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Bertrand L, d'Ortho MP, Reynaud E, Lejoyeux M, Bourgin P, Geoffroy PA. Polysomnography in seasonal affective disorder: A systematic review and meta-analysis. J Affect Disord 2021; 292:405-415. [PMID: 34144365 DOI: 10.1016/j.jad.2021.05.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/26/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND . Although sleep disturbances are ubiquitous in depression, studies assessing sleep architecture lead to conflicting results, possibly because of the heterogeneity in this disorder. We aimed to focus on Seasonal Affective Disorder (SAD), which is directly associated with circadian and sleep homeostasis impairments. METHODS . A systematic search was conducted in July 2019. Original papers reporting data about night sleep architecture using polysomnography (PSG), in SAD or remitted-SAD and controls, were included. RESULTS . Seven studies were retained and included 183 individuals, including 109 patients with SAD and 74 healthy controls. The random-effects meta-analysis showed that rapid eye movement sleep (REM) was significantly increased in SAD compared to controls (REM amount: SMD=1[0.11,1.88], p = 0.027; REM percentage: SMD=0.71[0.02,1.40], p = 0.045). Remitted SAD patients, compared to controls, also had a significantly increased REM sleep (REM amount: SMD=1.84[0.78,2.90], p<0.001; REM percentage: SMD=1.27[0.51,2.03], p = 0.001) and a significantly decreased REM latency (SMD=-0.93[-1.73,-0.13], p = 0.022). No differences were observed for total sleep time, sleep efficiency, and slow-wave-sleep. LIMITATIONS . Most studies had small sample size, with no placebo group and with open designs. CONCLUSIONS . REM sleep amount and latency appear altered both during the acute and remitted phase of SAD, representing trait markers with interesting diagnosis and therapeutic implications.
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Affiliation(s)
- Léa Bertrand
- Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hospital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - Marie-Pia d'Ortho
- Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France; Department of Sleep Disorders, Physiology and Functionnal Explorations, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - Eve Reynaud
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000, Strasbourg, France
| | - Michel Lejoyeux
- Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hospital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - Patrice Bourgin
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000, Strasbourg, France; Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), Strasbourg University Hospital, 1 place de l'hôpital, 67000, Strasbourg, France
| | - Pierre A Geoffroy
- Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hospital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France; Université de Paris, NeuroDiderot, Inserm, F-75019 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000, Strasbourg, France.
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2
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Roecklein KA, Franzen PL, Wescott DL, Hasler BP, Miller MA, Donofry SD, DuPont CM, Gratzmiller SM, Drexler SP, Wood-Vasey WM, Gamlin PD. Melanopsin-driven pupil response in summer and winter in unipolar seasonal affective disorder. J Affect Disord 2021; 291:93-101. [PMID: 34029883 PMCID: PMC8693789 DOI: 10.1016/j.jad.2021.04.084] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/19/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
A retinal subsensitivity to environmental light may trigger Seasonal Affective Disorder (SAD) under low wintertime light conditions. The main aim of this study was to assess the responses of melanopsin-containing retinal ganglion cells in participants (N= 65) diagnosed with unipolar SAD compared to controls with no history of depression. Participants attended a summer visit, a winter visit, or both. Retinal responses to light were measured using the post-illumination pupil response (PIPR) to assess melanopsin-driven responses in the non-visual light input pathway. Linear mixed-effects modeling was used to test a group*season interaction on the Net PIPR (red minus blue light response, percent baseline). We observed a significant group*season interaction such that the PIPR decreased from summer to winter significantly in the SAD group while not in the control group. The SAD group PIPR was significantly lower in winter compared to controls but did not differ between groups in summer. Only 60% of the participants underwent an eye health exam, although all participants reported no history of retinal pathology, and eye exam status was neither associated with outcome nor different between groups. This seasonal variation in melanopsin driven non-visual responses to light may be a risk factor for SAD, and further highlights individual differences in responses to light for direct or indirect effects of light on mood.
