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Park YM. Relationship between SSRI-induced sexual dysfunction and central serotonergic activity based on the loudness dependence of auditory evoked potentials. Psychopharmacology (Berl) 2014; 231:551-5. [PMID: 24005532 DOI: 10.1007/s00213-013-3265-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 08/22/2013] [Indexed: 11/28/2022]
Abstract
RATIONALE It has been hypothesized that selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction can occur more frequently in patients with higher central serotonergic activity, and that this higher serotonergic activity can induce inhibition of sexual desire, ejaculation, and orgasm. Thus, the aim of this study was to determine the relationship between SSRI-induced sexual dysfunction and increased serotonin. METHOD Event-related potentials for the loudness dependence of auditory evoked potentials (LDAEP) were measured in 46 patients at a single time point. The subjects' scores on the Hamilton Depression Rating Scale and Antidepressant Side-Effect Checklist were also determined by the investigators at the same time point. All patients had received SSRI monotherapy. RESULTS Overall, 37 % (17/46) of the patients experienced some form of SSRI-induced sexual dysfunction: lack of sexual desire, impotence, orgasm, and menstrual abnormality or mastalgia were experienced by 21.7, 8.3, 15.2, and 20.6 % of the patients, respectively. The subjects were thus divided into two groups-those with and without sexual dysfunction-and their data were compared. There was a tendency for the LDAEP to be lower in the group with sexual dysfunction (1.04 ± 0.77 μV) than the group without sexual dysfunction (1.45 ± 0.86 μV), although the difference was not statistically significant (p = 0.086). Furthermore, the distribution of the frequency of SSRI-induced sexual dysfunction differed marginally significantly between patients with low and high LDAEP, dichotomized according to the median LDAEP on the Cz electrode (χ (2) = 3.664, p = 0.056). CONCLUSIONS There was a relatively high frequency of SSRI-induced sexual dysfunction in patients with low LDAEP.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, 2240, Daehwa-Dong, Ilsan Seo-Gu, Goyang, 411-706, Republic of Korea,
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Van Rheenen TE, Rossell SL. Auditory-prosodic processing in bipolar disorder; from sensory perception to emotion. J Affect Disord 2013; 151:1102-7. [PMID: 24074483 DOI: 10.1016/j.jad.2013.08.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 08/30/2013] [Accepted: 08/30/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Accurate emotion processing is critical to understanding the social world. Despite growing evidence of facial emotion processing impairments in patients with bipolar disorder (BD), comprehensive investigations of emotional prosodic processing is limited. The existing (albeit sparse) literature is inconsistent at best, and confounded by failures to control for the effects of gender or low level sensory-perceptual impairments. The present study sought to address this paucity of research by utilizing a novel behavioural battery to comprehensively investigate the auditory-prosodic profile of BD. METHODS Fifty BD patients and 52 healthy controls completed tasks assessing emotional and linguistic prosody, and sensitivity for discriminating tones that deviate in amplitude, duration and pitch. RESULTS BD patients were less sensitive than their control counterparts in discriminating amplitude and durational cues but not pitch cues or linguistic prosody. They also demonstrated impaired ability to recognize happy intonations; although this was specific to male's with the disorder. The recognition of happy in the patient group was correlated with pitch and amplitude sensitivity in female patients only. LIMITATIONS The small sample size of patients after stratification by current mood state prevented us from conducting subgroup comparisons between symptomatic, euthymic and control participants to explicitly examine the effects of mood. CONCLUSIONS Our findings indicate the existence of a female advantage for the processing of emotional prosody in BD, specifically for the processing of happy. Although male BD patients were impaired in their ability to recognize happy prosody, this was unrelated to reduced tone discrimination sensitivity. This study indicates the importance of examining both gender and low order sensory perceptual capacity when examining emotional prosody.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Brain and Psychological Sciences Research Centre, Swinburne University, Melbourne, VIC 3122, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC 3004, Australia.
