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Moyses-Oliveira M, Zamariolli M, Tempaku PF, Fernandes Galduroz JC, Andersen ML, Tufik S. Shared genetic mechanisms underlying association between sleep disturbances and depressive symptoms. Sleep Med 2024; 119:44-52. [PMID: 38640740 DOI: 10.1016/j.sleep.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/28/2024] [Accepted: 03/16/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVES Polygenic scores (PGS) for sleep disturbances and depressive symptoms in an epidemiological cohort were contrasted. The overlap between genes assigned to variants that compose the PGS predictions was tested to explore the shared genetic bases of sleep problems and depressive symptoms. METHODS PGS analysis was performed on the São Paulo Epidemiologic Sleep Study (EPISONO, N = 1042), an adult epidemiological sample. A genome wide association study (GWAS) for depression grounded the PGS calculations for Beck Depression Index (BDI), while insomnia GWAS based the PGS for Insomnia Severity Index (ISI) and Pittsburg Sleep Quality Index (PSQI). Pearson's correlation was applied to contrast PGS and clinical scores. Fisher's Exact and Benjamin-Hochberg tests were used to verify the overlaps between PGS-associated genes and the pathways enriched among their intersections. RESULTS All PGS models were significant when individuals were divided as cases or controls according to BDI (R2 = 1.2%, p = 0.00026), PSQI (R2 = 3.3%, p = 0.007) and ISI (R2 = 3.4%, p = 0.021) scales. When clinical scales were used as continuous variables, the PGS models for BDI (R2 = 1.5%, p = 0.0004) and PSQI scores (R2 = 3.3%, p = 0.0057) reached statistical significance. PSQI and BDI scores were correlated, and the same observation was applied to their PGS. Genes assigned to variants that compose the best-fit PGS predictions for sleep quality and depressive symptoms were significantly overlapped. Pathways enriched among the intersect genes are related to synapse function. CONCLUSIONS The genetic bases of sleep quality and depressive symptoms are correlated; their implicated genes are significantly overlapped and converge on neural pathways. This data suggests that sleep complaints accompanying depressive symptoms are not secondary issues, but part of the core mental illness.
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Affiliation(s)
| | - Malu Zamariolli
- Sleep Institute, Associacao Fundo de Incentivo a Pesquisa, Sao Paulo, Brazil
| | - Priscila F Tempaku
- Sleep Institute, Associacao Fundo de Incentivo a Pesquisa, Sao Paulo, Brazil
| | | | - Monica L Andersen
- Sleep Institute, Associacao Fundo de Incentivo a Pesquisa, Sao Paulo, Brazil; Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Sleep Institute, Associacao Fundo de Incentivo a Pesquisa, Sao Paulo, Brazil; Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
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Gilmore GR, Dyche J. Sleep/wake regularity and cognition in college students using antidepressants. Physiol Behav 2024; 273:114414. [PMID: 37992793 DOI: 10.1016/j.physbeh.2023.114414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/11/2023] [Accepted: 11/18/2023] [Indexed: 11/24/2023]
Abstract
The current project examined sleep, sleep/wake regularity, and cognition in college students diagnosed with depression and using serotonergic antidepressants and in those without a depression diagnosis. Forty participants either using antidepressants (n = 20, 24.75 ± 6.82 years) or without a depression diagnosis (n = 20, 21.70 ± 2.74 years) wore actigraphs for two consecutive weeks (14 days). Cognitive tasks were completed on day 1 (along with demographic surveys) and day 14. Effect sizes indicated that compared to non-clinically depressed peers, participants using antidepressants exhibited slightly greater wake after sleep onset (d = 0.36) and lower sleep efficiency (d = 0.40); however, these differences were likely not noticed by the sleeper. No sleep regularity or cognitive differences were present between groups. Within the antidepressant group, higher dosage predicted greater time in bed (R2 = 0.77), but less total sleep time (R2 = 0.86). The time of day that participants took their antidepressant exhibited differential effects on certain cognitive parameters, such as procedural reaction time and spatial processing, and interactions with years of antidepressant use were found. Self-reported wake episodes also predicted better reaction time and inhibition in the antidepressant group. This study is the first to demonstrate that sleep/wake regularity is comparable between people using antidepressants and non-clinically depressed human samples. For individuals using antidepressants, years of use, dosage, and time of day of use have predictive qualities for reaction times, spatial processing, and inhibition.