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Affiliation(s)
- Kathryn A. Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,The Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania, USA.,Corresponding Author:Kathryn A. Roecklein, Ph.D. Associate Professor Department of Psychology, University of Pittsburgh 210 S. Bouquet Street Pittsburgh, PA 15206 (412) 624-4553
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Delainey L. Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan A. Miller
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shannon D. Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caitlin M. DuPont
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah M. Gratzmiller
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Scott P. Drexler
- Department of Ophthalmology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - W. Michael Wood-Vasey
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul D. Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
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3
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Silverstein SM, Demmin DL, Schallek JB, Fradkin SI. Measures of Retinal Structure and Function as Biomarkers in Neurology and Psychiatry. Biomark Neuropsychiatry 2020. [DOI: 10.1016/j.bionps.2020.100018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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4
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Venner A, Todd WD, Fraigne J, Bowrey H, Eban-Rothschild A, Kaur S, Anaclet C. Newly identified sleep-wake and circadian circuits as potential therapeutic targets. Sleep 2020; 42:5306564. [PMID: 30722061 DOI: 10.1093/sleep/zsz023] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/25/2019] [Indexed: 02/06/2023] Open
Abstract
Optogenetics and chemogenetics are powerful tools, allowing the specific activation or inhibition of targeted neuronal subpopulations. Application of these techniques to sleep and circadian research has resulted in the unveiling of several neuronal populations that are involved in sleep-wake control, and allowed a comprehensive interrogation of the circuitry through which these nodes are coordinated to orchestrate the sleep-wake cycle. In this review, we discuss six recently described sleep-wake and circadian circuits that show promise as therapeutic targets for sleep medicine. The parafacial zone (PZ) and the ventral tegmental area (VTA) are potential druggable targets for the treatment of insomnia. The brainstem circuit underlying rapid eye movement sleep behavior disorder (RBD) offers new possibilities for treating RBD and neurodegenerative synucleinopathies, whereas the parabrachial nucleus, as a nexus linking arousal state control and breathing, is a promising target for developing treatments for sleep apnea. Therapies that act upon the hypothalamic circuitry underlying the circadian regulation of aggression or the photic regulation of arousal and mood pathway carry enormous potential for helping to reduce the socioeconomic burden of neuropsychiatric and neurodegenerative disorders on society. Intriguingly, the development of chemogenetics as a therapeutic strategy is now well underway and such an approach has the capacity to lead to more focused and less invasive therapies for treating sleep-wake disorders and related comorbidities.
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Affiliation(s)
- Anne Venner
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA.,Department of Neurology, Harvard Medical School, Boston, MA
| | - William D Todd
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA.,Department of Neurology, Harvard Medical School, Boston, MA
| | - Jimmy Fraigne
- Department of Cell and Systems Biology, University of Toronto, Toronto, Ontario, Canada
| | - Hannah Bowrey
- Department of Psychiatry, Rutgers Biomedical Health Sciences, Rutgers University, Newark, NJ.,Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Satvinder Kaur
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA.,Department of Neurology, Harvard Medical School, Boston, MA
| | - Christelle Anaclet
- Department of Neurobiology, Brudnick Neuropsychiatric Research Institute, NeuroNexus Institute, Graduate Program in Neuroscience - Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA
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5
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Youssef P, Nath S, Chaimowitz GA, Prat SS. Electroretinography in psychiatry: A systematic literature review. Eur Psychiatry 2019; 62:97-106. [PMID: 31553929 DOI: 10.1016/j.eurpsy.2019.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 09/07/2019] [Indexed: 02/01/2023] Open
Abstract
This review aims to consolidate the available information on use of electroretinography as a diagnostic tool in psychiatry. The electroretinogram (ERG) has been found to have diagnostic utility in cocaine withdrawal (reduced light-adapted b-wave response), major depressive disorder (reduced contrast gain in pattern ERG), and schizophrenia (reduced a- and b-wave amplitudes). This review examines these findings as well as the applicability of ERG to substance use disorder, Alzheimer's disease, autism spectrum disorder, panic disorder, eating disorders, attention deficit hyperactivity disorder, and medication use. While there have been promising results, current research suffers from a lack of specificity. Further research that quantifies anomalies in ERG present in psychiatric illness is needed.
