Different patterns of abnormal gamma oscillatory activity in unipolar and bipolar disorder patients during an implicit emotion task

The Pathophysiological Underpinnings of Gamma-Band Alterations in Psychiatric Disorders

Investigating the biophysiological substrates of psychiatric illnesses is of great interest to our understanding of disorders' etiology, the identification of reliable biomarkers, and potential new therapeutic avenues. Schizophrenia represents a consolidated model of γ alterations arising from the aberrant activity of parvalbumin-positive GABAergic interneurons, whose dysfunction is associated with perineuronal net impairment and neuroinflammation. This model of pathogenesis is supported by molecular, cellular, and functional evidence. Proof for alterations of γ oscillations and their underlying mechanisms has also been reported in bipolar disorder and represents an emerging topic for major depressive disorder. Although evidence from animal models needs to be further elucidated in humans, the pathophysiology of γ-band alteration represents a common denominator for different neuropsychiatric disorders. The purpose of this narrative review is to outline a framework of converging results in psychiatric conditions characterized by γ abnormality, from neurochemical dysfunction to alterations in brain rhythms.

Predictive Value of qEEG in Manic Switch of Depressed Patients

Backgrounds: More than half of the patients with bipolar disorder (BD) had depressive episodes at the onset of BD. Despite some suggested clinical predictors, there are no certain criteria for predicting which unipolar depression patient switch to manic episodes during the treatment course. Electrophysiological markers can address this issue. Methods: Pretreatment quantitative electroencephalography (qEEG) records of patients diagnosed with major depressive disorder (MDD) or BD at the first visit were included in the study. Patients with MDD were also grouped with manic switch (MS) or MDD based on the diagnosis of later visits. The qEEG spectral power was analyzed across 3 groups, that is, MS, MDD, and BD. Results: Compared to patients whose diagnosis did not change, patients with MS had accelerated high-frequency activities predominantly in the left hemisphere (central-parietal-occipital regions). In contrast, they showed increased slow wave activity predominantly in the right hemisphere (parietal-occipital regions). Conclusion: It can be concluded that searching for electrophysiological markers, which have distinct advantages of repeatability, noninvasiveness, and cost-effectiveness, can facilitate the prediction of the MS.

Velocity of conduction between columns and layers in barrel cortex reported by parvalbumin interneurons

Inhibitory interneurons expressing parvalbumin (PV) play critical roles throughout the brain. Their rapid spiking enables them to control circuit dynamics on a millisecond time scale, and the timing of their activation by different excitatory pathways is critical to these functions. We used a genetically encoded hybrid voltage sensor to image PV interneuron voltage changes with sub-millisecond precision in primary somatosensory barrel cortex (BC) of adult mice. Electrical stimulation evoked depolarizations with a latency that increased with distance from the stimulating electrode, allowing us to determine conduction velocity. Spread of responses between cortical layers yielded an interlaminar conduction velocity and spread within layers yielded intralaminar conduction velocities in different layers. Velocities ranged from 74 to 473 μm/ms depending on trajectory; interlaminar conduction was 71% faster than intralaminar conduction. Thus, computations within columns are more rapid than between columns. The BC integrates thalamic and intracortical input for functions such as texture discrimination and sensory tuning. Timing differences between intra- and interlaminar PV interneuron activation could impact these functions. Imaging of voltage in PV interneurons reveals differences in signaling dynamics within cortical circuitry. This approach offers a unique opportunity to investigate conduction in populations of axons based on their targeting specificity.

A review of critical brain oscillations in depression and the efficacy of transcranial magnetic stimulation treatment

Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do not respond to these treatments. Therefore, the investigation of reliable and valid brain oscillations as potential indices for facilitating the precision of diagnosis and treatment protocols has become a critical issue. The current review focuses on brain oscillations that, mostly based on EEG power analysis and connectivity, distinguish between MDD and controls, responders and non-responders, and potential depression severity indices, prognostic indicators, and potential biomarkers for rTMS or iTBS treatment. The possible roles of each biomarker and the potential reasons for heterogeneous results are discussed, and the directions of future studies are proposed.

Ketamine supresses REM sleep and markedly increases EEG gamma oscillations in the Wistar Kyoto rat model of treatment-resistant depression

Wistar-Kyoto (WKY) rats exhibit depression-like characteristics and decreased sensitivity to monoamine-based antidepressants, making them a suitable model of treatment-resistant depression (TRD). Ketamine has emerged recently as a rapidly acting antidepressant with high efficacy in TRD. Our aim was to determine whether subanaesthetic doses of ketamine can correct sleep and electroencephalogram (EEG) alterations in WKY rats and whether any ketamine-induced changes differentially affect WKY rats compared to Sprague-Dawley (SD) rats. Thus, we surgically implanted 8SD and 8 WKY adult male rats with telemetry transmitters and recorded their EEG, electromyogram, and locomotor activity after vehicle or ketamine (3, 5 or 10mg/kg, s.c.) treatment. We also monitored the plasma concentration of ketamine and its metabolites, norketamine and hydroxynorketamine in satellite animals. We found that WKY rats, have an increased amount of rapid eye movement (REM) sleep, fragmented sleep-wake pattern, and increased EEG delta power during non-REM sleep compared to SD rats. Ketamine suppressed REM sleep and increased EEG gamma power during wakefulness in both strains, but the gamma increase was almost twice as large in WKY rats than in SD rats. Ketamine also increased beta oscillations, but only in WKY rats. These differences in sleep and EEG are unlikely to be caused by dissimilarities in ketamine metabolism as the plasma concentrations of ketamine and its metabolites were similar in both strains. Our data suggest an enhanced antidepressant-like response to ketamine in WKY rats, and further support the predictive validity of acute REM sleep suppression as a measure of antidepressant responsiveness.

Gamma band VMPFC-PreCG.L connection variation after the onset of negative emotional stimuli can predict mania in depressive patients

OBJECTIVE

Because of the similar clinical symptoms, it is difficult to distinguish unipolar disorder (UD) from bipolar disorder (BD) in the depressive episode using the available clinical features, especially for those who meet the diagnostic criteria of UD, however, experience the manic episode during the follow-up (tBD).

METHODS

Magnetoencephalography recordings during a sad expression recognition task were obtained from 81 patients (27 BD, 24 tBD, 30 UD) and 26 healthy controls (HCs). Source analysis was applied to localize 64 regions of interest in the low gamma band (30-50 Hz). Regional functional connections (FCs) were constructed respectively within three time periods (early: 0-200 ms, middle: 200-400 ms, and post: 400-600 ms). The network-based statistic method was used to explore the abnormal connection patterns in tBD compared to UD and HC. BD was applied to explore whether such abnormality is still significant between every two groups of BD, tBD, UD, and HC.

RESULTS

The VMPFC-PreCG.L connection was found to be a significantly different connection between tBD and UD in the early time period and between tBD and BD in the middle time period. Furthermore, the middle/early time period ratio of FC value of VMPFC-PreCG.L connection was negatively correlated with the bipolarity index in tBD.

CONCLUSIONS

The VMPFC-PreCG.L connection in different time periods after the onset of sad facial stimuli may be a potential biomarker to distinguish the different states of BD. The FC ratio of VMPFC-PreCG.L connection may predict whether patients with depressive episodes subsequently develop mania.