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Affiliation(s)
- Gabriel R Gilmore
- Department of Psychology, University of Kentucky, 106-B Kastle Hall, Lexington, KY, 40506, United States.
| | - Jeff Dyche
- Department of Psychology, James Madison University, Miller Hall, MSC 7704, 91 E. Grace Street, Harrisonburg, VA, United States
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Collins HM, Pinacho R, Tam SKE, Sharp T, Bannerman DM, Peirson SN. Continuous home cage monitoring of activity and sleep in mice during repeated paroxetine treatment and discontinuation. Psychopharmacology (Berl) 2023; 240:2403-2418. [PMID: 37584734 PMCID: PMC10593620 DOI: 10.1007/s00213-023-06442-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/27/2023] [Indexed: 08/17/2023]
Abstract
RATIONALE Non-invasive home cage monitoring is emerging as a valuable tool to assess the effects of experimental interventions on mouse behaviour. A field in which these techniques may prove useful is the study of repeated selective serotonin reuptake inhibitor (SSRI) treatment and discontinuation. SSRI discontinuation syndrome is an under-researched condition that includes the emergence of sleep disturbances following treatment cessation. OBJECTIVES We used passive infrared (PIR) monitoring to investigate changes in activity, sleep, and circadian rhythms during repeated treatment with the SSRI paroxetine and its discontinuation in mice. METHODS Male mice received paroxetine (10 mg/kg/day, s.c.) for 12 days, then were swapped to saline injections for a 13 day discontinuation period and compared to mice that received saline injections throughout. Mice were continuously tracked using the Continuous Open Mouse Phenotyping of Activity and Sleep Status (COMPASS) system. RESULTS Repeated paroxetine treatment reduced activity and increased behaviourally-defined sleep in the dark phase. These effects recovered to saline-control levels within 24 h of paroxetine cessation, yet there was also evidence of a lengthening of sleep bouts in the dark phase for up to a week following discontinuation. CONCLUSIONS This study provides the first example of how continuous non-invasive home cage monitoring can be used to detect objective behavioural changes in activity and sleep during and after drug treatment in mice. These data suggest that effects of paroxetine administration reversed soon after its discontinuation but identified an emergent change in sleep bout duration, which could be used as a biomarker in future preclinical studies to prevent or minimise SSRI discontinuation symptoms.
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Affiliation(s)
- Helen M Collins
- University Department of Pharmacology, Oxford, UK
- University Department of Experimental Psychology, Oxford, UK
| | - Raquel Pinacho
- University Department of Pharmacology, Oxford, UK
- University Department of Experimental Psychology, Oxford, UK
| | - S K Eric Tam
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, Kavli Institute for Nanoscience Discovery, Dorothy Crowfoot Hodgkin Building, South Parks Road, Oxford, OX1 3QU, UK
| | - Trevor Sharp
- University Department of Pharmacology, Oxford, UK
| | | | - Stuart N Peirson
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, Kavli Institute for Nanoscience Discovery, Dorothy Crowfoot Hodgkin Building, South Parks Road, Oxford, OX1 3QU, UK.
