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Valerio MP, Szmulewicz AG, Lomastro J, Martino DJ. Neurocognitive performance in melancholic and non-melancholic major depressive disorder: A meta-analysis of comparative studies. Psychiatry Res 2021; 303:114078. [PMID: 34246007 DOI: 10.1016/j.psychres.2021.114078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 05/20/2021] [Accepted: 06/25/2021] [Indexed: 01/28/2023]
Affiliation(s)
- Marina P Valerio
- National Council of Scientific and Technical Research (CONICET), Ciudad Autónoma de Buenos Aires, Godoy Cruz 2290 (C1425FQB), Argentina; Psychiatric Emergencies Hospital Torcuato de Alvear, Ciudad Autónoma de Buenos Aires, Warnes 2630 (C1427DPS), Argentina
| | - Alejandro G Szmulewicz
- Harvard TH Chan School of Public Health, Epidemiology Department. Huntington Av 677, Boston, MA 02115, United States; Pharmacology Department, University of Buenos Aires School of Medicine, Paraguay 2155 8th Floor M1 (C1121ABG), Ciudad Autónoma de Buenos Aires, Argentina
| | - Julieta Lomastro
- Psychiatric Emergencies Hospital Torcuato de Alvear, Ciudad Autónoma de Buenos Aires, Warnes 2630 (C1427DPS), Argentina
| | - Diego J Martino
- National Council of Scientific and Technical Research (CONICET), Ciudad Autónoma de Buenos Aires, Godoy Cruz 2290 (C1425FQB), Argentina; Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Pacheco de Melo 1854 (C1126AAB), Ciudad Autónoma de Buenos Aires, Argentina.
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Lee HS, Baik SY, Kim YW, Kim JY, Lee SH. Prediction of Antidepressant Treatment Outcome Using Event-Related Potential in Patients with Major Depressive Disorder. Diagnostics (Basel) 2020; 10:diagnostics10050276. [PMID: 32375213 PMCID: PMC7277962 DOI: 10.3390/diagnostics10050276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/23/2020] [Accepted: 05/01/2020] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Prediction of treatment outcome has been one of the core objectives in clinical research of patients with major depressive disorder (MDD). This study explored the possibility of event-related potential (ERP) markers to predict antidepressant treatment outcomes among MDD patients; (2) Methods: Fifty-two patients with MDD were recruited and evaluated through Hamilton depression (HAM-D), Hamilton anxiety rating scale (HAM-A), and CORE. Patients underwent a battery of ERP measures including frontal alpha symmetry (FAA) in the low alpha band (8–10 Hz), mismatch negativity (MMN), and loudness-dependent auditory evoked potentials (LDAEP); (3) Results: During the eight weeks of study, 61% of patients achieved remission, and 77% showed successful treatment responsiveness. Patients with low FAA in F5/F6 demonstrated a significantly higher remission/response ratio and better treatment responsiveness (F (2.560, 117.755) = 3.84, p = 0.016) compared to patients with high FAA. In addition, greater FAA in F7/F8 EEG channels was significantly associated with greater melancholia scores (r = 0.34, p = 0.018). Other ERP markers lacked any significant effect; (4) Conclusions: Our results suggested low FAA (i.e., greater left frontal activity) could reflect a good treatment response in MDD patients. These findings support that FAA could be a promising index in understanding both MDD and melancholic subtype.
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Affiliation(s)
- Hyun Seo Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 50834, Korea; (H.S.L.); (S.Y.B.); (Y.-W.K.); (J.-Y.K.)
| | - Seung Yeon Baik
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 50834, Korea; (H.S.L.); (S.Y.B.); (Y.-W.K.); (J.-Y.K.)
| | - Yong-Wook Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 50834, Korea; (H.S.L.); (S.Y.B.); (Y.-W.K.); (J.-Y.K.)
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea
| | - Jeong-Youn Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 50834, Korea; (H.S.L.); (S.Y.B.); (Y.-W.K.); (J.-Y.K.)
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 50834, Korea; (H.S.L.); (S.Y.B.); (Y.-W.K.); (J.-Y.K.)
- Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang 50834, Korea
- Correspondence: or ; Tel.: +82-31-910-7260; Fax: +82-31-910-7268
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Hitchcock C, Rees C, Dalgleish T. The devil's in the detail: Accessibility of specific personal memories supports rose-tinted self-generalizations in mental health and toxic self-generalizations in clinical depression. J Exp Psychol Gen 2017; 146:1286-1295. [PMID: 28661167 PMCID: PMC6600872 DOI: 10.1037/xge0000343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Models of memory propose that separate systems underpin the storage and recollection of specific events from our past (e.g., the first day at school), and of the generic structure of our experiences (e.g., how lonely I am), and that interplay between these systems serves to optimize everyday cognition. Specifically, it is proposed that memories of discrete events help define the circumstances (boundary conditions) in which our generalized knowledge applies, thereby enhancing accuracy of memory-dependent cognitive processes. However, in the domain of self-judgment, cognition is systematically biased, with a robust self-enhancement bias characterizing healthy individuals and a negativity bias characterizing the clinically depressed. We hypothesized that self-enhancement effects in the mentally healthy may partly rest on an impaired ability for specific memories to set appropriate boundary conditions on positive self-generalizations, while the opposite may be true for self-referred negative traits in the depressed. To assess this, we asked healthy and depressed individuals to think about the applicability of a trait to themselves, then to recall a specific memory that was inconsistent with that trait which would therefore index a boundary condition for its applicability. Healthy individuals showed faster recall only for specific positive memories following negative trait evaluations, while depressed individuals demonstrated faster recall only of specific negative memories following positive trait evaluations—the pattern expected given the respective self-enhancement and negativity biases. Results suggest that specific memories may serve to delimit self-generalizations in biased ways, and thus support systemic biases in trait judgments characteristic of healthy and depressed individuals.
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Affiliation(s)
| | - Catrin Rees
- Medical Research Council Cognition and Brain Sciences Unit
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit
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Bosaipo NB, Foss MP, Young AH, Juruena MF. Neuropsychological changes in melancholic and atypical depression: A systematic review. Neurosci Biobehav Rev 2017; 73:309-325. [PMID: 28027956 DOI: 10.1016/j.neubiorev.2016.12.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 10/28/2016] [Accepted: 12/09/2016] [Indexed: 02/05/2023]
Abstract
There is not a consensus as to whether neuropsychological profiling can distinguish depressive subtypes. We aimed to systematically review and critically analyse the literature on cognitive function in patients with melancholic and atypical depression. We searched in databases PubMed, SCOPUS, Web of Knowledge and PsycInfo for papers comparing the neuropsychological performance of melancholic patients (MEL) to non-melancholic depressive patients (NMEL), including atypical depressives, and healthy controls (HC). All studies were scrutinised to determine the main methodological characteristics and particularly possible sources of bias influencing the results reported, using the STROBE statement checklist. We also provide effect size of the results reported for contrasts between MEL; patients and NMEL patients. Seventeen studies were included; most of them demonstrated higher neuropsychological impairments of MEL patients compared to both NMEL patients and HC on tasks requiring memory, executive function, attention and reaction time. Detailed analysis of the methodologies used in the studies revealed significant variability especially regarding the participants' sociodemographic characteristics, clinical characteristics of patients and differences in neuropsychological assessment. These findings suggest that MEL may have a distinct and impaired cognitive performance compared to NMEL depressive patients on tasks involving verbal and visual memory, executive function, sustained attention and span, as well as psychomotor speed, this last especially when cognitive load is increased. Additional studies with adequate control of potentially confounding variables will help to clarify further differences in the neuropsychological functioning of depressive subtypes.
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Affiliation(s)
- Nayanne Beckmann Bosaipo
- Section of Movement Disorders and Behavioral Neurology, Ribeirao Preto General Hospital of the University of Sao Paulo SP, Brazil
| | - Maria Paula Foss
- Section of Movement Disorders and Behavioral Neurology, Ribeirao Preto General Hospital of the University of Sao Paulo SP, Brazil
| | - Allan H Young
- Centre for Affective Disorders-Department of Psychological Medicine Institute of Psychiatry, Psychology and Neuroscience-King's College London, UK
| | - Mario Francisco Juruena
- Department of Neuroscience and Behavior, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil; Centre for Affective Disorders-Department of Psychological Medicine Institute of Psychiatry, Psychology and Neuroscience-King's College London, UK.