Convergent and divergent cognitive impairment of unipolar and bipolar depression: A magnetoencephalography resting-state study

BACKGROUND

Unipolar depression (UD) and bipolar depression (BD) showed convergent and divergent cognitive impairments. Neural oscillations are linked to the foundational cognitive processes. We aimed to investigate the underpinning spectral neuronal power patterns by magnetoencephalography (MEG), which combinates high spatial and temporal resolution. We hypothesized that patients with UD and BD exhibit common and distinct patterns, which may contribute to their cognitive impairments.

METHODS

Group cognitive tests were performed. Eyes closed resting-state MEG data were collected from 61 UD, 55 BD, and 52 healthy controls (HC). Nonparametric cluster-based permutation tests were performed to deal with the multiple comparison problem on channel-frequency MEG data. Correlation analysis of cognitive dysfunction scores and MEG oscillation were conducted by Spearman or partial correlation analysis.

RESULTS

Wisconsin Card Sorting Test showed similar cognitive impairment in patients with UD and BD. Moreover, patients with BD exhibited extensive cognitive deficits in verbal executive functions and visuospatial processing. Compare to HC, both patients with UD and BD showed increased frontal-central beta power while high gamma power was decreased in UD groups during the resting-state. The significant correlations between cognitive function and average beta power were observed.

CONCLUSIONS

Patients with BD had more cognitive impairments on different dimensions than those with UD, involving disrupted beta power modulations. Our investigation provides a better understanding of the neuroelectrophysiological process underlying cognitive impairments in patients with UD and BD.

Altered gamma oscillations and beta-gamma coupling in drug-naive first-episode major depressive disorder: Association with sleep and cognitive disturbance

OBJECTIVE

Gamma oscillations contribute to the pathogenesis mechanisms of major depressive disorder (MDD) have been proposed, but gamma activity is not well characterized. This study is the first attempt to investigate the altered gamma oscillations in first-episode MDD, particularly the beta-gamma coupling, and to determine the potential symptomatic relationship with the identified gamma dysregulation.

METHODS

Resting electroencephalography was recorded for 43 drug-naive first-episode MDD and 57 healthy control (HC) subjects. Integrated analysis of relative spectral power, weighted phase lag index, and phase-amplitude coupling (PAC) were utilized to reveal the alterations of gamma activities. Pearson's correlation was implemented to identify the relationship between altered gamma activities and the clinical depressive symptoms, which were categorized into four factors: anxiety somatization, retardation, cognitive disturbance, and sleep disturbance.

RESULTS

Compared with HC subjects, MDD patients showed not only significantly decreased gamma powers in the left temporal and the bilateral occipital regions but also weakened gamma connectivity between the left hemisphere and the right frontal region. Furthermore, attenuated beta-gamma PAC of MDD patients was observed in the left temporal regions. Importantly, the suppression of left occipital mid- and high gamma oscillations were negatively correlated with sleep disturbance, while the deficits in left temporal beta-mid-gamma PAC and beta-high gamma PAC showed negative correlations with cognitive disturbance.

LIMITATIONS

Important limitations are the small sample size and the possible inclusion of bipolar depression in the MDD group.

CONCLUSIONS

Our findings provide the first evidence that in first-episode MDD, aberrant gamma powers and beta-gamma coupling are associated with sleep and cognitive impairments, respectively, deepening our understanding of the physiological mechanisms underlying sleep and cognitive symptoms in first-episode MDD. Altered gamma oscillations emerge as promising biomarkers for diagnosing MDD.

Corticotropin-releasing factor receptor 1 in infralimbic cortex modulates social stress-altered decision-making

Chronic stress could lead to a bias in behavioral strategies toward habits. However, it remains unclear which neuronal system modulates stress-induced behavioral abnormality during decision making. The corticotropin-releasing factor (CRF) system in the medial prefrontal cortex (mPFC), which has been implicated in governing strategy choice, is involved in the response to stress. The present study aimed to clarify whether altered function in cortical CRF receptors is linked to abnormal behaviors after chronic stress. In results, mice subjected to a 10-day social defeat preferred to use a habitual strategy. The infralimbic cortex (IL), but not the prelimbic cortex (PL) or anterior cingulate cortex (ACC), showed higher cFos expression in stress-subjected mice than in control mice, which may be associated with habitual behavior choice. Furthermore, CRF receptor 1 (CRFR1) agonist and antagonist infusion in IL during behavioral training mimicked and rescued stress-caused behavioral change in the decision-making assessment, respectively. An electrophysiological approach showed that the frequencies of both spontaneous IPSC and spontaneous EPSC, but not their amplitude, increased after stress and were modulated by CRFR1 agents. Further recordings revealed that an increased ratio of excitation to inhibition (E/I ratio) of IL by stress was rescued under conditions with CRFR1 antagonist. Collectively, these data indicate that CRFR1 plays a critical role in stress-permitted or enhanced glutamatergic and GABAergic presynaptic transmission in direct or indirect ways, as well as the modulation for E/I ratio in the IL. Thus, CRFR1 in the mPFC may be a proper target for treating cases of chronic stress-altered behavior.

Electrophysiological correlates and predictors of the antidepressant response to repeated ketamine infusions in treatment-resistant depression

BACKGROUND

Sub-anesthetic ketamine doses rapidly reduce depressive symptoms, although additional investigations of the underlying neural mechanisms and the prediction of response outcomes are needed. Electroencephalographic (EEG)-derived measures have shown promise in predicting antidepressant response to a variety of treatments, and are sensitive to ketamine administration. This study examined their utility in characterizing changes in depressive symptoms following single and repeated ketamine infusions.

METHODS

Recordings were obtained from patients with treatment-resistant major depressive disorder (MDD) (N = 24) enrolled in a multi-phase clinical ketamine trial. During the randomized, double-blind, crossover phase (Phase 1), patients received intravenous ketamine (0.5 mg/kg) and midazolam (30 μg/kg), at least 1 week apart. For each medication, three resting, eyes-closed recordings were obtained per session (pre-infusion, immediately post-infusion, 2 h post-infusion), and changes in power (delta, theta1/2/total, alpha1/2/total, beta, gamma), alpha asymmetry, theta cordance, and theta source-localized anterior cingulate cortex activity were quantified. The relationships between ketamine-induced changes with early (Phase 1) and sustained (Phases 2,3: open-label repeated infusions) decreases in depressive symptoms (Montgomery-Åsberg Depression Rating Score, MADRS) and suicidal ideation (MADRS item 10) were examined.

RESULTS

Both medications decreased alpha and theta immediately post-infusion, however, only midazolam increased delta (post-infusion), and only ketamine increased gamma (immediately post- and 2 h post-infusion). Regional- and frequency-specific ketamine-induced EEG changes were related to and predictive of decreases in depressive symptoms (theta, gamma) and suicidal ideation (alpha). Early and sustained treatment responders differed at baseline in surface-level and source-localized theta.

