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Flasbeck V, Hirsch J, Petrak F, Meier JJ, Herpertz S, Gatermann S, Juckel G. Microbiome composition and central serotonergic activity in patients with depression and type 1 diabetes. Eur Arch Psychiatry Clin Neurosci 2024; 274:1177-1186. [PMID: 37847374 PMCID: PMC11226557 DOI: 10.1007/s00406-023-01694-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/20/2023] [Indexed: 10/18/2023]
Abstract
The role of gut-brain axis functioning gains growing attention in research on the pathophysiology of major depressive disorders. Here, especially consequences of altered microbiota composition on tryptophan metabolism resulting in altered serotonergic neurotransmission in the central nervous system (CNS) have reached a central position. Previous research, however, mainly focused on either microbiota and peripheral serotonin levels or central serotonergic neurotransmission. The present study aimed to combine the analysis of microbiota composition and central serotonergic activity using a valid neurophysiological indicator. We recruited 19 adult patients with type 1 diabetes and depression (D + D; 7 males), 19 patients with type 1 diabetes (D-; 7 male), and 20 healthy participants (HC; 7 males). Next to the analysis of fecal microbiota regarding α- and β-diversity, the loudness dependence of auditory evoked potential (LDAEP) was investigated, a non-invasive measurement of central serotonergic activity. High α-diversity was associated with high LDAEP, i.e., low serotonergic activity, in patients with diabetes and additional depression. Furthermore, relative abundances of bacterial families belonging to Bacteroidetes, Proteobacteria and Firmicutes were shown to have an impact on central serotonergic activity. This finding was supported by a tendency indicating an association of central serotonergic activity with the Bacteroidetes-Firmicutes ratio in both patients' groups. Together, this data suggests that the guts' microbiota composition might play an important role in regulating the central serotonergic activity in the brain.
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Affiliation(s)
- Vera Flasbeck
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Julia Hirsch
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791, Bochum, Germany
| | - Frank Petrak
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791, Bochum, Germany
| | - Juris J Meier
- Diabetes Division, Katholisches Klinikum Bochum, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Alexandrinenstr.1, 44791, Bochum, Germany
| | - Sören Gatermann
- German National Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Department of Medical Microbiology, Ruhr-University Bochum, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany.
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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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3
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Flasbeck V, Engelmann J, Klostermann B, Juckel G, Mavrogiorgou P. Relationships between fear of flying, loudness dependence of auditory evoked potentials and frontal alpha asymmetry. J Psychiatr Res 2023; 159:145-152. [PMID: 36724673 DOI: 10.1016/j.jpsychires.2023.01.031] [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: 02/03/2022] [Revised: 12/27/2022] [Accepted: 01/26/2023] [Indexed: 01/30/2023]
Abstract
Previous research has suggested that fear of flying, which is defined as a situational, specific phobia, could overlap with depressive and anxiety disorders. Whether the neuronal dysfunctions including altered serotonergic activity in the brain and altered neural oscillations observed for depressive and anxiety disorders also overlap with alterations in fear of flying is unclear. Here, thirty-six participants with self-reported fear of flying (FF) and forty-one unaffected participants (NFF) were recruited. The participants completed the Beck Depression Inventory (BDI-II), the State-trait Anxiety Inventory (STAI) and the Fear of Flying Scale (FFS). EEG-recording was conducted during resting-state and during presentation of auditory stimuli with varying loudness levels for analysis of the Loudness Dependence of Auditory Evoked Potentials (LDAEP), which is suggested to be inversely related to central serotonergic activity. Participants with fear of flying did not differ from the control group with regard to BDI-II and STAI data. The LDAEP was higher over F4 electrode in the FF group compared to controls, whereas exploratory analysis suggest that differences between groups were conveyed by female participants. Moreover, the FF group showed relatively higher right frontal alpha activity compared to the control group, whereas no difference in frequency power (alpha, beta and theta) was observed. Thus, this study brought the first hint for reduced serotonergic activity in individuals with fear of flying and relatively higher right frontal activity. Thus, based on the preliminary findings, future research should aim to examine the boundaries with anxiety and depressive disorders and to clarify the distinct neural mechanisms.
