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Goldschmied JR, Cheng P, Armitage R, Deldin PJ. A preliminary investigation of the role of slow-wave activity in modulating waking EEG theta as a marker of sleep propensity in major depressive disorder. J Affect Disord 2019; 257:504-509. [PMID: 31319342 PMCID: PMC6743727 DOI: 10.1016/j.jad.2019.07.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/05/2019] [Accepted: 07/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Both EEG slow-wave activity (SWA) during sleep and EEG theta activity during waking have been shown to increase with extended waking, and decrease following sleep, suggesting that both are markers of sleep propensity. In individuals with major depressive disorder (MDD), however, altered patterns of SWA have been noted, suggesting that sleep homeostasis is dysregulated. This study aimed to examine if slow-wave disruption would alter sleep propensity differently in healthy controls (HC) and those with MDD. METHODS 25 individuals (13 diagnosed with MDD and 12 HC) participated. Following one night of adaptation sleep, participants underwent one night of baseline sleep, and one night of selective slow-wave disruption by auditory stimuli. In the evening, before sleep, and in the morning following sleep, waking EEG was recorded from participants in an upright position, with eyes open. RESULTS Repeated measures ANOVA revealed a significant three-way interaction, such that AM theta activity was significantly lower following slow-wave disruption in those with MDD, but not in HC. Additionally, SWA was not correlated with theta activity in MDD. LIMITATIONS These data are based on a relatively small sample size of unmedicated individuals with MDD. CONCLUSIONS These data may suggest that SWA plays a differential role in the homeostatic regulation of sleep in HC, and in MDD, and provide additional evidence that the presence of SWA may be maladaptive in MDD.
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Affiliation(s)
- Jennifer R. Goldschmied
- Center for Sleep & Circadian Neurobiology, University of Pennsylvania, 125 S.31st St, Philadelphia, PA 19104, United States
| | - Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health System, 39450 W 12 Mile Rd, Novi MI 48377, United States.
| | - Roseanne Armitage
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States.
| | - Patricia J. Deldin
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, United States
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Huang J, Ulke C, Strauss M. Brain arousal regulation and depressive symptomatology in adults with attention-deficit/hyperactivity disorder (ADHD). BMC Neurosci 2019; 20:43. [PMID: 31429702 PMCID: PMC6701141 DOI: 10.1186/s12868-019-0526-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/14/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The aim of the present study was to evaluate the stability of brain arousal in adult attention-deficit/hyperactivity disorder (ADHD) outpatients with and without depressive symptomatology, and its association with depressive symptom severity and absolute electroencephalogram (EEG) power in different frequency bands. METHODS We included 31 outpatient adults (45.16% females), who were diagnosed according to DSM-IV and received no medication. Their arousal stability score (index of the steepness of arousal decline during a 15-min EEG under resting conditions), the absolute EEG power and self-reports, including depressive and ADHD-related symptoms, were analyzed. Participants were split into an unstable and stable arousal group based on the median (= 6) of the arousal stability score. RESULTS ADHD patients in the stable group reported more severe depressive symptoms (p = 0.018) and showed reduced absolute EEG power in the delta (0.002 ≤ p ≤ 0.025) and theta (0.011 ≤ p ≤ 0.034) bands compared to those in the unstable group. There was no correlation between the arousal stability score and self-report-scales concerning ADHD-related symptoms (0.214 ≤ p ≤ 0.989), but a positive association with self-reported depressive severity (p = 0.018) and negative association with powers in the EEG delta and theta bands (0.001 ≤ p ≤ 0.033). CONCLUSIONS In view of high comorbidity of depression and ADHD in adult patients, these findings support the assumption that brain arousal regulation could be considered as a helpful marker for the clinical differentiation between ADHD and depression.
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Affiliation(s)
- Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103, Leipzig, Germany.