CONCLUSIONS

Ketamine exerts frequency-specific changes on EEG-derived measures, which are related to depressive symptom decreases in treatment-resistant MDD and provide information regarding early and sustained individual response to ketamine.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov: Action of Ketamine in Treatment-Resistant Depression, NCT01945047.

Altered effective connectivity in migraine patients during emotional stimuli: a multi-frequency magnetoencephalography study

BACKGROUND

Migraine is a common and disabling primary headache, which is associated with a wide range of psychiatric comorbidities. However, the mechanisms of emotion processing in migraine are not fully understood yet. The present study aimed to investigate the neural network during neutral, positive, and negative emotional stimuli in the migraine patients.

METHODS

A total of 24 migraine patients and 24 age- and sex-matching healthy controls were enrolled in this study. Neuromagnetic brain activity was recorded using a whole-head magnetoencephalography (MEG) system upon exposure to human facial expression stimuli. MEG data were analyzed in multi-frequency ranges from 1 to 100 Hz.

RESULTS

The migraine patients exhibited a significant enhancement in the effective connectivity from the prefrontal lobe to the temporal cortex during the negative emotional stimuli in the gamma frequency (30-90 Hz). Graph theory analysis revealed that the migraine patients had an increased degree and clustering coefficient of connectivity in the delta frequency range (1-4 Hz) upon exposure to positive emotional stimuli and an increased degree of connectivity in the delta frequency range (1-4 Hz) upon exposure to negative emotional stimuli. Clinical correlation analysis showed that the history, attack frequency, duration, and neuropsychological scales of the migraine patients had a negative correlation with the network parameters in certain frequency ranges.

CONCLUSIONS

The results suggested that the individuals with migraine showed deviant effective connectivity in viewing the human facial expressions in multi-frequencies. The prefrontal-temporal pathway might be related to the altered negative emotional modulation in migraine. These findings suggested that migraine might be characterized by more universal altered cerebral processing of negative stimuli. Since the significant result in this study was frequency-specific, more independent replicative studies are needed to confirm these results, and to elucidate the neurocircuitry underlying the association between migraine and emotional conditions.

The Neurometabolic Basis of Mood Instability: The Parvalbumin Interneuron Link-A Systematic Review and Meta-Analysis

The neurobiological bases of mood instability are poorly understood. Neuronal network alterations and neurometabolic abnormalities have been implicated in the pathophysiology of mood and anxiety conditions associated with mood instability and hence are candidate mechanisms underlying its neurobiology. Fast-spiking parvalbumin GABAergic interneurons modulate the activity of principal excitatory neurons through their inhibitory action determining precise neuronal excitation balance. These interneurons are directly involved in generating neuronal networks activities responsible for sustaining higher cerebral functions and are especially vulnerable to metabolic stress associated with deficiency of energy substrates or mitochondrial dysfunction. Parvalbumin interneurons are therefore candidate key players involved in mechanisms underlying the pathogenesis of brain disorders associated with both neuronal networks' dysfunction and brain metabolism dysregulation. To provide empirical support to this hypothesis, we hereby report meta-analytical evidence of parvalbumin interneurons loss or dysfunction in the brain of patients with Bipolar Affective Disorder (BPAD), a condition primarily characterized by mood instability for which the pathophysiological role of mitochondrial dysfunction has recently emerged as critically important. We then present a comprehensive review of evidence from the literature illustrating the bidirectional relationship between deficiency in mitochondrial-dependent energy production and parvalbumin interneuron abnormalities. We propose a mechanistic explanation of how alterations in neuronal excitability, resulting from parvalbumin interneurons loss or dysfunction, might manifest clinically as mood instability, a poorly understood clinical phenotype typical of the most severe forms of affective disorders. The evidence we report provides insights on the broader therapeutic potential of pharmacologically targeting parvalbumin interneurons in psychiatric and neurological conditions characterized by both neurometabolic and neuroexcitability abnormalities.

Atypical development of emotional face processing networks in autism spectrum disorder from childhood through to adulthood

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MEG connectivity to emotional faces in ASD and typical controls 6–39 years of age was investigated.

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Distinct age-related changes in connectivity were observed in the groups to happy and angry faces.

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Age-related between-group differences in functional connectivity were found in gamma band.

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Emotion-specific age-related between-group differences were seen in beta.

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Findings highlight specific neurodevelopmental trajectories to emotional faces in ASD vs. TD.

Impairments in social functioning are hallmarks of autism spectrum disorder (ASD) and atypical functional connectivity may underlie these difficulties. Emotion processing networks typically undergo protracted maturational changes, however, those with ASD show either hyper- or hypo-connectivity with little consensus on the functional connectivity underpinning emotion processing. Magnetoencephalography was used to investigate age-related changes in whole-brain functional connectivity of eight regions of interest during happy and angry face processing in 190 children, adolescents and adults (6–39 years) with and without ASD. Findings revealed age-related changes from child- through to mid-adulthood in functional connectivity in controls and in ASD in theta, as well as age-related between-group differences across emotions, with connectivity decreasing in ASD, but increasing for controls, in gamma. Greater connectivity to angry faces was observed across groups in gamma. Emotion-specific age-related between-group differences in beta were also found, that showed opposite trends with age for happy and angry in ASD. Our results establish altered, frequency-specific developmental trajectories of functional connectivity in ASD, across distributed networks and a broad age range, which may finally help explain the heterogeneity in the literature.

The activity and connectivity of the facial emotion processing neural circuitry in bipolar disorder: a systematic review

BACKGROUND

Facial emotion processing abnormalities may be a trait feature of bipolar disorder (BD). These social cognitive impairments may be due to alterations in the neural processing of facial affective information in visual ("core"), and limbic and prefrontal ("extended") networks, however, the precise neurobiological mechanism(s) underlying these symptoms are unclear.

METHODS

We conducted a systematic review to appraise the literature on the activity and connectivity of the facial emotion processing neural circuitry in BD. Two reviewers undertook a search of the electronic databases PubMed, Scopus and PsycINFO, to identify relevant literature published since inception up until September 2019. Study eligibility criteria included; BD participants, neuroimaging, and facial emotion processing tasks.

RESULTS

Out of an initial yield of 6121 articles, 66 were eligible for inclusion in this review. We identified differences in neural activity and connectivity within and between occipitotemporal, limbic, and prefrontal regions, in response to facial affective stimuli, in BD compared to healthy controls.

LIMITATIONS

The methodologies used across studies varied considerably.

CONCLUSIONS

The findings from this review suggest abnormalities in both the activity and connectivity of facial emotion processing neural circuitry in BD. It is recommended that future research aims to further define the connectivity and spatiotemporal course of neural events within and between occipitotemporal, limbic, and prefrontal regions.