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Affiliation(s)
- Vera Flasbeck
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
| | - Josefina Engelmann
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
| | - Bettina Klostermann
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
| | - Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
| | - Paraskevi Mavrogiorgou
- Department of Psychiatry, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
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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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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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Jang KI, Lee SH, Huh HJ, Chae JH. Influence of the 5-HT3A Receptor Gene Polymorphism and Childhood Sexual Trauma on Central Serotonin Activity. PLoS One 2015; 10:e0145269. [PMID: 26701104 PMCID: PMC4689356 DOI: 10.1371/journal.pone.0145269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/02/2015] [Indexed: 01/21/2023] Open
Abstract
Background Gene-environment interactions are important for understanding alterations in human brain function. The loudness dependence of auditory evoked potential (LDAEP) is known to reflect central serotonergic activity. Single nucleotide polymorphisms (SNPs) in the 5-HT3A serotonin receptor gene are associated with psychiatric disorders. This study aimed to investigate the effect between 5-HT3A receptor gene polymorphisms and childhood sexual trauma on the LDAEP as an electrophysiological marker in healthy subjects. Methods A total of 206 healthy subjects were recruited and evaluated using the childhood trauma questionnaire (CTQ) and hospital anxiety and depression scale (HADS). Peak-to-peak N1/P2 was measured at five stimulus intensities, and the LDAEP was calculated as the linear-regression slope. In addition, the rs1062613 SNPs of 5-HT3A (CC, CT, and TT) were analyzed in healthy subjects. Results There was a significant interaction between scores on the CTQ-sexual abuse subscale and 5-HT3A genotype on the LDAEP. Subjects with the CC polymorphism had a significantly higher LDEAP than T carriers in the sexually abused group. In addition, CC genotype subjects in the sexually abused group showed a significantly higher LDAEP compared with CC genotype subjects in the non-sexually abused group. Conclusions Our findings suggest that people with the CC polymorphism of the 5-HT3A gene have a greater risk of developing mental health problems if they have experienced childhood sexual abuse, possibly due to low central serotonin activity. Conversely, the T polymorphism may be protective against any central serotonergic changes following childhood sexual trauma.
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Affiliation(s)
- Kuk-In Jang
- Department of Biomedicine & Health Sciences, The Catholic University of Korea, College of Medicine, Seoul, Korea
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea
| | - Hyu Jung Huh
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jeong-Ho Chae
- Department of Biomedicine & Health Sciences, The Catholic University of Korea, College of Medicine, Seoul, Korea
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
- * E-mail:
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Park YM. Relationship between Serotonergic Dysfunction Based on Loudness Dependence of Auditory-Evoked Potentials and Suicide in Patients with Major Depressive Disorder. Psychiatry Investig 2015; 12:421-4. [PMID: 26508951 PMCID: PMC4620297 DOI: 10.4306/pi.2015.12.4.421] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/18/2015] [Accepted: 06/18/2015] [Indexed: 11/30/2022] Open
Abstract
The relationship between suicidality and the loudness dependence of auditory-evoked potentials (LDAEP) remains controversial. This article reviews the literature related to the LDAEP and suicide in patients with major depressive disorder, and suggests future research directions. Serotonergic dysfunction in suicidality seems to be more complicated than was originally thought. Studies of suicide based on the LDAEP have produced controversial results, but it is possible that these are due to differences in study designs and the smallness of samples. For example, some studies have evaluated suicide ideation and the LDAEP, while others have evaluated suicide attempts and the LDAEP. Furthermore, some of the latter studies enrolled acute suicide attempters, while others enrolled those with the history of previous suicide attempts, irrespective of whether these were acute or chronic. Thus, a more robust study design is needed in future studies, for example by evaluating the LDAEP immediately after a suicide attempt rather than in those with a history of suicide attempts and suicide ideation in order to reduce bias. Moreover, genuine suicide attempt, self-injurious behaviors, and faked suicide attempt need to be discriminated in the future.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