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Olbrich S, Arns M. EEG biomarkers in major depressive disorder: discriminative power and prediction of treatment response. Int Rev Psychiatry 2013; 25:604-18. [PMID: 24151805 DOI: 10.3109/09540261.2013.816269] [Citation(s) in RCA: 184] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Major depressive disorder (MDD) has high population prevalence and is associated with substantial impact on quality of life, not least due to an unsatisfactory time span of sometimes several weeks from initiation of treatment to clinical response. Therefore extensive research focused on the identification of cost-effective and widely available electroencephalogram (EEG)-based biomarkers that not only allow distinguishing between patients and healthy controls but also have predictive value for treatment response for a variety of treatments. In this comprehensive overview on EEG research on MDD, biomarkers that are either assessed at baseline or during the early course of treatment and are helpful in discriminating patients from healthy controls and assist in predicting treatment outcome are reviewed, covering recent decades up to now. Reviewed markers include quantitative EEG (QEEG) measures, connectivity measures, EEG vigilance-based measures, sleep-EEG-related measures and event-related potentials (ERPs). Further, the value and limitations of these different markers are discussed. Finally, the need for integrated models of brain function and the necessity for standardized procedures in EEG biomarker research are highlighted to enhance future research in this field.
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Affiliation(s)
- Sebastian Olbrich
- Clinic for Psychiatry and Psychotherapy, University Hospital Leipzig , Germany
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Park YM, Lee SH. Clinical Usefulness of Loudness Dependence of Auditory Evoked Potentials (LDAEP) in Patients with Bipolar Disorder. Psychiatry Investig 2013; 10:233-7. [PMID: 24302945 PMCID: PMC3843014 DOI: 10.4306/pi.2013.10.3.233] [Citation(s) in RCA: 13] [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: 08/05/2013] [Revised: 08/06/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
While it has been reported previously that the loudness dependence of auditory evoked potentials (LDAEP) is a putative biological marker or a predictor of treatment response, there have been few studies of LDAEP in bipolar disorder. However, a recent study by Park and colleagues raised the possibility that the LDAEP could be useful as a biological marker of bipolar disorder. They found that the LDAEP was significantly higher in normal controls than in patients with either bipolar disorder or schizophrenia. Lee and colleagues also examined the LDAEP in bipolar disorder and normal controls, and found that it differed according to the bipolar phase, being significantly higher in cases of euthymic bipolar disorder, bipolar depression, and bipolar mania. With regard to treatment response, early clinical findings were that a higher LDAEP and a stronger intensity dependence of visual evoked potentials were related to a favorable response to lithium treatment. Juckel and colleagues recently demonstrated that the pretreatment LDAEP could be a predictor of successful prophylactic lithium treatment. The present article reviews the literature in order to determine whether the LDAEP can be used as a biological marker or a predictor of treatment response in patients with bipolar disorder and of manic switch or treatment resistance in patients with major depressive episode(s).
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
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Jaworska N, Protzner A. Electrocortical features of depression and their clinical utility in assessing antidepressant treatment outcome. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:509-14. [PMID: 24099498 DOI: 10.1177/070674371305800905] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Major depressive disorder (MDD) is primarily characterized by decreased affect and accompanying behavioural consequences, but it is also associated with cognitive dysfunction. Assessment of electroencephalographic (EEG) activity and associated event-related potentials (ERPs; derived from averaged EEG activity in response to a stimulus) in the context of MDD has provided insights into the electrocortical abnormalities associated with the disorder. Importantly, EEG and ERPs also have emerged as candidates for predicting and optimizing antidepressant (AD) treatment outcome. This is critical in light of relatively low remission rates or a limited response to initial AD interventions. In contrast to other neuroimaging approaches, EEG and ERPs may be superior for predicting and monitoring AD response, as electrocortical measures are relatively inexpensive, easy to use, and have excellent temporal (that is, millisecond) resolution, enabling fine-grained assessment of basic cognitive and emotive processes. This review aims to highlight the most consistently noted EEG and ERP features in MDD, which may one day assist with diagnostic confirmation, as well as the potential clinical utility of specific electrocortical measures in aiding with response prediction.
