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Zandstra MG, Meijs H, Somers M, Stam CJ, de Wilde B, van Hecke J, Niemegeers P, Luykx JJ, van Dellen E. Associations between psychotropic drugs and rsEEG connectivity and network characteristics: a cross-sectional study in hospital-admitted psychiatric patients. Front Neurosci 2023; 17:1176825. [PMID: 37781262 PMCID: PMC10541222 DOI: 10.3389/fnins.2023.1176825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Resting-state EEG (rsEEG) characteristics, such as functional connectivity and network topology, are studied as potential biomarkers in psychiatric research. However, the presence of psychopharmacological treatment in study participants poses a potential confounding factor in biomarker research. To address this concern, our study aims to explore the impact of both single and multi-class psychotropic treatments on aforementioned rsEEG characteristics in a psychiatric population. Methods RsEEG was analyzed in a real-world cross-sectional sample of 900 hospital-admitted psychiatric patients. Patients were clustered into eight psychopharmacological groups: unmedicated, single-class treatment with antipsychotics (AP), antidepressants (AD) or benzodiazepines (BDZ), and multi-class combinations of these treatments. To assess the associations between psychotropic treatments and the macroscale rsEEG characteristics mentioned above, we employed a general linear model with post-hoc tests. Additionally, Spearman's rank correlation analyses were performed to explore potential dosage effects. Results Compared to unmedicated patients, single-class use of AD was associated with lower functional connectivity in the delta band, while AP was associated with lower functional connectivity in both the delta and alpha bands. Single-class use of BDZ was associated with widespread rsEEG differences, including lower functional connectivity across frequency bands and a different network topology within the beta band relative to unmedicated patients. All of the multi-class groups showed associations with functional connectivity or topology measures, but effects were most pronounced for concomitant use of all three classes of psychotropics. Differences were not only observed in comparison with unmedicated patients, but were also evident in comparisons between single-class, multi-class, and single/multi-class groups. Importantly, multi-class associations with rsEEG characteristics were found even in the absence of single-class associations, suggesting potential cumulative or interaction effects of different classes of psychotropics. Dosage correlations were only found for antipsychotics. Conclusion Our exploratory, cross-sectional study suggests small but significant associations between single and multi-class use of antidepressants, antipsychotics and benzodiazepines and macroscale rsEEG functional connectivity and network topology characteristics. These findings highlight the importance of considering the effects of specific psychotropics, as well as their interactions, when investigating rsEEG biomarkers in a medicated psychiatric population.
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Affiliation(s)
- Melissa G. Zandstra
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Hannah Meijs
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Metten Somers
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Cornelis J. Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bieke de Wilde
- Department of Psychiatry, Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
| | - Jan van Hecke
- Department of Psychiatry, Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
| | - Peter Niemegeers
- Department of Psychiatry, Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
| | - Jurjen J. Luykx
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Neurology, Universitair Ziekenhuis (UZ), Brussels, Belgium
- Vrije Universiteit Brussel, Brussels, Belgium
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Mackintosh AJ, de Bock R, Lim Z, Trulley VN, Schmidt A, Borgwardt S, Andreou C. Psychotic disorders, dopaminergic agents and EEG/MEG resting-state functional connectivity: A systematic review. Neurosci Biobehav Rev 2020; 120:354-371. [PMID: 33171145 DOI: 10.1016/j.neubiorev.2020.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/28/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022]
Abstract
Both dysconnectivity and dopamine hypotheses are two well researched pathophysiological models of psychosis. However, little is known about the association of dopamine dysregulation with brain functional connectivity in psychotic disorders, specifically through the administration of antipsychotic medication. In this systematic review, we summarize the existing evidence on the association of dopaminergic effects with electro- and magnetoencephalographic (EEG/MEG) resting-state brain functional connectivity assessed by sensor- as well as source-level measures. A wide heterogeneity of results was found amongst the 20 included studies with increased and decreased functional connectivity in medicated psychosis patients vs. healthy controls in widespread brain areas across all frequency bands. No systematic difference in results was seen between studies with medicated and those with unmedicated psychosis patients and very few studies directly investigated the effect of dopamine agents with a pre-post design. The reported evidence clearly calls for longitudinal EEG and MEG studies with large participant samples to directly explore the association of antipsychotic medication effects with neural network changes over time during illness progression and to ultimately support the development of new treatment strategies.
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Affiliation(s)
- Amatya Johanna Mackintosh
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland
| | - Renate de Bock
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland
| | - Zehwi Lim
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Valerie-Noelle Trulley
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - André Schmidt
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Stefan Borgwardt
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Christina Andreou
- University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 60/62, 4055 Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany.
