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Spoelma MJ, Serafimovska A, Parker G. Differentiating melancholic and non-melancholic depression via biological markers: A review. World J Biol Psychiatry 2023; 24:761-810. [PMID: 37259772 DOI: 10.1080/15622975.2023.2219725] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Melancholia is a severe form of depression that is typified by greater genetic and biological influence, distinct symptomatology, and preferential response to physical treatment. This paper sought to broadly overview potential biomarkers of melancholia to benefit differential diagnosis, clinical responses and treatment outcomes. Given nuances in distinguishing melancholia as its own condition from other depressive disorder, we emphasised studies directly comparing melancholic to non-melancholic depression. METHODS A comprehensive literature search was conducted. Key studies were identified and summarised qualitatively. RESULTS 105 studies in total were identified. These studies covered a wide variety of biomarkers, and largely fell into three domains: endocrinological (especially cortisol levels, particularly in response to the dexamethasone suppression test), neurological, and immunological (particularly inflammatory markers). Less extensive evidence also exists for metabolic, genetic, and cardiovascular markers. CONCLUSIONS Definitive conclusions were predominantly limited due to substantial heterogeneity in how included studies defined melancholia. Furthermore, this heterogeneity could be responsible for the between- and within-group variability observed in the candidate biomarkers that were examined. Therefore, clarifying these definitional parameters may help identify underlying patterns in biomarker expression to improve diagnostic and therapeutic precision for the depressive disorders.
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Affiliation(s)
- Michael J Spoelma
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | | | - Gordon Parker
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
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2
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Luo G, Rao H, An P, Li Y, Hong R, Chen W, Chen S. Exploring Adaptive Graph Topologies and Temporal Graph Networks for EEG-Based Depression Detection. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3947-3957. [PMID: 37773916 DOI: 10.1109/tnsre.2023.3320693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
In recent years, Graph Neural Networks (GNNs) based on deep learning techniques have achieved promising results in EEG-based depression detection tasks but still have some limitations. Firstly, most existing GNN-based methods use pre-computed graph adjacency matrices, which ignore the differences in brain networks between individuals. Additionally, methods based on graph-structured data do not consider the temporal dependency information of brain networks. To address these issues, we propose a deep learning algorithm that explores adaptive graph topologies and temporal graph networks for EEG-based depression detection. Specifically, we designed an Adaptive Graph Topology Generation (AGTG) module that can adaptively model the real-time connectivity of the brain networks, revealing differences between individuals. In addition, we designed a Graph Convolutional Gated Recurrent Unit (GCGRU) module to capture the temporal dynamical changes of brain networks. To further explore the differential features between depressed and healthy individuals, we adopt Graph Topology-based Max-Pooling (GTMP) module to extract graph representation vectors accurately. We conduct a comparative analysis with several advanced algorithms on both public and our own datasets. The results reveal that our final model achieves the highest Area Under the Receiver Operating Characteristic Curve (AUROC) on both datasets, with values of 83% and 99%, respectively. Furthermore, we perform extensive validation experiments demonstrating our proposed method's effectiveness and advantages. Finally, we present a comprehensive discussion on the differences in brain networks between healthy and depressed individuals based on the outputs of our final model's AGTG and GTMP modules.
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3
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Alterations in EEG functional connectivity in individuals with depression: A systematic review. J Affect Disord 2023; 328:287-302. [PMID: 36801418 DOI: 10.1016/j.jad.2023.01.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/19/2023]
Abstract
The brain works as an organised, network-like structure of functionally interconnected regions. Disruptions to interconnectivity in certain networks have been linked to symptoms of depression and impairments in cognition. Electroencephalography (EEG) is a low-burden tool by which differences in functional connectivity (FC) can be assessed. This systematic review aims to provide a synthesis of evidence relating to EEG FC in depression. A comprehensive electronic literature search for terms relating to depression, EEG, and FC was conducted on studies published before the end of November 2021, according to PRISMA guidelines. Studies comparing EEG measures of FC of individuals with depression to that of healthy control groups were included. Data was extracted by two independent reviewers, and the quality of EEG FC methods was assessed. Fifty-two studies assessing EEG FC in depression were identified: 36 assessed resting-state FC, and 16 assessed task-related or other (i.e., sleep) FC. Somewhat consistent findings in resting-state studies suggest for no differences between depression and control groups in EEG FC in the delta and gamma frequencies. However, while most resting-state studies noted a difference in alpha, theta, and beta, no clear conclusions could be drawn about the direction of the difference, due to considerable inconsistencies between study design and methodology. This was also true for task-related and other EEG FC. More robust research is needed to understand the true differences in EEG FC in depression. Given that the FC between brain regions drives behaviour, cognition, and emotion, characterising how FC differs in depression is essential for understanding the aetiology of depression.