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Affiliation(s)
- Natalia Jaworska
- Postdoctoral Fellow, Department of Psychiatry, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta
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Wyss C, Hitz K, Hengartner MP, Theodoridou A, Obermann C, Uhl I, Roser P, Grünblatt E, Seifritz E, Juckel G, Kawohl W. The loudness dependence of auditory evoked potentials (LDAEP) as an indicator of serotonergic dysfunction in patients with predominant schizophrenic negative symptoms. PLoS One 2013; 8:e68650. [PMID: 23874705 PMCID: PMC3709903 DOI: 10.1371/journal.pone.0068650] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 05/31/2013] [Indexed: 11/18/2022] Open
Abstract
Besides the influence of dopaminergic neurotransmission on negative symptoms in schizophrenia, there is evidence that alterations of serotonin (5-HT) system functioning also play a crucial role in the pathophysiology of these disabling symptoms. From post mortem and genetic studies on patients with negative symptoms a 5-HT dysfunction is documented. In addition atypical neuroleptics and some antidepressants improve negative symptoms via serotonergic action. So far no research has been done to directly clarify the association between the serotonergic functioning and the extent of negative symptoms. Therefore, we examined the status of brain 5-HT level in negative symptoms in schizophrenia by means of the loudness dependence of auditory evoked potentials (LDAEP). The LDAEP provides a well established and non-invasive in vivo marker of the central 5-HT activity. We investigated 13 patients with schizophrenia with predominant negative symptoms treated with atypical neuroleptics and 13 healthy age and gender matched controls with a 32-channel EEG. The LDAEP of the N1/P2 component was evaluated by dipole source analysis and single electrode estimation at Cz. Psychopathological parameters, nicotine use and medication were assessed to control for additional influencing factors. Schizophrenic patients showed significantly higher LDAEP in both hemispheres than controls. Furthermore, the LDAEP in the right hemisphere in patients was related to higher scores in scales assessing negative symptoms. A relationship with positive symptoms was not found. These data might suggest a diminished central serotonergic neurotransmission in patients with predominant negative symptoms.
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Affiliation(s)
- Christine Wyss
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Konrad Hitz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Michael P. Hengartner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Caitriona Obermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Idun Uhl
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Patrik Roser
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Zurich, Switzerland
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Jaworska N, Blondeau C, Tessier P, Norris S, Fusee W, Blier P, Knott V. Response prediction to antidepressants using scalp and source-localized loudness dependence of auditory evoked potential (LDAEP) slopes. Prog Neuropsychopharmacol Biol Psychiatry 2013; 44:100-7. [PMID: 23360662 PMCID: PMC3654010 DOI: 10.1016/j.pnpbp.2013.01.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/12/2013] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
Abstract
The loudness-dependence of the auditory evoked potential (LDAEP) slope may be inversely related to serotonin (5-HT) neurotransmission. Thus, steep LDAEPs tend to predict a positive response to selective serotonin reuptake inhibitor (SSRI) antidepressants, which augment 5-HT. However, LDAEPs also predict outcome to antidepressants indirectly altering 5-HT (e.g. bupropion). Hence, the LDAEP's predicative specificity and sensitivity to antidepressant response/outcome remains elusive. Scalp N1, P2 and N1/P2 LDAEP slopes and standardized low resolution brain electromagnetic tomography (sLORETA)-localized N1 and P2 LDAEP slopes were assessed in depressed individuals (N=51) at baseline, 1 and 12 weeks post-treatment with one of three antidepressant regimens [escitalopram (ESC)+bupropion (BUP), ESC or BUP]. Clinical response was greatest with ESC+BUP at week 1. Treatment responders had steep N1 sLORETA-LDAEP baseline slopes while non-responders had shallow ones. P2 sLORETA-LDAEP slope increases at 1 week existed in responders; decreases were noted in non-responders. Exploratory analyses indicated that more BUP and ESC responders versus non-responders had steep baseline N1 sLORETA-LDAEP slopes. Additionally, slight decreases in scalp P2 LDAEP by week 1 existed for ESC treatment, while slope increases existed with ESC+BUP treatment. Only baseline N1 sLORETA-LDAEP discriminated treatment responders/non-responders. This work confirms that certain LDAEP measures are associated with treatment outcome and appear to be differentially modulated with varying antidepressant drug regimens, though this should be confirmed using larger samples.
