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Fitzgerald PJ. Affective disorders and the loudness dependence of the auditory evoked potential: Serotonin and beyond. Neurosci Lett 2024; 827:137734. [PMID: 38499279 DOI: 10.1016/j.neulet.2024.137734] [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: 01/10/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 03/20/2024]
Abstract
Identifying additional noninvasive biomarkers for affective disorders, such as unipolar major depressive disorder (MDD) and bipolar disorder (BD), could aid in the diagnosis and treatment of these prevalent and debilitating neuropsychiatric conditions. One such candidate biomarker is the loudness dependence of the auditory evoked potential (LDAEP), an event-related potential that measures responsiveness of the auditory cortex to different intensities of sound. The LDAEP has been associated with MDD and BD, including therapeutic response to particular classes of antidepressant drugs, while also correlating with several other neuropsychiatric disorders. It has been suggested that increased values of the LDAEP indicate low central serotonergic neurotransmission, further implicating this EEG measure in depression. Here, we briefly review the literature on the LDAEP in affective disorders, including its association with serotonergic signaling, as well as with that of other neurotransmitters such as dopamine. We summarize key findings on the LDAEP and the genetics of these neurotransmitters, as well as prediction of response to particular classes of antidepressants in MDD, including SSRIs versus noradrenergic agents. The possible relationship between this EEG measure and suicidality is addressed. We also briefly analyze acute pharmacologic studies of serotonin and/or dopamine precursor depletion and the LDAEP. In conclusion, the existing literature suggests that serotonin and norepinephrine may modulate the LDAEP in an opposing manner, and that this event-related marker may be of use in predicting response to chronic treatment with particular pharmacologic agents in the context of affective disorders, such as MDD and BD, including in the presence of suicidality.
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Affiliation(s)
- Paul J Fitzgerald
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA.
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2
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Zhan Q, Kong F. Mechanisms associated with post-stroke depression and pharmacologic therapy. Front Neurol 2023; 14:1274709. [PMID: 38020612 PMCID: PMC10651767 DOI: 10.3389/fneur.2023.1274709] [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: 08/08/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Stroke is one of the most common cerebrovascular diseases, which is the cause of long-term mental illness and physical disability, Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, and its mechanisms are characterized by complexity, plurality, and diversity, which seriously affects the quality of survival and prognosis of patients. Studies have focused on and recognized neurotransmitter-based mechanisms and selective serotonin-reuptake inhibitors (SSRIs) can be used to treat PSD. Neuroinflammation, neuroendocrinology, neurotrophic factors, and the site of the stroke lesion may affect neurotransmitters. Thus the mechanisms of PSD have been increasingly studied. Pharmacological treatment mainly includes SSRIs, noradrenergic and specific serotonergic antidepressant (NaSSA), anti-inflammatory drugs, vitamin D, ect, which have been confirmed to have better efficacy by clinical studies. Currently, there is an increasing number of studies related to the mechanisms of PSD. However, the mechanisms and pharmacologic treatment of PSD is still unclear. In the future, in-depth research on the mechanisms and treatment of PSD is needed to provide a reference for the prevention and treatment of clinical PSD.
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Affiliation(s)
- Qingyang Zhan
- Institute of Chinese Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Fanyi Kong
- Neurosurgery, Affiliated First Hospital, Harbin Medical University, Harbin, China
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Jang KI, Kim S, Chae JH, Lee C. Machine learning-based classification using electroencephalographic multi-paradigms between drug-naïve patients with depression and healthy controls. J Affect Disord 2023; 338:270-277. [PMID: 37271294 DOI: 10.1016/j.jad.2023.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Electroencephalography (EEG) is a supplementary diagnostic tool in psychiatry but lacks practical usage. EEG has demonstrated inconsistent diagnostic ability because major depressive disorder (MDD) is a heterogeneous psychiatric disorder with complex pathologies. In clinical psychiatry, it is essential to detect these complexities using multiple EEG paradigms. Though the application of machine learning to EEG signals in psychiatry has increased, an improvement in its classification performance is still required clinically. We tested the classification performance of multiple EEG paradigms in drug-naïve patients with MDD and healthy controls (HCs). METHODS Thirty-one drug-naïve patients with MDD and 31 HCs were recruited in this study. Resting-state EEG (REEG), the loudness dependence of auditory evoked potentials (LDAEP), and P300 were recorded for all participants. Linear discriminant analysis (LDA) and support vector machine (SVM) classifiers with t-test-based feature selection were used to classify patients and HCs. RESULTS The highest accuracy was 94.52 % when 14 selected features, including 12 P300 amplitudes (P300A) and two LDAEP features, were layered. The accuracy was 90.32 % when a SVM classifier for 30 selected features (14 P300A, 14 LDAEP, and 2 REEG) was layered in comparison to each REEG, P300A, and LDAEP, the best accuracies of which were 71.57 % (2-layered with LDA), 87.12 % (1-layered with LDA), and 83.87 % (6-layered with SVM), respectively. LIMITATIONS The present study was limited by small sample size and difference in formal education year. CONCLUSIONS Multiple EEG paradigms are more beneficial than a single EEG paradigm for classifying drug-naïve patients with MDD and HCs.