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4
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Subramanian S, Labonte AK, Nguyen T, Luong AH, Hyche O, Smith SK, Hogan RE, Farber NB, Palanca BJA, Kafashan M. Correlating electroconvulsive therapy response to electroencephalographic markers: Study protocol. Front Psychiatry 2022; 13:996733. [PMID: 36405897 PMCID: PMC9670172 DOI: 10.3389/fpsyt.2022.996733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Electroconvulsive therapy (ECT) is an effective intervention for patients with major depressive disorder (MDD). Despite longstanding use, the underlying mechanisms of ECT are unknown, and there are no objective prognostic biomarkers that are routinely used for ECT response. Two electroencephalographic (EEG) markers, sleep slow waves and sleep spindles, could address these needs. Both sleep microstructure EEG markers are associated with synaptic plasticity, implicated in memory consolidation, and have reduced expression in depressed individuals. We hypothesize that ECT alleviates depression through enhanced expression of sleep slow waves and sleep spindles, thereby facilitating synaptic reconfiguration in pathologic neural circuits. Methods Correlating ECT Response to EEG Markers (CET-REM) is a single-center, prospective, observational investigation. Wireless wearable headbands with dry EEG electrodes will be utilized for at-home unattended sleep studies to allow calculation of quantitative measures of sleep slow waves (EEG SWA, 0.5-4 Hz power) and sleep spindles (density in number/minute). High-density EEG data will be acquired during ECT to quantify seizure markers. Discussion This innovative study focuses on the longitudinal relationships of sleep microstructure and ECT seizure markers over the treatment course. We anticipate that the results from this study will improve our understanding of ECT.
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Affiliation(s)
- Subha Subramanian
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Alyssa K. Labonte
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Neuroscience Graduate Program, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Thomas Nguyen
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Anhthi H. Luong
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Department of Health Policy and Management, Columbia University, New York, NY, United States
| | - Orlandrea Hyche
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - S. Kendall Smith
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, MO, United States
| | - R. Edward Hogan
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Nuri B. Farber
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Ben Julian A. Palanca
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, MO, United States
- Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
- Neuroimaging Labs Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - MohammadMehdi Kafashan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, MO, United States
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5
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Li ZR, Liu DG, Xie S, Wang YH, Han YS, Li CY, Zou MS, Jiang HX. Sleep deprivation leads to further impairment of hippocampal synaptic plasticity by suppressing melatonin secretion in the pineal gland of chronically unpredictable stress rats. Eur J Pharmacol 2022; 930:175149. [PMID: 35878808 DOI: 10.1016/j.ejphar.2022.175149] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 11/27/2022]
Abstract
There has been ample research showing that insomnia is a potential trigger of depression as well as a symptom of depression. These two factors contribute to behavioral problems and are closely related to the plasticity of hippocampal synapses. Although depression and insomnia impair hippocampal synaptic plasticity, the mechanism by which this happens remains a mystery. This study aimed to investigate the pathogenesis of insomnia comorbidity in depression and the regulatory effect of venlafaxine combined with melatonin on hippocampal synaptic plasticity in chronic unpredictable mild stress (CUMS) with sleep deprivation (SD) rats. Thus, rats were subjected to 14 days of chronic mild unpredictable stress, gradually acclimated to sleep deprivation on days 12-14. Followed by 21 consecutive days of sleep deprivation, 18 hours per day, with daily gavage of venlafaxine (13.5 mg/kg) + melatonin (72 mg/kg) on days 15-36. Venlafaxine + melatonin treatment improves depression-like behavior, pentobarbital sodium experimental sleep latency, and sleep duration in CUMS +SD rats. In addition to improving depressive-like behaviors, sleep deprivation also upregulates the expression of caspase-specific cysteine protein 3 (Caspase 3) in the pineal glial cells of chronic mild rats, as well as in hippocampal microglia. Expression