Peking University Huilongguan Clinical Medical School, Nandian Road, Changping District, Beijing, 100096 China ,grid.414351.60000 0004 0530 7044Department of Psychiatry, Beijing Huilongguan Hospital, Beijing, China
| | - Lvzhen Huang
- grid.411634.50000 0004 0632 4559Department of Ophthalmology, People’s Hospital of Peking University, Beijing, China
| | - Jingxu Chen
- grid.11135.370000 0001 2256 9319Department of Psychiatry, Peking University Huilongguan Clinical Medical School, Nandian Road, Changping District, Beijing, 100096 China ,grid.414351.60000 0004 0530 7044Department of Psychiatry, Beijing Huilongguan Hospital, Beijing, China
| | - Shaoxiao Yan
- grid.11135.370000 0001 2256 9319Department of Psychiatry, Peking University Huilongguan Clinical Medical School, Nandian Road, Changping District, Beijing, 100096 China ,grid.414351.60000 0004 0530 7044Department of Psychiatry, Beijing Huilongguan Hospital, Beijing, China
| | - Fude Yang
- Department of Psychiatry, Peking University Huilongguan Clinical Medical School, Nandian Road, Changping District, Beijing, 100096, China.
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Retinal structural changes in mood disorders: The optical coherence tomography to better understand physiopathology? Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110080. [PMID: 32827610 DOI: 10.1016/j.pnpbp.2020.110080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Mood disorders are particularly common, disabling conditions. Diagnosis can be difficult as it may involve different pathophysiological assumptions. This could explain why such disorders are resistant to treatment. The retina is part of the central nervous system and shares a common embryonic origin with the brain. Optical coherence tomography (OCT) is an imaging technique for analysing the different layers of the retina. We reviewed studies that examined the retina with OCT in mood disorders. METHODS We conducted Pubmed search and additional manual research based on the bibliography in each of selected articles. We found and analysed 11 articles relevant to our subject. RESULTS This literature review confirms that it is possible to use OCT to detect neurodegeneration and neuroinflammation in mood disorders. Their impact is thought to depend on the duration and severity of the disease, and whether it is in acute or chronic stage. The differences seen in studies dealing with depression and those looking at bipolar disorder may reflect the particular characteristics of each disorder. A number of OCT parameters can be proposed as biomarkers of active or chronic inflammation and neurodegeneration. Markers of predisposition to an at-risk mental state are also suggested. LIMITATIONS The main limitation is selection bias, studies including more varied population would help to confirm and precise these results. CONCLUSION OCT is thus a particularly promising tool for evaluating some of the etiopathogenetic mechanisms involved in mood disorders. The combination with other approaches could help to find more specific biomarkers.
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Li X, Fan F, Chen X, Li J, Ning L, Lin K, Chen Z, Qin Z, Yeung AS, Li X, Wang L, So KF. Computer Vision for Brain Disorders Based Primarily on Ocular Responses. Front Neurol 2021; 12:584270. [PMID: 33967931 PMCID: PMC8096911 DOI: 10.3389/fneur.2021.584270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 03/15/2021] [Indexed: 11/18/2022] Open
Abstract
Real-time ocular responses are tightly associated with emotional and cognitive processing within the central nervous system. Patterns seen in saccades, pupillary responses, and spontaneous blinking, as well as retinal microvasculature and morphology visualized via office-based ophthalmic imaging, are potential biomarkers for the screening and evaluation of cognitive and psychiatric disorders. In this review, we outline multiple techniques in which ocular assessments may serve as a non-invasive approach for the early detections of various brain disorders, such as autism spectrum disorder (ASD), Alzheimer's disease (AD), schizophrenia (SZ), and major depressive disorder (MDD). In addition, rapid advances in artificial intelligence (AI) present a growing opportunity to use machine learning-based AI, especially computer vision (CV) with deep-learning neural networks, to shed new light on the field of cognitive neuroscience, which is most likely to lead to novel evaluations and interventions for brain disorders. Hence, we highlight the potential of using AI to evaluate brain disorders based primarily on ocular features.
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Affiliation(s)
- Xiaotao Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States.,BIAI INC., Chelmsford, MA, United States.,BIAI Intelligence Biotech LLC, Shenzhen, China
| | - Fangfang Fan
- Department of Neurology, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Xuejing Chen
- Retina Division, Department of Ophthalmology, Boston University Eye Associates, Boston University, Boston, MA, United States
| | - Juan Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,BIAI INC., Chelmsford, MA, United States.,BIAI Intelligence Biotech LLC, Shenzhen, China
| | - Li Ning
- Center for High Performance Computing, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Kangguang Lin
- Department of Affective Disorders and Academician Workstation of Mood and Brain Sciences, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong-Hong Kong-Macau Institute of Central Nervous System (CNS) Regeneration, Jinan University, Guangzhou, China
| | - Zan Chen
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Zhenyun Qin
- Key Laboratory for Nonlinear Mathematical Models and Methods, School of Mathematical Science, Fudan University, Shanghai, China
| | - Albert S Yeung
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Xiaojian Li
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Liping Wang
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Kwok-Fai So
- Guangdong-Hong Kong-Macau Institute of Central Nervous System (CNS) Regeneration, Jinan University, Guangzhou, China.,The State Key Laboratory of Brain and Cognitive Sciences, Department of Ophthalmology, University of Hong Kong, Pok Fu Lam, Hong Kong
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21
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Salmela V, Socada L, Söderholm J, Heikkilä R, Lahti J, Ekelund J, Isometsä E. Reduced visual contrast suppression during major depressive episodes. J Psychiatry Neurosci 2021; 46:E222-E231. [PMID: 33703869 PMCID: PMC8061742 DOI: 10.1503/jpn.200091] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Previous studies have suggested that processing of visual contrast information could be altered in major depressive disorder. To clarify the changes at different levels of the visual hierarchy, we behaviourally measured contrast perception in 2 centre-surround conditions, assessing retinal and cortical processing. METHODS As part of a prospective cohort study, our sample consisted of controls (n = 29; 21 female) and patients with unipolar depression, bipolar disorder and borderline personality disorder who had baseline major depressive episodes (n = 111; 74 female). In a brightness induction test that assessed retinal processing, participants compared the perceived luminance of uniform patches (presented on a computer screen) as the luminance of the backgrounds was varied. In a contrast suppression test that assessed cortical processing, participants compared the perceived contrast of gratings, which were presented with collinearly or orthogonally oriented backgrounds. RESULTS Brightness induction was similar for patients with major depressive episodes and controls (p = 0.60, d = 0.115, Bayes factor = 3.9), but contrast suppression was significantly lower for patients than for controls (p < 0.006, d = 0.663, Bayes factor = 35.2). We observed no statistically significant associations between contrast suppression and age, sex, or medication or diagnostic subgroup. At follow-up (n = 74), we observed some normalization of contrast perception. LIMITATIONS We assessed contrast perception using behavioural tests instead of electrophysiology. CONCLUSION The reduced contrast suppression we observed may have been caused by decreased retinal feedforward or cortical feedback signals. Because we observed intact brightness induction, our results suggest normal retinal but altered cortical processing of visual contrast during a major depressive episode. This alteration is likely to be present in multiple types of depression and to partially normalize upon remission.