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Affiliation(s)
- Peter Youssef
- Bachelor of Health Sciences Program, McMaster University, Hamilton, Ontario, Canada
| | - Siddharth Nath
- MD/PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Gary A Chaimowitz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Sebastien S Prat
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
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6
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Berman G, Muttuvelu D, Berman D, Larsen JI, Licht RW, Ledolter J, Kardon RH. Decreased retinal sensitivity in depressive disorder: a controlled study. Acta Psychiatr Scand 2018; 137:231-240. [PMID: 29336011 DOI: 10.1111/acps.12851] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare pupil responses in depressed patients with a seasonal pattern, depressed patients without a seasonal pattern and healthy controls as a function of daylight hours on the testing day. METHOD Patients suffering from a major depressive episode were included in wintertime. The pupil light reflex was measured at inclusion and in the following summer using a binocular pupillometer. A protocol of low (1 lux) and high (400 lux) intensity red and blue lights was used to assess rod, cone and melanopsin-containing intrinsic photosensitive retinal ganglion cell input to the pupil reflex. RESULTS The mean group pupil responses associated with a melanopsin-mediated sustained pupil response at 400 lux blue light were significantly reduced in the depressed subjects (N = 39) as compared to the healthy controls (N = 24) (P = 0.023). Across all groups, a reduction in number of daylight hours was significantly associated with a reduction in sustained pupil response (P = 0.007). All groups showed an equal effect of daylight hours on the melanopsin-mediated sustained pupil response. CONCLUSION The melanopsin-mediated sustained pupil contraction to offset of high-intensity blue light is reduced in depressed patients. These results further emphasize the interaction of light exposure with depression.
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Affiliation(s)
- G Berman
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - D Muttuvelu
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - D Berman
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - J I Larsen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - R W Licht
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - J Ledolter
- Department of Veterans Affairs Hospital, Iowa City Veterans Affairs Center for Prevention of Visual Loss, Iowa City, IA, USA
| | - R H Kardon
- Department of Veterans Affairs Hospital, Iowa City Veterans Affairs Center for Prevention of Visual Loss, Iowa City, IA, USA.,Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics and Veterans Administration Hospitals, Iowa City, IA, USA
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7
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Garbazza C, Benedetti F. Genetic Factors Affecting Seasonality, Mood, and the Circadian Clock. Front Endocrinol (Lausanne) 2018; 9:481. [PMID: 30190706 PMCID: PMC6115502 DOI: 10.3389/fendo.2018.00481] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022] Open
Abstract
In healthy humans, seasonality has been documented in psychological variables, chronotype, sleep, feeding, metabolic and autonomic function, thermoregulation, neurotransmission, and hormonal response to stimulation, thus representing a relevant factor to account for, especially when considering the individual susceptibility to disease. Mood is largely recognized as one of the central aspects of human behavior influenced by seasonal variations. This historical notion, already mentioned in ancient medical reports, has been recently confirmed by fMRI findings, which showed that seasonality in human cognitive brain functions may influence affective control with annual variations. Thus, seasonality plays a major role in mood disorders, affecting psychopathology, and representing the behavioral correlate of a heightened sensitivity to factors influencing circannual rhythms in patients. Although the genetic basis of seasonality and seasonal affective disorder (SAD) has not been established so far, there is growing evidence that factors affecting the biological clock, such as gene polymorphisms of the core clock machinery and seasonal changes of the light-dark cycle, exert a marked influence on the behavior of patients affected by mood disorders. Here we review recent findings about the effects of individual gene variants on seasonality, mood, and psychopathological characteristics.