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Parker G, McCraw S. The properties and utility of the CORE measure of melancholia. J Affect Disord 2017; 207:128-135. [PMID: 27721186 DOI: 10.1016/j.jad.2016.09.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 09/20/2016] [Accepted: 09/24/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The CORE measure was designed to assess a central feature of melancholia - signs of psychomotor disturbance (PMD) - and so provide an alternate non-symptom based measure of melancholia or of its probability. This review evaluates development and application studies undertaken over the last 25 years to consider how well it has met its original objectives. METHODS All studies published using the CORE measure as either the only or an adjunctive measure of melancholia were obtained and are considered in this review. RESULTS Findings suggest high reliability in quantifying CORE scores can be achieved and that it has construct validity as a measure of PMD. A number of application studies assessing socio-demographic factors, cognitive and motor impairment, dexamethasone suppression and thyrotropin-releasing hormone, response to psychotherapy and to electroconvulsive therapy support its validity as a measure of melancholia, while functional brain imaging studies suggest that the measure identifies regions of decreased connectivity. LIMITATIONS Use of the CORE benefits from rater training and for subjects to be assessed at or near nadir of their depressive episode. There have been insufficient studies evaluating genetic factors, and the treatment response of CORE-defined melancholic patients to antidepressant drugs of differing classes. CONCLUSIONS The CORE, either as a proxy or direct measure of melancholia, provides a strategy for assigning depressed subjects a diagnosis or melancholic or non-melancholic depression or for estimating the probability of melancholia.
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Affiliation(s)
- Gordon Parker
- School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia.
| | - Stacey McCraw
- School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia
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Liu H, Sarapas C, Shankman SA. Anticipatory reward deficits in melancholia. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:631-40. [PMID: 27175986 DOI: 10.1037/abn0000172] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dysfunctional reward processing has long been considered an important feature of major depressive disorder (MDD). However, depression is a heterogeneous construct and the nature of this heterogeneity may contribute to some of the inconsistent empirical findings on reward dysfunction in MDD. The current study examined 1 source of heterogeneity, melancholic symptoms, and its association with reward processing. In individuals with MDD (N = 141) and MDD-free controls (N = 113), electroencephalogram (EEG) alpha asymmetry was measured during a behavioral reward task that probed reward anticipation. Melancholic depression was measured both categorically (Diagnostic and Statistical Manual of Mental Disorders [DSM] diagnosis) and dimensionally (Hamilton Endogenomorphy Scale [HES]). Results showed that a dimensional (and not categorical) definition of melancholia predicted reward processing, with higher melancholic symptoms predicting reduced reward anticipation. Importantly, the effects of melancholic symptoms on reduced reward anticipation remained above and beyond overall depression severity. These results suggest that dysfunctional reward processing may only be associated with melancholic symptoms, not depression in general. (PsycINFO Database Record
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Affiliation(s)
- Huiting Liu
- Department of Psychology, University of Illinois at Chicago
| | - Casey Sarapas
- Department of Psychology, University of Illinois at Chicago
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Darcet F, Gardier AM, Gaillard R, David DJ, Guilloux JP. Cognitive Dysfunction in Major Depressive Disorder. A Translational Review in Animal Models of the Disease. Pharmaceuticals (Basel) 2016; 9:ph9010009. [PMID: 26901205 PMCID: PMC4812373 DOI: 10.3390/ph9010009] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/28/2016] [Accepted: 02/01/2016] [Indexed: 02/07/2023] Open
Abstract
Major Depressive Disorder (MDD) is the most common psychiatric disease, affecting millions of people worldwide. In addition to the well-defined depressive symptoms, patients suffering from MDD consistently complain about cognitive disturbances, significantly exacerbating the burden of this illness. Among cognitive symptoms, impairments in attention, working memory, learning and memory or executive functions are often reported. However, available data about the heterogeneity of MDD patients and magnitude of cognitive symptoms through the different phases of MDD remain difficult to summarize. Thus, the first part of this review briefly overviewed clinical studies, focusing on the cognitive dysfunctions depending on the MDD type. As animal models are essential translational tools for underpinning the mechanisms of cognitive deficits in MDD, the second part of this review synthetized preclinical studies observing cognitive deficits in different rodent models of anxiety/depression. For each cognitive domain, we determined whether deficits could be shared across models. Particularly, we established whether specific stress-related procedures or unspecific criteria (such as species, sex or age) could segregate common cognitive alteration across models. Finally, the role of adult hippocampal neurogenesis in rodents in cognitive dysfunctions during MDD state was also discussed.
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Affiliation(s)
- Flavie Darcet
- Université Paris-Saclay, University Paris-Sud, Faculté de Pharmacie, CESP, INSERM UMRS1178, Chatenay-Malabry 92296, France.
| | - Alain M Gardier
- Université Paris-Saclay, University Paris-Sud, Faculté de Pharmacie, CESP, INSERM UMRS1178, Chatenay-Malabry 92296, France.
| | - Raphael Gaillard
- Laboratoire de "Physiopathologie des maladies Psychiatriques", Centre de Psychiatrie et Neurosciences U894, INSERM, Université Paris Descartes, Sorbonne Paris Cité, Paris 75014, France.