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Vila-Merkle H, González-Martínez A, Campos-Jiménez R, Martínez-Ricós J, Teruel-Martí V, Lloret A, Blasco-Serra A, Cervera-Ferri A. Sex differences in amygdalohippocampal oscillations and neuronal activation in a rodent anxiety model and in response to infralimbic deep brain stimulation. Front Behav Neurosci 2023; 17:1122163. [PMID: 36910127 PMCID: PMC9995972 DOI: 10.3389/fnbeh.2023.1122163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Depression and anxiety are highly comorbid mental disorders with marked sex differences. Both disorders show altered activity in the amygdala, hippocampus, and prefrontal cortex. Infralimbic deep brain stimulation (DBS-IL) has anxiolytic and antidepressant effects, but the underlying mechanisms remain unclear. We aimed to contribute to understanding sex differences in the neurobiology of these disorders. Methods In male and female rats, we recorded neural oscillations along the dorsoventral axis of the hippocampus and the amygdala in response to an anxiogenic drug, FG-7142. Following this, we applied DBS-IL. Results Surprisingly, in females, the anxiogenic drug failed to induce most of the changes observed in males. We found sex differences in slow, delta, theta, and beta oscillations, and the amygdalo-hippocampal communication in response to FG-7142, with modest changes in females. Females had a more prominent basal gamma, and the drug altered this band only in males. We also analyzed c-Fos expression in both sexes in stress-related structures in response to FG-7142, DBS-IL, and combined interventions. With the anxiogenic drug, females showed reduced expression in the nucleus incertus, amygdala, septohippocampal network, and neocortical levels. In both experiments, the DBS-IL reversed FG-7142-induced effects, with a more substantial effect in males than females. Discussion Here, we show a reduced response in female rats which contrasts with the higher prevalence of anxiety in women but is consistent with other studies in rodents. Our results open compelling questions about sex differences in the neurobiology of anxiety and depression and their study in animal models.
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Affiliation(s)
- Hanna Vila-Merkle
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Alicia González-Martínez
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Rut Campos-Jiménez
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Joana Martínez-Ricós
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Teruel-Martí
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Ana Lloret
- Department of Physiology, Faculty of Medicine, Health Research Institute INCLIVA, CIBERFES, University of Valencia, Valencia, Spain
| | - Arantxa Blasco-Serra
- Study Group for the Anatomical Substrate of Pain and Analgesia (GESADA) Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain
| | - Ana Cervera-Ferri
- Neuronal Circuits Laboratory, Department of Human Anatomy and Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
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The Oscillatory Profile Induced by the Anxiogenic Drug FG-7142 in the Amygdala-Hippocampal Network Is Reversed by Infralimbic Deep Brain Stimulation: Relevance for Mood Disorders. Biomedicines 2021; 9:biomedicines9070783. [PMID: 34356846 PMCID: PMC8301458 DOI: 10.3390/biomedicines9070783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 01/02/2023] Open
Abstract
Anxiety and depression exhibit high comorbidity and share the alteration of the amygdala–hippocampal–prefrontal network, playing different roles in the ventral and dorsal hippocampi. Deep brain stimulation of the infralimbic cortex in rodents or the human equivalent—the subgenual cingulate cortex—constitutes a fast antidepressant treatment. The aim of this work was: (1) to describe the oscillatory profile in a rodent model of anxiety, and (2) to deepen the therapeutic basis of infralimbic deep brain stimulation in mood disorders. First, the anxiogenic drug FG-7142 was administered to anaesthetized rats to characterize neural oscillations within the amygdala and the dorsoventral axis of the hippocampus. Next, deep brain stimulation was applied. FG-7142 administration drastically reduced the slow waves, increasing delta, low theta, and beta oscillations in the network. Moreover, FG-7142 altered communication in these bands in selective subnetworks. Deep brain stimulation of the infralimbic cortex reversed most of these FG-7142 effects. Cross-frequency coupling was also inversely modified by FG-7142 and by deep brain stimulation. Our study demonstrates that the hyperactivated amygdala–hippocampal network associated with the anxiogenic drug exhibits an oscillatory fingerprint. The study contributes to comprehending the neurobiological basis of anxiety and the effects of infralimbic deep brain stimulation.