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Affiliation(s)
- Corrado Garbazza
- Centre for Chronobiology, University of Basel, Basel, Switzerland
- Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
- *Correspondence: Corrado Garbazza
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
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8
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Münch M, Ladaique M, Roemer S, Hashemi K, Kawasaki A. Melanopsin-Mediated Acute Light Responses Measured in Winter and in Summer: Seasonal Variations in Adults with and without Cataracts. Front Neurol 2017; 8:464. [PMID: 28955293 PMCID: PMC5601987 DOI: 10.3389/fneur.2017.00464] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/21/2017] [Indexed: 11/19/2022] Open
Abstract
Seasonal adaptation is a ubiquitous behavior seen in many species on both global hemispheres and is conveyed by changing photoperiods. In humans this seasonal adaptation is less apparent, in part because changes in daylength are masked by the use of electrical lighting at night. On the other hand, cataracts which reduce light transmission, may compound seasonal changes related to the reduced daylength of winter. To better understand the effects of different photoperiod lengths in healthy adults without and with cataracts, we tested their melanopsin-mediated light responses in summer vs. winter. Fifty-two participants (mean age 67.4 years; 30 with bilateral cataracts and 22 age-matched controls with clear lenses; pseudophakes) were tested twice, once in summer and once in winter. At each test session we assessed the electroretinogram and pupil responses during daytime and we determined melatonin suppression, subjective sleepiness and mood in response to light exposure in the evening. Circadian rest-activity cycles and sleep from activity recordings were also analyzed for both seasons. Both groups had similar visual function. There were no seasonal differences in the electroretinogram. For the pupil responses to bright blue light, the post-illumination pupil response (PIPR) was greater in winter than summer in pseudophakes, but not in cataract participants, whereas melatonin suppression to acute light exposure showed no differences between both groups and seasons. Overall, intra-daily variability of rest-activity was worse in winter but participants felt sleepier and reported worse mood at the laboratory in evening time in the summer. Those with cataracts had poorer sleep quality with lower sleep efficiency, and higher activity during sleep in winter than summer. In this study, the PIPR showed a seasonal variation in which a larger response was found during winter. This variation was only detected in participants with a clear intraocular lens. In the cataract group, visual function was not impaired yet these participants showed a lack of seasonal changes in the pupil response to blue light and poorer sleep in winter. These findings raise the question for tailored lighting conditions for cataract patients in order to counter potentially deleterious effects of living with chronically lower light exposure.
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Affiliation(s)
- Mirjam Münch
- Group Sleep Research & Clinical Chronobiology, Institute of Physiology, Charité University Médicine Berlin, Berlin, Germany
| | - Myriam Ladaique
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
| | - Ségolène Roemer
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
| | - Kattayoon Hashemi
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
| | - Aki Kawasaki
- Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland
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Hébert M, Mérette C, Paccalet T, Gagné AM, Maziade M. Electroretinographic anomalies in medicated and drug free patients with major depression: Tagging the developmental roots of major psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2017; 75:10-15. [PMID: 28007463 DOI: 10.1016/j.pnpbp.2016.12.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/01/2016] [Accepted: 12/05/2016] [Indexed: 11/17/2022]
Abstract
The retina is tagged as an approachable part of the brain due to its common embryonic origin and appears as a promising site of investigation for psychiatric disorders. Retinal function is assessed best with the electroretinogram (ERG), which was obtained in a large sample of patients with major depressive disorder and matched controls. ERG cone and rod luminance response functions were recorded in non-dilated eyes in 100 major depressive disorder patients (MDD) and 100 controls, (mean age of 42.8 and 40.9y. o. respectively). Amongst MDD patients, 17 were drug free (mean age 41.2y. o). In medicated patients, at the cone level, a prolonged b-wave was observed (p≤0.01). In drug free patients a prolonged b-wave was discovered only when averaging the implicit time of the 3 highest b-wave amplitudes of the photopic hill. For the medicated patients, the mixed rods/cones a-wave was reduced (p=0.01) whereas a trend (p=0.06) was observed for the pure rod b-wave (reduced) and the mixed rods/cones (reduced and prolonged; p=0.05). In drug free patients, a similar pattern could be observed in terms of effect sizes. Overall, medicated and drug free MDD patients shared some deficits suggesting that some anomalies are present above and beyond the effect of medication. Of interest, the prolonged cone and reduced rod amplitude were reported by our group in schizophrenia patients, suggesting a common neurodevelopmental root of major psychiatric disorders.