- Service de Psychiatrie, Centre Hospitalier Sainte-Anne, Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris 75014, France.
- Human Histopathology and Animal Models, Infection and Epidemiology Department, Institut Pasteur, Paris 75015, France.
| | - Denis J David
- Université Paris-Saclay, University Paris-Sud, Faculté de Pharmacie, CESP, INSERM UMRS1178, Chatenay-Malabry 92296, France.
| | - Jean-Philippe Guilloux
- Université Paris-Saclay, University Paris-Sud, Faculté de Pharmacie, CESP, INSERM UMRS1178, Chatenay-Malabry 92296, France.
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Day CV, Gatt JM, Etkin A, DeBattista C, Schatzberg AF, Williams LM. Cognitive and emotional biomarkers of melancholic depression: An iSPOT-D report. J Affect Disord 2015; 176:141-50. [PMID: 25710095 DOI: 10.1016/j.jad.2015.01.061] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depressed patients with melancholic features have distinct impairments in cognition and anhedonia, but it remains unknown whether these impairments can be quantified on neurocognitive biomarker tests of behavioral performance. We compared melancholic major depressive disorder (MDD) patients to non-melancholic MDD patients and controls on a neurocognitive test battery that assesses eight general and emotional cognitive domains including the hypothesized decision-making and reward-threat perception. METHODS MDD outpatients (n=1008) were assessed using a computerized battery of tests. MDD participants met DSM-IV criteria for MDD and had a score ≥16 on the 17-item Hamilton Rating Scale for Depression. Melancholic MDD was defined using the Mini-International Neuropsychiatric Interview and a psychomotor disturbance observer-rated CORE measure score >7. Controls were age- and gender-matched with no previous DSM-IV or significant medical history. RESULTS Melancholic participants (33.7% of the MDD sample) exhibited significantly poorer performance than controls across each domain of cognitive function and for speed of emotion identification and implicit emotion priming. Compared to the non-melancholic group, specific disturbances were seen on tests of information speed, decision speed, and reward-relevant emotional processing of happy expressions, even after co-varying for symptom severity. LIMITATIONS Assessments were taken at only one medication-free time point. Reward was investigated using an emotional faces task. CONCLUSIONS Melancholic MDD is distinguished by a specific neurocognitive marker profile consistent with reduced decision-making capacity under time demands and loss of reward sensitivity. This profile suggests an underlying deficit in mesolimbic-cortical circuitry for motivationally-directed behavior.
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Affiliation(s)
- Claire V Day
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney 2006, NSW, Australia; Westmead Millennium Institute, Westmead 2145, NSW, Australia; Brain Resource Ltd., 235 Jones Street, Sydney, NSW, Australia; Brain Resource Inc., 1000 Sansome Street, San Francisco, CA 94111, USA
| | - Justine M Gatt
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney 2006, NSW, Australia; Westmead Millennium Institute, Westmead 2145, NSW, Australia; Neuroscience Research Australia, Randwick 2031, NSW, Australia; School of Psychology, University of New South Wales, Sydney 2052, NSW, Australia
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA.
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Day CV, John Rush A, Harris AWF, Boyce PM, Rekshan W, Etkin A, DeBattista C, Schatzberg AF, Arnow BA, Williams LM. Impairment and distress patterns distinguishing the melancholic depression subtype: an iSPOT-D report. J Affect Disord 2015; 174:493-502. [PMID: 25554994 DOI: 10.1016/j.jad.2014.10.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study seeks to provide a comprehensive and systematic evaluation of baseline clinical and psychological features and treatment response characteristics that differentiate Major Depressive Disorder (MDD) outpatients with and without melancholic features. Reflecting the emphasis in DSM-5, we also include impairment and distress. METHODS Participants were assessed pre-treatment on clinical features (severity, risk factors, comorbid conditions, illness course), psychological profile (personality, emotion regulation), functional capacity (social and occupational function, quality of life) and distress/coping (negativity bias, emotional resilience, social skills, satisfaction with life). Participants were randomized to sertraline, escitalopram or venlafaxine extended-release and re-assessed post-treatment at 8 weeks regarding remission, response, and change in impairment and distress. RESULTS Patients with melancholic features (n=339; 33.7%) were distinguished clinically from non-melancholics by more severe depressive symptoms and greater exposure to abuse in childhood. Psychologically, melancholic patients were defined by introversion, and a greater use of suppression to regulate negative emotion. Melancholics also had poorer capacity for social and occupational function, and physical and psychological quality of life, along with poorer coping, reflected in less emotional resilience and capacity for social skills. Post-treatment, melancholic patients had lower remission and response, but some of this effect was due to the more severe symptoms pre-treatment. The distress/coping outcome measure of capacity for social skills remained significantly lower for melancholic participants. LIMITATIONS Due to the cross-sectional nature of this study, causal pathways cannot be concluded. CONCLUSIONS Findings provide new insights into a melancholic profile of reduced ability to function interpersonally or effectively deal with one׳s emotions. This distinctly poorer capacity for social skills remained post-treatment. The pre-treatment profile may account for some of the difficulty in achieving remission or response with treatment.