Venlafaxine Stimulates an MMP-9-Dependent Increase in Excitatory/Inhibitory Balance in a Stress Model of Depression

Emerging evidence suggests that there is a reduction in overall cortical excitatory to inhibitory balance in major depressive disorder (MDD), which afflicts ∼14%-20% of individuals. Reduced pyramidal cell arborization occurs with stress and MDD, and may diminish excitatory neurotransmission. Enhanced deposition of perineuronal net (PNN) components also occurs with stress. Since parvalbumin-expressing interneurons are the predominant cell population that is enveloped by PNNs, which enhance their ability to release GABA, excess PNN deposition likely increases pyramidal cell inhibition. In the present study, we investigate the potential for matrix metalloprotease-9 (MMP-9), an endopeptidase secreted in response to neuronal activity, to contribute to the antidepressant efficacy of the serotonin/norepinephrine reuptake inhibitor venlafaxine in male mice. Chronic venlafaxine increases MMP-9 levels in murine cortex, and increases both pyramidal cell arborization and PSD-95 expression in the cortex of WT but not MMP-9-null mice. We have previously shown that venlafaxine reduces PNN deposition and increases the power of ex vivo γ oscillations in conventionally housed mice. γ power is increased with pyramidal cell disinhibition and with remission from MDD. Herein we observe that PNN expression is increased in a corticosterone-induced stress model of disease and reduced by venlafaxine. Compared with mice that receive concurrent venlafaxine, corticosterone-treated mice also display reduced ex vivo γ power and impaired working memory. Autopsy-derived PFC samples show elevated MMP-9 levels in antidepressant-treated MDD patients compared with controls. These preclinical and postmortem findings highlight a link between extracellular matrix regulation and MDD.SIGNIFICANCE STATEMENT Reduced excitatory neurotransmission occurs with major depressive disorder, and may be normalized by antidepressant treatment. Underlying molecular mechanisms are, however, not well understood. Herein we investigate a potential role for an extracellular protease, released from neurons and known to play a role in learning and memory, in antidepressant-associated increases in excitatory transmission. Our data suggest that this protease, matrix metalloprotease-9, increases branching of excitatory neurons and concomitantly attenuates the perineuronal net to potentially reduce inhibitory input to these neurons. Matrix metalloprotease-9 may thus enhance overall excitatory/inhibitory balance and neuronal population dynamics, which are important to mood and memory.

Electrophysiological biomarkers of antidepressant response to ketamine in treatment-resistant depression: Gamma power and long-term potentiation

Over the last two decades, the discovery of ketamine's antidepressant properties has galvanized research into the neurobiology of treatment-resistant depression. Nevertheless, the mechanism of action underlying antidepressant response to ketamine remains unclear. This study reviews electrophysiological studies of ketamine's effects in individuals with depression as well as healthy controls, with a focus on two putative markers of synaptic potentiation: gamma oscillations and long-term potentiation. The review focuses on: 1) measures of gamma oscillations and power and their relationship to both acute, psychotomimetic drug effects as well as delayed antidepressant response in mood disorders; 2) changes in long-term potentiation as a promising measure of synaptic potentiation following ketamine administration; and 3) recent efforts to model antidepressant response to ketamine using novel computational modeling techniques, in particular the application of dynamic causal modeling to electrophysiological data. The latter promises to better characterize the mechanisms underlying ketamine's antidepressant effects.

Common and distinct neural activities in frontoparietal network in first-episode bipolar disorder and major depressive disorder: Preliminary findings from a follow-up resting state fMRI study

BACKGROUND

It is difficult to distinguish bipolar disorder (BD) from major depressive disorder (MDD), especially with the initial depressive episode. In this study, we compared neural activities of BD and MDD patients during the first-episode (FE) to investigate common and distinct neural activities and further explore predictive indicators in the two diseases.

METHODS

FE-MDD patients were performed resting state functional magnetic resonance imaging and followed up after scanning. After follow-up, FE-MDD patients were regrouped into FE-BD and FE-MDD patients. The study included 24 FE-BD patients, 28 FE-MDD patients, and 30 age- and sex-matched healthy controls (HC) to investigate neural activities with regional homogeneity (ReHo) analysis among the 3 groups.

RESULTS

Compared to HC, FE-BD patients displayed significantly higher ReHo values in the superior frontal gyrus, the medial superior frontal gyrus within right-side cerebral hemisphere than FE-MDD patients and HC. Compared to HC, FE-BD and FE-MDD patients displayed significant decreased ReHo values in the paracentral lobule, the precuneus and the median cingulate and paracingulate gyrus within bilateral cerebral hemisphere, and the postcentral gyrus and the precentral gyrus within the right-side. FE-BD displayed significant lower ReHo values than FE-MDD patients in these regions.

LIMITATIONS

The potential effects of medicine, age, course of disease and handedness on results could not be ignored.

CONCLUSIONS

Abnormal neural activities of frontoparietal network may provide common and distinct markers to affective disorders and scientific basis for further prediction researches of affective disorders.

Venlafaxine stimulates PNN proteolysis and MMP-9-dependent enhancement of gamma power; relevance to antidepressant efficacy

Drugs that target monoaminergic transmission represent a first-line treatment for major depression. Though a full understanding of the mechanisms that underlie antidepressant efficacy is lacking, evidence supports a role for enhanced excitatory transmission. This can occur through two non-mutually exclusive mechanisms. The first involves increased function of excitatory neurons through relatively direct mechanisms such as enhanced dendritic arborization. Another mechanism involves reduced inhibitory function, which occurs with the rapid antidepressant ketamine. Consistent with this, GABAergic interneuron-mediated cortical inhibition is linked to reduced gamma oscillatory power, a rhythm also diminished in depression. Remission of depressive symptoms correlates with restoration of gamma power. As a result of strong excitatory input, reliable GABA release, and fast firing, PV-expressing neurons (PV neurons) represent critical pacemakers for synchronous oscillations. PV neurons also represent the predominant GABAergic population enveloped by perineuronal nets (PNNs), lattice-like structures that localize glutamatergic input. Disruption of PNNs reduces PV excitability and enhances gamma activity. Studies suggest that monoamine reuptake inhibitors reduce integrity of the PNN. Mechanisms by which these inhibitors reduce PNN integrity, however, remain largely unexplored. A better understanding of these issues might encourage development of therapeutics that best up-regulate PNN-modulating proteases. We observe that the serotonin/norepinephrine reuptake inhibitor venlafaxine increases hippocampal matrix metalloproteinase (MMP)-9 levels as determined by ELISA and concomitantly reduces PNN integrity in murine hippocampus as determined by analysis of sections following their staining with a fluorescent PNN-binding lectin. Moreover, venlafaxine-treated mice (30 mg/kg/day) show an increase in carbachol-induced gamma power in ex vivo hippocampal slices as determined by local field potential recording and Matlab analyses. Studies with mice deficient in matrix metalloproteinase 9 (MMP-9), a protease linked to PNN disruption in other settings, suggest that MMP-9 contributes to venlafaxine-enhanced gamma power. In conclusion, our results support the possibility that MMP-9 activity contributes to antidepressant efficacy through effects on the PNN that may in turn enhance neuronal population dynamics involved in mood and/or memory. Cover Image for this issue: doi: 10.1111/jnc.14498.

Abnormal early dynamic individual patterns of functional networks in low gamma band for depression recognition

BACKGROUND

The functional networks are associated with emotional processing in depression. The mapping of dynamic spatio-temporal brain networks is used to explore individual performance during early negative emotional processing. However, the dysfunctions of functional networks in low gamma band and their discriminative potentialities during early period of emotional face processing remain to be explored.