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Affiliation(s)
- Kuk-In Jang
- Cognitive Science Research Group, Korea Brain Research Institute (KBRI), Daegu, Republic of Korea
| | - Sungkean Kim
- Department of Human-Computer Interaction, Hanyang University, Ansan, Republic of Korea
| | - Jeong-Ho Chae
- Department of psychiatry, College of medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chany Lee
- Cognitive Science Research Group, Korea Brain Research Institute (KBRI), Daegu, Republic of Korea.
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Mavrogiorgou P, Seltsam F, Kiefner D, Flasbeck V, Juckel G. Narcissism and central serotonergic neurotransmission in depression. World J Biol Psychiatry 2023; 24:233-242. [PMID: 35757904 DOI: 10.1080/15622975.2022.2095026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Based on previous research, it has been proposed that the development of depressive disorders is related to altered functioning of the serotonergic systems as well as the personality style, including narcissism. However, it is unclear to date how personality style, especially narcissism, depressive disorders and serotonergic activity are related. METHODS We included 74 patients with a depressive disorder (DP) and 74 healthy controls (HC) in the study. All participants completed the Personality Style and Disorder Inventory (PSDI) and the Beck Depression Inventory (BDI II). Moreover, we conducted EEG recordings for analysis of serotonergic neurotransmission by using the so-called intensity or loudness dependence of the auditory evoked potentials (LDAEP). RESULTS Significantly higher LDAEP results emerged for the DP group compared to the HC group, which indicated lower serotonergic activity in the patient's group. In addition, the positive correlation between ambitious-narcissistic personality and LDAEP reached significance in depressive patients. LIMITATIONS There was only a monocentric cross-sectional study with only one scale having differences between the two groups due to age and education. CONCLUSIONS Our data supports the theory of lower serotonergic activity in patients with depressive disorders and further suggests that high narcissistic personality traits are related to lower serotonergic neurotransmission in patients.
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Affiliation(s)
- Paraskevi Mavrogiorgou
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum, Germany
| | - Florian Seltsam
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum, Germany
| | - David Kiefner
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum, Germany
| | - Vera Flasbeck
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum, Germany
| | - Georg Juckel
- LWL-Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, Bochum, Germany
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Ip CT, Ganz M, Ozenne B, Olbrich S, Beliveau V, Dam VH, Köhler-Forsberg K, Jørgensen MB, Frøkjær VG, Knudsen GM. Association between the loudness dependence of auditory evoked potential, serotonergic neurotransmission and treatment outcome in patients with depression. Eur Neuropsychopharmacol 2023; 70:32-44. [PMID: 36863106 DOI: 10.1016/j.euroneuro.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 03/04/2023]
Abstract
Previous studies have suggested that the loudness dependence of auditory evoked potential (LDAEP) is associated with the effectiveness of antidepressant treatment in patients with major depressive disorders (MDD). Furthermore, both LDAEP and the cerebral serotonin 4 receptor (5-HT4R) density is inversely related to brain serotonin levels. We included 84 patients with MDD and 22 healthy controls to examined the association between LDAEP and treatment response and its association with cerebral 5-HT4R density. Participants underwent both EEG and 5-HT4R neuroimaging with [11C]SB207145 PET. Thirty-nine patients with MDD were re-examined after 8 weeks of treatment with selective serotonin reuptake inhibitors/serotonin noradrenaline reuptake inhibitor (SSRI/SNRI). We found that the cortical source of LDAEP was higher in untreated patients with MDD compared to healthy controls (p=0.03). Prior to SSRI/SNRI treatment, subsequent treatment responders had a negative association between LDAEP and depressive symptoms and a positive association between scalp LDAEP and symptom improvement at week 8. This was not found in source LDAEP. In healthy controls, we found a positive correlation between both scalp and source LDAEP and cerebral 5-HT4R binding but that was not observed in patients with MDD. We did not see any changes in scalp and source LDAEP in response to SSRI/SNRI treatment. These results support a theoretical framework where both LDAEP and cerebral 5-HT4R are indices of cerebral 5-HT levels in healthy individuals while this association seems to be disrupted in MDD. The combination of the two biomarkers may be useful for stratifying patients with MDD. Clinical Trials Registration:https://clinicaltrials.gov/ct2/show/NCT02869035?draw=1Registration number: NCT0286903.
