Right-lateralization of N2-amplitudes in depressive adolescents: an emotional go/no-go study

Electrophysiological correlates of inhibitory control in children: Relations with prenatal maternal risk factors and child psychopathology

Inhibitory control plays an important role in children's cognitive and socioemotional development, including their psychopathology. It has been established that contextual factors such as socioeconomic status (SES) and parents' psychopathology are associated with children's inhibitory control. However, the relations between the neural correlates of inhibitory control and contextual factors have been rarely examined in longitudinal studies. In the present study, we used both event-related potential (ERP) components and time-frequency measures of inhibitory control to evaluate the neural pathways between contextual factors, including prenatal SES and maternal psychopathology, and children's behavioral and emotional problems in a large sample of children (N = 560; 51.75% females; Mage = 7.13 years; Rangeage = 4-11 years). Results showed that theta power, which was positively predicted by prenatal SES and was negatively related to children's externalizing problems, mediated the longitudinal and negative relation between them. ERP amplitudes and latencies did not mediate the longitudinal association between prenatal risk factors (i.e., prenatal SES and maternal psychopathology) and children's internalizing and externalizing problems. Our findings increase our understanding of the neural pathways linking early risk factors to children's psychopathology.

Emotional Modulation of Response Inhibition in Adolescents During Acute Suicidal Crisis: Event-Related Potentials in an Emotional Go/NoGo Task

Objectives. Suicide is the second leading cause of adolescent deaths and may be linked to difficulties with inhibitory and emotional processing. This study assessed the neural correlates of cognitive inhibition during emotional processing in adolescents hospitalized for a suicidal crisis. Methods. Event-related potentials were recorded during an emotional Go/NoGo task in 12 adolescents who attempted suicide and 12 age- and sex-matched healthy controls. Results. Compared to the control group, the suicidal group showed significantly reduced positivity at the time of the P3d (difference waveform reflecting NoGo minus Go trials) in response to happy and neutral, but not sad stimuli. For happy stimuli, this group difference was restricted to the right hemisphere. Further analyses indicated that the suicidal group had a reversed pattern of P3 amplitude in response to inhibition, with lower amplitudes in the NoGo compared to the Go conditions. Suicidal symptoms severity strongly correlated with lower amplitude of the P3d in response to neutral faces. Conclusions. These findings provide more insight into inhibition difficulties in adolescents with acute suicidal risk. Interactions between emotional and inhibition processing should be considered when treating acutely suicidal youths.

Automatic Positive and Negative Emotion Regulation in Adolescents with Major Depressive Disorder

INTRODUCTION

Adolescents with major depressive disorder (MDD) exhibit hypoactivity to positive stimuli and hyperactivity to negative stimuli in terms of neural responses. Automatic emotion regulation (AER) activates triple networks (i.e., the central control network, default mode network, and salience network). Based on previous studies, we hypothesized that adolescents with MDD exhibit dissociable spatiotemporal deficits during positive and negative AER.

METHODS

We first collected EEG data from 32 adolescents with MDD and 35 healthy adolescents while they performed an implicit emotional Go/NoGo task. Then, we characterized the spatiotemporal dynamics of cortical activity during AER.

RESULTS

In Go trials, MDD adolescents exhibited reduced N2 amplitudes, enhanced theta power for positive pictures, and stronger bottom-up information flow from the left orbitofrontal cortex (OFC) to the right superior frontal gyrus compared to top-down information flow than the controls. In contrast, in NoGo trials, MDD adolescents exhibited elevated P3 amplitudes, enhanced theta power, and stronger top-down information flows from the right middle frontal gyrus to the right OFC and the left insula than the controls.

CONCLUSION

Overall, adolescents with MDD exhibited impaired automatic attention to positive emotions and impaired automatic response inhibition. These findings have potential implications for the clinical treatment of adolescents with MDD.

Effects of acute transcutaneous vagus nerve stimulation on emotion recognition in adolescent depression

BACKGROUND

Transcutaneous vagus nerve stimulation (tVNS) is a promising therapeutic option for major depressive disorder (MDD) in adults. Alternative third-line treatments for MDD in adolescents are scarce. Here we aimed to assess the effects of acute tVNS on emotion recognition in adolescents with MDD.