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103, Leipzig, Germany
| | - Maria Strauss
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103, Leipzig, Germany
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Abstract
PURPOSE OF REVIEW In this review, we aim to integrate the most recent research highlighting alterations in sleep slow-wave activity (SWA), and impairments in neuroplasticity in major depressive disorder (MDD) into a novel model of disorder maintenance. RECENT FINDINGS Sleep homeostasis has been shown to be impaired in MDD, with a subset of individuals also demonstrating impaired SWA. SWA is considered a marker of the homeostatic regulation of sleep, and is implicated in the downscaling of synaptic strength in the context of maintaining homeostatic plasticity. Individuals with MDD have been shown to exhibit impairments in both neural plasticity such as loss of dendritic branching, and synaptic plasticity such as decreased long-term potentiation-dependent learning and memory. Alterations in the homeostatic regulation of sleep, SWA, and synaptic plasticity in MDD suggest an underlying impairment in the modulation of synaptic strength. One candidate mechanism for this impairment is AMPA receptor trafficking.
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Goldschmied JR, Cheng P, Hoffmann R, Boland EM, Deldin PJ, Armitage R. Effects of slow-wave activity on mood disturbance in major depressive disorder. Psychol Med 2019; 49:639-645. [PMID: 29807554 PMCID: PMC6472262 DOI: 10.1017/s0033291718001332] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Studies have demonstrated that decreases in slow-wave activity (SWA) predict decreases in depressive symptoms in those with major depressive disorder (MDD), suggesting that there may be a link between SWA and mood. The aim of the present study was to determine if the consequent change in SWA regulation following a mild homeostatic sleep challenge would predict mood disturbance. METHODS Thirty-seven depressed and fifty-nine healthy adults spent three consecutive nights in the sleep laboratory. On the third night, bedtime was delayed by 3 h, as this procedure has been shown to provoke SWA. The Profile of Mood States questionnaire was administered on the morning following the baseline and sleep delay nights to measure mood disturbance. RESULTS Results revealed that following sleep delay, a lower delta sleep ratio, indicative of inadequate dissipation of SWA from the first to the second non-rapid eye movement period, predicted increased mood disturbance in only those with MDD. CONCLUSIONS These data demonstrate that in the first half of the night, individuals with MDD who have less SWA dissipation as a consequence of impaired SWA regulation have greater mood disturbance, and may suggest that appropriate homeostatic regulation of sleep is an important factor in the disorder.
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Affiliation(s)
- Jennifer R Goldschmied
- Center for Sleep & Circadian Neurobiology, University of Pennsylvania,125 S.31st St, Philadelphia, PA 19104,USA
| | - Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health System,39450 W 12 Mile Rd, Novi MI 48377,USA
| | - Robert Hoffmann
- Department of Psychiatry,University of Michigan,4250 Plymouth Rd, Ann Arbor, MI 48109,USA
| | - Elaine M Boland
- Behavioral Health Service,Cpl. Michael J. Crescenz VA Medical Center,3900 Woodland Ave., Philadelphia, PA 19104,USA
| | - Patricia J Deldin
- Department of Psychiatry,University of Michigan,4250 Plymouth Rd, Ann Arbor, MI 48109,USA
| | - Roseanne Armitage
- Department of Psychiatry,University of Michigan,4250 Plymouth Rd, Ann Arbor, MI 48109,USA
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Dolsen EA, Cheng P, Arnedt JT, Swanson L, Casement MD, Kim HS, Goldschmied JR, Hoffmann RF, Armitage R, Deldin PJ. Neurophysiological correlates of suicidal ideation in major depressive disorder: Hyperarousal during sleep. J Affect Disord 2017; 212:160-166. [PMID: 28192765 PMCID: PMC5361570 DOI: 10.1016/j.jad.2017.01.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/04/2017] [Accepted: 01/22/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Suicide is a major public health concern, and a barrier to reducing the suicide rate is the lack of objective predictors of risk. The present study considers whether quantitative sleep electroencephalography (EEG) may be a neurobiological correlate of suicidal ideation. METHODS Participants included 84 (45 female, mean age=26.6) adults diagnosed with major depressive disorder (MDD). The item that measures thoughts of death or suicide on the Quick Inventory of Depressive Symptomatology (QIDS) was used to classify 47 participants as low suicidal ideation (24 females, mean age=26.1) and 37 as high suicidal ideation (21 females, mean age=27.3). Data were obtained from archival samples collected at the University of Michigan and University of Texas Southwestern Medical Center between 2004 and 2012. Sleep EEG was quantified using power spectral analysis, and focused on alpha, beta, and delta frequencies. RESULTS Results indicated that participants with high compared to low suicidal ideation experienced 1) increased fast frequency activity, 2) decreased delta activity, and 3) increased alpha-delta sleep after adjusting for age, sex, depression, and insomnia symptoms. LIMITATIONS Limitations include the exclusion of imminent suicidal intent, a single suicidal ideation item, and cross-sectional archival data. CONCLUSIONS This is one of the first studies to provide preliminary support that electrophysiological brain activity during sleep is associated with increased suicidal ideation in MDD, and may point toward central nervous system (CNS) hyperarousal during sleep as a neurobiological correlate of suicidal ideation.