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Affiliation(s)
- Claire V Day
- Brain Dynamics Center, Psychiatry, University of Sydney Medical School, Sydney, NSW 2145 Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Westmead Clinical School, Australia; Brain Resource Ltd., 235 Jones Street, Sydney, NSW, Australia; Brain Resource Inc., 1000 Sansome Street, San Francisco, CA 94111, USA.
| | - A John Rush
- Duke-National University of Singapore, Graduate Medical School Singapore, 8 College Road, Singapore 169857, Singapore
| | - Anthony W F Harris
- Brain Dynamics Center, Psychiatry, University of Sydney Medical School, Sydney, NSW 2145 Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Westmead Clinical School, Australia
| | - Philip M Boyce
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Westmead Clinical School, Australia
| | - William Rekshan
- Brain Resource Ltd., 235 Jones Street, Sydney, NSW, Australia; Brain Resource Inc., 1000 Sansome Street, San Francisco, CA 94111, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Bruce A Arnow
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Leanne M Williams
- Brain Dynamics Center, Psychiatry, University of Sydney Medical School, Sydney, NSW 2145 Australia; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
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Wingenfeld K, Wolf OT. Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder - 2014 Curt Richter Award Winner. Psychoneuroendocrinology 2015; 51:282-95. [PMID: 25462901 DOI: 10.1016/j.psyneuen.2014.10.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/17/2014] [Accepted: 10/09/2014] [Indexed: 12/15/2022]
Abstract
Stress hormones influence a wide range of cognitive functions, including memory performance and executive function. It is well established that glucocorticoids enhance memory consolidation but impair memory retrieval. While most of the effects have been attributed to glucocorticoid receptors (GR), the importance of mineralocorticoid receptors (MR) has been also emphasized. Dysfunctions in hypothalamic-pituitary-adrenal (HPA) axis have been reported for several mental disorders. While major depressive disorder (MDD) as well as borderline personality disorder (BPD) seem to be characterized by enhanced cortisol release in concert with a reduced feedback sensitivity of the HPA axis, in posttraumatic stress disorder (PTSD) a contrary picture has been reported. Despite the fact that altered GR function has been discussed for these disorders only very few studies have investigated the effects of glucocorticoids on cognitive performance in these patients so far. In a series of studies, we investigated the effects of glucocorticoids on cognition (i.e. declarative memory, working memory and response inhibition) in different mental disorders such as MDD, PTSD and BPD. While in patients with MDD cortisol administration failed to effect memory retrieval, patients with PTSD and BPD showed enhanced rather than impaired memory retrieval after cortisol administration. These results indicate an altered sensitivity to cortisol in these disorders. Results from one of our recent studies in the field of social cognition underline the importance of the MR. We found that emotional empathy was enhanced through stimulation of the MR via fludrocortisone in healthy participants and women with BPD. This review aims to integrate these findings and discuss potential mechanisms and implications.