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Affiliation(s)
- Marc Hébert
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département d'ophtalmologie et ORL - chirurgie cervico-faciale, Université Laval, Québec, Canada.
| | - Chantal Mérette
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada
| | - Thomas Paccalet
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Anne-Marie Gagné
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Michel Maziade
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada
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Roecklein K, Wong P, Ernecoff N, Miller M, Donofry S, Kamarck M, Wood-Vasey WM, Franzen P. The post illumination pupil response is reduced in seasonal affective disorder. Psychiatry Res 2013; 210:150-8. [PMID: 23809464 PMCID: PMC3795919 DOI: 10.1016/j.psychres.2013.05.023] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 05/15/2013] [Accepted: 05/19/2013] [Indexed: 10/26/2022]
Abstract
Individuals with seasonal affective disorder (SAD) may have a decreased retinal sensitivity in the non-image forming light-input pathway. We examined the post illumination pupil response (PIPR) among individuals with SAD and healthy controls to identify possible differences in the melanopsin signaling pathway. We also investigated whether melanopsin gene (OPN4) variations would predict variability in the PIPR. Fifteen SAD and 15 control participants (80% women, mean age 36.7 years, S.D.=14.5) were assessed in the fall/winter. Participants were diagnosed based on DSM-IV-TR criteria. Infrared pupillometry was used to measure pupil diameter prior to, during, and after red and blue stimuli. In response to blue light, the SAD group had a reduced PIPR and a lower PIPR percent change relative to controls. The PIPR after the blue stimulus also varied on the basis of OPN4 I394T genotype, but not OPN4 P10L genotype. These findings may indicate that individuals with SAD have a less sensitive light input pathway as measured by the PIPR, leading to differences in neurobiological and behavioral responses such as alertness, circadian photoentrainment, and melatonin release. In addition, this sensitivity may vary based on sequence variations in OPN4, although a larger sample and replication is needed.
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Affiliation(s)
- Kathryn Roecklein
- Department of Psychology, University of Pittsburgh, 201S Bouquet St, Pittsburgh, PA 15260, USA.
| | - Patricia Wong
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Natalie Ernecoff
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Megan Miller
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Shannon Donofry
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | - Marissa Kamarck
- Department of Psychology, University of Pittsburgh, 201 S Bouquet St, Pittsburgh, PA 15260, USA
| | | | - Peter Franzen
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh PA, USA
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11
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Visual contrast sensitivity in major depressive disorder. J Psychosom Res 2013; 75:83-6. [PMID: 23751244 DOI: 10.1016/j.jpsychores.2013.03.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 03/12/2013] [Accepted: 03/15/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Through the eyes of those depressed, the world may appear dull and gray. Visual contrast sensitivity has recently been reported to be lower in depressed patients compared to healthy controls. We aimed to examine the consistency of this finding and to explore the underlying retinal electrophysiology. METHODS Twenty subjects with major depressive disorder and 20 matched healthy controls were studied. Pattern electroretinogram (PERG) and subjective visual contrast test were used to assess visual contrast sensitivity. Full-field electroretinography (ffERG) was additionally used to assess retinal neurophysiology. Depression was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and depression severity was measured using standard psychometric scales. RESULTS Visual contrast sensitivity was significantly lower in depressed patients compared to controls based on the Landolt C visual contrast test, but no difference was found between groups using PERG and ffERG. Greater severity of depressive symptoms correlated (r=0.49, p=0.001) with poorer visual contrast sensitivity. CONCLUSIONS Depressed subjects had reduced visual contrast discrimination performance, but this finding could not be consistently determined using PERG. The neurobiological link between major depressive disorder and visual contrast sensitivity warrants further investigation.
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12
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Roecklein KA, Wong PM, Miller MA, Donofry SD, Kamarck ML, Brainard GC. Melanopsin, photosensitive ganglion cells, and seasonal affective disorder. Neurosci Biobehav Rev 2012; 37:229-39. [PMID: 23286902 DOI: 10.1016/j.neubiorev.2012.12.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 11/05/2012] [Accepted: 12/21/2012] [Indexed: 02/05/2023]
Abstract
In two recent reports, melanopsin gene variations were associated with seasonal affective disorder (SAD), and in changes in the timing of sleep and activity in healthy individuals. New studies have deepened our understanding of the retinohypothalamic tract, which translates environmental light received by the retina into neural signals sent to a set of nonvisual nuclei in the brain that are responsible for functions other than sight including circadian, neuroendocrine and neurobehavioral regulation. Because this pathway mediates seasonal changes in physiology, behavior, and mood, individual variations in the pathway may explain why approximately 1-2% of the North American population develops mood disorders with a seasonal pattern (i.e., Major Depressive and Bipolar Disorders with a seasonal pattern, also known as seasonal affective disorder/SAD). Components of depression including mood changes, sleep patterns, appetite, and cognitive performance can be affected by the biological and behavioral responses to light. Specifically, variations in the gene sequence for the retinal photopigment, melanopsin, may be responsible for significant increased risk for mood disorders with a seasonal pattern, and may do so by leading to changes in activity and sleep timing in winter. The retinal sensitivity of SAD is hypothesized to be decreased compared to controls, and that further decrements in winter light levels may combine to trigger depression in winter. Here we outline steps for new research to address the possible role of melanopsin in seasonal affective disorder including chromatic pupillometry designed to measure the sensitivity of melanopsin containing retinal ganglion cells.