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Affiliation(s)
- Viljami Salmela
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
| | - Lumikukka Socada
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
| | - John Söderholm
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
| | - Roope Heikkilä
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
| | - Jari Lahti
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
| | - Jesper Ekelund
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
| | - Erkki Isometsä
- From the Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Salmela, Lahti); and the Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Socada, Söderholm, Heikkilä, Ekelund, Isometsä)
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22
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Demmin DL, Silverstein SM. Visual Impairment and Mental Health: Unmet Needs and Treatment Options. Clin Ophthalmol 2020; 14:4229-4251. [PMID: 33299297 PMCID: PMC7721280 DOI: 10.2147/opth.s258783] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/06/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose An estimated 2.2 billion people are visually impaired worldwide. Given that age-related vision loss is a primary cause of vision impairment, this number is projected to rise with increases in average lifespan. Vision loss often results in significant disability and is associated with a substantial economic burden, reduced quality-of-life, concurrent medical issues, and mental health problems. In this review, the mental health needs of people with vision impairment are examined. Patients and methods A review of recent literature on mental health outcomes and current treatments in people with visual impairment was conducted. Results Considerable data indicate that rates of depression and anxiety are elevated among people with visual impairments. Moreover, individuals of lower socioeconomic status may be at increased risk for vision impairment and subsequent mental health problems. Existing psychosocial interventions for improving mental health in people with visual impairment show some promise, but are limited by low adherence and lack generalizability. Conclusion In order to improve outcomes, a better understanding of the mechanisms linking visual impairment and poor mental health is needed. It will also be essential to develop more effective interventions and expand access to services to improve the detection and treatment of mental health problems in this population.
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Affiliation(s)
- Docia L Demmin
- Department of Psychology, Rutgers University, Piscataway, NJ, USA
| | - Steven M Silverstein
- Departments of Psychiatry, Neuroscience, and Ophthalmology, University of Rochester, Rochester, NY, USA
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23
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Jung KI, Hong SY, Shin DY, Lee NY, Kim TS, Park CK. Attenuated Visual Function in Patients with Major Depressive Disorder. J Clin Med 2020; 9:jcm9061951. [PMID: 32580488 PMCID: PMC7356808 DOI: 10.3390/jcm9061951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022] Open
Abstract
Background: We sought to investigate visual function, primarily, and structural changes in retinal ganglion cells, secondarily, in patients with major depressive disorder. Methods: A total of 50 normal participants and 49 patients with major depressive disorder were included in this cross-sectional study. The participants underwent 24–2 standard automated perimetry and spectral-domain optical coherence tomography. Results: The pattern standard deviation (PSD) in the visual field test was higher in the major depressive disorder patients than in the normal control subjects (p = 0.017). The patients with major depressive disorder showed reduced minimum ganglion cell–inner plexiform layer (GCIPL) thickness relative to the normal control participants (p = 0.015). The average score on the Hamilton Depression Rating scale showed a significant correlation with the PSD, minimum GCIPL thickness, and inferior GCIPL thickness (r = 0.265, p = 0.009; r = −0.239, p = 0.017; and r = −0.204, p = 0.043, respectively). The multivariate analysis of factors associated with PSD showed old age and a high Hamilton Depression Rating score to be relevant (p = 0.002 and 0.028, respectively). Conclusions: Visual function was decreased and the GCIPL thickness was reduced in major depressive disorder patients. The retinal neurodegenerative process in depression might be considered in patients with depression.
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Affiliation(s)
- Kyoung In Jung
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.I.J.); (S.-Y.H.); (D.Y.S.); (N.Y.L.)
- Department of Ophthalmology, Seoul St. Mary’s Hospital, Seoul 06591, Korea
| | - Seo-Yeon Hong
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.I.J.); (S.-Y.H.); (D.Y.S.); (N.Y.L.)
| | - Da Young Shin
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.I.J.); (S.-Y.H.); (D.Y.S.); (N.Y.L.)
- Department of Ophthalmology, Seoul St. Mary’s Hospital, Seoul 06591, Korea
| | - Na Young Lee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.I.J.); (S.-Y.H.); (D.Y.S.); (N.Y.L.)
- Department of Ophthalmology, Eunpyung St. Mary’s Hospital, Seoul 03312, Korea
| | - Tae-Suk Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: (T.-S.K.); (C.K.P.); Tel.: +82-02-2258-6085 (T.-S.K.); +82-02-2258-6199 (C.K.P.); Fax: +82-02-594-3870 (T.-S.K.); +82-02-599-7405 (C.K.P.)
| | - Chan Kee Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (K.I.J.); (S.-Y.H.); (D.Y.S.); (N.Y.L.)
- Department of Ophthalmology, Seoul St. Mary’s Hospital, Seoul 06591, Korea
- Correspondence: (T.-S.K.); (C.K.P.); Tel.: +82-02-2258-6085 (T.-S.K.); +82-02-2258-6199 (C.K.P.); Fax: +82-02-594-3870 (T.-S.K.); +82-02-599-7405 (C.K.P.)
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24
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Silverstein SM, Demmin DL, Schallek JB, Fradkin SI. Measures of Retinal Structure and Function as Biomarkers in Neurology and Psychiatry. Biomark Neuropsychiatry 2020. [DOI: 10.1016/j.bionps.2020.100018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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25
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Cosker E, Schwan R, Angioi-Duprez K, Laprévote V, Schwitzer T. New insights on the role of the retina in diagnostic and therapeutic strategies in major depressive disorder. Neurosci Biobehav Rev 2020; 113:262-272. [PMID: 32147530 DOI: 10.1016/j.neubiorev.2020.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) affects people worldwide. MDD treatments include antidepressants, which involve a delayed onset of action, long-term treatment, side effects and, frequently, only partial efficacy. The lack of access to the living brain, and the complex and still poorly elucidated pathophysiology of MDD, hinders treatment development. There is not only a need for new treatment strategies, but also for new approaches to investigating the pathophysiology of MDD. Light therapy is a well-established treatment acting through the retina. Since the retina is part of the central nervous system, it has been suggested as a useful area for investigating mental illness. In this article, we will first set out the evidence that MDD affects the retina's structure and function. We will then review studies evaluating the efficacy of light therapy in unipolar non-seasonal MDD. Finally, we discuss the disruption of melatoninergic pathways in MDD, its assessment through the retina and the treatment of this disruption with light therapy.
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Affiliation(s)
- Eve Cosker
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Nancy, France
| | | | - Vincent Laprévote
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Nancy, France
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Nancy, France.
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26
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Werner AL, Tebartz van Elst L, Ebert D, Friedel E, Bubl A, Clement HW, Lukačin R, Bach M, Bubl E. Normalization of increased retinal background noise after ADHD treatment: A neuronal correlate. Schizophr Res 2020; 219:77-83. [PMID: 31053491 DOI: 10.1016/j.schres.2019.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/14/2019] [Accepted: 04/17/2019] [Indexed: 02/06/2023]
Abstract
Inattention, distractibility, and problems inhibiting irrelevant information impose a large disease burden in attention deficit hyperactivity disorder (ADHD). Problems with cognitive function are found in many major psychiatric disorders, and our understanding of ADHD might add to our knowledge of other neuropsychiatric disorders. Despite the high impact of ADHD, the pathophysiology and the mechanism of treatment action remains poorly understood. Increasing evidence suggests that elevated neuronal and retinal background noise plays a prominent role in ADHD. However, the effect of treatment (e.g., methylphenidate) on noise remains unclear. For this study, retinal background noise was assessed with the pattern-electroretinogram (PERG) in 20 drug-naïve adults with ADHD before and after treatment with methylphenidate and in 21 control subjects. Background noise was identified using the Fourier magnitude at frequencies adjacent to the stimulus-response frequency of 12.5 Hz. At baseline, we found an elevated retinal background noise in ADHD patients (Mdn = 0.079 μV) compared to controls (Mdn = 0.062 μV; z = -2.79, p = 0.016, r = -0.44). The noise in the ADHD group decreased significantly at follow-up after treatment with methylphenidate (Mdn = 0.069 μV, z = -2.39, p = 0.035, r = -0.39) while there was no change in the control group. PERG-based retinal noise is increased in adult ADHD and normalizes along with clinical symptoms following treatment with methylphenidate. The retinal noise level might be a promising marker of ADHD in clinical and basic research and illustrates the biological match with nonhuman ADHD models.