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Affiliation(s)
- Cheng-Teng Ip
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
| | - Melanie Ganz
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Public Health, Section of Biostatistics, University of Copenhagen, Denmark
| | - Sebastian Olbrich
- Department for Psychiatry, Psychotherapy and Psychosomatic, University Zurich, Switzerland
| | - Vincent Beliveau
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Vibeke H Dam
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kristin Köhler-Forsberg
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Martin B Jørgensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Vibe G Frøkjær
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and NeuroPharm, University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Park EJ, Park YM, Lee SH, Kim B. The Loudness Dependence of Auditory Evoked Potentials is associated with the Symptom Severity and Treatment in Boys with Attention Deficit Hyperactivity Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:514-525. [PMID: 35879036 PMCID: PMC9329111 DOI: 10.9758/cpn.2022.20.3.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 01/20/2022] [Accepted: 02/02/2022] [Indexed: 11/18/2022]
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Eun Jin Park
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Young-Min Park
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Bongseog Kim
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
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Changes in the TMS-evoked potential N100 in the dorsolateral prefrontal cortex as a function of depression severity in adolescents. J Neural Transm (Vienna) 2022; 129:1339-1352. [PMID: 36029418 PMCID: PMC9550695 DOI: 10.1007/s00702-022-02539-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022]
Abstract
Studies using transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) revealed an imbalance between cortical excitation and inhibition (E/I) in the dorsolateral prefrontal cortex (DLPFC) in depression. As adolescence is a developmental period with an increase in depression prevalence and profound neural changes, it is crucial to study the relationship between depression and cortical excitability in adolescence. We aimed to investigate the cortical excitability of the DLPFC in adolescents with depression and a dependency of the TMS-evoked potential N100 on the depression severity. 36 clinical patients (12–18 years of age; 21 females) with a major depressive episode were assessed twice in a longitudinal design: shortly after admission (T0) and after six weeks of intervention (T1). GABA-B-mediated cortical inhibition in the left and right DLPFC, as assessed by the N100, was recorded with EEG. Significantly higher depression scores were reported at T0 compared to T1 (p < 0.001). N100 amplitudes were significantly increased (i.e., more negative) at T0 compared to T1 (p = 0.03). No significant hemispheric difference was found in the N100 component. The correlation between the difference in depression severity and the difference in N100 amplitudes (T0–T1) obtained during stimulation of the left DLPFC did not remain significant after correction for testing in both hemispheres. Higher N100 amplitudes during a state of greater depression severity are suggestive of an E/I imbalance in the DLPFC in adolescents with an acute depressive episode. The N100 reduction potentially reflects a normalization of DLPFC over inhibition in association with decreased depressive symptomatology, indicating severity dependency.
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Kangas ES, Vuoriainen E, Lindeman S, Astikainen P. Auditory event-related potentials in separating patients with depressive disorders and non-depressed controls: A narrative review. Int J Psychophysiol 2022; 179:119-142. [PMID: 35839902 DOI: 10.1016/j.ijpsycho.2022.07.003] [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: 10/29/2021] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
This narrative review brings together the findings regarding the differences in the auditory event-related potentials (ERPs) between patients with depressive disorder and non-depressed control subjects. These studies' results can inform us of the possible alterations in sensory-cognitive processing in depressive disorders and the potential of using these ERPs in clinical applications. Auditory P3, mismatch negativity (MMN) and loudness dependence of auditory evoked potentials (LDAEP) were the subjects of the investigation. A search in PubMed yielded 84 studies. The findings of the reviewed studies were not highly consistent, but some patterns could be identified. For auditory P3b, the common findings were attenuated amplitude and prolonged latency among depressed patients. Regarding auditory MMN, especially the amplitude of duration deviance MMN was commonly attenuated, and the amplitude of frequency deviance MMN was increased in depressed patients. In LDAEP studies, generally, no differences between depressed patients and non-depressed controls were reported, although some group differences concerning specific depression subtypes were found. This review posits that future research should investigate whether certain stimulus conditions are particularly efficient at separating depressed and non-depressed participant groups. Future studies should contrast responses in different subpopulations of depressed patients, as well as different clinical groups (e.g., depressive disorder and anxiety disorder patients), to investigate the specificity of the auditory ERP alterations for depressive disorders.
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Affiliation(s)
- Elina S Kangas
- Department of Psychology, University of Jyvaskyla, Jyväskylä, Finland.
| | - Elisa Vuoriainen
- Human Information Processing Laboratory, Faculty of Social Sciences / Psychology, Tampere University, Tampere, Finland
| | - Sari Lindeman
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Jyväskylä, Finland
| | - Piia Astikainen
- Department of Psychology, University of Jyvaskyla, Jyväskylä, Finland
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Jang KI, Kim S, Lee C, Chae JH. Association between the loudness dependence of auditory evoked potentials and age in patients with schizophrenia and depression. J Int Med Res 2022; 50:3000605221109789. [PMID: 35808808 PMCID: PMC9274422 DOI: 10.1177/03000605221109789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Although serotonergic dysfunction is significantly associated with major
depressive disorder (MDD) and schizophrenia (SCZ), comparison of
serotonergic dysfunction in both diseases has received little attention.
Serotonin hypotheses have suggested diminished and elevated serotonin
activity in MDD and SCZ, respectively. However, the foundations underlying
these hypotheses are unclear regarding changes in serotonin
neurotransmission in the aging brain. The loudness dependence of auditory
evoked potentials (LDAEP) reflects serotonin neurotransmission. The present
study compared the LDAEP between patients with SCZ or MDD and healthy
controls (HCs). We further examined whether age was correlated with the
LDAEP and clinical symptoms. Methods This prospective clinical study included 105 patients with SCZ (n = 54) or
MDD (n = 51). Additionally, 35 HCs were recruited for this study. The LDAEP
was measured on the midline channels via 62 electroencephalography
channels. Results Patients with SCZ or MDD showed a significantly smaller mean LDAEP than those
in HCs. The LDAEP was positively correlated with age in patients with SCZ or
MDD. Conclusions Changes in central serotonergic activity could be indicated by evaluating the
LDAEP in patients with SCZ or MDD. Age-related reductions in serotonergic
activity may be screened using the LDAEP in patients with SCZ or MDD.