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Habukawa M, Uchimura N, Maeda M, Ogi K, Hiejima H, Kakuma T. Differences in rapid eye movement (REM) sleep abnormalities between posttraumatic stress disorder (PTSD) and major depressive disorder patients: REM interruption correlated with nightmare complaints in PTSD. Sleep Med 2017; 43:34-39. [PMID: 29482809 DOI: 10.1016/j.sleep.2017.10.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/01/2017] [Accepted: 10/06/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The presence of repeated nightmares in posttraumatic stress disorder (PTSD) has been hypothesized as a dysfunction of rapid eye movement (REM) sleep, but there has been remarkably little agreement about the pathophysiology. This presents a deterrent to more effective treatments. REM sleep abnormalities including elevated REM density also have been replicated in major depressive disorder (MDD). The purpose of this study was to clarify the difference of REM sleep abnormalities between the two disorders for understanding the pathophysiology of sleep disturbances in PTSD. METHODS Polysomnographic measures were compared among 14 PTSD patients (aged 23.7 ± 5.5 years) and 14 MDD patients (aged 27.9 ± 10.1 years) under drug-naive or drug-free conditions. We defined REM interruption by summing the intrusive wake times during the REM period and adding the subsequent wake times to the last epoch of REM period. The significant polysomnographic measures were correlated with PTSD symptoms within the PTSD group. RESULTS REM interruption was significantly increased in the PTSD group compared with the MDD group (12.2 vs 2.1 min, p = 0.001). REM density was also significantly increased in the PTSD group compared with the MDD group (30.5 vs 23.1%, p = 0.019). Within the PTSD group, we found significant correlations between the severity of trauma-related nightmare complaints and the percentage of REM interruption (R = 0.62, p = 0.017), but not REM density. CONCLUSIONS REM sleep abnormalities are different between PTSD and MDD. Increased REM interruption may be a biological marker correlated with nightmare complaints in PTSD patients. Treatments including pharmacotherapy that reduces REM interruption might ameliorate nightmares in PTSD.
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Affiliation(s)
- Mitsunari Habukawa
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masaharu Maeda
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Hukushima, Hukushima, Japan
| | - Kimihiro Ogi
- Department of Psychiatry, Ueda Hospital, Chikugo, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- The Biostatistics Center, Medical School, Kurume University, Kurume, Fukuoka, Japan
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Romeo B, Choucha W, Fossati P, Rotge JY. Facteurs prédictifs de la réponse antidépressive à la kétamine dans les épisodes dépressifs majeurs résistants : revue de la littérature. Encephale 2017; 43:354-362. [DOI: 10.1016/j.encep.2016.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022]
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Olbrich S, van Dinteren R, Arns M. Personalized Medicine: Review and Perspectives of Promising Baseline EEG Biomarkers in Major Depressive Disorder and Attention Deficit Hyperactivity Disorder. Neuropsychobiology 2016; 72:229-40. [PMID: 26901357 DOI: 10.1159/000437435] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/06/2015] [Indexed: 11/19/2022]
Abstract
Personalized medicine in psychiatry is in need of biomarkers that resemble central nervous system function at the level of neuronal activity. Electroencephalography (EEG) during sleep or resting-state conditions and event-related potentials (ERPs) have not only been used to discriminate patients from healthy subjects, but also for the prediction of treatment outcome in various psychiatric diseases, yielding information about tailored therapy approaches for an individual. This review focuses on baseline EEG markers for two psychiatric conditions, namely major depressive disorder and attention deficit hyperactivity disorder. It covers potential biomarkers from EEG sleep research and vigilance regulation, paroxysmal EEG patterns and epileptiform discharges, quantitative EEG features within the EEG main frequency bands, connectivity markers and ERP components that might help to identify favourable treatment outcome. Further, the various markers are discussed in the context of their potential clinical value and as research domain criteria, before giving an outline for future studies that are needed to pave the way to an electrophysiological biomarker-based personalized medicine.