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Affiliation(s)
- Anna Lisa Werner
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Germany
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Germany
| | - Evelyn Friedel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Germany
| | - Anna Bubl
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Germany; Department of Psychiatry and Psychotherapy, University of Saarland, Germany
| | - Hans-Willi Clement
- Department of Child and Adolescent Psychiatry, Medical Center - University of Freiburg, Germany
| | - Richard Lukačin
- Chromsystems Instruments & Chemicals GmbH, Gräfelfing, Munich, Germany
| | - Michael Bach
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Emanuel Bubl
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Germany; Department of Psychiatry and Psychotherapy, University of Saarland, Germany.
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27
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People with current major depression resemble healthy controls on flash Electroretinogram indices associated with impairment in people with stabilized schizophrenia. Schizophr Res 2020; 219:69-76. [PMID: 31375317 DOI: 10.1016/j.schres.2019.07.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/10/2019] [Accepted: 07/13/2019] [Indexed: 11/21/2022]
Abstract
Flash electroretinography (fERG) has been used to identify anomalies in retinal functioning in several psychiatric disorders. In schizophrenia (SCZ), fERG abnormalities are reliably observed, but findings from studies of major depressive disorder (MDD) have been less consistent. In this study, fERG data were recorded from MDD patients in a current major depressive episode (n = 25), and compared to data from SCZ patients (n = 25) and healthy controls (HC; n = 25), to determine the degree to which fERG anomalies in acute MDD overlap or contrast with those observed in stabilized (though not symptom free) SCZ. The primary variables of interest were a-wave (photoreceptor activity), b-wave (bipolar-Müller cell activity), and photopic negative response (PhNR; ganglion cell activity) amplitudes and implicit times. Across most conditions, there were no significant differences between the MDD and HC groups in a- or b-wave response, but the SCZ group consistently demonstrated reduced amplitudes. Interestingly, MDD patients demonstrated an increase in photopic a-wave implicit time relative to SCZ patients, and a decrease in PhNR implicit time relative to controls. Correlations between BDI-II scores and fERG metrics were not significant for either patient group. Overall, these data indicate that, using an fERG protocol that distinguishes SCZ patients from controls, MDD patients experiencing a current depressive episode closely resemble healthy controls in their fERG responses. Therefore, MDD-related fERG changes may be more subtle than those observed in SCZ and detectable only with larger sample sizes than we employed and/or using a different set of fERG test parameters.
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28
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Almonte MT, Capellàn P, Yap TE, Cordeiro MF. Retinal correlates of psychiatric disorders. Ther Adv Chronic Dis 2020; 11:2040622320905215. [PMID: 32215197 PMCID: PMC7065291 DOI: 10.1177/2040622320905215] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/08/2020] [Indexed: 12/27/2022] Open
Abstract
Diagnosis and monitoring of psychiatric disorders rely heavily on subjective self-reports of clinical symptoms, which are complicated by the varying consistency of accounts reported by patients with an impaired mental state. Hence, more objective and quantifiable measures have been sought to provide clinicians with more robust methods to evaluate symptomology and track progression of disease in response to treatments. Owing to the shared origins of the retina and the brain, it has been suggested that changes in the retina may correlate with structural and functional changes in the brain. Vast improvements in retinal imaging, namely optical coherence tomography (OCT) and electrodiagnostic technology, have made it possible to investigate the eye at a microscopic level, allowing for the investigation of potential biomarkers in vivo. This review provides a summary of retinal biomarkers associated with schizophrenia, bipolar disorder and major depression, demonstrating how retinal biomarkers may be used to complement existing methods and provide structural markers of pathophysiological mechanisms that underpin brain dysfunction in psychiatric disorders.
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Affiliation(s)
- Melanie T. Almonte
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | | | - Timothy E. Yap
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
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29
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Matthews J, Nagao K, Ding C, Newby R, Kempster P, Hohwy J. Raised visual contrast thresholds with intact attention and metacognition in functional motor disorder. Cortex 2020; 125:161-174. [PMID: 31991241 DOI: 10.1016/j.cortex.2019.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/04/2019] [Accepted: 12/09/2019] [Indexed: 02/07/2023]
Abstract
Functional motor disorders (FMDs) are distinguished by signs that lack congruence with recognised patterns of organic disease and show inconsistency over time. Their pathophysiology is poorly understood, but there is evidence that irregularities in perceptual and cognitive processing lie at the heart of these conditions. Here, we draw on a predictive coding account of functional neurological disorders to study perceptual decision-making in three groups: 20 patients with FMDs (14 with functional movements and 6 with functional weakness), 20 with phenotypically-matched organic motor disorders, and 20 age-matched healthy controls. We examine four cognitive domains with putative roles in FMD pathogenesis: attention, expectations, sensory processing (perceptual sensitivity), and metacognition (introspective evaluation of performance). We augmented a dual-task paradigm, manipulating the visual contrast required for target detection to examine these domains in one design. With sensory input (stimulus contrast) psychometrically adjusted to staircase target detection at a fixed level for all groups, the FMD group exhibited statistically equivalent attentional, expectational and metacognitive processing to healthy controls. However, we demonstrate Bayesian evidence and a frequentist trend that FMD patients require higher visual contrast than controls to maintain the same detection sensitivity (BF10 = 8.1, pholm = .066). This was statistically equivalent to the visual contrast required by the organic group, and unlikely to be accounted for by medication use or comorbid psychopathology. The organic group showed differences in processing of attention and expectations for target detection that were not observed in either healthy controls or the functional group. The distinctive behavioural profile of FMDs may arise from abnormalities in basic sensory processing, while higher attentional, expectational and metacognitive mechanisms remain intact. Conceptualising functional neurological disorders under a predictive coding account may consolidate and refine existing pathophysiological theories about them.
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Affiliation(s)
- Julian Matthews
- Cognition & Philosophy Lab, Monash University, Clayton, Australia.
| | - Kanae Nagao
- Neurosciences Department, Monash Medical Centre, Clayton, Australia.
| | - Catherine Ding
- Neurosciences Department, Monash Medical Centre, Clayton, Australia.
| | - Rachel Newby
- Neurosciences Department, Monash Medical Centre, Clayton, Australia.
| | - Peter Kempster
- Neurosciences Department, Monash Medical Centre, Clayton, Australia; Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia.
| | - Jakob Hohwy
- Cognition & Philosophy Lab, Monash University, Clayton, Australia.