of ionic calcium-binding adaptor 1 (iba-1), downregulates the secretion of several synaptic plasticity-related proteins, notably cAMP response element binding protein (CREB), glial cell line-derived neurotrophic factor (GDNF), and the synaptic scaffolding protein Spinophiline (Spinophiline). Hematoxylin-eosin staining showed that the structure of the pineal gland and hippocampus was damaged, and Golgi staining showed that the dendrites and spines in the DG area of the hippocampus were destroyed, vaguely aggregated or even disappeared, and the connection network could not be established. Western blot analysis further revealed a positive correlation between low melatonin levels and reduced Spinophiline protein. Interestingly, venlafaxine + melatonin reversed these events by promoting hippocampal synaptic plasticity by regulating melatonin secretion from the pineal gland. Therefore, it exerted an antidepressant effect in sleep deprivation combined with CUMS model rats. Overall, the results of this study suggest that the pathophysiology of depressive insomnia comorbidity is mediated by impaired pineal melatonin secretion and impaired hippocampal synaptic plasticity. In addition, these responses are associated with melatonin secretion from the pineal gland.
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Affiliation(s)
- Zi-Rong Li
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, Nanning, 530022, China; State Key Laboratory of Chinese Medicine Powder and Medicine Innovation in Hunan (incubation), Hunan University of Chinese Medicine, Hunan, Changsha, 410208, China
| | - De-Guo Liu
- Department of Breast Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, Nanning, 530022, China
| | - Sheng Xie
- Prevention of Diseases with Traditional Chinese Medicine Center, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, Nanning, 530022, China.
| | - Yu-Hong Wang
- State Key Laboratory of Chinese Medicine Powder and Medicine Innovation in Hunan (incubation), Hunan University of Chinese Medicine, Hunan, Changsha, 410208, China.
| | - Yuan-Shan Han
- Department of Experimental Center for Medical Innovation, The First Affiliated Hospital of Hunan University of Chinese Medicine, Hunan, Changsha, 410021, China
| | - Chun-Yan Li
- State Key Laboratory of Chinese Medicine Powder and Medicine Innovation in Hunan (incubation), Hunan University of Chinese Medicine, Hunan, Changsha, 410208, China
| | - Man-Shu Zou
- State Key Laboratory of Chinese Medicine Powder and Medicine Innovation in Hunan (incubation), Hunan University of Chinese Medicine, Hunan, Changsha, 410208, China
| | - Hai-Xing Jiang
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, 530021, China
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6
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Zhang Y, Wang K, Yu W, Guo X, Wen J, Luo Y. Minimal EEG channel selection for depression detection with connectivity features during sleep. Comput Biol Med 2022; 147:105690. [DOI: 10.1016/j.compbiomed.2022.105690] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
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7
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Song Y, Wang K, Wei Y, Zhu Y, Wen J, Luo Y. Graph Theory Analysis of the Cortical Functional Network During Sleep in Patients With Depression. Front Physiol 2022; 13:858739. [PMID: 35721531 PMCID: PMC9199990 DOI: 10.3389/fphys.2022.858739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
Depression, a common mental illness that seriously affects the psychological health of patients, is also thought to be associated with abnormal brain functional connectivity. This study aimed to explore the differences in the sleep-state functional network topology in depressed patients. A total of 25 healthy participants and 26 depressed patients underwent overnight 16-channel electroencephalography (EEG) examination. The cortical networks were constructed by using functional connectivity metrics of participants based on the weighted phase lag index (WPLI) between the EEG signals. The results indicated that depressed patients exhibited higher global efficiency and node strength than healthy participants. Furthermore, the depressed group indicated right-lateralization in the δ band. The top 30% of connectivity in both groups were shown in undirected connectivity graphs, revealing the distinct link patterns between the depressed and control groups. Links between the hemispheres were noted in the patient group, while the links in the control group were only observed within each hemisphere, and there were many long-range links inside the hemisphere. The altered sleep-state functional network topology in depressed patients may provide clues for a better understanding of the depression pathology. Overall, functional network topology may become a powerful tool for the diagnosis of depression.