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Affiliation(s)
- Natalia Jaworska
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Claude Blondeau
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Pierre Tessier
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Sandhaya Norris
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Wendy Fusee
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
,Departments of Psychiatry & Cellular and Molecular Medicine, University of Ottawa
| | - Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
,Department of Psychology, University of Ottawa, Ottawa, ON, Canada
,Departments of Psychiatry & Cellular and Molecular Medicine, University of Ottawa
,Department of Psychology/Behavioural Neuroscience, Carleton University, Ottawa, ON, Canada
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Park YM, Lee SH. Can the Loudness Dependence of Auditory Evoked Potentials and Suicidality Be Used to Differentiate between Depressive Patients with and without Bipolarity. Psychiatry Investig 2013; 10:143-7. [PMID: 23798962 PMCID: PMC3687048 DOI: 10.4306/pi.2013.10.2.143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/04/2013] [Accepted: 01/08/2013] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE This study aimed to test the hypothesis that the loudness dependence of auditory evoked potentials (LDAEP) can be used to predict the presence of bipolarity in patients with major depressive episodes. METHODS A cohort of 61 patients who met the criteria for major depressive disorder (MDD) following diagnosis using Axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision, and who had no history of hypomanic or manic episodes was included in this study. The patients were stratified into two subgroups based on whether or not they achieved a positive score for the Korean versions of the Mood Disorder Questionnaire (K-MDQ). The LDAEP was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. RESULTS The Barratt Impulsiveness Scale (BIS) score was also higher for the positive screening group (81.24±11.87) than for the negative screening group (73.30±14.92; p=0.039, independent t-test). However, the LDAEP, Beck Depression Inventory, Hamilton Depression Rating Scale, Beck Hopelessness Scale (BHS), and Hamilton Anxiety Scale scores did not differ significantly between them. When binary logistic regression analysis was carried, the relationship between the positive or negative subgroups for K-MDQ and BIS or Beck Scale for Suicidal Ideation (BSS) score was also significant (respectively, p=0.017, p=0.038). CONCLUSION We found that LDAEP was not significantly different between depressive patients with and without bipolarity. However, our study has revealed the difference between two subgroups based on whether or not they achieved a positive score for the K-MDQ in BIS or BSS score.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
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Park YM, Lee SH, Lee HJ, Kang SG, Min JA, Chae JH. Association between BDNF gene polymorphisms and serotonergic activity using loudness dependence of auditory evoked potentials in healthy subjects. PLoS One 2013; 8:e60340. [PMID: 23593198 PMCID: PMC3621878 DOI: 10.1371/journal.pone.0060340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 02/25/2013] [Indexed: 11/18/2022] Open
Abstract
It has been proposed that the loudness dependence of auditory evoked potentials (LDAEP) would be a reliable indicator of central serotonin system activity in humans. Serotonin levels and turnover are also increased by brain-derived neurotrophic factor (BDNF). The aim of the present study was to determine whether there is an association between genetic polymorphisms of BDNF and the LDAEP in healthy Korean young adults. The cohort comprised 211 mentally and physically healthy subjects, all of whom were nonsmokers (111 males, 100 females; age: 20∼32 years). To avoid hormonal effects, the LDAEP was measured during days 2–5 after the beginning of menstruation for female subjects. In addition, BDNF polymorphisms (rs6265, rs2030324, and rs1491850) were genotyped. The strength of the LDAEP differed significantly among the BDNF genotype groups. Furthermore, the distribution of genotypic frequencies differed significantly between subjects with high and low LDAEPs. In particular, subjects with the Val/Met (A/G) genotype for rs6265, the T/T genotype for rs2030324, or the C/C genotype for rs1491850 had a higher LDAEP, indicating lower central serotonergic activity. A low LDAEP was more prevalent than a high LDAEP among those with the C-T haplotype (C genotype for rs2030424 and T genotype for rs1491850). Our results concur with previous findings on BDNF polymorphisms and serotonergic drug responses in psychiatric disorder patients. The present results suggest the possibility that BDNF polymorphisms and LDAEP patterns can predict altered serotonergic activity.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Inje University, Ilsan Paik Hospital, Goyang, Republic of Korea
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Clinical characteristics associated with different strengths of loudness dependence of auditory evoked potentials (LDAEP) in major depressive disorder. Psychiatry Res 2012; 200:374-81. [PMID: 23021319 DOI: 10.1016/j.psychres.2012.06.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/19/2012] [Accepted: 06/24/2012] [Indexed: 02/07/2023]
Abstract
Loudness dependence of auditory evoked potentials (LDAEP), also called as intensity dependence of auditory evoked potentials (IDAP), has been proposed as a potential marker for central serotonergic tone and has been noticed for its possible clinical implications in depression. However, its distributions in major depressive disorder (MDD) and factors affecting it are largely unknown. In this study, we examined its distribution and relationships with various demographic and clinical variables in MDD patients. In 143 MDD patients, the LDAEP was measured using five intensities of auditory stimulus. The influences of ten independent variables (age, gender, education years, marital status, psychiatric family history, age of onset, suicide attempt history, depression severity, later augmentation of mood stabilizer, and smoking status) on the LDAEP strength were examined using univariate analyses and data mining method. The mean (±S.D.) LDAEP was 0.90 (±0.73)μV/10dB (-0.78-3.83μV/10dB). Female gender, smoking, and being married were consistently associated with a weaker LDAEP. In the pathway model, sequential combination of being male, living alone, and older age predicted the strongest LDAEP, whereas female gender, older age, and smoking predicted the weakest LDAEP. These variables need to be considered when interpreting the LDAEP.