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30
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Qi X, Fan H, Yang X, Chen Y, Deng W, Guo W, Wang Q, Chen E, Li T, Ma X. High level of pattern glare in major depressive disorder. BMC Psychiatry 2019; 19:415. [PMID: 31864335 PMCID: PMC6925875 DOI: 10.1186/s12888-019-2399-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/09/2019] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Visual deficits have been reported in abundance by recent studies on major depressive disorder. Pattern glare manifests as visual distortions, such as the symptoms of headache, glare, eyestrain, illusions of shapes, colors, and motion when viewing repetitive striped patterns, of which some can be observed in major depressive disorder. Inspired by what mentioned, the present study aims to explore whether there exists association between pattern glare and major depressive disorder and further attempts to explore possible clinical diagnostic value of pattern glare in major depressive disorder. METHODS Twenty-four patients diagnosed with major depressive disorder (MDDs group) were compared with 30 age-, gender- and education level-matched healthy control subjects (HCs group) on their visual stress with black-and-white gratings of different spatial frequencies-0.3 (low-SF), 2.3 (mid-SF), and 9.4 (high-SF) cycles per degree (c/deg)-which was named pattern glare test. The MDDs group divided into first episode medication-free group (fMDD) and recurrent medicated group (rMDD), comparisons of pattern glare scores (PGS) were performed within the MDDs group. We used Pearson and Spearman analysis to explore the relationship between some clinical indexes and pattern glare scores. ROC (receiver operating characteristic) curve was used to evaluate whether pattern glare test was able to discriminate patients and healthy controls. RESULTS The mid-SF pattern glare score significantly elevated in patients with major depressive disorder compared to control subjects. No differences of pattern glare scores were found between fMDD and rMDD. A significant negative correlation between mid-high difference and age in HCs group was found. There were no correlations between other variables and pattern glare scores. The mid-SF score has limited value in the diagnosis of major depressive disorder. CONCLUSIONS We observed an increased level of pattern glare in patients with major depressive disorder, reflecting the existence of cortical hyper-excitability in major depressive disorder. The mid-SF score may have a value in understanding cortical excitability in major depressive disorder.
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Affiliation(s)
- Xiongwei Qi
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Huanhuan Fan
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Xiao Yang
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Yayun Chen
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Wei Deng
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjun Guo
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Eric Chen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Tao Li
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610064, People's Republic of China. .,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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31
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Youssef P, Nath S, Chaimowitz GA, Prat SS. Electroretinography in psychiatry: A systematic literature review. Eur Psychiatry 2019; 62:97-106. [PMID: 31553929 DOI: 10.1016/j.eurpsy.2019.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 09/07/2019] [Indexed: 02/01/2023] Open
Abstract
This review aims to consolidate the available information on use of electroretinography as a diagnostic tool in psychiatry. The electroretinogram (ERG) has been found to have diagnostic utility in cocaine withdrawal (reduced light-adapted b-wave response), major depressive disorder (reduced contrast gain in pattern ERG), and schizophrenia (reduced a- and b-wave amplitudes). This review examines these findings as well as the applicability of ERG to substance use disorder, Alzheimer's disease, autism spectrum disorder, panic disorder, eating disorders, attention deficit hyperactivity disorder, and medication use. While there have been promising results, current research suffers from a lack of specificity. Further research that quantifies anomalies in ERG present in psychiatric illness is needed.
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Affiliation(s)
- Peter Youssef
- Bachelor of Health Sciences Program, McMaster University, Hamilton, Ontario, Canada
| | - Siddharth Nath
- MD/PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Gary A Chaimowitz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Sebastien S Prat
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
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32
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Zweerings J, Zvyagintsev M, Turetsky BI, Klasen M, König AA, Roecher E, Gaebler AJ, Mathiak K. Fronto-parietal and temporal brain dysfunction in depression: A fMRI investigation of auditory mismatch processing. Hum Brain Mapp 2019; 40:3657-3668. [PMID: 31081231 DOI: 10.1002/hbm.24623] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022] Open
Abstract
Mismatch responses reflect neural mechanisms of early cognitive processing in the auditory domain. Disturbances of these mechanisms on multiple levels of neural processing may contribute to clinical symptoms in major depression (MD). A functional magnetic resonance imaging (fMRI) study was conducted to identify neurobiological foundations of altered mismatch processing in MD. Twenty-five patients with major depression and 25 matched healthy individuals completed an auditory mismatch paradigm optimized for fMRI. Brain activity during mismatch processing was compared between groups. Moreover, seed-based connectivity analyses investigated depression-specific brain networks. In patients, mismatch processing was associated with reduced activation in the right auditory cortex as well as in a fronto-parietal attention network. Moreover, functional coupling between the right auditory cortex and frontal areas was reduced in patients. Seed-to voxel analysis on the whole-brain level revealed reduced connectivity between the auditory cortex and the thalamus as well as posterior cingulate. The present study indicates deficits in sensory processing on the level of the auditory cortex in depression. Hyposensitivity in a fronto-parietal network presumably reflects altered attention mechanisms in depression. The observed impairments may contribute to psychopathology by reducing the ability of the affected individuals to orient attention toward important environmental cues.
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Affiliation(s)
- Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Institute for Neuroscience and Medicine (INM-10): JARA Institute Brain Structure Function, Research Center Jülich, Jülich, Germany
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Institute for Neuroscience and Medicine (INM-10): JARA Institute Brain Structure Function, Research Center Jülich, Jülich, Germany.,Brain Imaging Facility, Interdisciplinary Centre for Clinical Studies (IZKF), School of Medicine, RWTH Aachen University, Aachen, Germany
| | - Bruce I Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Martin Klasen
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Institute for Neuroscience and Medicine (INM-10): JARA Institute Brain Structure Function, Research Center Jülich, Jülich, Germany
| | - Andrea A König
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany
| | - Erik Roecher
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Institute for Neuroscience and Medicine (INM-10): JARA Institute Brain Structure Function, Research Center Jülich, Jülich, Germany
| | - Arnim J Gaebler
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Institute for Neuroscience and Medicine (INM-10): JARA Institute Brain Structure Function, Research Center Jülich, Jülich, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Institute for Neuroscience and Medicine (INM-10): JARA Institute Brain Structure Function, Research Center Jülich, Jülich, Germany
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33
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Moreno-Ortega M, Prudic J, Rowny S, Patel GH, Kangarlu A, Lee S, Grinband J, Palomo T, Perera T, Glasser MF, Javitt DC. Resting state functional connectivity predictors of treatment response to electroconvulsive therapy in depression. Sci Rep 2019; 9:5071. [PMID: 30911075 PMCID: PMC6433903 DOI: 10.1038/s41598-019-41175-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/26/2019] [Indexed: 02/07/2023] Open
Abstract
There is increasing focus on use of resting-state functional connectivity (RSFC) analyses to subtype depression and to predict treatment response. To date, identification of RSFC patterns associated with response to electroconvulsive therapy (ECT) remain limited, and focused on interactions between dorsal prefrontal and regions of the limbic or default-mode networks. Deficits in visual processing are reported in depression, however, RSFC with or within the visual network have not been explored in recent models of depression. Here, we support prior studies showing in a sample of 18 patients with depression that connectivity between dorsal prefrontal and regions of the limbic and default-mode networks serves as a significant predictor. In addition, however, we demonstrate that including visual connectivity measures greatly increases predictive power of the RSFC algorithm (>80% accuracy of remission). These exploratory results encourage further investigation into visual dysfunction in depression, and use of RSFC algorithms incorporating the visual network in prediction of response to both ECT and transcranial magnetic stimulation (TMS), offering a new framework for the development of RSFC-guided TMS interventions in depression.