METHODS

Functional brain networks were constructed from the MEG recordings of 54 depressed patients and 54 controls in low gamma band (30-48 Hz). Dynamic connectivity regression (DCR) algorithm analyzed the individual change points of time series in response to emotional stimuli and constructed individualized spatio-temporal patterns. The nodal characteristics of patterns were calculated and fed into support vector machine (SVM). Performance of the classification algorithm in low gamma band was validated by dynamic topological characteristics of individual patterns in comparison to alpha and beta band.

RESULTS

The best discrimination accuracy of individual spatio-temporal patterns was 91.01% in low gamma band. Individual temporal patterns had better results compared to group-averaged temporal patterns in all bands. The most important discriminative networks included affective network (AN) and fronto-parietal network (FPN) in low gamma band.

LIMITATIONS

The sample size is relatively small. High gamma band was not considered.

CONCLUSIONS

The abnormal dynamic functional networks in low gamma band during early emotion processing enabled depression recognition. The individual information processing is crucial in the discovery of abnormal spatio-temporal patterns in depression during early negative emotional processing. Individual spatio-temporal patterns may reflect the real dynamic function of subjects while group-averaged data may neglect some individual information.

Gamma oscillations as a biomarker for major depression: an emerging topic

Identifying biomarkers for major depression is of high importance for improving diagnosis and treatment of this common and debilitating neuropsychiatric disorder, as the field seeks to move toward both personalized and more effective treatments. Here we focus on electroencephalography (EEG) or direct scalp voltage recordings as such a biomarker, with an emphasis on gamma and high gamma oscillations (or "rhythms"). In the last several decades, alpha and theta band rhythms have been found to provide information on depressive state as well as recovery, but the gamma band is less well characterized with respect to depression. We summarize some key findings on gamma rhythms (especially their amplitude) as a biomarker or endophenotype for major depression. These studies suggest: (1) under certain conditions gamma rhythms can distinguish subjects with major depression from healthy controls, (2) gamma may distinguish bipolar disorder from unipolar depression, (3) various pharmacological and non-pharmacological treatments that counteract depression also alter gamma, (4) animal models of depression-like behavior show gamma abnormalities, with changes in gamma associated with therapeutic recovery. The most informative approaches in the future may combine profiles of gamma band power across the brain to assess ratios of activity across regions. Overall we have good evidence to suggest that gamma rhythms may provide objective information on major depressive disease status, but we will need further work to better define the precise measures to follow.

EEG gamma synchronization is associated with response to paroxetine treatment

BACKGROUND

Resistance to medication is a significant problem in psychiatric practice, and effective methods for predicting response are needed to optimize treatment efficacy and limit morbidity. Gamma oscillations are considered as an index of the brain's general cognitive activity; however, the role of gamma oscillations in disease has not been studied sufficiently.

AIM

This study aimed to determine if gamma power during rest can be used to predict response to anti-depressant medication treatment.

METHOD

Hamilton Depression Rating Scale (HDRS) score and resting state gamma power was measured in 18 medication-free patients during an episode of major depression. After 6 weeks of paroxetine monotherapy HDRS was administered again.

RESULTS

Baseline gamma power at frontal, central and temporal electrodes before treatment was significantly related to post-treatment change in HDRS scores.

CONCLUSION

The results indicate that gamma oscillations could be considered a marker of response to paroxetine treatment in patients with major depression.

Neuronal connectivity in major depressive disorder: a systematic review

BACKGROUND

The causes of major depressive disorder (MDD), as one of the most common psychiatric disorders, still remain unclear. Neuroimaging has substantially contributed to understanding the putative neuronal mechanisms underlying depressed mood and motivational as well as cognitive impairments in depressed individuals. In particular, analyses addressing changes in interregional connectivity seem to be a promising approach to capture the effects of MDD at a systems level. However, a plethora of different, sometimes contradicting results have been published so far, making general conclusions difficult. Here we provide a systematic overview about connectivity studies published in the field over the last decade considering different methodological as well as clinical issues.

METHODS

A systematic review was conducted extracting neuronal connectivity results from studies published between 2002 and 2015. The findings were summarized in tables and were graphically visualized.

RESULTS

The review supports and summarizes the notion of an altered frontolimbic mood regulation circuitry in MDD patients, but also stresses the heterogeneity of the findings. The brain regions that are most consistently affected across studies are the orbitomedial prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, cerebellum and the basal ganglia.

CONCLUSION

The results on connectivity in MDD are very heterogeneous, partly due to different methods and study designs, but also due to the temporal dynamics of connectivity. While connectivity research is an important step toward a complex systems approach to brain functioning, future research should focus on the dynamics of functional and effective connectivity.

Stream of consciousness: Quantum and biochemical assumptions regarding psychopathology

The accepted paradigms of mainstream neuropsychiatry appear to be incompletely adequate and in various cases offer equivocal analyses. However, a growing number of new approaches are being proposed that suggest the emergence of paradigm shifts in this area. In particular, quantum theories of mind, brain and consciousness seem to offer a profound change to the current approaches. Unfortunately these quantum paradigms harbor at least two serious problems. First, they are simply models, theories, and assumptions, with no convincing experiments supporting their claims. Second, they deviate from contemporary mainstream views of psychiatric illness and do so in revolutionary ways. We suggest a possible way to integrate experimental neuroscience with quantum models in order to address outstanding issues in psychopathology. A key role is played by the phenomenon called the "stream of consciousness", which can be linked to the so-called "Gamma Synchrony" (GS), which is clearly demonstrated by EEG data. In our novel proposal, a unipolar depressed patient could be seen as a subject with an altered stream of consciousness. In particular, some clues suggest that depression is linked to an "increased power" stream of consciousness. It is additionally suggested that such an approach to depression might be extended to psychopathology in general with potential benefits to diagnostics and therapeutics in neuropsychiatry.

Chronic Stress Increases Prefrontal Inhibition: A Mechanism for Stress-Induced Prefrontal Dysfunction

BACKGROUND

Multiple neuropsychiatric disorders, e.g., depression, are linked to imbalances in excitatory and inhibitory neurotransmission and prefrontal cortical dysfunction, and are concomitant with chronic stress.

METHODS

We used electrophysiologic (n = 5-6 animals, 21-25 cells/group), neuroanatomic (n = 6-8/group), and behavioral (n = 12/group) techniques to test the hypothesis that chronic stress increases inhibition of medial prefrontal cortex (mPFC) glutamatergic output neurons.

RESULTS

Using patch clamp recordings from infralimbic mPFC pyramidal neurons, we found that chronic stress selectively increases the frequency of miniature inhibitory postsynaptic currents with no effect on amplitude, which suggests that chronic stress increases presynaptic gamma-aminobutyric acid release. Elevated gamma-aminobutyric acid release under chronic stress is accompanied by increased inhibitory appositions and terminals onto glutamatergic cells, as assessed by both immunohistochemistry and electron microscopy. Furthermore, chronic stress decreases glucocorticoid receptor immunoreactivity specifically in a subset of inhibitory neurons, which suggests that increased inhibitory tone in the mPFC after chronic stress may be caused by loss of a glucocorticoid receptor-mediated brake on interneuron activity. These neuroanatomic and functional changes are associated with impairment of a prefrontal-mediated behavior. During chronic stress, rats initially make significantly more errors in the delayed spatial win-shift task, an mPFC-mediated behavior, which suggests a diminished impact of the mPFC on decision making.