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Park YM, Lee BH, Lee SH. The association between serum lipid levels, suicide ideation, and central serotonergic activity in patients with major depressive disorder. J Affect Disord 2014; 159:62-5. [PMID: 24679391 DOI: 10.1016/j.jad.2014.01.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 01/30/2014] [Accepted: 01/31/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is some evidence that low lipid levels cause suicide in depressed patients. The purpose of this study was to identify whether low serum lipid levels are associated with suicide ideation or are correlated with central serotonin function. METHODS Auditory processing for the loudness dependence of auditory evoked potentials (LDAEP) was measured in 73 outpatients with major depressive disorder. The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) were administered on the same day as measurement of the LDAEP. In addition, serum levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) levels were measured. All subjects had received antidepressant monotherapy. RESULTS The depressed subjects were divided into those with and without suicide ideation according to the score for HAMD item 3 or BDI item 9. TG levels differed significantly between the two groups, whereas body mass index (BMI), total cholesterol, LDL, HDL, and LDAEP did not. The scores for HAMD item 3 and BDI item 9 were negatively correlated with TG levels (p=0.045 and 0.026, respectively). The LDAEP was negatively correlated with TG levels (p=0.012). Although there was tendency toward a negative correlation between the LDAEP and serum LDL, it did not reach statistical significance (p=0.068). LIMITATIONS The cross-sectional design of this study means that baseline serum lipid levels were not measured. CONCLUSION The findings of this study revealed a relationship between TG and suicide ideation that is independent of both BMI and body weight. Furthermore, serum lipid levels were associated with central serotonergic activity, as assessed using the LDAEP.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, 2240, Daehwa-dong, Ilsanseo-gu, Goyang 411-706, Republic of Korea.
| | - Bun-Hee Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, 2240, Daehwa-dong, Ilsanseo-gu, Goyang 411-706, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, 2240, Daehwa-dong, Ilsanseo-gu, Goyang 411-706, Republic of Korea
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Park YM, Lee BH, Um TH, Kim S. Serum BDNF levels in relation to illness severity, suicide attempts, and central serotonin activity in patients with major depressive disorder: a pilot study. PLoS One 2014; 9:e91061. [PMID: 24663244 PMCID: PMC3963843 DOI: 10.1371/journal.pone.0091061] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 02/08/2014] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to test the hypothesis that serum levels of brain-derived neurotrophic factor (BDNF) are correlated with the loudness dependence of auditory evoked potentials (LDAEP). The question of whether there is a difference in BDNF levels between depressive patients according to their illness severity, history of suicide attempts, and central serotonin activity was also addressed. A sample of 51 patients who met the criteria for major depressive disorder following diagnosis using axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders – text revision comprised the study subjects. The patients were stratified into two subgroups based on their illness severity, history of suicide attempts, and their LDAEP values. The LDAEP was evaluated by measuring the auditory event-related potentials, and serum BDNF was measured using blood sampling before beginning medication with serotonergic agents. There was no difference in serum BDNF levels between the two patient subgroups. The subgroup with moderate-to-severe depression (n = 16) was reanalyzed after stratifying it into two subgroups according to LDAEP and BDNF values (dichotomized at the medians into low and high). The high-LDAEP subgroup had higher serum BDNF levels and total Barratt Impulsiveness Scale score than the low-LDAEP subgroup (p = 0.03 and 0.036, respectively). Serum BDNF levels were positively correlated with LDAEP and total Beck Hopelessness Scale (BHS) score (r = 0.56, p = 0.025, and r = 0.59, p = 0.016, respectively). The high-BDNF subgroup had a higher LDAEP and total BHS score than the low-BDNF subgroup (p = 0.046 and p = 0.011, respectively). This is the first study to demonstrate a relationship between the BDNF level and LDAEP in Asian depressive patients. Intriguingly, the high-BDNF subgroup (divided according to illness severity) exhibited a more severe psychopathology on some psychometric rating scales, a finding that conflicts with previous results.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