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Affiliation(s)
- M Moreno-Ortega
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA. .,Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - J Prudic
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA
| | - S Rowny
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA
| | - G H Patel
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA
| | - A Kangarlu
- Department of Psychiatry, Radiology and Biomedical Engineering, Columbia University, New York, NY, USA
| | - S Lee
- Department of Psychiatry and Biostatistics, New York State Psychiatric Institute/Columbia University, New York, NY, USA
| | - J Grinband
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA
| | - T Palomo
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Complutense University, Madrid, Spain
| | - T Perera
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA
| | - M F Glasser
- Departments of Radiology and Neuroscience, Washington University Medical School, St. Louis, MO, USA
| | - D C Javitt
- Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY, USA
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Schwitzer T, Schwan R, Angioi-Duprez K, Lalanne L, Giersch A, Laprevote V. Cannabis use and human retina: The path for the study of brain synaptic transmission dysfunctions in cannabis users. Neurosci Biobehav Rev 2019; 106:11-22. [PMID: 30773228 DOI: 10.1016/j.neubiorev.2018.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 11/08/2018] [Accepted: 12/02/2018] [Indexed: 01/01/2023]
Abstract
Owing to the difficulty of obtaining direct access to the functioning brain, new approaches are needed for the indirect exploration of brain disorders in neuroscience research. Due to its embryonic origin, the retina is part of the central nervous system and is well suited to the investigation of neurological functions in psychiatric and addictive disorders. In this review, we focus on cannabis use, which is a crucial public health challenge, since cannabis is one of the most widely used addictive drugs in industrialized countries. We first explain why studying retinal function is relevant when exploring the effects of cannabis use on brain function. Next, we describe both the retinal electrophysiological measurements and retinal dysfunctions observed after acute and regular cannabis use. We then discuss how these retinal dysfunctions may inform brain synaptic transmission abnormalities. Finally, we present various directions for future research on the neurotoxic effects of cannabis use.
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Affiliation(s)
- Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Maison des Addictions, CHRU Nancy, Nancy, France
| | | | - Laurence Lalanne
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Pôle de Psychiatrie Santé Mentale et Addictologie, Fédération de Médecine Translationnelle de Strasbourg, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Anne Giersch
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Vincent Laprevote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
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35
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Schwitzer T, Schwan R, Angioi-Duprez K, Giersch A, Lalanne L, Albuisson E, Laprevote V. Delayed bipolar and ganglion cells neuroretinal processing in regular cannabis users: The retina as a relevant site to investigate brain synaptic transmission dysfunctions. J Psychiatr Res 2018; 103:75-82. [PMID: 29783078 DOI: 10.1016/j.jpsychires.2018.04.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 04/25/2018] [Accepted: 04/30/2018] [Indexed: 12/23/2022]
Abstract
Cannabis use is widespread worldwide, but the impact of smoking cannabis regularly on brain synaptic transmission has only been partially elucidated. The retina is considered as an easy means of determining dysfunction in brain synaptic transmission. The endocannabinoid system is involved in regulating retinal synaptic transmission, which might also be affected by tobacco. Previous preliminary results have shown impairments in retinal ganglion cell response in cannabis users. Here, we test the extent to which earlier retinal levels-bipolar cells and photoreceptors-are affected in cannabis users, i.e. by the association of tobacco and cannabis. We recorded pattern (PERG) and flash (fERG) ERG in 53 regular cannabis users and 29 healthy controls. Amplitude and peak time of P50 and N95 (PERG) and of a- and b-waves (fERG) were evaluated. Cannabis users showed a significant increase in PERG N95 peak time and in fERG light-adapted 3.0 b-wave peak time, compared with controls (p = 0.0001 and p = 0.002, respectively; Mann-Whitney U test). No significant difference was found between the groups in terms of wave amplitude (p = 0.525 and p = 0.767 for the N95 and light-adapted 3.0 b-wave amplitude respectively; Mann-Whitney U test). The results demonstrated delayed ganglion and bipolar cell responses in cannabis users. These results reflect a delay in the transmission of visual information from the retina to the brain. This retinal dysfunction may be explained by an effect of cannabis use on retinal synaptic transmission. Main limitations of these results concern tobacco and alcohol use that differed between groups. The consequences of these anomalies on visual perception along with the molecular mechanisms underlying this retinal dysfunction should be explored in future human and animal studies.
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Affiliation(s)
- Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; EA7298, INGRES, Université de Lorraine, Vandœuvre-lès-Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Maison des Addictions, CHRU Nancy, Nancy, France
| | | | - Anne Giersch
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Laurence Lalanne
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Pôle de Psychiatrie et d'addictologie, Fédération de Médecine Translationnelle de Strasbourg, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Eliane Albuisson
- Pôle S(2)R, PARC, BIOBASE, CHRU Nancy, Vandoeuvre lès Nancy, France; Université de Lorraine, Faculté de Médecine, InSciDens, Vandoeuvre lès Nancy, France; Université de Lorraine, CNRS, IECL, Nancy, France
| | - Vincent Laprevote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; EA7298, INGRES, Université de Lorraine, Vandœuvre-lès-Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Pôle de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France; Maison des Addictions, CHRU Nancy, Nancy, France
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36
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Schönfeldt-Lecuona C, Schmidt A, Kregel T, Kassubek J, Dreyhaupt J, Freudenmann RW, Connemann BJ, Pinkhardt EH, Gahr M. Retinal changes in patients with major depressive disorder - A controlled optical coherence tomography study. J Affect Disord 2018; 227:665-671. [PMID: 29174740 DOI: 10.1016/j.jad.2017.11.077] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 10/26/2017] [Accepted: 11/12/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Recent studies on the pathophysiology of major depression (MD) indicate that degenerative and inflammatory processes may play a role. This finding is supported by magnetic resonance imaging (MRI)-based meta-analysis that show volume reductions in circumscribed areas of the brain in patients with MD. Using optical coherence tomography (OCT), retinal changes have been demonstrated in neurodegenerative disorders. In light of this inflammatory/degenerative hypothesis, we tested whether patients with MD exhibit retinal alterations that might correlate with the severity and duration of the disease. METHODS Patients with MD and age- and gender-matched healthy controls were recruited for the measurement of the total volume and thickness of their retina as well as the thicknesses and volumes of five different retinal layers using single-layer-analysis provided by the spectral-domain-OCT. RESULTS OCT data from 28 patients with MD and 20 healthy controls were available for evaluation. The exploratory intra-individual group comparison of the two eyes showed a small but significant difference in the retinal total volume (right = 8.69mm3; left = 8.72mm3; p = 0.03) only in patients with MD. There were no other significant differences between the patients with MD and the healthy controls with respect to the OCT measurements. LIMITATIONS The small group size as well as the absence of correction for multiple testing due to the exploratory design should be considered as limitations of our study. CONCLUSION While retinal total volume differs between the eyes of patients with MD, the comparison of retinal parameters between these patients and age- and gender-matched healthy volunteers did not show any differences.
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Affiliation(s)
| | - Arno Schmidt
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Germany
| | - Thomas Kregel
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Germany
| | - Jan Kassubek
- Department of Neurology, University Clinic Ulm, Germany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany
| | | | | | | | - Maximilian Gahr
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Germany
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37
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Schwitzer T, Schwan R, Bubl E, Lalanne L, Angioi-Duprez K, Laprevote V. Looking into the brain through the retinal ganglion cells in psychiatric disorders: A review of evidences. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:155-162. [PMID: 28336492 DOI: 10.1016/j.pnpbp.2017.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/06/2017] [Accepted: 03/19/2017] [Indexed: 01/11/2023]
Abstract
Psychiatry and neuroscience research need novel approaches to indirectly investigate brain function. As the retina is an anatomical and developmental extension of the central nervous system (CNS), changes in retinal function may reflect neurological dysfunctions in psychiatric disorders. The last and most integrated retinal relay before visual information transfer to the brain is the ganglion cell layer. Here, based on collected arguments, we argue that these cells offer a crucial site for indirectly investigating brain function. We describe the anatomical and physiological properties of these cells together with measurements of their functional properties named pattern electroretinogram (PERG). Based on ganglion cell dysfunctions measured with PERG in neurological disorders, we argue for the relevance of studying ganglion cell function in psychiatric research. We review studies that have evaluated ganglion cell function in psychiatric and addictive disorders and discuss how changes in PERG measurements could be functional markers of pathophysiological mechanisms of psychiatric disorders.