CONCLUSIONS

Taken together, the data suggest that chronic stress increases synaptic inhibition onto prefrontal glutamatergic output neurons, limiting the influence of the prefrontal cortex in control of stress reactivity and behavior. Thus, these data provide a mechanistic link among chronic stress, prefrontal cortical hypofunction, and behavioral dysfunction.

Effects of neonatal stress on gamma oscillations in hippocampus

Chronic early life stress increases adult risk for depression, bipolar disorder and schizophrenia, illnesses characterized by aberrant functions of cognition and memory. We asked whether chronic early life stress disrupts maturation of gamma oscillations, on which these functions depend. Lifelong impairment of the stress response results from separation of rat pups from the dam for three hours per day during a critical period of hippocampal development (PNDs 2–14). Parvalbumin-expressing interneurons, including the basket cell network which is fundamental to gamma oscillations, are reduced in number in post mortem studies of bipolar disorder and schizophrenia, and in chronically-stressed adult rats. To determine effects of chronic early life stress on gamma oscillations, we separated pups from dams once each day on PNDs 2–14 and recorded in vitro at PNDs 15–21. In control pups, separated for 15 minutes per day, gamma power had highly significant correlations with both age (p = 0.0022) and weight (p = 0.0024); gamma in pups separated for 180 minutes per day was not correlated with either factor. ANCOVA indicated significant differences between the groups in both measures. These findings indicate that chronic early life stress can disrupt maturation of the gamma oscillation network.

Non-Conscious Perception of Emotions in Psychiatric Disorders: The Unsolved Puzzle of Psychopathology

Psychophysiological and functional neuroimaging studies have frequently and consistently shown that emotional information can be processed outside of the conscious awareness. Non-conscious processing comprises automatic, uncontrolled, and fast processing that occurs without subjective awareness. However, how such non-conscious emotional processing occurs in patients with various psychiatric disorders requires further examination. In this article, we reviewed and discussed previous studies on the non-conscious emotional processing in patients diagnosed with anxiety disorder, schizophrenia, bipolar disorder, and depression, to further understand how non-conscious emotional processing varies across these psychiatric disorders. Although the symptom profile of each disorder does not often overlap with one another, these patients commonly show abnormal emotional processing based on the pathology of their mood and cognitive function. This indicates that the observed abnormalities of emotional processing in certain social interactions may derive from a biased mood or cognition process that precedes consciously controlled and voluntary processes. Since preconscious forms of emotional processing appear to have a major effect on behaviour and cognition in patients with these disorders, further investigation is required to understand these processes and their impact on patient pathology.

Shared reduction of oscillatory natural frequencies in bipolar disorder, major depressive disorder and schizophrenia

INTRODUCTION

Recent studies have demonstrated that cortical brain areas tend to oscillate at a specific natural frequency when directly perturbed by transcranial magnetic stimulation (TMS). Fast electroencephalographic (EEG) oscillations, which typically originate from frontal regions, have been reported to be markedly reduced in schizophrenia.

METHODS

Here we employed TMS/EEG to assess the natural frequency of the premotor area in a sample of 48 age-matched participants (12 each in major depression disorder (MDD)), bipolar disorder (BPD), schizophrenia (SCZ) and healthy controls. Event related spectral perturbations (ERSP) were obtained for each study participant using wavelet decomposition.

RESULTS

TMS resulted in a significant activation of the beta/gamma band response (21-50 Hz) to frontal cortical perturbation in healthy control subjects. By contrast, the main frequencies of frontal EEG responses to TMS were significantly reduced in patients with BPD, MDD and SCZ (11-27 Hz) relative to healthy subjects.

CONCLUSIONS

Patients with bipolar disorder, major depression and schizophrenia showed a significantly lower natural frequency of frontal cortico-thalamocortical circuits compared to healthy controls. These results suggest a common neurobiological mechanism of corticothalamic impairment. The most likely candidates include dysfunction of GABAergic circuits.

LIMITATIONS

Further studies are needed to consider other biological markers, gene variants, and their interaction with clinical variables.

Two cellular hypotheses explaining the initiation of ketamine's antidepressant actions: Direct inhibition and disinhibition

A single, low dose of ketamine evokes antidepressant actions in depressed patients and in patients with treatment-resistant depression (TRD). Unlike classic antidepressants, which regulate monoamine neurotransmitter systems, ketamine is an antagonist of the N-methyl-D-aspartate (NMDA) family of glutamate receptors. The effectiveness of NMDAR antagonists in TRD unveils a new set of targets for therapeutic intervention in major depressive disorder (MDD) and TRD. However, a better understanding of the cellular mechanisms underlying these effects is required for guiding future therapeutic strategies, in order to minimize side effects and prolong duration of efficacy. Here we review the evidence for and against two hypotheses that have been proposed to explain how NMDAR antagonism initiates protein synthesis and increases excitatory synaptic drive in corticolimbic brain regions, either through selective antagonism of inhibitory interneurons and cortical disinhibition, or by direct inhibition of cortical pyramidal neurons. This article is part of the Special Issue entitled 'Synaptopathy--from Biology to Therapy'.

Serotonin Modulation of Prefronto-Hippocampal Rhythms in Health and Disease

There is mounting evidence that most cognitive functions depend upon the coordinated activity of neuronal networks often located far from each other in the brain. Ensembles of neurons synchronize their activity, generating oscillations at different frequencies that may encode behavior by allowing an efficient communication between brain areas. The serotonin system, by virtue of the widespread arborisation of serotonergic neurons, is in an excellent position to exert strong modulatory actions on brain rhythms. These include specific oscillatory activities in the prefrontal cortex and the hippocampus, two brain areas essential for many higher-order cognitive functions. Psychiatric patients show abnormal oscillatory activities in these areas, notably patients with schizophrenia who display psychotic symptoms as well as affective and cognitive impairments. Synchronization of neural activity between the prefrontal cortex and the hippocampus seems to be important for cognition and, in fact, reduced prefronto-hippocampal synchrony has been observed in a genetic mouse model of schizophrenia. Here, we review recent advances in the field of neuromodulation of brain rhythms by serotonin, focusing on the actions of serotonin in the prefrontal cortex and the hippocampus. Considering that the serotonergic system plays a crucial role in cognition and mood and is a target of many psychiatric treatments, it is surprising that this field of research is still in its infancy. In that regard, we point to future investigations that are much needed in this field.