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Abstract
Objective Sleep disturbances are common among women in midlife; prevalence increases among perimenopausal/postmenopausal women with vasomotor symptoms. Paroxetine 7.5 mg is the only nonhormonal treatment that has been approved in the United States for moderate to severe vasomotor symptoms associated with menopause. In two pivotal phase 3 studies evaluating its efficacy and safety, improvements in sleep disturbances were also prospectively evaluated. Methods Postmenopausal women with moderate to severe vasomotor symptoms were randomly assigned to paroxetine 7.5 mg (n = 591) or placebo (n = 593) once daily for 12 weeks (both studies) or 24 weeks (24-wk study). Predefined assessments on weeks 4, 12, and 24 included number of nighttime awakenings attributed to vasomotor symptoms, sleep-onset latency, sleep duration, and sleep-related adverse events. The two studies’ data for weeks 1 to 12 were pooled. Results At baseline, participants reported a mean of 3.6 awakenings/night attributed to vasomotor symptoms. Nighttime awakenings attributed to vasomotor symptoms were significantly reduced within 4 weeks of initiating paroxetine 7.5 mg treatment (39% reduction vs 28% for placebo; P = 0.0049), and reductions were sustained through 12 or 24 weeks of treatment. Paroxetine 7.5 mg treatment also significantly increased nighttime sleep duration (week 4, +31 vs +16 min for placebo; P = 0.0075), but no significant between-group differences in sleep-onset latency or sleep-related adverse events such as sedation were observed. Conclusions In postmenopausal women treated for menopausal vasomotor symptoms, paroxetine 7.5 mg significantly reduces the number of nighttime awakenings attributed to vasomotor symptoms and increases sleep duration without differentially affecting sleep-onset latency or sedation.
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Chien MY, Chen HC. Poor sleep quality is independently associated with physical disability in older adults. J Clin Sleep Med 2015; 11:225-32. [PMID: 25515275 DOI: 10.5664/jcsm.4532] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 11/03/2014] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVE We aimed to evaluate the association between sleep quality and physical disability in community-dwelling older adults. METHODS There were 213 community-dwelling adults (76 men and 137 women) aged 65 years and above participated into this investigation. The Groningen Activity Restriction Scale and the Pittsburgh Sleep Quality Index were utilized to evaluate physical disability and subjective sleep quality, respectively. Global functional capacity was measured by the 6-minute walk test (6MWT). The Mini Mental State Examination and the Chinese Geriatric Depression Screening Scale were used to evaluate cognitive function and depression. RESULTS Univariate analysis revealed a correlation between physical disability and poor sleep quality, older age, 2 or more comorbidities, depression, functional capacity, and poor cognitive function. However, in the multivariate analyses, depression failed to show significant association with physical disability. In contrast, an independent association was observed between poor sleep quality and physical disability (OR = 2.03; 95% CI: 1.02-4.05). CONCLUSIONS In community-dwelling older adults, subjective poor sleep was significantly associated with physical disability, even after controlling for the effects of other established risk factors.