METHODS

Adolescents (14-17 years) with MDD (n = 33) and non-depressed controls (n = 30) received tVNS or sham-stimulation in a cross-sectional, case-control, within-subject cross-randomized controlled trial, while performing different tasks assessing emotion recognition. Correct responses, response times, and errors of omission and commission on three different computerized emotion recognition tasks were assessed as main outcomes. Simultaneous recordings of electrocardiography and electro dermal activity, as well as sampling of saliva for the determination of α-amylase, were used to quantify the effects on autonomic nervous system function.

RESULTS

tVNS had no effect on the recognition of gradually or static expressed emotions but altered response inhibition on the emotional Go/NoGo-task. Specifically, tVNS increased the likelihood of omitting a response toward sad target-stimuli in adolescents with MDD, while decreasing errors (independent of the target emotion) in controls. Effects of acute tVNS on autonomic nervous system function were found in non-depressed controls only.

CONCLUSIONS

Acute tVNS alters the recognition of briefly presented facial expressions of negative valence in adolescents with MDD while generally increasing emotion recognition in controls. tVNS seems to specifically alter early visual processing of stimuli of negative emotional valence in MDD. These findings suggest a potential therapeutic benefit of tVNS in adolescent MDD that requires further evaluation within clinical trials.

Affective Processing Biases in Relation to Past, Current, and Future Depression in Children and Adolescents

BACKGROUND

The affective go/no-go (AGN) task has been used to assess affective biases in attention set-shifting and deficits in inhibitory control of emotional information among depressed youth, but results have been inconsistent. We aimed to test AGN robustness and clarify temporal relationships between depressive symptoms and affective processing in youth.

METHODS

We evaluated AGN performance twice (Time 1 N = 306; Time 2 N = 238) in relation to current, previous, and future depression in the same children/adolescents with depression and those without diagnoses who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Mixed repeated ANCOVAs were powered to detect small-medium group by valence interactions in response latency and errors. Supplemental regression analyses examined depressive symptoms as a continuous variable in relation to AGN performance.

RESULTS

No clear pattern emerged, mirroring the broader AGN literature. In primary analyses, group by valence interactions were only observed at one AGN administration; none replicated across administrations. Similarly, in regression analyses depressive symptoms had no relation to affective processing biases/deficits at AGN Time 1, though some relationships were detected between symptoms and AGN Time 2.

LIMITATIONS

Relatively few youth met criteria for a depressive disorder, though analyses were appropriately powered and supplemental analyses examined depressive symptoms continuously. Comparison groups were not healthy controls at recruitment but were free from any Axis I disorder at AGN administration.

CONCLUSIONS

Given the inconsistency of AGN findings, attention should be focused on tasks that provide more sensitive, robust measures of emotional information processing in depressed youth.

The role of attentional deployment during distancing in adolescents with major depression

Individuals with major depression (MD) show deficits in cognitive reappraisal. It is yet unexplored how the act of directing visual attention away from/towards emotional aspects impacts on cognitive reappraisal in MD. Thus, we examined the role of attentional deployment during cognitive reappraisal (specifially during distancing) in adolescent MD. 36 MD adolescents and 37 healthy controls (12-18 years) performed a cognitive reappraisal task during which they a) down-regulated self-reported negative affective responses to negative pictures via distancing, or b) simply attended to the pictures. During the task, attentional focus was systematically varied by directing participants' gaze to emotional vs. non-emotional picture aspects. The validity of this experimental manipulation was checked by continuous eye-tracking during the task. Across groups and gaze focus conditions, distancing diminished negative affective responses to the pictures. Regulation success significantly differed between groups dependent on gaze focus: MD adolescents showed relatively less regulation success than controls in the emotional gaze focus condition, while the reverse was true for the non-emotional gaze focus condition. The results suggest that in MD adolescents, an emotional context might interfere with emotion regulatory aims. The findings can provide an important starting point for the development of innovative training regimes that target deficient reappraisal processes in adolescents suffering from MD.

Neural underpinnings of the relationships between sensation seeking and emotion regulation in adolescents

There is little neurological evidence linking sensation seeking and emotion regulation in adolescence, which is characterised as an emotionally fluctuant period. The present study examined the relationship between sensation seeking and emotion regulation in adolescents. Electroencephalograms were recorded from 22 high sensation-seeking adolescents (HSSs, M_age  = 12.36) and 24 low sensation-seeking adolescents (LSSs, M_age  = 12.84) during the reactivity and regulation-image task. Group differences in event-related brain potentials (ERPs) associated with the regulation of negative and neutral stimuli were analysed. The results showed that (a) the P2 of HSSs were larger than LSSs during emotion regulation; (b) in down-regulation conditions, the LPP in all time windows were smaller than no-regulation in LSSs. However, there was no significant difference in HSSs; (c) the LPP 300-600 and LPP 1000-1500 of down-regulation were smaller in LSSs than HSSs; (d) for LPP 600-1000, HSSs induced larger LPP than LSSs in the negative down-regulation and negative no-regulation conditions. The results provide neurological evidence that higher sensation seeking is related to the high reactivity to emotional stimuli and poor cognitive control during the regulation of emotions.