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Affiliation(s)
- Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, 3500 Sennott Square, 210 South Bouquet St., Pittsburgh, PA 15260, USA.
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Johnsen MT, Wynn R, Bratlid T. Is there a negative impact of winter on mental distress and sleeping problems in the subarctic: the Tromsø Study. BMC Psychiatry 2012; 12:225. [PMID: 23234541 PMCID: PMC3561204 DOI: 10.1186/1471-244x-12-225] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 11/29/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prior studies have suggested that the darkness of winter impacts the level of mental distress and sleeping problems. Our study investigated whether people living in the sub-arctic had more sleeping problems or mental distress during winter. METHODS The cross sectional population Tromsø Study was conducted in Tromsø, North Norway, at 69.4 degrees North and above the Arctic Circle. The study included entire birth cohorts and random samples of the population aged 30 to 87 years. Data was collected continuously from 1 October 2007 to the end of December 2008 except July. 8951 persons completed questionnaires including the HSCL-10 and the MCTQ. RESULTS There were no significant differences in the reporting of current mental distress depending on season. Significantly more reported current sleeping problems in winter than in the other seasons, and less sleeping problems was found in spring. CONCLUSIONS In this sub-arctic population, insomnia was most prevalent in winter, but there were no significant seasonal differences in mental distress. Although some people in the sub-arctic clearly are mentally negatively affected by the darkness of winter, the negative impact of winter on mental distress for the adult population is not conclusive.
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Affiliation(s)
- May Trude Johnsen
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
| | - Rolf Wynn
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway,University Hospital of North Norway, Tromsø, Norway
| | - Trond Bratlid
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway,University Hospital of North Norway, Tromsø, Norway
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Roecklein KA, Wong PM, Franzen PL, Hasler BP, Wood-Vasey WM, Nimgaonkar VL, Miller MA, Kepreos KM, Ferrell RE, Manuck SB. Melanopsin gene variations interact with season to predict sleep onset and chronotype. Chronobiol Int 2012; 29:1036-47. [PMID: 22881342 DOI: 10.3109/07420528.2012.706766] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The human melanopsin gene has been reported to mediate risk for seasonal affective disorder (SAD), which is hypothesized to be caused by decreased photic input during winter when light levels fall below threshold, resulting in differences in circadian phase and/or sleep. However, it is unclear if melanopsin increases risk of SAD by causing differences in sleep or circadian phase, or if those differences are symptoms of the mood disorder. To determine if melanopsin sequence variations are associated with differences in sleep-wake behavior among those not suffering from a mood disorder, the authors tested associations between melanopsin gene polymorphisms and self-reported sleep timing (sleep onset and wake time) in a community sample (N = 234) of non-Hispanic Caucasian participants (age 30-54 yrs) with no history of psychological, neurological, or sleep disorders. The authors also tested the effect of melanopsin variations on differences in preferred sleep and activity timing (i.e., chronotype), which may reflect differences in circadian phase, sleep homeostasis, or both. Daylength on the day of assessment was measured and included in analyses. DNA samples were genotyped for melanopsin gene polymorphisms using fluorescence polarization. P10L genotype interacted with daylength to predict self-reported sleep onset (interaction p < .05). Specifically, sleep onset among those with the TT genotype was later in the day when individuals were assessed on longer days and earlier in the day on shorter days, whereas individuals in the other genotype groups (i.e., CC and CT) did not show this interaction effect. P10L genotype also interacted in an analogous way with daylength to predict self-reported morningness (interaction p < .05). These results suggest that the P10L TT genotype interacts with daylength to predispose individuals to vary in sleep onset and chronotype as a function of daylength, whereas other genotypes at P10L do not seem to have effects that vary by daylength. A better understanding of how melanopsin confers heightened responsivity to daylength may improve our understanding of a broad range of behavioral responses to light (i.e., circadian, sleep, mood) as well as the etiology of disorders with seasonal patterns of recurrence or exacerbation.