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Affiliation(s)
- Meng-Yueh Chien
- College of Medicine, National Taiwan University, Taipei, and the Physical Therapy Center of National Taiwan University Hospital, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taiwan
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Decreased delta sleep ratio and elevated alpha power predict vulnerability to depression during interferon-alpha treatment. Acta Neuropsychiatr 2015; 27:14-24. [PMID: 25434651 DOI: 10.1017/neu.2014.30] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Although poor sleep accompanies depression, it is unknown which specific sleep abnormalities precede depression. This is similarly the case for depression developing during interferon-α (IFN-α) therapy. Because vulnerability becomes evident in those who slept poorly before IFN-α, we prospectively determined which specific aspect of sleep could predict subsequent depression. METHODS Two nights of polysomnography with quantitative electroencephalogram (EEG) were obtained in 24 adult, euthymic subjects--all subsequently treated with IFN-α for hepatitis C. Every 2 weeks, a Beck Depression Inventory-II (BDI-II) score was obtained, and the maximal increase in BDI-II from pre-treatment baseline--excluding the sleep question--was determined. RESULTS The delta sleep ratio (DSR; an index of early-night restorative delta power) was inversely associated with BDI-II increases (p<0.01), as was elevated alpha power (8-12 Hz; p<0.001). Both delta (0.5-4 Hz) and alpha power exhibited high between-night correlations (r=0.83 and 0.92, respectively). In mixed-effect repeated-measure analyses, there was an interaction between alpha power and DSR (p<0.001)--subjects with low alpha power and elevated DSR were resilient to developing depression. Most other sleep parameters--including total sleep time and percentage of time in slow wave sleep--were not associated with subsequent changes in depression. CONCLUSIONS Both high DSR and low alpha power may be specific indices of resilience. As most other aspects of sleep were not associated with resilience or vulnerability, sleep interventions to prevent depression may need to specifically target these specific sleep parameters.
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Wang YQ, Li R, Zhang MQ, Zhang Z, Qu WM, Huang ZL. The Neurobiological Mechanisms and Treatments of REM Sleep Disturbances in Depression. Curr Neuropharmacol 2015; 13:543-53. [PMID: 26412074 PMCID: PMC4790401 DOI: 10.2174/1570159x13666150310002540] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/11/2015] [Accepted: 01/25/2015] [Indexed: 12/23/2022] Open
Abstract
Most depressed patients suffer from sleep abnormalities, which are one of the critical symptoms of depression. They are robust risk factors for the initiation and development of depression. Studies about sleep electroencephalograms have shown characteristic changes in depression such as reductions in non-rapid eye movement sleep production, disruptions of sleep continuity and disinhibition of rapid eye movement (REM) sleep. REM sleep alterations include a decrease in REM sleep latency, an increase in REM sleep duration and REM sleep density with respect to depressive episodes. Emotional brain processing dependent on the normal sleep-wake regulation seems to be failed in depression, which also promotes the development of clinical depression. Also, REM sleep alterations have been considered as biomarkers of depression. The disturbances of norepinephrine and serotonin systems may contribute to REM sleep abnormalities in depression. Lastly, this review also discusses the effects of different antidepressants on REM sleep disturbances in depression.
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Affiliation(s)
- Yi-Qun Wang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
| | - Rui Li
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
| | - Meng-Qi Zhang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
| | - Ze Zhang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
- Institutes of Brain
Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai,
China
| | - Wei-Min Qu
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
- Institutes of Brain
Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai,
China
| | - Zhi-Li Huang
- Department of Pharmacology, Shanghai Key Laboratory of Bioactive Small Molecules, and State
Key Laboratory of Medical Neurobiology, School of Basic Medical Sciences
- Institutes of Brain
Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai,
China
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Olbrich S, Arns M. EEG biomarkers in major depressive disorder: discriminative power and prediction of treatment response. Int Rev Psychiatry 2013; 25:604-18. [PMID: 24151805 DOI: 10.3109/09540261.2013.816269] [Citation(s) in RCA: 183] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Major depressive disorder (MDD) has high population prevalence and is associated with substantial impact on quality of life, not least due to an unsatisfactory time span of sometimes several weeks from initiation of treatment to clinical response. Therefore extensive research focused on the identification of cost-effective and widely available electroencephalogram (EEG)-based biomarkers that not only allow distinguishing between patients and healthy controls but also have predictive value for treatment response for a variety of treatments. In this comprehensive overview on EEG research on MDD, biomarkers that are either assessed at baseline or during the early course of treatment and are helpful in discriminating patients from healthy controls and assist in predicting treatment outcome are reviewed, covering recent decades up to now. Reviewed markers include quantitative EEG (QEEG) measures, connectivity measures, EEG vigilance-based measures, sleep-EEG-related measures and event-related potentials (ERPs). Further, the value and limitations of these different markers are discussed. Finally, the need for integrated models of brain function and the necessity for standardized procedures in EEG biomarker research are highlighted to enhance future research in this field.