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Affiliation(s)
- Yingjie Song
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Kejie Wang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yu Wei
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yongpeng Zhu
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Jinfeng Wen
- Department of Psychology, Guangdong, 999 Brain Hospital, Guangzhou, China
| | - Yuxi Luo
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instruments, Sun Yat-sen University, Guangzhou, China
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8
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Lian J, Luo Y, Zheng M, Zhang J, Liang J, Wen J, Guo X. Sleep-Dependent Anomalous Cortical Information Interaction in Patients With Depression. Front Neurosci 2022; 15:736426. [PMID: 35069093 PMCID: PMC8772413 DOI: 10.3389/fnins.2021.736426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022] Open
Abstract
Depression is a prevalent mental illness with high morbidity and is considered the main cause of disability worldwide. Brain activity while sleeping is reported to be affected by such mental illness. To explore the change of cortical information flow during sleep in depressed patients, a delay symbolic phase transfer entropy of scalp electroencephalography signals was used to measure effective connectivity between cortical regions in various frequency bands and sleep stages. The patient group and the control group shared similar patterns of information flow between channels during sleep. Obvious information flows to the left hemisphere and to the anterior cortex were found. Moreover, the occiput tended to be the information driver, whereas the frontal regions played the role of the receiver, and the right hemispheric regions showed a stronger information drive than the left ones. Compared with healthy controls, such directional tendencies in information flow and the definiteness of role division in cortical regions were both weakened in patients in most frequency bands and sleep stages, but the beta band during the N1 stage was an exception. The computable sleep-dependent cortical interaction may provide clues to characterize cortical abnormalities in depressed patients and should be helpful for the diagnosis of depression.
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Affiliation(s)
- Jiakai Lian
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yuxi Luo
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Sensing Technology and Biomedical Instruments, Sun Yat-sen University, Guangzhou, China
| | - Minglong Zheng
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Jiaxi Zhang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Jiuxing Liang
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Jinfeng Wen
- Department of Psychology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Xinwen Guo
- Department of Psychology, Guangdong 999 Brain Hospital, Guangzhou, China
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9
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Lian J, Song Y, Zhang Y, Guo X, Wen J, Luo Y. Characterization of specific spatial functional connectivity difference in depression during sleep. J Neurosci Res 2021; 99:3021-3034. [PMID: 34637550 DOI: 10.1002/jnr.24947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/14/2021] [Accepted: 08/04/2021] [Indexed: 11/08/2022]
Abstract
Depression is a common mental illness and a large number of researchers have been still devoted to exploring effective biomarkers for the identification of depression. Few researches have been conducted on functional connectivity (FC) during sleep in depression. In this paper, a novel depression characterization is proposed using specific spatial FC features of sleep electroencephalography (EEG). Overnight polysomnography recordings were obtained from 26 healthy individuals and 25 patients with depression. The weighted phase lag indexes (WPLIs) of four frequency bands and five sleep periods were obtained from 16 EEG channels. The high discriminative connections extracted via feature evaluation and the cross-within variation (CW)-the spatial feature constructed to characterize the different performances in inter- and intra-hemispheric FC based on WPLIs, were utilized to classify patients and normal controls. The results showed that enhanced average FC and spatial differences, higher inter-hemispheric FC and lower intra-hemispheric FC, were found in patients. Furthermore, abnormalities in the inter-hemispheric connections of the temporal lobe in the theta band should be important indicators of depression. Finally, both CW and high discriminative WPLI features performed well in depression screening and CW was more specific for characterizing abnormal cortical EEG performance of depression. Our work investigated and characterized the abnormalities in sleep cortical activity in patients with depression, and may provide potential biomarkers for assisting with depression identification and new insights into the understanding of pathological mechanisms in depression.