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Ostermann J, Uhl I, Köhler E, Juckel G, Norra C. The loudness dependence of auditory evoked potentials and effects of psychopathology and psychopharmacotherapy in psychiatric inpatients. Hum Psychopharmacol 2012; 27:595-604. [PMID: 24446538 DOI: 10.1002/hup.2269] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Many studies have provided evidence for the loudness dependence of auditory evoked potentials (LDAEP) as a marker for central serotonergic activity but remained inconclusive for its suitability in clinical use. METHODS A cross-sectional sample of 162 psychiatric inpatients (major depression N = 86, bipolar disorder N = 12, schizophrenia N = 50, and schizoaffective disorder N = 14) and 40 healthy subjects was retrospectively examined for LDAEP and effects of psychopathology and psychopharmacology. RESULTS The LDAEP was weaker in patients with affective disorders than in healthy subjects but did not differentiate between the total patient sample and healthy controls. LDAEP correlated significantly with dimensions of the Brief Symptom Inventory in the total patient sample (depression, paranoid ideation, psychoticism, Global Symptom Index, and Positive Symptom Distress Index), in patients with affective disorders (depression) and with schizophrenia spectrum disorders (depression, psychoticism, Global Symptom Index, and Positive Symptom Distress Index). Similar correlations were found in depressed patients with a single noradrenergic and specific serotonergic antidepressant or serotonin-norepinephrine reuptake inhibitor. There was a negative correlation between dosage of typical antipsychotics and LDAEP. Hypnotics generally led to a lower LDAEP. CONCLUSION The LDAEP in patients is related to severity of psychopathologic syndromes irrespective of diagnosis. Chronic psychopharmacologic treatment may also differentially modulate the LDAEP, but longitudinal studies are needed.
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Affiliation(s)
- Julia Ostermann
- Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, LWL University Hospital Bochum, Bochum, Germany
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Sandner G, Meyer L, Angst MJ, Guignard B, Guiberteau T, Mensah-Nyagan AG. Neonatal ventral hippocampal lesions modify pain perception and evoked potentials in rats. Behav Brain Res 2012; 234:167-74. [DOI: 10.1016/j.bbr.2012.06.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 06/20/2012] [Accepted: 06/22/2012] [Indexed: 01/27/2023]
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Jaworska N, Blier P, Fusee W, Knott V. Scalp- and sLORETA-derived loudness dependence of auditory evoked potentials (LDAEPs) in unmedicated depressed males and females and healthy controls. Clin Neurophysiol 2012; 123:1769-78. [DOI: 10.1016/j.clinph.2012.02.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 02/06/2012] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
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Lee KS, Park YM, Lee SH. Serotonergic dysfunction in patients with bipolar disorder assessed by the loudness dependence of the auditory evoked potential. Psychiatry Investig 2012; 9:298-306. [PMID: 22993531 PMCID: PMC3440481 DOI: 10.4306/pi.2012.9.3.298] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 06/15/2012] [Accepted: 06/17/2012] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The loudness dependence of the auditory evoked potential (LDAEP) is suggested to be a marker of serotonin system function. This study explored the LDAEP of multiple mood statuses (depression, mania, and euthymia) and its clinical implication in bipolar disorder patients. METHODS A total of 89 subjects, comprising 35 patients with bipolar disorder, 32 patients with schizophrenia, and 22 healthy controls were evaluated. The bipolar disorder cases comprised 10 depressed patients, 15 patients with mania, and 10 euthymic patients. The N1/P2 peak-to-peak amplitudes were measured at 5 stimulus intensities, and the LDAEP was calculated as the slope of the linear regression. Both cortical and source LDAEP values were calculated. RESULTS LDAEP varied according to mood