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Affiliation(s)
- Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adulte du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; EA7298, INGRES, Université de Lorraine, Vandœuvre-lès-Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adulte du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; EA7298, INGRES, Université de Lorraine, Vandœuvre-lès-Nancy, France; Maison des Addictions, CHRU Nancy, Nancy, France
| | - Emanuel Bubl
- Saarland University Medical Center, Department for Psychiatry and Psychotherapy, Homburg, Germany
| | - Laurence Lalanne
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | | | - Vincent Laprevote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adulte du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; EA7298, INGRES, Université de Lorraine, Vandœuvre-lès-Nancy, France; Maison des Addictions, CHRU Nancy, Nancy, France
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38
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Nguyen CTO, Hui F, Charng J, Velaedan S, van Koeverden AK, Lim JKH, He Z, Wong VHY, Vingrys AJ, Bui BV, Ivarsson M. Retinal biomarkers provide "insight" into cortical pharmacology and disease. Pharmacol Ther 2017; 175:151-177. [PMID: 28174096 DOI: 10.1016/j.pharmthera.2017.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The retina is an easily accessible out-pouching of the central nervous system (CNS) and thus lends itself to being a biomarker of the brain. More specifically, the presence of neuronal, vascular and blood-neural barrier parallels in the eye and brain coupled with fast and inexpensive methods to quantify retinal changes make ocular biomarkers an attractive option. This includes its utility as a biomarker for a number of cerebrovascular diseases as well as a drug pharmacology and safety biomarker for the CNS. It is a rapidly emerging field, with some areas well established, such as stroke risk and multiple sclerosis, whereas others are still in development (Alzheimer's, Parkinson's, psychological disease and cortical diabetic dysfunction). The current applications and future potential of retinal biomarkers, including potential ways to improve their sensitivity and specificity are discussed. This review summarises the existing literature and provides a perspective on the strength of current retinal biomarkers and their future potential.
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Affiliation(s)
- Christine T O Nguyen
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia.
| | - Flora Hui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jason Charng
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Shajan Velaedan
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Anna K van Koeverden
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jeremiah K H Lim
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Vickie H Y Wong
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Bang V Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Magnus Ivarsson
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
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Kalenderoglu A, Çelik M, Sevgi-Karadag A, Egilmez OB. Optic coherence tomography shows inflammation and degeneration in major depressive disorder patients correlated with disease severity. J Affect Disord 2016; 204:159-65. [PMID: 27344626 DOI: 10.1016/j.jad.2016.06.039] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/09/2016] [Accepted: 06/11/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous research has consistently detected inflammation in the etiology of depression and neuroimaging studies have demonstrated gray matter abnormalities implying a neurodegenerative process in depression. The aim of this study was to compare ganglion cell layer (GCL), and inner plexiform layer (IPL) volumes and retinal nerve fiber layer (RNFL) thickness between first episode and recurrent major depressive disorder (MDD) patients and controls using optic coherence tomography (OCT) in order to detect findings supporting a degenerative process. Also choroid thicknesses of the same groups were compared to examine effects of inflammation on MDD. METHODS This study included 50 recurrent MDD patients, 50 first episode MDD patients and 50 controls. OCT measurements were performed by a spectral OCT device. GCL and IPL volumes and RNFL and choroid thicknesses were measured automatically by the device. RESULTS GCL and IPL volumes were significantly smaller in recurrent depression patients than first episode patients and in all MDD patients than controls. Also there were significant negative correlations between their volumes and disease severity parameters such as Ham-D and CGI scores, and disease duration. RNFL thicknesses were also lower in recurrent MDD patients than first episode patients and all MDD patients than controls but statistical significance was achieved only for global RNFL and temporal superior RNFL. Mean choroid thickness was higher in MDD patients than controls and in first episode MDD patients than recurrent MDD patients. LIMITATIONS Cross-sectional design of our study limits conclusions about progressive degeneration during the course of MDD. Lack of a control neuroimaging method like magnetic resonance imaging makes it hard to draw firm conclusions from our results. CONCLUSIONS OCT finding of decreased GCL and IPL volumes supports previous research suggesting degeneration in MDD. OCT may be an important tool to track neurodegeneration in patients with major depression. Considering RNFL to be the latest layer that will be affected during course of degeneration, GCL and IPL volumes appear to be better parameters to follow. In addition, choroid may be an important structure to detect acute attack period and to follow inflammatory process in MDD like in systemic inflammatory diseases.
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Affiliation(s)
- Aysun Kalenderoglu
- Psychiatry Department of Adiyaman University Medical School, Adiyaman, Turkey
| | - Mustafa Çelik
- Psychiatry Department of Adiyaman University Medical School, Adiyaman, Turkey.
| | - Ayse Sevgi-Karadag
- Ophthalmology Department of Adiyaman University Medical School, Adiyaman, Turkey
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40
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Yıldız M, Alim S, Batmaz S, Demir S, Songur E, Ortak H, Demirci K. Duration of the depressive episode is correlated with ganglion cell inner plexifrom layer and nasal retinal fiber layer thicknesses: Optical coherence tomography findings in major depression. Psychiatry Res Neuroimaging 2016; 251:60-66. [PMID: 27124425 DOI: 10.1016/j.pscychresns.2016.04.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 04/17/2016] [Indexed: 01/20/2023]
Abstract
Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases. Since the axons in retinal nerve fiber layer (RNFL) are nonmyelinated within the retina, OCT has been used in various neurodegenerative diseases to visualize the process of neurodegeneration. Decreases in RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses were observed in patients with schizophrenia. To date, there is no clinical research investigating OCT parameters in patients with MD. We compared the RNFL thickness, GCIPL thickness in 58 MD patients and 57 healthy controls, and investigated their correlation with clinical variables of depression. Depressed patients were not different from the healthy controls with regard to OCT parameters. GCIPL and nasal RNFL were correlated with the duration of the latest depressive episode. Some measures of OCT were negatively associated with clinical variables like a family history of psychiatric diagnosis and the duration of the latest episode. Larger studies including depressed patients of different severity, including structured interviews and controlling for the effect of antidepressant treatment will provide better results.
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Affiliation(s)
- Mesut Yıldız
- Department of Psychiatry, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey.
| | - Sait Alim
- Department of Ophthalmology, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Sedat Batmaz
- Department of Psychiatry, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Selim Demir
- Department of Ophthalmology, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Emrah Songur
- Department of Psychiatry, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Hüseyin Ortak
- Department of Ophthalmology, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Kadir Demirci
- Department of Psychiatry, Süleyman Demirel University, Faculty of Medicine, Isparta, Turkey
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The emerging field of retinal electrophysiological measurements in psychiatric research: A review of the findings and the perspectives in major depressive disorder. J Psychiatr Res 2015; 70:113-20. [PMID: 26424430 DOI: 10.1016/j.jpsychires.2015.09.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 08/15/2015] [Accepted: 09/08/2015] [Indexed: 02/08/2023]
Abstract
Major depressive disorder (MDD) is a severe mental illness leading to long-term disabilities. One of the current challenges in psychiatric research is to develop new approaches to investigate the pathophysiology of MDD and monitor drug response in order to provide better therapeutic strategies to the patients. Since the retina is considered as part of the central nervous system, it was suggested that it constitutes an appropriate site to investigate mental illnesses. In the past years, several teams assessed the retinal function of patients with mood disorders and many relevant abnormalities have been reported. Investigation of the retinal electrophysiological abnormalities in MDD remains a young emerging field, but we believe that the current findings are very promising and we argue that objective retinal electrophysiological measurements may eventually become relevant tools to investigate the pathophysiology of MDD. Here, we review the retinal abnormalities detected with objective electrophysiological measurements such as the flash electroretinogram (fERG), the pattern electroretinogram (PERG) and the electrooculogram (EOG) in patients with MDD. We discuss how these changes might reflect the pathophysiology of MDD in both clinical and scientific points of view, according especially to the monoamine neurotransmission deficiency hypothesis. We also discuss the technical details that must be taken into consideration for a potential use of the objective retinal electrophysiological measurements as tools to investigate the pathophysiology of MDD.