- * E-mail:
| | - Bun-Hee Lee
- Department of Psychiatry, Gangnam Eulji Hospital, Eulji University, Seoul, Republic of Korea
| | - Tae Hyun Um
- Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Sollip Kim
- Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
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Park YM. Relationship between SSRI-induced sexual dysfunction and central serotonergic activity based on the loudness dependence of auditory evoked potentials. Psychopharmacology (Berl) 2014; 231:551-5. [PMID: 24005532 DOI: 10.1007/s00213-013-3265-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 08/22/2013] [Indexed: 11/28/2022]
Abstract
RATIONALE It has been hypothesized that selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction can occur more frequently in patients with higher central serotonergic activity, and that this higher serotonergic activity can induce inhibition of sexual desire, ejaculation, and orgasm. Thus, the aim of this study was to determine the relationship between SSRI-induced sexual dysfunction and increased serotonin. METHOD Event-related potentials for the loudness dependence of auditory evoked potentials (LDAEP) were measured in 46 patients at a single time point. The subjects' scores on the Hamilton Depression Rating Scale and Antidepressant Side-Effect Checklist were also determined by the investigators at the same time point. All patients had received SSRI monotherapy. RESULTS Overall, 37 % (17/46) of the patients experienced some form of SSRI-induced sexual dysfunction: lack of sexual desire, impotence, orgasm, and menstrual abnormality or mastalgia were experienced by 21.7, 8.3, 15.2, and 20.6 % of the patients, respectively. The subjects were thus divided into two groups-those with and without sexual dysfunction-and their data were compared. There was a tendency for the LDAEP to be lower in the group with sexual dysfunction (1.04 ± 0.77 μV) than the group without sexual dysfunction (1.45 ± 0.86 μV), although the difference was not statistically significant (p = 0.086). Furthermore, the distribution of the frequency of SSRI-induced sexual dysfunction differed marginally significantly between patients with low and high LDAEP, dichotomized according to the median LDAEP on the Cz electrode (χ (2) = 3.664, p = 0.056). CONCLUSIONS There was a relatively high frequency of SSRI-induced sexual dysfunction in patients with low LDAEP.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, 2240, Daehwa-Dong, Ilsan Seo-Gu, Goyang, 411-706, Republic of Korea,
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Han C, Wang SM, Kato M, Lee SJ, Patkar AA, Masand PS, Pae CU. Second-generation antipsychotics in the treatment of major depressive disorder: current evidence. Expert Rev Neurother 2014; 13:851-70. [DOI: 10.1586/14737175.2013.811901] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Park YM, Lee SH. Clinical Usefulness of Loudness Dependence of Auditory Evoked Potentials (LDAEP) in Patients with Bipolar Disorder. Psychiatry Investig 2013; 10:233-7. [PMID: 24302945 PMCID: PMC3843014 DOI: 10.4306/pi.2013.10.3.233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 08/06/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
While it has been reported previously that the loudness dependence of auditory evoked potentials (LDAEP) is a putative biological marker or a predictor of treatment response, there have been few studies of LDAEP in bipolar disorder. However, a recent study by Park and colleagues raised the possibility that the LDAEP could be useful as a biological marker of bipolar disorder. They found that the LDAEP was significantly higher in normal controls than in patients with either bipolar disorder or schizophrenia. Lee and colleagues also examined the LDAEP in bipolar disorder and normal controls, and found that it differed according to the bipolar phase, being significantly higher in cases of euthymic bipolar disorder, bipolar depression, and bipolar mania. With regard to treatment response, early clinical findings were that a higher LDAEP and a stronger intensity dependence of visual evoked potentials were related to a favorable response to lithium treatment. Juckel and colleagues recently demonstrated that the pretreatment LDAEP could be a predictor of successful prophylactic lithium treatment. The present article reviews the literature in order to determine whether the LDAEP can be used as a biological marker or a predictor of treatment response in patients with bipolar disorder and of manic switch or treatment resistance in patients with major depressive episode(s).