Conditional neuroligin-2 knockout in adult medial prefrontal cortex links chronic changes in synaptic inhibition to cognitive impairments

Abnormal activity in the medial prefrontal cortex (mPFC) is consistently observed in neuropsychiatric disorders, but the mechanisms involved remain unclear. Chronic aberrant excitation and/or inhibition of mPFC neurons were proposed to cause cognitive impairments. However, direct evidence for this hypothesis is lacking because it is technically challenging to control synaptic properties in a chronic and locally restricted, yet specific, manner. Here, we generated conditional knockout (cKO) mice of neuroligin-2 (Nlgn2), a postsynaptic cell-adhesion molecule of inhibitory synapses linked to neuropsychiatric disorders. cKO of Nlgn2 in adult mPFC rendered Nlgn2 protein undetectable after already 2-3 weeks, but induced major reductions in synaptic inhibition after only 6-7 weeks, and caused parallel impairments in anxiety, fear memory and social interaction behaviors. Moreover, cKO of Nlgn2 severely impaired behavioral stimulation of immediate-early gene expression in the mPFC, suggesting that chronic reduction in synaptic inhibition uncoupled the mPFC from experience-dependent inputs. Our results indicate that Nlgn2 is required for continuous maintenance of inhibitory synapses in the adult mPFC, and that chronic impairment of local inhibition disengages the mPFC from its cognitive functions by partially uncoupling the mPFC from experience-induced inputs.

Impaired fast-spiking interneuron function in a genetic mouse model of depression

Rhythmic neuronal activity provides a frame for information coding by co-active cell assemblies. Abnormal brain rhythms are considered as potential pathophysiological mechanisms causing mental disease, but the underlying network defects are largely unknown. We find that mice expressing truncated Disrupted-in-Schizophrenia 1 (Disc1), which mirror a high-prevalence genotype for human psychiatric illness, show depression-related behavior. Theta and low-gamma synchrony in the prelimbic cortex (PrlC) is impaired in Disc1 mice and inversely correlated with the extent of behavioural despair. While weak theta activity is driven by the hippocampus, disturbance of low-gamma oscillations is caused by local defects of parvalbumin (PV)-expressing fast-spiking interneurons (FS-INs). The number of FS-INs is reduced, they receive fewer excitatory inputs, and form fewer release sites on targets. Computational analysis indicates that weak excitatory input and inhibitory output of FS-INs may lead to impaired gamma oscillations. Our data link network defects with a gene mutation underlying depression in humans.

DOI:http://dx.doi.org/10.7554/eLife.04979.001

Our thoughts and emotions are produced and processed by complex networks of neurons inside our brains. Signals are sent from one neuron to another via chemical messengers, and pass through the neuron as an electrical signal. The electrical signals produced by a brain region often show steady rhythms, or oscillations. In the brains of many people diagnosed with certain mental disorders, such as schizophrenia and major depression, these oscillations are disrupted, but how these changes in rhythm are linked to defects in the networks of neurons behind the electrical activity is not well understood.

Studies of a family in Scotland over several decades revealed that a gene called DISC1 was shortened in family members who had been diagnosed with mental illnesses. Recently, scientists have been able to create mice that have mutations that are equivalent to this DISC1 mutation. It is hoped that studying the behavior and neural activity of these mutant mice could lead to a better understanding of human mental disorders.

Sauer et al. confirmed that the mutant mice showed depression-related behavior; in experiments that involved trying to escape from hopeless situations, the mutant mice gave up on their escape attempts much sooner than the normal mice. Recording the brain activity of these ‘depressed’ mice showed that the activity of a brain region called the prelimbic cortex was weak and disordered—very much like the brain activity seen in human depression. In particular, two types of brain activity, called theta and low-gamma oscillations, were not synchronized.

To determine precisely what causes these abnormal oscillations, Sauer et al. took brain slices from depressed mice, and then stained them with dyes that showed the circuits in the prelimbic cortex more clearly. This revealed that depressed mice had developmental defects in a specific type of inhibitory neuron called fast-spiking interneurons—there were fewer of these cells, and the neurons that were there did not have the correct number of connections to other neurons. Further investigation showed that these neurons had difficulties receiving and releasing the chemical messengers that allow neurons to communicate, and Sauer et al. thought that this might cause the low-gamma oscillation problems.

To confirm this theory, Sauer et al. created a computer model that simulated the defective interneurons. The simulations support the theory that the defects in the fast-spiking interneurons cause the abnormal low-gamma rhythms seen in depressed mice. In the future, a better understanding of the defects of inhibitory cells in DISC1 mutants and other mouse models of mental illness might open up new avenues for targeted drug design. As the prelimbic cortex combines inputs from various other brain areas, a further challenge will be to examine whether these inputs influence the activity of the prelimbic cortex and thus contribute to depression-related behavior.

DOI:http://dx.doi.org/10.7554/eLife.04979.002

Increased visual gamma power in schizoaffective bipolar disorder

BACKGROUND

Electroencephalography and magnetoencephalography (MEG) studies have identified alterations in gamma-band (30-80 Hz) cortical activity in schizophrenia and mood disorders, consistent with neural models of disturbed glutamate (and GABA) neuron influence over cortical pyramidal cells. Genetic evidence suggests specific deficits in GABA-A receptor function in schizoaffective bipolar disorder (SABP), a clinical syndrome with features of both bipolar disorder and schizophrenia. This study investigated gamma oscillations in this under-researched disorder.

METHOD

MEG was used to measure induced gamma and evoked responses to a visual grating stimulus, known to be a potent inducer of primary visual gamma oscillations, in 15 individuals with remitted SABP, defined using Research Diagnostic Criteria, and 22 age- and sex-matched healthy controls.

RESULTS

Individuals with SABP demonstrated increased sustained visual cortical power in the gamma band (t 35 = -2.56, p = 0.015) compared to controls. There were no group differences in baseline gamma power, transient or sustained gamma frequency, alpha band responses or pattern onset visual-evoked responses.

CONCLUSIONS

Gamma power is increased in remitted SABP, which reflects an abnormality in the cortical inhibitory-excitatory balance. Although an interaction between gamma power and medication can not be ruled out, there were no group differences in evoked responses or baseline measures. Further work is needed in other clinical populations and at-risk relatives. Pharmaco-magnetoencephalography studies will help to elucidate the specific GABA and glutamate pathways affected.

Asymmetric engagement of amygdala and its gamma connectivity in early emotional face processing

The amygdala has been regarded as a key substrate for emotion processing. However, the engagement of the left and right amygdala during the early perceptual processing of different emotional faces remains unclear. We investigated the temporal profiles of oscillatory gamma activity in the amygdala and effective connectivity of the amygdala with the thalamus and cortical areas during implicit emotion-perceptual tasks using event-related magnetoencephalography (MEG). We found that within 100 ms after stimulus onset the right amygdala habituated to emotional faces rapidly (with duration around 20–30 ms), whereas activity in the left amygdala (with duration around 50–60 ms) sustained longer than that in the right. Our data suggest that the right amygdala could be linked to autonomic arousal generated by facial emotions and the left amygdala might be involved in decoding or evaluating expressive faces in the early perceptual emotion processing. The results of effective connectivity provide evidence that only negative emotional processing engages both cortical and subcortical pathways connected to the right amygdala, representing its evolutional significance (survival). These findings demonstrate the asymmetric engagement of bilateral amygdala in emotional face processing as well as the capability of MEG for assessing thalamo-cortico-limbic circuitry.

Brain electrical source imaging in manic and depressive episodes of bipolar disorder

OBJECTIVE

Bipolar disorder (BD) electroencephalographic (EEG) studies have reported varying results. The present study compared EEG in BD during manic and depressive episodes, using brain electrical source imaging [standardized low-resolution electromagnetic tomography (sLORETA)] to assess the cortical spatial distribution of the sources of EEG oscillation frequencies.