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Affiliation(s)
- Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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Fornaro M, Bandini F, Ogliastro C, Cordano C, Martino M, Cestari L, Escelsior A, Rocchi G, Colicchio S, Perugi G. Electroretinographic assessment in major depressed patients receiving duloxetine: might differences between responders and non-responders indicate a differential biological background? J Affect Disord 2011; 135:154-9. [PMID: 21820182 DOI: 10.1016/j.jad.2011.07.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 07/13/2011] [Accepted: 07/14/2011] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Despite intense research efforts, still too little is known about the biological determinants of depression, thus soliciting diverse study approaches. Among others, the electroretinography (ERG) has been proposed even as a putative proxy (retinal) measurement of central dopaminergic activity for Major Depressive Disorder (MDD) both in drug-naïve patients and subjects receiving antidepressant treatments. Nonetheless, current evidences are merely preliminary, essentially considering just older classes of antidepressants, thus requiring confirmation studies even with newer agents as duloxetine. METHOD Twenty MDD subjects and 20 matched controls received duloxetine 60 mg/day for 12 weeks, being monitored both by standard ERG recording and by administration of the Hamilton scales for Depression and Anxiety and the Young Mania Rating Scale at baseline and week 12 (end of the study). RESULTS ERG mean rod b-wave amplitude significantly reduced from baseline to week 12 in those depressed subjects achieving final response (p=.024), decreasing from the highest rank values to the ones, substantially unmodified, seen among non-responders and controls. LIMITATIONS Small sample size and lack of multiple assessments. CONCLUSIONS At least some MDD patients responding to duloxetine might exhibit a peculiar ERG pattern, hypothetically indicating a specific biological background. If confirmed by larger-sampled studies, these results might shed further light in the understanding of the biological determinants of different subtypes of depression, ideally showing alternative patterns of response upon different treatment interventions.
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Affiliation(s)
- Michele Fornaro
- Department of Neurosciences, Ophthalmology and Genetics - Section of Psychiatry, University of Genova, Italy.
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Abnormal hypothalamic response to light in seasonal affective disorder. Biol Psychiatry 2011; 70:954-61. [PMID: 21820647 PMCID: PMC5323254 DOI: 10.1016/j.biopsych.2011.06.022] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/20/2011] [Accepted: 06/20/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Vulnerability to the reduction in natural light associated with fall/winter is generally accepted as the main trigger of seasonal affective disorder (SAD), whereas light therapy is a treatment of choice of the disorder. However, the relationship between exposure to light and mood regulation remains unclear. As compared with green light, blue light was shown to acutely modulate emotion brain processing in healthy individuals. Here, we investigated the impact of light on emotion brain processing in patients with SAD and healthy control subjects and its relationship with retinal light sensitivity. METHODS Fourteen symptomatic untreated patients with SAD (34.5 ± 8.2 years; 9 women) and 16 healthy control subjects (32.3 ± 7.7 years; 11 women) performed an auditory emotional task in functional magnetic resonance imaging during the fall/winter season, while being exposed to alternating blue and green monochromatic light. Scotopic and photopic retinal light sensitivities were then evaluated with electroretinography. RESULTS Blue light enhanced responses to auditory emotional stimuli in the posterior hypothalamus in patients with SAD, whereas green light decreased these responses. These effects of blue and green light were not observed in healthy control subjects, despite similar retinal sensitivity in SAD and control subjects. CONCLUSIONS These results point to the posterior hypothalamus as the neurobiological substrate involved in specific aspects of SAD, including a distinctive response to light and altered emotional responses.
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