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Affiliation(s)
- Katja Wingenfeld
- Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute for Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany
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Lin K, Xu G, Lu W, Ouyang H, Dang Y, Lorenzo-Seva U, Guo Y, Bessonov D, Akiskal HS, So KF, Lee TMC. Neuropsychological performance in melancholic, atypical and undifferentiated major depression during depressed and remitted states: a prospective longitudinal study. J Affect Disord 2014; 168:184-91. [PMID: 25061955 DOI: 10.1016/j.jad.2014.06.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 06/05/2014] [Accepted: 06/24/2014] [Indexed: 01/26/2023]
Abstract
BACKGROUND Considerable evidence has demonstrated that melancholic and atypical major depression have distinct biological correlates relative to undifferentiated major depression, but few studies have specifically delineated neuropsychological performance for them. METHOD In a six-week prospective longitudinal study, we simultaneously compared neuropsychological performance among melancholic depression (n=142), atypical depression (n=76), undifferentiated major depression (n=91), and healthy controls (n=200) during a major depressive episode and a clinically remitted state, respectively. We administered neuropsychological tests assessing processing speed, attention, shifting, planning, verbal fluency, visual spatial memory, and verbal working memory to all participants. RESULTS During the depressive state, the three subtypes displayed extensive cognitive impairment, except for attention, when compared with the healthy controls. Melancholic depression significantly differed from atypical depression in processing speed and verbal fluency. In the remitted state, the three subtypes recovered their visual spatial memory and verbal working memory functions to the healthy control level. The recovery of the other domains (processing speed, set shifting, planning, and verbal fluency), however, was different across the subtypes. No predictive relationship existed between neuropsychological performance and the treatment outcome. LIMITATIONS The drop-out rate in the six-week longitudinal study was relatively high. CONCLUSION Our data provide preliminary evidence that during depressed states the three major depressive subtypes display similar cognitive deficits in some domains but differ in such domains as processing speed and verbal fluency. The recovery of the cognitive deficits following clinical remission from depression may be associated with subtypes of major depressive disorder.
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Affiliation(s)
- Kangguang Lin
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong
| | - Guiyun Xu
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China.
| | - Weicong Lu
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Huiyi Ouyang
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Yamei Dang
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Urbano Lorenzo-Seva
- Research Centre for Behavioral Assessment, Department of Psychology, Rovira i Virgili University, Tarragona, Spain
| | - Yangbo Guo
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Daniel Bessonov
- International Mood Center, University of California at San Diego, La Jolla, USA
| | - Hagop S Akiskal
- International Mood Center, University of California at San Diego, La Jolla, USA
| | - Kwok-Fai So
- Department of Ophthalmology, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Tatia M C Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong.
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Ren Z, Sahir N, Murakami S, Luellen BA, Earnheart JC, Lal R, Kim JY, Song H, Luscher B. Defects in dendrite and spine maturation and synaptogenesis associated with an anxious-depressive-like phenotype of GABAA receptor-deficient mice. Neuropharmacology 2014; 88:171-9. [PMID: 25107590 DOI: 10.1016/j.neuropharm.2014.07.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/08/2014] [Accepted: 07/21/2014] [Indexed: 11/27/2022]
Abstract
Mice that were rendered heterozygous for the γ2 subunit of GABAA receptors (γ2(+/-) mice) have been characterized extensively as a model for major depressive disorder. The phenotype of these mice includes behavior indicative of heightened anxiety, despair, and anhedonia, as well as defects in hippocampus-dependent pattern separation, HPA axis hyperactivity and increased responsiveness to antidepressant drugs. The γ2(+/-) model thereby provides strong support for the GABAergic deficit hypothesis of major depressive disorder. Here we show that γ2(+/-) mice additionally exhibit specific defects in late stage survival of adult-born hippocampal granule cells, including reduced complexity of dendritic arbors and impaired maturation of synaptic spines. Moreover, cortical γ2(+/-) neurons cultured in vitro show marked deficits in GABAergic innervation selectively when grown under competitive conditions that may mimic the environment of adult-born hippocampal granule cells. Finally, brain extracts of γ2(+/-) mice show a numerical but insignificant trend (p = 0.06) for transiently reduced expression of brain derived neurotrophic factor (BDNF) at three weeks of age, which might contribute to the previously reported developmental origin of the behavioral phenotype of γ2(+/-) mice. The data indicate increasing congruence of the GABAergic, glutamatergic, stress-based and neurotrophic deficit hypotheses of major depressive disorder.
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Affiliation(s)
- Zhen Ren
- Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA; Center for Molecular Investigation of Neurological Disorders, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Nadia Sahir
- Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Shoko Murakami
- Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Beth A Luellen
- Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA
| | - John C Earnheart
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Rachnanjali Lal
- Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Ju Young Kim
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Hongjun Song
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; The Solomon Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Bernhard Luscher
- Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA; Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA 16802, USA; Center for Molecular Investigation of Neurological Disorders, The Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA.