METHODS

Two independent datasets (a total of 95 patients with bipolar I disorder, of whom 59 were female) were analyzed. Dataset #1 comprised 14 patients in a manic as well as a depressive episode. Dataset #2 comprised 26 patients in a manic episode and 55 patients in a depressive episode. From the head surface-recorded EEG, sLORETA cortical activity was computed in eight EEG frequency bands, and compared between mood states in both datasets. The results from the two datasets were combined using conjunction analysis.

RESULTS

Conjunction analysis yielded significant differences between mood states: In manic compared to depressive states, patients had lesser theta frequency band activity (right-hemispheric lateral lower prefrontal and anterior temporal, mainly Brodmann areas 13, 38, and 47), and greater beta-2 and beta-3 frequency band activity (extended bilateral prefrontal-to-parietal, mainly Brodmann area 6, and the cingulate).

CONCLUSIONS

The spatial organization of the brain's electrical oscillations differed in patients with BD between manic and depressive mood states. The brain areas implementing the main functions that show opposing abnormalities during manic and depressive episodes were affected by unduly increased or decreased activity (beta or theta). The discussion considers that facilitating (beta) or inhibiting (theta) electrical activity can in either case result in behavioral facilitation or inhibition, depending on the function of the brain area.

Downregulation of neuregulin 1-ErbB4 signaling in parvalbumin interneurons in the rat brain may contribute to the antidepressant properties of ketamine

Increasing evidence underscores the strong, rapid, and sustained antidepressant properties of ketamine with a good tolerability profile in patients with depression; however, the underlying mechanisms are not fully elucidated. Neuregulin 1 (NRG1) is a bipolar disorder susceptibility gene and a biomarker of major depressive disorder, which regulates pyramidal neuron activity via ErbB4 in parvalbumin interneurons. Moreover, NRG1-ErbB4 signaling is reported to play a key role in the modulation of synaptic plasticity through regulating the neurotransmission. We therefore hypothesized that hypofunction of NRG1-ErbB4 signaling in parvalbumin interneurons is involved in the process of ketamine exerting rapid antidepressant actions in rats subjected to the forced swimming test (FST). The results showed that ketamine reduced the immobility time and latency to feed of rats receiving the FST, downregulated the levels of NRG1, phosphorylated ErbB4 (p-ErbB4), parvalbumin, 67-kDA isoform of glutamic acid decarboxylase (GAD67), gamma-aminobutyric acid (GABA), and upregulated the levels of glutamate in the rat prefrontal cortex and hippocampus. Pretreatment with NRG1 abolished both ketamine's antidepressant effects and ketamine-induced reduction in p-ErbB4, parvalbumin, GAD67, and GABA levels and increase in glutamate levels. These results suggest that the downregulation of NRG1-ErbB4 signaling in parvalbumin interneurons in the rat brain may be a mechanism underlying ketamine's antidepressant properties.

Abnormal early gamma responses to emotional faces differentiate unipolar from bipolar disorder patients

This study investigates the cortical abnormalities of early emotion perception in patients with major depressive disorder (MDD) and bipolar disorder (BD) using gamma oscillations. Twenty-three MDD patients, twenty-five BD patients, and twenty-four normal controls were enrolled and their event-related magnetoencephalographic responses were recorded during implicit emotional tasks. Our results demonstrated abnormal gamma activity within 100 ms in the emotion-related regions (amygdala, orbitofrontal (OFC) cortex, anterior insula (AI), and superior temporal pole) in the MDD patients, suggesting that these patients may have dysfunctions or negativity biases in perceptual binding of emotional features at very early stage. Decreased left superior medial frontal cortex (smFC) responses to happy faces in the MDD patients were correlated with their serious level of depression symptoms, indicating that decreased smFC activity perhaps underlies irregular positive emotion processing in depressed patients. In the BD patients, we showed abnormal activation in visual regions (inferior/middle occipital and middle temporal cortices) which responded to emotional faces within 100 ms, supporting that the BD patients may hyperactively respond to emotional features in perceptual binding. The discriminant function of gamma activation in the left smFC, right medial OFC, right AI/inferior OFC, and the right precentral cortex accurately classified 89.6% of patients as unipolar/bipolar disorders.

Right fronto-parietal dysfunction underlying spatial attention in bipolar disorder

Although the neural underpinning of bipolar disorder (BD) is still unknown, recent research suggests that the right fronto-parietal cortex is particularly affected in BD patients. If this were true, we would expect atypical functional cerebral asymmetries in allocation of visuospatial attention. To test this hypothesis, euthymic BD patients and age- and gender-matched healthy controls were compared on the visual line-bisection task, a reliable measure of visuospatial attention, associated with right parietal function. Line bisection performance (i.e. absolute and directional bias) was compared between groups as a function of response hand and line position. The results showed a typical hand-use effect in healthy controls involving a larger leftward bias (i.e. pseudoneglect) with the left hand than with the right hand. Although euthymic BD patients did not differ from healthy controls in the overall accuracy (i.e. absolute bias), they differed significantly in the directional line bisection bias. In contrast to healthy controls, BD patients did not significantly deviate from the veridical center, regardless of which hand was used to bisect horizontal lines. This finding indicates an atypical functional cerebral asymmetry in visuospatial attention in euthymic BD patients, supporting the idea of a dysfunction especially in the right fronto-parietal cortex.

Marked reductions in visual evoked responses but not γ-aminobutyric acid concentrations or γ-band measures in remitted depression

BACKGROUND

Magnetic resonance spectroscopy (MRS) studies have consistently demonstrated reduced cortical γ-aminobutyric acid (GABA) concentrations in individuals with major depression. However, evidence for a persistent deficit during remission, which would suggest that GABA dysfunction is a possible trait marker of depression, is equivocal. Although MRS measures total concentration of GABA, magneto-encephalography provides direct measures of neural activity, with cortical γ oscillations shaped by the activity of GABAergic inhibitory interneurons. In this study we investigated whether γ oscillations and GABA concentrations would differ in individuals with remitted depression (RD) compared with never depressed control subjects (ND).

METHODS

Thirty-seven healthy, unmedicated female volunteers (n = 19 RD, and n = 18 ND) were recruited. The γ oscillation frequencies and amplitudes in the visual cortex, induced by simple grating stimuli, were quantified with time-frequency analyses. Distinct GABA/glutamate + glutamine MRS peaks were resolved from MEGA-PRESS difference spectra in prefrontal, occipital, and subcortical volumes.

RESULTS

The RD and ND individuals did not differ in the frequency of subclinical depressive symptoms. The ND were slightly older (mean = 23 years vs. 21 years), but age did not correlate with dependent measures. There were no group differences in GABA levels or induced cortical γ measures, but RD individuals had markedly reduced M80 (C1) components of the pattern-onset evoked response (46% reduction, Cohen's d = 1.01, p = .006).

CONCLUSIONS

Both MRS and magneto-encephalography measures of the GABA system are normal in RD. However, the early visual evoked response is a potential trait marker of the disorder.