Looking While Unhappy: A Mood-Congruent Attention Bias Toward Sad Adult Faces in Children

A negative mood-congruent attention bias has been consistently observed, for example, in clinical studies on major depression. This bias is assumed to be dysfunctional in that it supports maintaining a sad mood, whereas a potentially adaptive role has largely been neglected. Previous experiments involving sad mood induction techniques found a negative mood-congruent attention bias specifically for young individuals, explained by an adaptive need for information transfer in the service of mood regulation. In the present study we investigated the attentional bias in typically developing children (aged 6–12 years) when happy and sad moods were induced. Crucially, we manipulated the age (adult vs. child) of the displayed pairs of facial expressions depicting sadness, anger, fear and happiness. The results indicate that sad children indeed exhibited a mood specific attention bias toward sad facial expressions. Additionally, this bias was more pronounced for adult faces. Results are discussed in the context of an information gain which should be stronger when looking at adult faces due to their more expansive life experience. These findings bear implications for both research methods and future interventions.

Effects of a 6-week, whole-body vibration strength-training on depression symptoms, endocrinological and neurobiological parameters in adolescent inpatients experiencing a major depressive episode (the "Balancing Vibrations Study"): study protocol for a randomized placebo-controlled trial

BACKGROUND

Moderate to vigorous endurance and strength-training exercise was suggested as a treatment option for major depression. However, there is little evidence to support this suggestion in adolescent patients. The present study investigates the effects of a whole-body vibration strength-training intervention on symptoms in medication-naïve adolescent inpatients experiencing a major depressive episode. Potential underlying endocrinological and neurobiological mechanisms are explored.

METHODS/DESIGN

A double-blinded randomized controlled trial is conducted at the University Hospital of Cologne in Germany, comparing a 6-week, whole-body vibration strength-training with a 6-week placebo-intervention, as add-on therapy to inpatient treatment as usual. Forty-one subjects (13-18 years of age) will be included in each of the two groups. The study is powered to detect (α = .05, β = .2) a medium effect size difference between the two groups (d = .5) in terms of patients' change in the Children's Depression Rating Scale raw-score, from baseline until the end of the intervention. As secondary endpoints, the effects of exercise treatment on patients' cortisol awakening response as well as on brain-derived neurotrophic factor, insulin-like growth factor 1 and inflammatory markers (tumor necrosis factor-alpha, interleukin-6 and C-reactive protein) serum levels will be assessed.

DISCUSSION

This study will provide evidence on the effectiveness of whole-body vibration strength-training as an add-on therapy in adolescent inpatients experiencing a major depressive episode. After completion of data collection, the present study will be the largest randomized controlled trial so far to investigate the effectiveness of an exercise intervention in inpatient adolescents suffering from a major depressive episode. Moreover, the present study may help to determine the underlying mechanisms of potential anti-depressant effects of exercise in depressed adolescent inpatients.

TRIAL REGISTRATION

DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00011772 . Registered on 20 March 2017.

