Acute dosing of vortioxetine strengthens event-related brain activity associated with engagement of attention and cognitive functioning in rats

Machine learning-based classification using electroencephalographic multi-paradigms between drug-naïve patients with depression and healthy controls

BACKGROUND

Electroencephalography (EEG) is a supplementary diagnostic tool in psychiatry but lacks practical usage. EEG has demonstrated inconsistent diagnostic ability because major depressive disorder (MDD) is a heterogeneous psychiatric disorder with complex pathologies. In clinical psychiatry, it is essential to detect these complexities using multiple EEG paradigms. Though the application of machine learning to EEG signals in psychiatry has increased, an improvement in its classification performance is still required clinically. We tested the classification performance of multiple EEG paradigms in drug-naïve patients with MDD and healthy controls (HCs).

METHODS

Thirty-one drug-naïve patients with MDD and 31 HCs were recruited in this study. Resting-state EEG (REEG), the loudness dependence of auditory evoked potentials (LDAEP), and P300 were recorded for all participants. Linear discriminant analysis (LDA) and support vector machine (SVM) classifiers with t-test-based feature selection were used to classify patients and HCs.

RESULTS

The highest accuracy was 94.52 % when 14 selected features, including 12 P300 amplitudes (P300A) and two LDAEP features, were layered. The accuracy was 90.32 % when a SVM classifier for 30 selected features (14 P300A, 14 LDAEP, and 2 REEG) was layered in comparison to each REEG, P300A, and LDAEP, the best accuracies of which were 71.57 % (2-layered with LDA), 87.12 % (1-layered with LDA), and 83.87 % (6-layered with SVM), respectively.

LIMITATIONS

The present study was limited by small sample size and difference in formal education year.

CONCLUSIONS

Multiple EEG paradigms are more beneficial than a single EEG paradigm for classifying drug-naïve patients with MDD and HCs.

Therapeutic Potential of Vortioxetine for Anxious Depression: A Post Hoc Analysis of Data from a Clinical Trial Conducted in Japan

AIM

Antidepressants, including selective serotonin reuptake inhibitors, often elicit a poor response in patients with major depressive disorder (MDD) with significant anxiety symptoms. This study investigated the effects of the multimodal antidepressant vortioxetine in patients with MDD and associated anxiety.

METHODS

This was a post hoc analysis of data from an 8-week, randomized, double-blind, placebo-controlled, Phase 3 study of vortioxetine (10 mg or 20 mg) in Japanese patients aged 20-75 years with recurrent MDD and a Montgomery-Åsberg Depression Rating Scale (MADRS) score of at least 26. Changes from baseline to week 8 in MADRS total score and Hamilton Depression Rating Scale (HAM-D) anxiety/somatization factor score were assessed in patients with anxious depression (HAM-D anxiety/somatization factor score ≥7) and without anxious depression.

RESULTS

Data were available for 489 patients. In patients with anxious depression, the least-squares (LS) mean difference (95% confidence interval [CI]) versus placebo in change in MADRS total score was -3.44 (-6.10, -0.77) for vortioxetine 10 mg and -4.51 (-7.15, -1.87) for vortioxetine 20 mg. In patients with non-anxious depression, the LS mean difference (95% CI) versus placebo was -1.81 (-4.71, 1.09) and -1.05 (-4.00, 1.90) for vortioxetine 10 mg and 20 mg, respectively. Changes from baseline in HAM-D anxiety/somatization factor score were greater in patients treated with vortioxetine 10 mg or 20 mg than in those treated with placebo.

CONCLUSION

Vortioxetine may be effective for patients with anxiety symptoms in MDD. Further research is warranted to investigate these effects in a real-world clinical setting.

CLINICAL TRIALS REGISTRATION

ClinicalTrials.gov identifier for primary study: NCT02389816.

Combined Effects of Electroacupuncture and Behavioral Training on Learning-Memory Ability and Event-Related Potential P300 in Rats with Mid/Advanced Cerebral Infarction

Background:

The effectiveness of the combination of electroacupuncture (EA) and behavioral training (BT) for mid/advanced cerebral infarction (M/ACI) and related mechanisms remains unclear. This study aimed to investigate the combined effects on the learning-memory ability and event-related potential P300 in rats with M/ACI.

Methods:

Eighty rats with M/ACI were divided into Group Model (M), Group EA, Group BT, and Group EA-BT (n = 20) according to the random number with five healthy rats in Group Control (CON). On the 6^th week after modeling, EA, BT, and EA-BT were given to Group EA, Group BT, and Group EA-BT, respectively, whereas Group M and Group CON were not given any intervention. Y-maze test and P300 were recorded before and after the intervention.

Results:

After intervention, the P300 latency was lower and the amplitude was higher in the Group EA-BT, Group EA, and Group BT than before (for latency, t = −7.638, −4.334, and −5.916; for amplitude, t = 8.125, 3.846, and 5.238; P < 0.01), with Group EA-BT superior to Group EA (for latency, t = −3.708; for amplitude, t = 3.653; P < 0.01) and Group BT (for latency, t = −2.067; for amplitude, t = 2.816; P < 0.05), with no significant difference between Group BT and EA (for latency, t = −1.439; for amplitude, t = 1.075; P > 0.05). While the performances of Y-maze tests in the Group EA-BT, Group EA, and Group BT were all better than before (t = 10.359, 4.520, and 7.791, P < 0.01), with Group EA-BT better than Group EA (t = 5.627, P < 0.01) and Group BT (t = 2.913, P < 0.01) respectively, and Group BT better than Group EA (t = 2.912, P < 0.01).

Conclusion:

EA or BT can affect P300 in rats with M/ACI, and the combination of these two methods can significantly improve the learning-memory ability.

Vortioxetine Differentially Modulates MK-801-Induced Changes in Visual Signal Detection Task Performance and Locomotor Activity

Attention impairment is a common feature of Major Depressive Disorder (MDD), and MDD-associated cognitive dysfunction may play an important role in determining functional status among this patient population. Vortioxetine is a multimodal antidepressant that may improve some aspects of cognitive function in MDD patients, and may indirectly increase glutamate neurotransmission in brain regions classically associated with attention function. Previous non-clinical research suggests that vortioxetine has limited effects on attention. This laboratory previously found that vortioxetine did not improve attention function in animals impaired by acute scopolamine administration, using the visual signal detection task (VSDT). However, vortioxetine has limited effects on acetylcholinergic neurotransmission, and thus it is possible that attention impaired by other mechanisms would be attenuated by vortioxetine. This study sought to investigate whether acute vortioxetine administration can attenuate VSDT impairments and hyperlocomotion induced by the non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist MK-801. We found that acute vortioxetine administration had no effect on VSDT performance on its own, but potentiated MK-801-induced VSDT impairments. Furthermore, vortioxetine had no effect on locomotor activity on its own, and did not alter MK-801-induced hyperlocomotion. We further investigated whether vortioxetine's effect on MK-801 could be driven by a kinetic interaction, but found that plasma and brain exposure for vortioxetine and MK-801 were similar whether administered alone or in combination. Thus, it appears that vortioxetine selectively potentiates MK-801-induced impairments in attention without altering its effects on locomotion, and further that this interaction must be pharmacodynamic in nature. A theoretical mechanism for this interaction is discussed.