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Affiliation(s)
- Jiakai Lian
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yingjie Song
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Yangting Zhang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Xinwen Guo
- Psychology Department, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Jinfeng Wen
- Psychology Department, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Yuxi Luo
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, Sun Yat-Sen University, Guangzhou, China
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Bruun CF, Arnbjerg CJ, Kessing LV. Electroencephalographic Parameters Differentiating Melancholic Depression, Non-melancholic Depression, and Healthy Controls. A Systematic Review. Front Psychiatry 2021; 12:648713. [PMID: 34489747 PMCID: PMC8417250 DOI: 10.3389/fpsyt.2021.648713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 07/27/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction: The objective of this systematic review was to investigate whether electroencephalographic parameters can serve as a tool to distinguish between melancholic depression, non-melancholic depression, and healthy controls in adults. Methods: A systematic review comprising an extensive literature search conducted in PubMed, Embase, Google Scholar, and PsycINFO in August 2020 with monthly updates until November 1st, 2020. In addition, we performed a citation search and scanned reference lists. Clinical trials that performed an EEG-based examination on an adult patient group diagnosed with melancholic unipolar depression and compared with a control group of non-melancholic unipolar depression and/or healthy controls were eligible. Risk of bias was assessed by the Strengthening of Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: A total of 24 studies, all case-control design, met the inclusion criteria and could be divided into three subgroups: Resting state studies (n = 5), sleep EEG studies (n = 10), and event-related potentials (ERP) studies (n = 9). Within each subgroup, studies were characterized by marked variability on almost all levels, preventing pooling of data, and many studies were subject to weighty methodological problems. However, the main part of the studies identified one or several EEG parameters that differentiated the groups. Conclusions: Multiple EEG modalities showed an ability to distinguish melancholic patients from non-melancholic patients and/or healthy controls. The considerable heterogeneity across studies and the frequent methodological difficulties at the individual study level were the main limitations to this work. Also, the underlying premise of shifting diagnostic paradigms may have resulted in an inhomogeneous patient population. Systematic Review Registration: Registered in the PROSPERO registry on August 8th, 2020, registration number CRD42020197472.
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Affiliation(s)
- Caroline Fussing Bruun
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Caroline Juhl Arnbjerg
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Simon L, Blay M, Galvao F, Brunelin J. Using EEG to Predict Clinical Response to Electroconvulsive Therapy in Patients With Major Depression: A Comprehensive Review. Front Psychiatry 2021; 12:643710. [PMID: 34248695 PMCID: PMC8264052 DOI: 10.3389/fpsyt.2021.643710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: An important approach to improve the therapeutic effect of electroconvulsive therapy (ECT) may be to early characterize patients who are more likely to respond. Our objective was to explore whether baseline electroencephalography (EEG) settings before the beginning of ECT treatment can predict future clinical response to ECT in patients with depressive disorder. Methods: We conducted a systematic search in the MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify studies using EEG in adults with depressive disorder treated by ECT. To investigate the predictive value of baseline EEG on clinical outcomes of ECT, we extracted from the retrieved studies and qualitatively described the association between the baseline EEG markers characteristics and the rates of future responders and/or remitters to ECT. Results: The primary search yielded 2,531 potentially relevant citations, and 12 articles were selected according to inclusion criteria. Most of the studies were prospective studies with small sample size. Sociodemographic and clinical characteristics of patients, ECT settings, EEG settings, and outcomes were heterogeneous. Event-related potential (ERP) paradigms were used in three studies, polysomnography was used in three studies, and the six other studies used EEG to measure cerebral connectivity and activity. Conclusions: P300 amplitude, coherence, and connectivity measures were correlated with remission in patients with depression treated by ECT. Sleep EEG recordings seemed not to be correlated with remission after ECT. Further prospective studies with large sample size are needed to determine optimal EEG parameters associated with clinical response to ECT in depressive disorder. Systematic Review Registration: PROSPERO CRD42020181978.