Zurückweisungsempfindlichkeit bei Jugendlichen mit Depression

Zusammenfassung. Fragestellung: Als Zurückweisungsempfindlichkeit (ZE) wird die Disposition bezeichnet, Zurückweisung ängstlich zu erwarten, als wahrscheinlicher wahrzunehmen und daraufhin überzureagieren. In Studien konnte bereits gezeigt werden, dass Zurückweisungsempfindlichkeit bei depressiv erkrankten Erwachsenen erhöht ist und depressive Symptome bei Jugendlichen begünstigt. Bisher liegen jedoch noch keine Befunde zu dispositionellen Unterschieden hinsichtlich der Zurückweisungsempfindlichkeit bei depressiv erkrankten Jugendlichen vor. Methodik: In der vorliegenden Studie wurde daher erstmals mittels eines Fragebogens zur Zurückweisungsempfindlichkeit für Kinder und Jugendliche (FZE-K) geprüft, ob sich zwischen depressiven Jugendlichen und gesunden Jugendlichen Unterschiede in der Zurückweisungsempfindlichkeit und den Handlungsintentionen nach einer Zurückweisungssituation finden. Eingeschlossen wurden n = 28 Jugendliche mit Depression sowie n = 32 gesunde Jugendliche im Alter von 12 bis 17 Jahren. Ergebnisse: Die Ergebnisse zeigten, dass depressive Jugendliche eine höhere ZE aufweisen, Zurückweisung ängstlicher erwarten und die Wahrscheinlichkeit, zurückgewiesen zu werden, als höher einschätzen. Zudem gaben depressive Jugendliche im Vergleich zu der Kontrollgruppe an, stärker mit Selbstattribution und Resignation auf eine Zurückweisung zu reagieren. Diskussion: Die Ergebnisse lassen sich gut in das klinische Bild und in kognitive Theorien der Depression einordnen. In zukünftigen Studien sollte untersucht werden, ob sich entsprechende Interventionen positiv auf den Verlauf depressiver Erkrankungen auswirken.

Right brain, left brain in depressive disorders: Clinical and theoretical implications of behavioral, electrophysiological and neuroimaging findings

The right and left side of the brain are asymmetric in anatomy and function. We review electrophysiological (EEG and event-related potential), behavioral (dichotic and visual perceptual asymmetry), and neuroimaging (PET, MRI, NIRS) evidence of right-left asymmetry in depressive disorders. Recent electrophysiological and fMRI studies of emotional processing have provided new evidence of altered laterality in depressive disorders. EEG alpha asymmetry and neuroimaging findings at rest and during cognitive or emotional tasks are consistent with reduced left prefrontal activity in depressed patients, which may impair downregulation of amygdala response to negative emotional information. Dichotic listening and visual hemifield findings for non-verbal or emotional processing have revealed abnormal perceptual asymmetry in depressive disorders, and electrophysiological findings have shown reduced right-lateralized responsivity to emotional stimuli in occipitotemporal or parietotemporal cortex. We discuss models of neural networks underlying these alterations. Of clinical relevance, individual differences among depressed patients on measures of right-left brain function are related to diagnostic subtype of depression, comorbidity with anxiety disorders, and clinical response to antidepressants or cognitive behavioral therapy.

Endophenotype best practices

This review examines the current state of electrophysiological endophenotype research and recommends best practices that are based on knowledge gleaned from the last decade of molecular genetic research with complex traits. Endophenotype research is being oversold for its potential to help discover psychopathology relevant genes using the types of small samples feasible for electrophysiological research. This is largely because the genetic architecture of endophenotypes appears to be very much like that of behavioral traits and disorders: they are complex, influenced by many variants (e.g., tens of thousands) within many genes, each contributing a very small effect. Out of over 40 electrophysiological endophenotypes covered by our review, only resting heart, a measure that has received scant advocacy as an endophenotype, emerges as an electrophysiological variable with verified associations with molecular genetic variants. To move the field forward, investigations designed to discover novel variants associated with endophenotypes will need extremely large samples best obtained by forming consortia and sharing data obtained from genome wide arrays. In addition, endophenotype research can benefit from successful molecular genetic studies of psychopathology by examining the degree to which these verified psychopathology-relevant variants are also associated with an endophenotype, and by using knowledge about the functional significance of these variants to generate new endophenotypes. Even without molecular genetic associations, endophenotypes still have value in studying the development of disorders in unaffected individuals at high genetic risk, constructing animal models, and gaining insight into neural mechanisms that are relevant to clinical disorder.

Cognitive impairment in generalized anxiety disorder revealed by event-related potential N270

BACKGROUND

Cognitive function in anxiety disorders has been the subject of limited investigation, especially in generalized anxiety disorder (GAD). The purpose of this study was to investigate the cognitive function in subjects with GAD using mismatch-triggered negativity N270.

METHODS

Fifteen medication-free patients with a DSM-IV diagnosis of GAD, and 15 well-matched healthy controls performed a dual-feature delayed matching task while event-related potentials were recorded from their scalp.

RESULTS

The GAD group was characterized by the decreased N270 amplitude in the left hemisphere. The smaller N270 amplitude was associated with greater symptoms of anxiety and depression.

CONCLUSION

Since N270 is thought to index cognitive function in different domains, including attention and memory, our results suggest that individuals with GAD have an impaired cognitive function, particularly in selective attention and working memory. These cognitive deficits may have clinical significance in subjects with GAD and should be considered in treatment planning.