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Tebartz van Elst L, Bach M, Blessing J, Riedel A, Bubl E. Normal Visual Acuity and Electrophysiological Contrast Gain in Adults with High-Functioning Autism Spectrum Disorder. Front Hum Neurosci 2015; 9:460. [PMID: 26379525 PMCID: PMC4549567 DOI: 10.3389/fnhum.2015.00460] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/06/2015] [Indexed: 12/29/2022] Open
Abstract
A common neurodevelopmental disorder, autism spectrum disorder (ASD), is defined by specific patterns in social perception, social competence, communication, highly circumscribed interests, and a strong subjective need for behavioral routines. Furthermore, distinctive features of visual perception, such as markedly reduced eye contact and a tendency to focus more on small, visual items than on holistic perception, have long been recognized as typical ASD characteristics. Recent debate in the scientific community discusses whether the physiology of low-level visual perception might explain such higher visual abnormalities. While reports of this enhanced, "eagle-like" visual acuity contained methodological errors and could not be substantiated, several authors have reported alterations in even earlier stages of visual processing, such as contrast perception and motion perception at the occipital cortex level. Therefore, in this project, we have investigated the electrophysiology of very early visual processing by analyzing the pattern electroretinogram-based contrast gain, the background noise amplitude, and the psychophysical visual acuities of participants with high-functioning ASD and controls with equal education. Based on earlier findings, we hypothesized that alterations in early vision would be present in ASD participants. This study included 33 individuals with ASD (11 female) and 33 control individuals (12 female). The groups were matched in terms of age, gender, and education level. We found no evidence of altered electrophysiological retinal contrast processing or psychophysical measured visual acuities. There appears to be no evidence for abnormalities in retinal visual processing in ASD patients, at least with respect to contrast detection.
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Affiliation(s)
- Ludger Tebartz van Elst
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
| | - Michael Bach
- Section Visual Function, Eye Center, University Medical Center, Freiburg, Germany
| | - Julia Blessing
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
| | - Andreas Riedel
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
| | - Emanuel Bubl
- Section for Experimental Neuropsychiatry, Department for Psychiatry and Psychotherapy, Albert-Ludwigs-University, Freiburg, Germany
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Retinal dysfunction of contrast processing in major depression also apparent in cortical activity. Eur Arch Psychiatry Clin Neurosci 2015; 265:343-50. [PMID: 25567477 DOI: 10.1007/s00406-014-0573-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/26/2014] [Indexed: 12/19/2022]
Abstract
Depressive disorder is often associated with the subjective experience of altered visual perception. Recent research has produced growing evidence for involvement of the visual system in the pathophysiology of depressive disorder. Using the pattern electroretinogram (PERG), we found reduced retinal contrast response in patients with major depression. Based on this observation, the question arises whether this change has a cortical correlate. To evaluate this, we analyzed the visual evoked potential (VEP) of the occipital cortex in 40 patients with depressive disorder and 28 healthy controls. As visual stimuli, checkerboard stimuli of 0.51° check size, 12.5 reversals per second and a contrast of 3-80% was used. In addition to the PERG, we recorded the VEP with an Oz versus FPz derivation. The amplitude versus contrast transfer function was compared across the two groups and correlated with the severity of depression, as measured by the Hamilton Depression Rating Scale and the Beck Depression Inventory. Patients with major depression displayed significantly reduced VEP amplitudes at all contrast levels compared to control subjects (p = 0.029). The VEP amplitude correlated with psychometric measures for severity of depression. The degree of depression reduced the contrast transfer function in the VEP to a lesser extent than in the PERG: While the PERG is reduced to ≈50%, the VEP is reduced to 75%. Our results suggest that depression affects the cortical response in major depression, but less so than the retinal responses. Modified contrast adaptation in the lateral geniculate nucleus or cortex possibly moderates the increased losses in the retina.
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Bubl E, Dörr M, Riedel A, Ebert D, Philipsen A, Bach M, Tebartz van Elst L. Elevated background noise in adult attention deficit hyperactivity disorder is associated with inattention. PLoS One 2015; 10:e0118271. [PMID: 25693192 PMCID: PMC4333120 DOI: 10.1371/journal.pone.0118271] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 01/12/2015] [Indexed: 12/21/2022] Open
Abstract
Background Inattention and distractibility are core symptoms of attention deficit hyperactivity disorder (ADHD). Still the neuronal organization is largely unknown. Previously we studied the electrophysiological activity of a distinct neuronal network—the retina—and found no change in stimulus-driven neural activity in patients with ADHD. However there is growing evidence for an elevated non stimulus-driven neural activity, or neuronal background noise, as underlying pathophysiological correlate. To further examine the biological bases that might underlie ADHD and problems with inattention, we performed a new analysis to test the hypothesis of an elevated background noise as underlying neuronal correlate for ADHD and problems with inattention in humans. A direct measure of background noise in patients with ADHD has not been described yet. Methods The retinal background noise was assessed based on pattern electroretinogram (PERG) data in 20 unmedicated ADHD patients and 20 healthy controls. The PERG is an electrophysiological measure for retinal ganglion cell function. ADHD severity was assessed by interview and questionnaire. Results Noise amplitude was significantly higher (138%) in patients with ADHD compared to the control group (p = 0.0047). Noise amplitude correlated significantly with psychometric measures for ADHD (CAARS) especially inattention (r = 0.44, p = 0.004). Conclusions The data provide evidence that an elevated background noise is associated with symptoms of inattention in ADHD and support the use of therapeutic interventions that reduce noise and distraction in patients with ADHD.
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Affiliation(s)
- Emanuel Bubl
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
- * E-mail:
| | - Michael Dörr
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Andreas Riedel
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
| | - Michael Bach
- University Eye Hospital, Albert-Ludwigs-University of Freiburg, Killianstrasse 5, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Albert-Ludwigs-University of Freiburg, Hauptstrasse 5, Freiburg, Germany
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Clark CM, Chiu CG, Diaz RL, Goghari VM. Intact anger recognition in depression despite aberrant visual facial information usage. J Affect Disord 2014; 165:196-202. [PMID: 24882200 DOI: 10.1016/j.jad.2014.04.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 04/25/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous literature has indicated abnormalities in facial emotion recognition abilities, as well as deficits in basic visual processes in major depression. However, the literature is unclear on a number of important factors including whether or not these abnormalities represent deficient or enhanced emotion recognition abilities compared to control populations, and the degree to which basic visual deficits might impact this process. METHODS The present study investigated emotion recognition abilities for angry versus neutral facial expressions in a sample of undergraduate students with Beck Depression Inventory-II (BDI-II) scores indicative of moderate depression (i.e., ≥20), compared to matched low-BDI-II score (i.e., ≤2) controls via the Bubbles Facial Emotion Perception Task. RESULTS Results indicated unimpaired behavioural performance in discriminating angry from neutral expressions in the high depressive symptoms group relative to the minimal depressive symptoms group, despite evidence of an abnormal pattern of visual facial information usage. LIMITATIONS The generalizability of the current findings is limited by the highly structured nature of the facial emotion recognition task used, as well as the use of an analog sample undergraduates scoring high in self-rated symptoms of depression rather than a clinical sample. CONCLUSIONS Our findings suggest that basic visual processes are involved in emotion recognition abnormalities in depression, demonstrating consistency with the emotion recognition literature in other psychopathologies (e.g., schizophrenia, autism, social anxiety). Future research should seek to replicate these findings in clinical populations with major depression, and assess the association between aberrant face gaze behaviours and symptom severity and social functioning.