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Affiliation(s)
- Kuk-In Jang
- Cognitive Science Research Group, Korea Brain Research Institute (KBRI), Daegu, Republic of Korea
| | - Sungkean Kim
- Department of Human-Computer Interaction, Hanyang University, Ansan, Republic of Korea
| | - Chany Lee
- Cognitive Science Research Group, Korea Brain Research Institute (KBRI), Daegu, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Abstract
BACKGROUND Serotonergic dysfunction may play an important role in motor and nonmotor symptoms of Parkinson's disease (PD). The loudness dependence of auditory evoked potentials (LDAEP) has been used to evaluate serotonergic activity. Therefore, this study aimed to determine central serotonergic activity using LDAEP in de novo PD according to the age at onset and changes in serotonergic activity after dopaminergic treatment. METHODS A total of 30 patients with unmedicated PD, 16 in the early-onset and 14 in the late-onset groups, were enrolled. All subjects underwent comprehensive neurological examination, laboratory tests, the Unified Parkinson's Disease Rating Scale, and LDAEP. The LDAEP was calculated as the slope of the two N1/P2 peaks measured at the Cz electrode, first at baseline conditions (pretreatment) and a second time after 12 weeks (post-treatment) following dopaminergic medications. RESULTS The absolute values of pretreatment N1/P2 LDAEP (early-onset: late-onset, 0.99 ± 0.68: 1.62 ± 0.88, p = 0.035) and post-treatment N1 LDAEP (early-onset: late-onset, -0.61 ± 0.61: -1.26 ± 0.91, p = 0.03) were significantly lower in the early-onset group compared with those of the late-onset group. In addition, a higher value of pretreatment N1/P2 LDAEP was significantly correlated with the late-onset group (coefficient = 1.204, p = 0.044). The absolute value of the N1 LDAEP decreased after 12 weeks of taking dopaminergic medication (pretreatment: post-treatment, -1.457 ± 1.078: -0.904 ± 0.812, p = 0.0018). CONCLUSIONS Based on the results of this study, LDAEP could be a marker for serotonergic neurotransmission in PD. Central serotonergic activity assessed by LDAEP may be more preserved in early-onset PD patients and can be altered with dopaminergic medication.
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Yoon S, Kim Y, Lee SH. Does the Loudness Dependence of Auditory Evoked Potential Predict Response to Selective Serotonin Reuptake Inhibitors?: A Meta-analysis. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:254-261. [PMID: 33888654 PMCID: PMC8077049 DOI: 10.9758/cpn.2021.19.2.254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022]
Abstract
Objective Loudness of dependence of the auditory evoked potential (LDAEP) is an electroencephalogram-based measure that represents amplitude changes of auditory evoked potentials in primary auditory cortex. Several narrative reviews argued that pre-treatment LDAEP values predict responses to selective serotonin reuptake inhibitors (SSRIs). This study aims to quantify the overall relationship between baseline LDAEP values and treatment response to SSRIs in patients with depression and generalized anxiety disorders, evidenced by clinical symptoms reductions, across multiple studies. Methods In our meta-analysis, seven articles with a total sample of 241 patients were included. Results Our results showed that stronger baseline LDAEP values predicted favorable response to SSRIs for depression and anxiety, with a moderate effect size. Conclusion The current results support the idea that LDAEP is a promising biomarker for SSRIs treatment prediction in patients with depression and generalized anxiety disorder.
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Affiliation(s)
- Sunkyung Yoon
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Yourim Kim
- Clinical Emotion and Cognition Research Laboratory, Goyang, Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Goyang, Korea.,Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea
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Mismatch Negativity and Loudness Dependence of Auditory Evoked Potentials among Patients with Major Depressive Disorder, Bipolar II Disorder, and Bipolar I Disorder. Brain Sci 2020; 10:brainsci10110789. [PMID: 33126640 PMCID: PMC7692302 DOI: 10.3390/brainsci10110789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/17/2022] Open
Abstract
Mismatch negativity (MMN) and loudness dependence of auditory evoked potentials (LDAEP), which are event-related potentials, have been investigated as biomarkers. MMN indicates the pre-attentive function, while LDAEP may be an index of central serotonergic activity. This study aimed to test whether MMN and LDAEP are useful biological markers for distinguishing patients with bipolar disorder (BD) and major depressive disorder (MDD), as well as the relationship between MMN and LDAEP. Fifty-five patients with major depressive episodes, aged 20 to 65 years, who had MDD (n = 17), BD type II (BIID) (n = 27), and BD type I (BID) (n = 11), were included based on medical records. Patients with MDD had a higher MMN amplitude than those with BID. In addition, the MMN amplitude in F4 positively correlated with the Korean version of mood disorder questionnaire scores (r = 0.37, p = 0.014), while the MMN amplitude in F3 correlated negatively with LDAEP (r = −0.30, p = 0.024). The odds ratios for the BID group and some variables were compared with those for the MDD group using multinomial logistic regression analysis. As a result, a significant reduction of MMN amplitude was found under BID diagnosis compared to MDD diagnosis (p = 0.015). This study supported the hypothesis that MMN amplitude differed according to MDD, BIID, and BID, and there was a relationship between MMN amplitude and LDAEP. These findings also suggested that BID patients had a reduced automatic and pre-attentive processing associated with serotonergic activity or N-methyl-D-aspartate receptor.