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Hyett M, Parker G, Breakspear M. Bias and discriminability during emotional signal detection in melancholic depression. BMC Psychiatry 2014; 14:122. [PMID: 24766992 PMCID: PMC4022535 DOI: 10.1186/1471-244x-14-122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 04/08/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Cognitive disturbances in depression are pernicious and so contribute strongly to the burden of the disorder. Cognitive function has been traditionally studied by challenging subjects with modality-specific psychometric tasks and analysing performance using standard analysis of variance. Whilst informative, such an approach may miss deeper perceptual and inferential mechanisms that potentially unify apparently divergent emotional and cognitive deficits. Here, we sought to elucidate basic psychophysical processes underlying the detection of emotionally salient signals across individuals with melancholic and non-melancholic depression. METHODS Sixty participants completed an Affective Go/No-Go (AGN) task across negative, positive and neutral target stimuli blocks. We employed hierarchical Bayesian signal detection theory (SDT) to model psychometric performance across three equal groups of those with melancholic depression, those with a non-melancholic depression and healthy controls. This approach estimated likely response profiles (bias) and perceptual sensitivity (discriminability). Differences in the means of these measures speak to differences in the emotional signal detection between individuals across the groups, while differences in the variance reflect the heterogeneity of the groups themselves. RESULTS Melancholic participants showed significantly decreased sensitivity to positive emotional stimuli compared to those in the non-melancholic group, and also had a significantly lower discriminability than healthy controls during the detection of neutral signals. The melancholic group also showed significantly higher variability in bias to both positive and negative emotionally salient material. CONCLUSIONS Disturbances of emotional signal detection in melancholic depression appear dependent on emotional context, being biased during the detection of positive stimuli, consistent with a noisier representation of neutral stimuli. The greater heterogeneity of the bias across the melancholic group is consistent with a more labile disorder (i.e. variable across the day). Future work will aim to understand how these findings reflect specific individual differences (e.g. prior cognitive biases) and clarify whether such biases change dynamically during cognitive tasks as internal models of the sensorium are refined and updated in response to experience.
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Affiliation(s)
- Matthew Hyett
- Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
- School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia
- Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia
| | - Michael Breakspear
- Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia
- School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia
- The Royal Brisbane and Women’s Hospital, Herston, QLD 4029, Australia
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Gabbay V, Ely BA, Li Q, Bangaru SD, Panzer AM, Alonso CM, Castellanos FX, Milham MP. Striatum-based circuitry of adolescent depression and anhedonia. J Am Acad Child Adolesc Psychiatry 2013; 52:628-41.e13. [PMID: 23702452 PMCID: PMC3762469 DOI: 10.1016/j.jaac.2013.04.003] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/19/2013] [Accepted: 04/01/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Striatum-based circuits have been implicated in both major depressive disorder (MDD) and anhedonia, a symptom that reflects deficits of reward processing. Yet adolescents with MDD often exhibit a wide range of anhedonia severity. Addressing this clinical phenomenon, we aimed to use intrinsic functional connectivity (iFC) to study striatum-based circuitry in relation to categorical diagnosis of MDD and anhedonia severity. METHOD A total of 21 psychotropic medication-free adolescents with MDD and 21 healthy controls (HC), group-matched for age and sex, underwent resting-state functional magnetic resonance imagining (fMRI) scans. Voxelwise maps indicating correlation strengths of spontaneous blood-oxygenation-level-dependent (BOLD) signals among 6 bilateral striatal seeds (dorsal caudate, ventral caudate, nucleus accumbens, dorsal-rostral putamen, dorsal-caudal putamen, ventral-rostral putamen) and the remaining brain regions were compared between groups. Relationships between striatal iFC and severity of MDD and anhedonia were examined in the MDD group. Analyses were corrected for multiple comparisons. RESULTS Adolescents with MDD manifested increased iFC between all striatal regions bilaterally and the dorsomedial prefrontal cortex (dmPFC), as well as between the right ventral caudate and the anterior cingulate cortex (ACC). MDD severity was associated with iFC between the striatum and midline structures including the precuneus, posterior cingulate cortex, and dmPFC. However, distinct striatal iFC patterns involving the pregenual ACC, subgenual ACC, supplementary motor area, and supramarginal gyrus were associated with anhedonia severity. CONCLUSIONS Although MDD diagnosis and severity were related to striatal networks involving midline cortical structures, distinct circuits within the reward system were associated with anhedonia. Findings support the incorporation of both categorical and dimensional approaches in neuropsychiatric research.