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
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Park YM, Lee SH. Can the Loudness Dependence of Auditory Evoked Potentials and Suicidality Be Used to Differentiate between Depressive Patients with and without Bipolarity. Psychiatry Investig 2013; 10:143-7. [PMID: 23798962 PMCID: PMC3687048 DOI: 10.4306/pi.2013.10.2.143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/04/2013] [Accepted: 01/08/2013] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE This study aimed to test the hypothesis that the loudness dependence of auditory evoked potentials (LDAEP) can be used to predict the presence of bipolarity in patients with major depressive episodes. METHODS A cohort of 61 patients who met the criteria for major depressive disorder (MDD) following diagnosis using Axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision, and who had no history of hypomanic or manic episodes was included in this study. The patients were stratified into two subgroups based on whether or not they achieved a positive score for the Korean versions of the Mood Disorder Questionnaire (K-MDQ). The LDAEP was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. RESULTS The Barratt Impulsiveness Scale (BIS) score was also higher for the positive screening group (81.24±11.87) than for the negative screening group (73.30±14.92; p=0.039, independent t-test). However, the LDAEP, Beck Depression Inventory, Hamilton Depression Rating Scale, Beck Hopelessness Scale (BHS), and Hamilton Anxiety Scale scores did not differ significantly between them. When binary logistic regression analysis was carried, the relationship between the positive or negative subgroups for K-MDQ and BIS or Beck Scale for Suicidal Ideation (BSS) score was also significant (respectively, p=0.017, p=0.038). CONCLUSION We found that LDAEP was not significantly different between depressive patients with and without bipolarity. However, our study has revealed the difference between two subgroups based on whether or not they achieved a positive score for the K-MDQ in BIS or BSS score.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
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Kim DH, Park YM. The association between suicidality and serotonergic dysfunction in depressed patients. J Affect Disord 2013; 148:72-6. [PMID: 23312213 DOI: 10.1016/j.jad.2012.11.051] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 11/20/2012] [Accepted: 11/20/2012] [Indexed: 11/16/2022]
Abstract
The loudness dependence of auditory evoked potentials (LDAEP) has been proposed as a reliable indicator of central serotonin system activity in animal and some human studies. Since low central serotonergic activity is related to suicidality, it is possible that the LDAEP can be used to predict suicidality. The aim of the present study was to determine whether there is an association between suicidality and LDAEP in a depressed Korean population. Data from 38 depressive subjects (10 males, 28 females; mean age: 40.79 years) were analyzed. The subjects were divided into two groups: with prior suicide attempts (SA; n=17) and no prior suicide attempts (NSA; n=21). The LDAEP was evaluated by measuring auditory event-related potentials. Peak-to-peak N1/P2 amplitudes were calculated at five stimulus intensities, and the LDAEP was calculated as the slope of the linear-regression curve. The LDAEP values differed significantly between the SA and NSA groups. Depressed subjects with a history of suicide attempts seem to be characterized by large LDAEP values, indicating low serotonergic activity. The findings of the present study support the view that low serotonergic activity is related to the suicidality of depressed subjects. Thus, LDAEP, which can reflect serotonergic activity, may be a practical biological marker for suicidality.
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Affiliation(s)
- Do-Hyung Kim
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, 2240, Daehwa-dong, Ilsanseo-gu, Goyang 411-706, Republic of Korea
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Park YM, Lee SH, Lee HJ, Kang SG, Min JA, Chae JH. Association between BDNF gene polymorphisms and serotonergic activity using loudness dependence of auditory evoked potentials in healthy subjects. PLoS One 2013; 8:e60340. [PMID: 23593198 PMCID: PMC3621878 DOI: 10.1371/journal.pone.0060340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 02/25/2013] [Indexed: 11/18/2022] Open
Abstract