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Affiliation(s)
- Sebastian Olbrich
- Clinic for Psychiatry and Psychotherapy, University Hospital Leipzig , Germany
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Zarate CA, Mathews DC, Furey ML. Human biomarkers of rapid antidepressant effects. Biol Psychiatry 2013; 73:1142-55. [PMID: 23374639 PMCID: PMC3672383 DOI: 10.1016/j.biopsych.2012.11.031] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/13/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
Abstract
Mood disorders such as major depressive disorder and bipolar disorder--and their consequent effects on the individual and society--are among the most disabling and costly of all medical illnesses. Although a number of antidepressant treatments are available in clinical practice, many patients still undergo multiple and lengthy medication trials before experiencing relief of symptoms. Therefore a tremendous need exists to improve current treatment options and to facilitate more rapid, successful treatment in patients suffering from the deleterious neurobiological effects of ongoing depression. Toward that end, ongoing research is exploring the identification of biomarkers that might be involved in prevention, diagnosis, treatment response, severity, or prognosis of depression. Biomarkers evaluating treatment response will be the focus of this review, given the importance of providing relief to patients in a more expedient and systematic manner. A novel approach to developing such biomarkers of response would incorporate interventions with a rapid onset of action--such as sleep deprivation or intravenous drugs (e.g., ketamine or scopolamine). This alternative translational model for new treatments in psychiatry would facilitate shorter studies, improve feasibility, and increase higher compound throughput testing for these devastating disorders.
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Affiliation(s)
- Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
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Duncan WC, Selter J, Brutsche N, Sarasso S, Zarate CA. Baseline delta sleep ratio predicts acute ketamine mood response in major depressive disorder. J Affect Disord 2013; 145:115-9. [PMID: 22871531 PMCID: PMC3494813 DOI: 10.1016/j.jad.2012.05.042] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/05/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND Electroencephalographic (EEG) sleep slow wave activity (SWA; EEG power between 0.6 and 4Hz) has been proposed as a marker of central synaptic plasticity. Decreased generation of sleep slow waves--a core feature of sleep in depression--indicates underlying plasticity changes in the disease. Various measures of SWA have previously been used to predict antidepressant treatment response. This study examined the relationship between baseline patterns of SWA in the first two NREM episodes and antidepressant response to an acute infusion of the N-methyl-d-aspartate (NMDA) antagonist ketamine. METHODS Thirty patients (20M, 10F, 18-65) fulfilling DSM-IV criteria for treatment-resistant major depressive disorder (MDD) who had been drug-free for two weeks received a single open-label infusion of ketamine hydrochloride (.5mg/kg) over 40 min. Depressive symptoms were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS) before and after ketamine infusion. Sleep recordings were obtained the night before the infusion and were visually scored. SWA was computed for individual artifact-free NREM sleep epochs, and averaged for each NREM episode. Delta sleep ratio (DSR) was calculated as SWA(NREM1)/SWA(NREM2). RESULTS A significant positive correlation was observed between baseline DSR and reduced MADRS scores from baseline to Day 1 (r=.414, p=.02). LIMITATIONS The sample size was relatively small (N=30) and all subjects had treatment-resistant MDD, which may limit the generalizability of the findings. Further studies are needed to replicate and extend this observation to other patient groups. CONCLUSIONS DSR may be a useful baseline predictor of ketamine response in individuals with treatment-resistant MDD.
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Affiliation(s)
- Wallace C. Duncan
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Jessica Selter
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Nancy Brutsche
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Simone Sarasso
- University of Wisconsin, Department of Psychiatry, Madison, Wisconsin, USA
- Department of Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milano, Italy
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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