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de la Salle S, Choueiry J, Shah D, Bowers H, McIntosh J, Ilivitsky V, Knott V. Effects of Ketamine on Resting-State EEG Activity and Their Relationship to Perceptual/Dissociative Symptoms in Healthy Humans. Front Pharmacol 2016; 7:348. [PMID: 27729865 PMCID: PMC5037139 DOI: 10.3389/fphar.2016.00348] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/15/2016] [Indexed: 11/13/2022] Open
Abstract
N-methyl-D-aspartate (NMDA) receptor antagonists administered to healthy humans results in schizophrenia-like symptoms, which preclinical research suggests are due to glutamatergically altered brain oscillations. Here, we examined resting-state electroencephalographic activity in 21 healthy volunteers assessed in a placebo-controlled, double-blind, randomized study involving administration of either a saline infusion or a sub-anesthetic dose of ketamine, an NMDA receptor antagonist. Frequency-specific current source density (CSD) was assessed at sensor-level and source-level using eLORETA within regions of interest of a triple network model of schizophrenia (this model posits a dysfunctional switching between large-scale Default Mode and Central Executive networks by the monitor-controlling Salience Network). These CSDs were measured in each session along with subjective symptoms as indexed with the Clinician Administered Dissociative States Scale. Ketamine-induced CSD reductions in slow (delta/theta and alpha) and increases in fast (gamma) frequencies at scalp electrode sites were paralleled by frequency-specific CSD changes in the Default Mode, Central Executive, and Salience networks. Subjective symptoms scores were increased with ketamine and ratings of depersonalization in particular were associated with alpha CSD reductions in general and in specific regions of interest in each of the three networks. These results tentatively support the hypothesis that pathological brain oscillations associated with hypofunctional NMDA receptor activity may contribute to the emergence of the perceptual/dissociate symptoms of schizophrenia.
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Affiliation(s)
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, University of Ottawa Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, University of Ottawa Ottawa, ON, Canada
| | - Hayley Bowers
- Department of Psychology, University of Guelph Guelph, ON, Canada
| | - Judy McIntosh
- University of Ottawa Institute of Mental Health Research Ottawa, ON, Canada
| | - Vadim Ilivitsky
- Department of Psychiatry, University of OttawaOttawa, ON, Canada; Royal Ottawa Mental Health CentreOttawa, ON, Canada
| | - Verner Knott
- School of Psychology, University of OttawaOttawa, ON, Canada; Department of Cellular and Molecular Medicine, University of OttawaOttawa, ON, Canada; University of Ottawa Institute of Mental Health ResearchOttawa, ON, Canada; Department of Psychiatry, University of OttawaOttawa, ON, Canada
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Guevara MA, Hernández-González M, Sanz-Martin A, Amezcua C. EEGcorco: a computer program to simultaneously calculate and statistically analyze EEG coherence and correlation. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/jbise.2011.412096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Siekmeier PJ, Stufflebeam SM. Patterns of spontaneous magnetoencephalographic activity in patients with schizophrenia. J Clin Neurophysiol 2010; 27:179-90. [PMID: 20461010 PMCID: PMC3665947 DOI: 10.1097/wnp.0b013e3181e0b20a] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Magnetoencephalography noninvasively measures the magnetic fields produced by the brain. Pertinent research articles from 1993 to 2009 that measured spontaneous, whole-head magnetoencephalography activity in patients with schizophrenia were reviewed. Data on localization of oscillatory activity and correlation of these findings with psychotic symptoms are summarized. Although the variety of measures used by different research groups makes a quantitative meta-analysis difficult, it appears that magnetoencephalography activity in patients may exhibit identifiable patterns, defined by topographic organization and frequency band. Specifically, 11 of the 12 studies showed increased theta (4-8 Hz) and delta (1-4 Hz) band oscillations in the temporal lobes of patients; of the 10 studies that examined the relationship between oscillatory activity and symptomatology, 8 found a positive correlation between temporal lobe theta activity and positive schizophrenic symptoms. Abnormally high frontal delta activity was not seen. These findings are analyzed in comparison with the electroencephalogram literature on schizophrenics, and possible confounds (e.g., medication effects) are discussed. In the future, magnetoencephalography might be used to assist in diagnosis or might be fruitfully used in conjunction with new neuroscience research approaches such as computational modeling, which may be able to link oscillatory activity and cellular-level pathology.
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Affiliation(s)
- Peter J Siekmeier
- Harvard Medical School and McLean Hospital, Belmont, Massachusetts 02478, USA.
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Micheloyannis S, Pachou E, Stam CJ, Breakspear M, Bitsios P, Vourkas M, Erimaki S, Zervakis M. Small-world networks and disturbed functional connectivity in schizophrenia. Schizophr Res 2006; 87:60-6. [PMID: 16875801 DOI: 10.1016/j.schres.2006.06.028] [Citation(s) in RCA: 311] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Revised: 06/03/2006] [Accepted: 06/18/2006] [Indexed: 12/23/2022]
Abstract
Disturbances in "functional connectivity" have been proposed as a major pathophysiological mechanism for schizophrenia, and in particular, for cognitive disorganization. Detection and estimation of these disturbances would be of clinical interest. Here we characterize the spatial pattern of functional connectivity by computing the "synchronization likelihood" (SL) of EEG at rest and during performance of a 2Back working memory task using letters of the alphabet presented on a PC screen in subjects with schizophrenia and healthy controls. The spatial patterns of functional connectivity were then characterized with graph theoretical measures to test whether a disruption of an optimal spatial pattern ("small-world") of the functional connectivity network underlies schizophrenia. Twenty stabilized patients with schizophrenia, who were able to work, and 20 healthy controls participated in the study. During the working memory (WM) task healthy subjects exhibited small-world properties (a combination of local clustering and high overall integration of the functional networks) in the alpha, beta and gamma bands. These properties were not present in the schizophrenia group. These findings are in accordance with a partially inadequate organization of neuronal networks in subjects with schizophrenia. This method could be helpful for diagnosis and evaluation of the severity of the disease, as well as understanding the pathophysiologic mechanisms underlying cognitive dysfunction in schizophrenia.
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