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Affiliation(s)
- Louis Simon
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France.,Lyon University, Université Lyon 1, Villeurbanne, France
| | - Martin Blay
- Centre Hospitalier Le Vinatier, Bron, France.,Lyon University, Université Lyon 1, Villeurbanne, France
| | | | - Jerome Brunelin
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France.,Lyon University, Université Lyon 1, Villeurbanne, France
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12
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Alterations of neural network organization during REM sleep in women: implication for sex differences in vulnerability to mood disorders. Biol Sex Differ 2020; 11:22. [PMID: 32334638 PMCID: PMC7183628 DOI: 10.1186/s13293-020-00297-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/07/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Sleep plays an important role in vulnerability to mood disorders. However, despite the existence of sex differences in vulnerability to mood disorders, no study has yet investigated the sex effect on sleep network organization and its potential involvement in vulnerability to mood disorders. The aim of our study was to empirically investigate the sex effect on network organization during REM and slow-wave sleep using the effective connectivity measured by Granger causality. METHODS Polysomnographic data from 44 healthy individuals (28 men and 16 women) recruited prospectively were analysed. To obtain the 19 × 19 connectivity matrix of all possible pairwise combinations of electrodes by Granger causality method from our EEG data, we used the Toolbox MVGC multivariate Granger causality. The computation of the network measures was realized by importing these connectivity matrices into EEGNET Toolbox. RESULTS In men and women, all small-world coefficients obtained are compatible with a small-world network organization during REM and slow-wave sleep. However, compared to men, women present greater small-world coefficients during REM sleep as well as for all EEG bands during this sleep stage, which indicates the presence of a small-world network organization less marked during REM sleep as well as for all EEG bands during this sleep stage in women. In addition, in women, these small-world coefficients during REM sleep as well as for all EEG bands during this sleep stage are positively correlated with the presence of subclinical symptoms of depression. CONCLUSIONS Thus, the highlighting of these sex differences in network organization during REM sleep indicates the presence of differences in the global and local processing of information during sleep between women and men. In addition, this small-world network organization less marked during REM sleep appears to be a marker of vulnerability to mood disorders specific to women, which opens up new perspectives in understanding sex differences in the occurrence of mood disorders.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Route de Lennik, 808, 1070 Anderlecht, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Route de Lennik, 808, 1070 Anderlecht, Brussels, Belgium
| | - Gwénolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Route de Lennik, 808, 1070 Anderlecht, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Route de Lennik, 808, 1070 Anderlecht, Brussels, Belgium
| | - Paul Linkowski
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Route de Lennik, 808, 1070 Anderlecht, Brussels, Belgium
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Hein M, Lanquart JP, Mungo A, Hubain P, Loas G. Impact of number of sleep ultradian cycles on polysomnographic parameters related to REM sleep in major depression: Implications for future sleep research in psychiatry. Psychiatry Res 2020; 285:112818. [PMID: 32035377 DOI: 10.1016/j.psychres.2020.112818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/18/2020] [Accepted: 01/25/2020] [Indexed: 12/22/2022]
Abstract
Given the contradictory data on REMS alterations in major depression, the aim of this study was to empirically demonstrate that based on the number of sleep ultradian cycles, it was possible to highlight different subtypes of major depression characterized by specific patterns of REMS alterations. Demographic and polysomnographic data from 211 individuals (30 healthy controls and 181 untreated major depressed individuals) recruited from the sleep laboratory database were analyzed. Major depressed individuals with sleep ultradian cycles <4 showed alterations consistent with REMS deficiency (non-shortened REM latency as well as decrease in REMS percentage, REMS duration and REMS/NREMS ratio) whereas major depressed individuals with sleep ultradian cycles >4 showed alterations consistent with REMS disinhibition (shortened REM latency as well as increase in REMS percentage, REMS duration and REMS/NREMS ratio). Regarding major depressed individuals with 4 sleep ultradian cycles, their REMS alterations were intermediate to those present in major depressed individuals with sleep ultradian cycles <4 and >4. Thus, in major depressed individuals, the highlighting of this heterogeneity of REMS alterations based on the number of sleep ultradian cycles seems to suggest the involvement of distinct pathophysiological mechanisms and could open new perspectives for future sleep research in psychiatry.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Anaïs Mungo
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwenolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
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