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Affiliation(s)
- Cameron M Clark
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada T2N 1N4
| | - Carina G Chiu
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada T2N 1N4
| | - Ruth L Diaz
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada T2N 1N4
| | - Vina M Goghari
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada T2N 1N4.
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Hosono Y, Kitaoka K, Urushihara R, Séi H, Kinouchi Y. Anxiety affects the amplitudes of red and green color-elicited flash visual evoked potentials in humans. THE JOURNAL OF MEDICAL INVESTIGATION 2014; 61:79-83. [PMID: 24705753 DOI: 10.2152/jmi.61.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
It has been reported that negative emotional changes and conditions affect the visual faculties of humans at the neural level. On the other hand, the effects of emotion on color perception in particular, which are based on evoked potentials, are unknown. In the present study, we investigated whether different anxiety levels affect the color information processing for each of 3 wavelengths by using flash visual evoked potentials (FVEPs) and State-Trait Anxiety Inventory. In results, significant positive correlations were observed between FVEP amplitudes and state or trait anxiety scores in the long (sensed as red) and middle (sensed as green) wavelengths. On the other hand, short-wavelength-evoked FVEPs were not correlated with anxiety level. Our results suggest that negative emotional conditions may affect color sense processing in humans.
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Affiliation(s)
- Yuki Hosono
- Department of Integrative Physiology, Institute of Health Biosciences, the University of Tokushima Graduate School
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Fitzgerald PJ. Gray colored glasses: is major depression partially a sensory perceptual disorder? J Affect Disord 2013; 151:418-422. [PMID: 23906865 DOI: 10.1016/j.jad.2013.06.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 06/15/2013] [Accepted: 06/19/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depression is a neuropsychiatric disorder that can involve profound dysregulation of mood. While depression is associated with additional abnormalities besides reduced mood, such as cognitive dysfunction, it is not well established that sensory perception is also altered in this disorder (aside from in psychotic depression). Recent studies have shown that visual processing, in as early a stage as the retina, is impaired in depression. This paper examines the hypothesis that major depression can involve alterations in sensory perception. METHODS A Pubmed literature search investigated several lines of evidence: innervation of sensory cortex by serotonin and norepinephrine; antidepressant drugs and depression itself affecting processing of facial expressions of emotion; electroencephalography (EEG) studies of depressed persons and antidepressant drugs; involvement of the serotonergic 5HT2A receptor in both depression and hallucinogenic drug action; psychotic depression involving sensory distortions; dopamine possibly playing a role in depression; and the antidepressant effect of blocking the NMDA receptor with ketamine. RESULTS Data from each of these lines of evidence support the hypothesis that major depression can involve sensory perceptual alterations. CONCLUSIONS Loss of interest in one's daily activities and inability to experience pleasure, also known as anhedonia, in major depression may in part be mediated by sensory abnormalities, whereby normal sensory perceptions are no longer present to activate reward circuitry. LIMITATIONS The data supporting the hypothesis tend to be associative, so further confirmation of the hypothesis awaits additional controlled experiments.
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Affiliation(s)
- Paul J Fitzgerald
- Department of Psychology, Room 3200 ILSB, Texas A&M University, College Station, TX 77843-4235, USA.
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Eramudugolla R, Wood J, Anstey KJ. Co-morbidity of depression and anxiety in common age-related eye diseases: a population-based study of 662 adults. Front Aging Neurosci 2013; 5:56. [PMID: 24106477 PMCID: PMC3788339 DOI: 10.3389/fnagi.2013.00056] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 09/09/2013] [Indexed: 12/16/2022] Open
Abstract
This study examined the prevalence of co-morbid age-related eye disease and symptoms of depression and anxiety in late life, and the relative roles of visual function and disease in explaining symptoms of depression and anxiety. A community-based sample of 662 individuals aged over 70 years was recruited through the electoral roll. Vision was measured using a battery of tests including high and low contrast visual acuity, contrast sensitivity, motion sensitivity, stereoacuity, Useful Field of View, and visual fields. Depression and anxiety symptoms were measured using the Goldberg scales. The prevalence of self-reported eye disease [cataract, glaucoma, or age-related macular degeneration (AMD)] in the sample was 43.4%, with 7.7% reporting more than one form of ocular pathology. Of those with no eye disease, 3.7% had clinically significant depressive symptoms. This rate was 6.7% among cataract patients, 4.3% among those with glaucoma, and 10.5% for AMD. Generalized linear models adjusting for demographics, general health, treatment, and disability examined self-reported eye disease and visual function as correlates of depression and anxiety. Depressive symptoms were associated with cataract only, AMD, comorbid eye diseases and reduced low contrast visual acuity. Anxiety was significantly associated with self-reported cataract, and reduced low contrast visual acuity, motion sensitivity and contrast sensitivity. We found no evidence for elevated rates of depressive or anxiety symptoms associated with self-reported glaucoma. The results support previous findings of high rates of depression and anxiety in cataract and AMD, and in addition show that mood and anxiety are associated with objective measures of visual function independently of self-reported eye disease. The findings have implications for the assessment and treatment of mental health in the context of late-life visual impairment.
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Affiliation(s)
- Ranmalee Eramudugolla
- Centre for Research on Ageing Health and Wellbeing, The Australian National University Canberra, ACT, Australia
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Hyett M, Parker G. Loss of light in the eyes: A window to melancholia. Med Hypotheses 2013; 81:186-91. [DOI: 10.1016/j.mehy.2013.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/15/2013] [Indexed: 12/15/2022]
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50
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Visual contrast sensitivity in major depressive disorder. J Psychosom Res 2013; 75:83-6. [PMID: 23751244 DOI: 10.1016/j.jpsychores.2013.03.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 03/12/2013] [Accepted: 03/15/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Through the eyes of those depressed, the world may appear dull and gray. Visual contrast sensitivity has recently been reported to be lower in depressed patients compared to healthy controls. We aimed to examine the consistency of this finding and to explore the underlying retinal electrophysiology. METHODS Twenty subjects with major depressive disorder and 20 matched healthy controls were studied. Pattern electroretinogram (PERG) and subjective visual contrast test were used to assess visual contrast sensitivity. Full-field electroretinography (ffERG) was additionally used to assess retinal neurophysiology. Depression was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and depression severity was measured using standard psychometric scales. RESULTS Visual contrast sensitivity was significantly lower in depressed patients compared to controls based on the Landolt C visual contrast test, but no difference was found between groups using PERG and ffERG. Greater severity of depressive symptoms correlated (r=0.49, p=0.001) with poorer visual contrast sensitivity. CONCLUSIONS Depressed subjects had reduced visual contrast discrimination performance, but this finding could not be consistently determined using PERG. The neurobiological link between major depressive disorder and visual contrast sensitivity warrants further investigation.
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