statuses, and was significantly stronger in cases of euthymia, depression, and mania. Cortical LDAEP was significantly stronger in patients with bipolar euthymia compared with schizophrenia, stronger in bipolar depression than in schizophrenia, stronger in healthy controls than in schizophrenia patients, and stronger in healthy controls than in patients with bipolar mania. Source LDAEP was significantly stronger in patients with bipolar euthymia, bipolar depression, and bipolar mania compared with schizophrenia, stronger in bipolar euthymia than in bipolar mania. Psychotic features weakened the source LDAEP relative to nonpsychotic features. The severity of the depressive symptom was negatively correlated with source LDAEP. CONCLUSION These findings suggest that the serotonin activity of patients with bipolar disorder may vary according to mood status. A longitudinal follow-up study should be pursued using drug-naive subjects.
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Affiliation(s)
- Kyung-Sang Lee
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
| | - Young-Min Park
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
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Park YM, Lee SH, Park EJ. Usefulness of LDAEP to predict tolerability to SSRIs in major depressive disorder: a case report. Psychiatry Investig 2012; 9:80-2. [PMID: 22396689 PMCID: PMC3285746 DOI: 10.4306/pi.2012.9.1.80] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 09/28/2011] [Accepted: 10/05/2011] [Indexed: 12/03/2022] Open
Abstract
We report here a patient with major depressive disorder who experienced severe adverse effects after the administration of SSRIs (serotonin selective reuptake inhibitors) without improvement of his depressive symptoms. These adverse effects disappeared and his depressive symptoms improved after discontinuation of the SSRIs and the administration of tianeptine. The patient exhibited a low value for the loudness dependent of auditory evoked potentials (LDAEP) -0.14 at baseline, which means that his central serotonergic neurotransmission was already highly active. We assumed that it was this high serotonergic activity that rendered him unresponsive to SSRIs, and brought on him the adverse effects, and that the tianeptine was effective due to the lack of serotonin reuptake inhibitory action. Thus, we suggest that LDAEP can be used to predict an individual patient's tolerability and clinical response to SSRIs in major depression.
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Affiliation(s)
- Young-Min Park
- Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
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Uhl I, Krumova EK, Regeniter S, Bär KJ, Norra C, Richter H, Assion HJ, Westermann A, Juckel G, Maier C. Association between wind-up ratio and central serotonergic function in healthy subjects and depressed patients. Neurosci Lett 2011; 504:176-180. [PMID: 21964385 DOI: 10.1016/j.neulet.2011.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 08/17/2011] [Accepted: 09/14/2011] [Indexed: 10/17/2022]
Abstract
Temporal summation of C-fiber evoked responses generates an increase in action potential discharge in second-order neurons and in perceived pain intensity (wind-up). This may be related to the central serotonergic system which modulates and partly inhibits sensory input. Aim of the study was to investigate the relationship between wind-up and serotonergic activity using loudness dependence of auditory evoked potentials (LDAEP). 18 healthy subjects were compared to 18 patients with major depression, a disease with a putative serotonin deficit. They were examined with quantitative sensory testing (QST) using the protocol of the German Research Network on Neuropathic Pain (DFNS), including the wind-up ratio (WUR), LDAEP, and psychometric measurements. We found a slight positive correlation between WUR and LDAEP both in healthy controls and depressed patients combined (r=0.340, p=0.043), indicating that WUR may be modulated by serotonergic activity. It can be concluded that inhibitory control to noxious stimuli is partly associated with the central serotonergic function as indicated by LDAEP.