It has been proposed that the loudness dependence of auditory evoked potentials (LDAEP) would be a reliable indicator of central serotonin system activity in humans. Serotonin levels and turnover are also increased by brain-derived neurotrophic factor (BDNF). The aim of the present study was to determine whether there is an association between genetic polymorphisms of BDNF and the LDAEP in healthy Korean young adults. The cohort comprised 211 mentally and physically healthy subjects, all of whom were nonsmokers (111 males, 100 females; age: 20∼32 years). To avoid hormonal effects, the LDAEP was measured during days 2–5 after the beginning of menstruation for female subjects. In addition, BDNF polymorphisms (rs6265, rs2030324, and rs1491850) were genotyped. The strength of the LDAEP differed significantly among the BDNF genotype groups. Furthermore, the distribution of genotypic frequencies differed significantly between subjects with high and low LDAEPs. In particular, subjects with the Val/Met (A/G) genotype for rs6265, the T/T genotype for rs2030324, or the C/C genotype for rs1491850 had a higher LDAEP, indicating lower central serotonergic activity. A low LDAEP was more prevalent than a high LDAEP among those with the C-T haplotype (C genotype for rs2030424 and T genotype for rs1491850). Our results concur with previous findings on BDNF polymorphisms and serotonergic drug responses in psychiatric disorder patients. The present results suggest the possibility that BDNF polymorphisms and LDAEP patterns can predict altered serotonergic activity.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Inje University, Ilsan Paik Hospital, Goyang, Republic of Korea
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Clinical characteristics associated with different strengths of loudness dependence of auditory evoked potentials (LDAEP) in major depressive disorder. Psychiatry Res 2012; 200:374-81. [PMID: 23021319 DOI: 10.1016/j.psychres.2012.06.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/19/2012] [Accepted: 06/24/2012] [Indexed: 02/07/2023]
Abstract
Loudness dependence of auditory evoked potentials (LDAEP), also called as intensity dependence of auditory evoked potentials (IDAP), has been proposed as a potential marker for central serotonergic tone and has been noticed for its possible clinical implications in depression. However, its distributions in major depressive disorder (MDD) and factors affecting it are largely unknown. In this study, we examined its distribution and relationships with various demographic and clinical variables in MDD patients. In 143 MDD patients, the LDAEP was measured using five intensities of auditory stimulus. The influences of ten independent variables (age, gender, education years, marital status, psychiatric family history, age of onset, suicide attempt history, depression severity, later augmentation of mood stabilizer, and smoking status) on the LDAEP strength were examined using univariate analyses and data mining method. The mean (±S.D.) LDAEP was 0.90 (±0.73)μV/10dB (-0.78-3.83μV/10dB). Female gender, smoking, and being married were consistently associated with a weaker LDAEP. In the pathway model, sequential combination of being male, living alone, and older age predicted the strongest LDAEP, whereas female gender, older age, and smoking predicted the weakest LDAEP. These variables need to be considered when interpreting the LDAEP.
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Lee KS, Park YM, Lee SH. Serotonergic dysfunction in patients with bipolar disorder assessed by the loudness dependence of the auditory evoked potential. Psychiatry Investig 2012; 9:298-306. [PMID: 22993531 PMCID: PMC3440481 DOI: 10.4306/pi.2012.9.3.298] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 06/15/2012] [Accepted: 06/17/2012] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The loudness dependence of the auditory evoked potential (LDAEP) is suggested to be a marker of serotonin system function. This study explored the LDAEP of multiple mood statuses (depression, mania, and euthymia) and its clinical implication in bipolar disorder patients. METHODS A total of 89 subjects, comprising 35 patients with bipolar disorder, 32 patients with schizophrenia, and 22 healthy controls were evaluated. The bipolar disorder cases comprised 10 depressed patients, 15 patients with mania, and 10 euthymic patients. The N1/P2 peak-to-peak amplitudes were measured at 5 stimulus intensities, and the LDAEP was calculated as the slope of the linear regression. Both cortical and source LDAEP values were calculated. RESULTS LDAEP varied according to mood statuses, and was significantly stronger in cases of euthymia, depression, and mania. Cortical LDAEP was significantly stronger in patients with bipolar euthymia compared with schizophrenia, stronger in bipolar depression than in schizophrenia, stronger in healthy controls than in schizophrenia patients, and stronger in healthy controls than in patients with bipolar mania. Source LDAEP was significantly stronger in patients with bipolar euthymia, bipolar depression, and bipolar mania compared with schizophrenia, stronger in bipolar euthymia than in bipolar mania. Psychotic features weakened the source LDAEP relative to nonpsychotic features. The severity of the depressive symptom was negatively correlated with source LDAEP. CONCLUSION These findings suggest that the serotonin activity of patients with bipolar disorder may vary according to mood status. A longitudinal follow-up study should be pursued using drug-naive subjects.
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Affiliation(s)
- Kyung-Sang Lee
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
| | - Young-Min Park
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea
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