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Citalopram reduces glutamatergic synaptic transmission in the auditory cortex via activation of 5-HT1A receptors. Neuroreport 2020; 30:1316-1322. [PMID: 31714483 DOI: 10.1097/wnr.0000000000001366] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Serotonin modulates cognitive processes and is related to various psychiatric disorders, including major depression. Administration of citalopram reduces the amplitude of auditory evoked potentials in depressed people and animal models, suggesting that 5-HT has an inhibitory role. Here, we characterize the modulation of excitatory post-synaptic currents by application of either 5-HT or agonists of 5-HT1A and 5-HT2 receptors, or by endogenous 5-HT evoked by citalopram on pyramidal neurons from layer II/III of rat auditory cortex. We found that application of 5-HT concentration-dependently reduces excitatory post-synaptic currents amplitude without changing the paired-pulse ratio, suggesting a post-synaptic modulation. We observed that selective agonists of 5-HT1A and 5-HT2 receptors [8-OH-DPAT (10 µM) and DOI (10 µM), respectively] mimic the effect of 5-HT on the excitatory post-synaptic currents. Effect of 5-HT was entirely blocked by co-application of the antagonists NAN-190 (1 µM) and ritanserin (200 nM). Similarly, citalopram application (1 μM) reduced the amplitude of the evoked excitatory post-synaptic currents. Reduction in the magnitude of the excitatory post-synaptic currents by endogenous 5-HT was interpolated in the dose-response curve elicited by exogenous 5-HT, yielding that citalopram raised the extracellular 5-HT concentration to 823 nM. Effect of citalopram was blocked by the previous application of NAN-190 but not ritanserin, indicating that citalopram reduces glutamatergic synaptic transmission via 5-HT1A receptors in layer II/III of the auditory cortex. These results suggest that the local activity of 5-HT contributes to decrease in the basal excitability of the auditory cortex for enhancing the detection of external relevant acoustic signals.
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Relationship between Auditory Evoked Potentials and Circadian Preference in Patients with Major Depressive Episodes. Brain Sci 2020; 10:brainsci10060370. [PMID: 32545632 PMCID: PMC7349307 DOI: 10.3390/brainsci10060370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 12/24/2022] Open
Abstract
Mood disorders often accompany circadian rhythm abnormalities. The serotonergic system (STS) is related to mood and circadian rhythm. This study aimed to test whether serotonergic neurotransmission, using the loudness dependence of auditory evoked potential (LDAEP), is associated with circadian preference in patients with major depressive disorder (MDD). Depression severity was assessed in 18–65-year-old outpatients (n = 48) using the Beck Depression Inventory scores and Hamilton Depression Rating Scale at baseline. Additionally, various scales, including the Korean version of the Composite Scale of Morningness (K-CSM), Korean version of the Mood Disorder Questionnaire (K-MDQ), and Korean version of the Childhood Trauma Questionnaire (K-CTQ), were used. LDAEP was also measured at baseline. The subjects were divided into three groups according to the circadian preference using total K-CSM scores (morningness (n = 10) vs intermediate (n = 19) vs. eveningness (n = 19)) and two groups according to median based on each K-CSM score, respectively (higher K-CSM (n = 25) vs. lower K-CSM (n = 23)). The bipolarity, suicidality, and age at onset differed among the three groups. Impulsivity, depression severity, suicidality, hopelessness, bipolarity, frequency of emotional abuse, and age at onset differed between the two group divisions. Thus, the STS might serve as the mediator between the circadian system and mood.
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Ruohonen EM, Kattainen S, Li X, Taskila AE, Ye C, Astikainen P. Event-Related Potentials to Changes in Sound Intensity Demonstrate Alterations in Brain Function Related to Depression and Aging. Front Hum Neurosci 2020; 14:98. [PMID: 32292334 PMCID: PMC7119431 DOI: 10.3389/fnhum.2020.00098] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/03/2020] [Indexed: 01/24/2023] Open
Abstract
Measures of the brain's automatic electrophysiological responses to sounds represent a potential tool for identifying age- and depression-related neural markers. However, these markers have rarely been studied related to aging and depression within one study. Here, we investigated auditory event-related potentials (ERPs) in the brain that may show different alterations related to aging and depression. We used an oddball condition employing changes in sound intensity to investigate: (i) sound intensity dependence; (ii) sensory gating; and (iii) change detection, all within a single paradigm. The ERPs of younger (18-40 years) and older (62-80 years) depressed female participants and age-matched non-depressed participants were measured. Intensity dependence was examined as the difference between N1 responses to repeated high- and low-intensity sounds, sensory gating as N1 responses to rare and repeated sounds, and change detection as indexed by the mismatch negativity (MMN). We found that intensity dependence was greater in older participants than younger ones, indicating effects related to aging but not to depression. For sensory gating, we found depression- and age-related alterations as increased N1 responses. No group differences were found for MMN. Although a sensory gating deficit was expected in older adults, this study is the first to demonstrate age-related overexcitability in sound intensity dependency. The results indicate that automatic brain responses to sound intensity changes are suitable for studying age- and depression-related neural markers but may not be sensitive enough to differentiate the effects of aging and depression.