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Affiliation(s)
- Idun Uhl
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany.
| | - Elena K Krumova
- Department of Pain Management, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Sabrina Regeniter
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Karl-Jürgen Bär
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Christine Norra
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Helmut Richter
- Department of Pain Management, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Hans-Jörg Assion
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Andrea Westermann
- Department of Pain Management, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Christoph Maier
- Department of Pain Management, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
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Simmons JG, Nathan PJ, Berger G, Allen NB. Chronic modulation of serotonergic neurotransmission with sertraline attenuates the loudness dependence of the auditory evoked potential in healthy participants. Psychopharmacology (Berl) 2011; 217:101-10. [PMID: 21465243 DOI: 10.1007/s00213-011-2265-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/11/2011] [Indexed: 11/24/2022]
Abstract
RATIONALE The loudness dependence of the auditory evoked potential (LDAEP) has been reported to be an effective non-invasive measure of central serotonergic neurotransmission. However, acute manipulations of the serotonergic system in humans and animals have yielded inconsistent findings. OBJECTIVES In this study, we examined the chronic effect of serotonergic manipulation using the selective serotonin reuptake inhibitor, sertraline, on the LDAEP. In addition, we examined the influence of 5-HTTLPR genotype and individual differences in plasma drug concentrations on the LDAEP. METHODS The study utilised a double-blind, placebo-controlled, between-group design in which 40 (24 female) healthy adults (M age = 22.0 years, SE = 0.7) were tested following placebo or sertraline for an average of 24 days. The LDAEP was assessed 6 h post-final dose, and changes in the slope of amplitude of the N1/P2 across intensities (60, 70, 80, 90, 100 dB) were examined at Cz. RESULTS The sertraline group had a significantly smaller LDAEP than the placebo group [F(1,38) = 5.97, p = 0.02]. Drug plasma levels did not correlate with the LDAEP in the sertraline group, and there was no influence of 5-HTTLPR genotype. CONCLUSIONS We show for the first time that chronically modulating serotonin neurotransmission alters the LDAEP in healthy adults, consistent with extant literature indicating a moderating role of serotonin on this neurophysiological biomarker. The findings from this study together with previous studies suggest that the LDAEP may be a more sensitive marker of long-term or chronic rather than acute changes in the serotonin system.
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Affiliation(s)
- Julian G Simmons
- Orygen Youth Health Research Centre, Locked Bag 10, Parkville, Victoria 3052, Australia
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Park YM, Kim DW, Kim S, Im CH, Lee SH. The loudness dependence of the auditory evoked potential (LDAEP) as a predictor of the response to escitalopram in patients with generalized anxiety disorder. Psychopharmacology (Berl) 2011; 213:625-32. [PMID: 21057773 DOI: 10.1007/s00213-010-2061-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 10/17/2010] [Indexed: 12/25/2022]
Abstract
RATIONALE The loudness dependence of the auditory evoked potential (LDAEP) has been proposed as a potential biological marker of central serotonergic activity. This study aimed to test the hypothesis that the LDAEP can be used to predict the response to escitalopram in patients with GAD. METHOD Twenty-five patients with GAD were recruited. Scores on the Hamilton Anxiety Rating Scale (HAM-A), Clinical Global Impression-Severity Scale (CGI-S), and Beck Anxiety Inventory (BAI) were evaluated. To evaluate the LDAEP, the auditory event-related potential was measured before beginning medication. Peak-to-peak N1/P2 amplitudes and current source densities were calculated at five stimulus intensities, and the LDAEP was calculated as the linear-regression slope. The current source densities of the evoked potentials were analyzed by standardized low-resolution brain electromagnetic tomography (sLORETA). The loudness dependence of the current densities (sLORETA-LDAEP) was also calculated. RESULTS The pretreatment LDAEPs of all patients were positively correlated with the CGI-S response rates at 4 and 8 weeks, and with the HAM-A and BAI response rates at 8 weeks. The sLORETA-LDAEPs were positively correlated with the HAM-A response rates after 8 weeks of treatment. The HAM-A and CGI response rates at 8 weeks were higher in patients with a strong pretreatment LDAEP than in those with a weak LDAEP. CONCLUSIONS The present study revealed that GAD patients with a favorable response to escitalopram treatment are characterized by a stronger pretreatment LDAEP. Measurement of the LDAEP appears to provide useful clinical information for predicting treatment responses in patients with GAD.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan-Paik Hospital, Inje University, Ilsanseo-gu, Goyang, Republic of Korea
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