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Affiliation(s)
- Emily A. Dolsen
- Department of Psychology, University of California, Berkeley, CA
94720, USA,Correspondence to: 2205 Tolman Hall, Berkeley, CA 94720
(E.A. Dolsen)
| | - Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Hospital, Detroit,
MI 48202, USA
| | - J. Todd Arnedt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
48109, USA
| | - Leslie Swanson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
48109, USA
| | | | - Hyang Sook Kim
- Department of Psychology, Sogang University, Seoul 121-742,
Korea
| | | | - Robert F. Hoffmann
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
48109, USA
| | - Roseanne Armitage
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
48109, USA
| | - Patricia J. Deldin
- Department of Psychology, University of Michigan, Ann Arbor, MI
48109, USA
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Cheng P, Goldschmied J, Deldin P, Hoffmann R, Armitage R. The role of fast and slow EEG activity during sleep in males and females with major depressive disorder. Psychophysiology 2015; 52:1375-81. [PMID: 26175101 PMCID: PMC4507274 DOI: 10.1111/psyp.12472] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 05/29/2015] [Indexed: 11/30/2022]
Abstract
Sleep difficulties are highly prevalent in depression, and appear to be a contributing factor in the development and maintenance of symptoms. However, despite the generally acknowledged relationship between sleep and depression, the neurophysiological substrates underlying this relationship still remain unclear. Two main hypotheses were tested in this study. The first hypothesis states that sleep in depression is characterized by inadequate generation of restorative sleep, as indexed by reduced amounts of slow-wave activity. Conversely, the second hypothesis states that poor sleep in depression is due to intrusions of fast-frequency activity that may be reflective of a hyperaroused central nervous system. This study aimed to test both hypotheses in a large sample of individuals with clinically validated depression, as well as to examine sex as a moderator. Results suggest that depression is better characterized by an overall decrease in slow-wave activity, which is related to elevated anxious and depressed mood the following morning. Results also suggest that females may be more likely to experience fast frequency activity related to depression symptom severity.
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Affiliation(s)
- Philip Cheng
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Patricia Deldin
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert Hoffmann
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Roseanne Armitage
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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Cheng P, Goldschmied J, Casement M, Kim HS, Hoffmann R, Armitage R, Deldin P. Reduction in delta activity predicted improved negative affect in Major Depressive Disorder. Psychiatry Res 2015; 228:715-8. [PMID: 26123231 DOI: 10.1016/j.psychres.2015.05.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 05/12/2015] [Accepted: 05/29/2015] [Indexed: 12/19/2022]
Abstract
While prior research has demonstrated a paradoxical antidepressant effect of slow-wave disruption (SWD), the specific dimensions of depression affected is still unclear. The current study aimed to extend this research by utilizing a dimensional approach in examining the antidepressant effects of SWD. Of particular interest is the affective dimension, as negative affect in depression is arguably the most salient characteristic of depression. This sample included 16 individuals with depression (10 female) recruited from the community. Participants slept in the lab for three nights (adaptation, baseline night, and SWD) with polysomnography, and completed measures of negative affect and depression severity the following morning. Results show that reduction in delta power was linearly associated with improved negative affect. Comparison of individual change scores revealed that half of the individuals showed improved negative affect, which is comparable to the reported 40-60% antidepressant response rate to sleep deprivation. Results suggest that vulnerability in the sleep homeostatic system may be a contributing individual differences factor in response to slow-wave disruption in depression.
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Affiliation(s)
- Philip Cheng
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States.
| | - Jennifer Goldschmied
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States
| | - Melynda Casement
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States
| | - Hyang Sook Kim
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States
| | - Robert Hoffmann
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States
| | - Roseanne Armitage
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States
| | - Patricia Deldin
- Department of Psychiatry University of Michigan, Ann Arbor, Ann Arbor MI 48105, United States
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