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Affiliation(s)
- Elisa M Ruohonen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Saara Kattainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Xueqiao Li
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Chaoxiong Ye
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Piia Astikainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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Pillai RLI, Bartlett EA, Ananth MR, Zhu C, Yang J, Hajcak G, Parsey RV, DeLorenzo C. Examining the underpinnings of loudness dependence of auditory evoked potentials with positron emission tomography. Neuroimage 2020; 213:116733. [PMID: 32169543 DOI: 10.1016/j.neuroimage.2020.116733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 11/30/2022] Open
Abstract
Loudness dependence of auditory evoked potentials (LDAEP) has long been considered to reflect central basal serotonin transmission. However, the relationship between LDAEP and individual serotonin receptors and transporters has not been fully explored in humans and may involve other neurotransmitter systems. To examine LDAEP's relationship with the serotonin system, we performed PET using serotonin-1A (5-HT1A) imaging via [11C]CUMI-101 and serotonin transporter (5-HTT) imaging via [11C]DASB on a mixed sample of healthy controls (n = 4: 4 females, 0 males), patients with unipolar (MDD, n = 11: 4 females, 7 males) and bipolar depression (BD, n = 8: 4 females, 4 males). On these same participants, we also performed electroencephalography (EEG) within a week of PET scanning, using 1000 Hz tones of varying intensity to evoke LDAEP. We then evaluated the relationship between LDAEP and 5-HT1A or 5-HTT binding in both the raphe (5-HT1A)/midbrain (5-HTT) areas and in the temporal cortex. We found that LDAEP was significantly correlated with 5-HT1A positively and with 5-HTT negatively in the temporal cortex (p < 0.05), but not correlated with either in midbrain or raphe. In males only, exploratory analysis showed multiple regions in which LDAEP significantly correlated with 5-HT1A throughout the brain; we did not find this with 5-HTT. This multimodal study partially validates preclinical models of a serotonergic influence on LDAEP. Replication in larger samples is necessary to further clarify our understanding of the role of serotonin in perception of auditory tones.
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Affiliation(s)
| | - Elizabeth A Bartlett
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, United States
| | - Mala R Ananth
- Department of Psychiatry, Stony Brook University, United States
| | - Chencan Zhu
- Department of Applied Mathematics and Statistics, Stony Brook University, United States
| | - Jie Yang
- Department of Family, Population, and Preventive Medicine, Stony Brook University, United States
| | - Greg Hajcak
- Department of Biomedical Sciences and Psychology, Florida State University, United States
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, United States
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, United States; Department of Biomedical Engineering, Stony Brook University, United States
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Park YM. The Hypothesis on the Prediction of Treatment Response with Buspirone Augmentation along with Serotonergic Antidepressant in Patients with Major Depressive Disorder Using Loudness Dependence of Auditory Evoked Potentials: Two Cases and Review of the Literature for Evidence. Psychiatry Investig 2020; 17:222-224. [PMID: 32151126 PMCID: PMC7113178 DOI: 10.30773/pi.2019.0293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/21/2019] [Indexed: 11/27/2022] Open
Abstract
Some studies have shown that augmenting buspirone with antidepressant has similar efficacy as the combination with two antidepressants in patients with major depressive disorder (MDD). Some researchers assume that the antidepressant boosting effect of buspirone is revealed under a poop-out state, which means a phenomenon where some patients having an initial response to an antidepressant may worsen or not improve any more even though they continue treatment because of serotonin depletion. Loudness dependence of auditory evoked potential (LDAEP) is a reliable marker of central serotonergic activity, and is inversely correlated with central serotonergic activity. Thus LDAEP will be a biological marker for prediction of treatment response with buspirone augmentation with SSRI because it can measure central serotonergic activity such as serotonin depletion. Two cases will be introduced and the literature evidence about whether LDAEP can predict the treatment response of buspirone augmentation in patients with MDD will be reviewed.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
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Comprehensive phenotyping of depression disease trajectory and risk: Rationale and design of Texas Resilience Against Depression study (T-RAD). J Psychiatr Res 2020; 122:22-32. [PMID: 31918350 DOI: 10.1016/j.jpsychires.2019.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/28/2019] [Accepted: 12/05/2019] [Indexed: 12/16/2022]
Abstract
Depression has a chronic and recurrent course often with early onset and is the leading cause of disability worldwide. In contrast to diagnoses for other conditions which rely on precise medical tests, the diagnosis of depression still focuses exclusively on symptom reports. As a result, heterogeneous patient groups are included under broad categories. Furthermore, in the absence of companion diagnostic tests, choosing specific treatments for patients remains imprecise with only one-third of patients entering remission with initial treatment, with others requiring multiple intervention steps to achieve remission. In addition to improving treatment outcomes, disease prevention is essential to reduce overall disease burden. Adolescence is a critical window where complex emotional, social, familial, and biological shifts may predispose to lifelong depression. Thus, personalized medicine, integrating individual variability in genes, brain function, and clinical phenotypes, can offer a comprehensive approach to provide precise diagnosis, novel drug development, optimal treatment assignment, and prevention of illness and its associated burden. Texas Resilience Against Depression study (T-RAD) encompasses two natural history, longitudinal (10 + years), prospective studies (D2K and RAD), each enrolling 2500 participants. The D2K study follows participants (ages 10 years and older) who have a current or past diagnosis of depression or bipolar disorder. The RAD study follows participants aged 10-24 years who are at risk for depression but not yet suffering from the disease. The T-RAD study will help to uncover the socio-demographic, lifestyle, clinical, psychological, and neurobiological factors that contribute to mood disorder onset, recurrence, progression, and differential treatment response.
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Steinberg LJ, Underwood MD, Bakalian MJ, Kassir SA, Mann JJ, Arango V. 5-HT1A receptor, 5-HT2A receptor and serotonin transporter binding in the human auditory cortex in depression. J Psychiatry Neurosci 2019; 44:294-302. [PMID: 31120232 PMCID: PMC6710086 DOI: 10.1503/jpn.180190] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Serotonergic system abnormalities are implicated in many psychiatric disorders, including major depression. The temporal lobe receives a high density of serotonergic afferent projections, and responses in the primary auditory cortex to sound are modulated by serotonergic tone. However, the associations between changes in serotonergic tone, disease state and changes in auditory cortical function remain to be clarified. METHODS We quantified serotonin 1A (5-HT1A) receptor binding, serotonin 2A (5-HT2A) receptor binding, and serotonin transporter (SERT) binding in Brodmann areas (BA) 41/42, 22, 9 and 4 from postmortem brain sections of 40 psychiatrically healthy controls and 39 individuals who had a history of a major depressive episode (MDE). RESULTS There was 33% lower 5-HT2A receptor binding in BA 41/42 in individuals who had an MDE than in controls (p = 0.0069). Neither 5-HT1A nor SERT binding in BA 41/42 differed between individuals who had an MDE and controls. We also found 14% higher 5-HT1A receptor binding (p = 0.045) and 21% lower SERT binding in BA 9 of individuals who had an MDE (p = 0.045). LIMITATIONS The study was limited by the small number of postmortem brain samples including BA 41/42 available for binding assays and the large overlap between suicide and depression in the MDE sample. CONCLUSION Depression may be associated with altered serotonergic function in the auditory cortex involving the 5-HT2A receptor and is part of a wider view of the pathophysiology of mood disorders extending beyond psychopathology.
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Affiliation(s)
- Louisa J. Steinberg
- From the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Bakalian, Kassir, Mann, Arango); the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Mann, Arango); and the Department of Radiology, Columbia University, New York, NY, USA (Mann)
| | - Mark D. Underwood
- From the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Bakalian, Kassir, Mann, Arango); the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Mann, Arango); and the Department of Radiology, Columbia University, New York, NY, USA (Mann)
| | - Mihran J. Bakalian
- From the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Bakalian, Kassir, Mann, Arango); the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Mann, Arango); and the Department of Radiology, Columbia University, New York, NY, USA (Mann)
| | - Suham A. Kassir
- From the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Bakalian, Kassir, Mann, Arango); the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Mann, Arango); and the Department of Radiology, Columbia University, New York, NY, USA (Mann)
| | - J. John Mann
- From the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Bakalian, Kassir, Mann, Arango); the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Mann, Arango); and the Department of Radiology, Columbia University, New York, NY, USA (Mann)
| | - Victoria Arango
- From the Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Bakalian, Kassir, Mann, Arango); the Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA (Steinberg, Underwood, Mann, Arango); and the Department of Radiology, Columbia University, New York, NY, USA (Mann)
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Widge AS, Bilge MT, Montana R, Chang W, Rodriguez CI, Deckersbach T, Carpenter LL, Kalin NH, Nemeroff CB. Electroencephalographic Biomarkers for Treatment Response Prediction in Major Depressive Illness: A Meta-Analysis. Am J Psychiatry 2019; 176:44-56. [PMID: 30278789 PMCID: PMC6312739 DOI: 10.1176/appi.ajp.2018.17121358] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Reducing unsuccessful treatment trials could improve depression treatment. Quantitative EEG (QEEG) may predict treatment response and is being commercially marketed for this purpose. The authors sought to quantify the reliability of QEEG for response prediction in depressive illness and to identify methodological limitations of the available evidence. METHOD The authors conducted a meta-analysis of diagnostic accuracy for QEEG in depressive illness, based on articles published between January 2000 and November 2017. The review included all articles that used QEEG to predict response during a major depressive episode, regardless of patient population, treatment, or QEEG marker. The primary meta-analytic outcome was the accuracy for predicting response to depression treatment, expressed as sensitivity, specificity, and the logarithm of the diagnostic odds ratio. Raters also judged each article on indicators of good research practice. RESULTS In 76 articles reporting 81 biomarkers, the meta-analytic estimates showed a sensitivity of 0.72 (95% CI=0.67-0.76) and a specificity of 0.68 (95% CI=0.63-0.73). The logarithm of the diagnostic odds ratio was 1.89 (95% CI=1.56-2.21), and the area under the receiver operator curve was 0.76 (95% CI=0.71-0.80). No specific QEEG biomarker or specific treatment showed greater predictive power than the all-studies estimate in a meta-regression. Funnel plot analysis suggested substantial publication bias. Most studies did not use ideal practices. CONCLUSIONS QEEG does not appear to be clinically reliable for predicting depression treatment response, as the literature is limited by underreporting of negative results, a lack of out-of-sample validation, and insufficient direct replication of previous findings. Until these limitations are remedied, QEEG is not recommended for guiding selection of psychiatric treatment.
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Affiliation(s)
- Alik S. Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Picower Institute for Learning & Memory, Massachusetts Institute of Technology, Cambridge, MA
| | - M. Taha Bilge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Rebecca Montana
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Weilynn Chang
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Linda L. Carpenter
- Butler Hospital and Warren Alpert Medical School of Brown University, Providence, RI
| | - Ned H. Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Charles B. Nemeroff
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL
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Lewine JD, Paulson K, Bangera N, Simon BJ. Exploration of the Impact of Brief Noninvasive Vagal Nerve Stimulation on EEG and Event‐Related Potentials. Neuromodulation 2018; 22:564-572. [DOI: 10.1111/ner.12864] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Jeffrey D. Lewine
- The Mind Research Network Albuquerque NM USA
- The Lovelace Family of Companies Albuquerque NM USA
- The Department of Neurology and the Department of PsychologyUniversity of New Mexico Albuquerque NM USA
| | - Kim Paulson
- The Mind Research Network Albuquerque NM USA
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Association of the loudness dependence of auditory evoked potentials with clinical changes to repetitive transcranial magnetic stimulation in patients with depression. J Affect Disord 2018; 238:451-457. [PMID: 29920440 DOI: 10.1016/j.jad.2018.05.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 04/09/2018] [Accepted: 05/17/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although the application of repetitive transcranial magnetic stimulation (rTMS) for treatment of depression has been well investigated, there are few biological predictors of clinical outcomes to rTMS treatment. Previous studies have suggested that the loudness dependence of auditory evoked potentials (LDAEP) can be used as a predictor of response to antidepressant treatment. However, little is known about the association between rTMS and LDAEP. The present study aimed to investigate whether baseline LDAEP is associated with clinical changes to rTMS treatment in patients with major depressive disorder (MDD), and to explore the effect of high-frequency rTMS on LDAEP. METHODS Thirty patients were randomized to receive 15 sessions of active (n = 15) or sham rTMS (n = 15). LDAEP and clinical measures of depression were assessed before and after 10 Hz rTMS treatment for 15 days. RESULTS Baseline LDAEP was associated with changes in scores on the Hamilton Rating Scale for Depression. There were no significant effects of rTMS on LDAEP. Patients with high LDAEP exhibited more favorable clinical changes than those with low LDAEP following treatment with rTMS. LIMITATIONS The sample was relatively small, and the participants were not divided into responders and non-responders group due to small sample. An influence of medication has not been controlled. CONCLUSIONS Our findings suggest that high baseline LDAEP may be associated with favorable clinical changes to rTMS treatment in patients with MDD. Further studies are required to replicate and validate the potential use of LDAEP as a predictor of clinical changes to rTMS treatment.
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Disrupted cortical brain network in post-traumatic stress disorder patients: a resting-state electroencephalographic study. Transl Psychiatry 2017; 7:e1231. [PMID: 28895942 PMCID: PMC5639244 DOI: 10.1038/tp.2017.200] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 07/07/2017] [Accepted: 07/14/2017] [Indexed: 12/13/2022] Open
Abstract
This study aimed to examine the source-level cortical brain networks of post-traumatic stress disorder (PTSD) based on the graph theory using electroencephalography (EEG). Sixty-six cortical source signals were estimated from 78 PTSD and 58 healthy controls (HCs) of resting-state EEG. Four global indices (strength, clustering coefficient (CC), path length (PL) and efficiency) and one nodal index (CC) were evaluated in six frequency bands (delta, theta, alpha, low beta, high beta and gamma). PTSD showed decreased global strength, CC and efficiency, in delta, theta, and low beta band and enhanced PL in theta and low beta band. In low beta band, the strength and CC correlated positively with the anxiety scores, while PL had a negative correlation. In addition, nodal CCs were reduced in PTSD in delta, theta and low beta band. Nodal CCs of theta band correlated negatively with rumination and re-experience symptom scores; while, nodal CCs in low beta band correlated positively with anxiety and pain severity. Inefficiently altered and symptom-dependent changes in cortical networks were seen in PTSD. Our source-level cortical network indices might be promising biomarkers for evaluating PTSD.
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Brain responses to sound intensity changes dissociate depressed participants and healthy controls. Biol Psychol 2017; 127:74-81. [PMID: 28499838 DOI: 10.1016/j.biopsycho.2017.05.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 05/04/2017] [Accepted: 05/07/2017] [Indexed: 11/22/2022]
Abstract
Depression is associated with bias in emotional information processing, but less is known about the processing of neutral sensory stimuli. Of particular interest is processing of sound intensity which is suggested to indicate central serotonergic function. We tested weather event-related brain potentials (ERPs) to occasional changes in sound intensity can dissociate first-episode depressed, recurrent depressed and healthy control participants. The first-episode depressed showed larger N1 amplitude to deviant sounds compared to recurrent depression group and control participants. In addition, both depression groups, but not the control group, showed larger N1 amplitude to deviant than standard sounds. Whether these manifestations of sensory over-excitability in depression are directly related to the serotonergic neurotransmission requires further research. The method based on ERPs to sound intensity change is fast and low-cost way to objectively measure brain activation and holds promise as a future diagnostic tool.
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Abstract
Major depressive disorder is one of the leading causes of disability in the world since depression is highly frequent and causes a strong burden. In order to reduce the duration of depressive episodes, clinicians would need to choose the most effective therapy for each individual right away. A prerequisite for this would be to have biomarkers at hand that would predict which individual would benefit from which kind of therapy (for example, pharmacotherapy or psychotherapy) or even from which kind of antidepressant class. In the past, neuroimaging, electroencephalogram, genetic, proteomic, and inflammation markers have been under investigation for their utility to predict targeted therapies. The present overview demonstrates recent advances in all of these different methodological areas and concludes that these approaches are promising but also that the aim to have such a marker available has not yet been reached. For example, the integration of markers from different systems needs to be achieved. With ongoing advances in the accuracy of sensing techniques and improvement of modelling approaches, this challenge might be achievable.
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Affiliation(s)
- Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
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