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Affiliation(s)
- Vilma Gabbay
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
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Hoffstaedter F, Sarlon J, Grefkes C, Eickhoff SB. Internally vs. externally triggered movements in patients with major depression. Behav Brain Res 2011; 228:125-32. [PMID: 22142951 DOI: 10.1016/j.bbr.2011.11.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 11/14/2011] [Accepted: 11/18/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Psychomotor retardation is a prominent clinical feature of major depression. While several studies investigated these deficits, differences between internally and externally triggered response selection and initiation are less well understood. In the current study, we delineate internally vs. externally driven response selection and initiation in depression and their relation to basic psychomotor functioning. METHODS 20 inpatients diagnosed with a (unipolar) major depression and 20 closely matched healthy controls performed a computerized motor paradigm assessing differences between internally and externally cued movements. Psychomotor performance and basic memory functions were assessed using a neuropsychological test-battery. To examine within group homogeneity a multivariate clustering approach was applied. RESULTS Patients featured a global slowing of internally and externally cued response selection compared to controls, as well as impairments in basic psychomotor functioning. Yet, basic motor speed was preserved. Furthermore, patients were more severely impaired when movements involved internal response selection. The data-driven clustering revealed two patient subgroups, which both showed psychomotor disturbances, while only one featured slowing of response selection. INTERPRETATION The results suggest a differential rather than a global psychomotor slowing in major depression with specific impairments of visuospatial and attentional processing as cognitive aspects of psychomotor functioning. As found for depression, in Parkinson's disease internally cued movements are more severely affected than externally cued reactions. Both may therefore be caused by dopaminergic deregulation due to frontostriatal deficits. Finally, multivariate clustering of behavioral data may be a promising future approach to identify subtypes of psychomotor or cognitive disturbances in different patient populations.
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Affiliation(s)
- Felix Hoffstaedter
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
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Abstract
Increasing evidence points to an association between major depressive disorders (MDDs) and diverse types of GABAergic deficits. In this review, we summarize clinical and preclinical evidence supporting a central and causal role of GABAergic deficits in the etiology of depressive disorders. Studies of depressed patients indicate that MDDs are accompanied by reduced brain concentration of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) and by alterations in the subunit composition of the principal receptors (GABA(A) receptors) mediating GABAergic inhibition. In addition, there is abundant evidence that suggests that GABA has a prominent role in the brain control of stress, the most important vulnerability factor in mood disorders. Furthermore, preclinical evidence suggests that currently used antidepressant drugs (ADs) designed to alter monoaminergic transmission and nonpharmacological therapies may ultimately act to counteract GABAergic deficits. In particular, GABAergic transmission has an important role in the control of hippocampal neurogenesis and neural maturation, which are now established as cellular substrates of most if not all antidepressant therapies. Finally, comparatively modest deficits in GABAergic transmission in GABA(A) receptor-deficient mice are sufficient to cause behavioral, cognitive, neuroanatomical and neuroendocrine phenotypes, as well as AD response characteristics expected of an animal model of MDD. The GABAergic hypothesis of MDD suggests that alterations in GABAergic transmission represent fundamentally important aspects of the etiological sequelae of MDDs that are reversed by monoaminergic AD action.
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Luscher B, Shen Q. Gamma-aminobutyric acidergic deficits cause melancholic depression: a reply to Markou and Geyer. Biol Psychiatry 2011; 69:e13-4; author reply e15-6. [PMID: 21126731 DOI: 10.1016/j.biopsych.2010.09.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 09/15/2010] [Indexed: 12/30/2022]
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Heinzel A, Northoff G, Boeker H, Boesiger P, Grimm S. Emotional processing and executive functions in major depressive disorder: dorsal prefrontal activity correlates with performance in the intra-extra dimensional set shift. Acta Neuropsychiatr 2010; 22:269-79. [PMID: 25385213 DOI: 10.1111/j.1601-5215.2010.00494.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED Heinzel A, Northoff G, Boeker H, Boesiger P, Grimm S. Emotional processing and executive functions in major depressive disorder: dorsal prefrontal activity correlates with performance in the intra-extra dimensional set shift. OBJECTIVE Major depressive disorder (MDD) is characterised by predominately negatively valenced emotional symptoms that are often accompanied by cognitive impairments. We posited that cognitive impairments in MDD are related to altered emotional processing in prefrontal cortex. METHODS We compared 20 medication-free patients with MDD and 29 matched healthy controls. Both groups performed an emotional task during functional magnetic resonance imaging (fMRI). Furthermore, they completed the intra-extra dimensional set shift (IED) test probing for cognitive impairments. Then we correlated the results of the IED with the changes in fMRI BOLD signal in MDD patients and healthy subjects. RESULTS The subcategory of the IED applying extradimensional shift (EDS) showed a divergent performance of the MDD group committing significantly more errors than the control group. Correlating the EDS errors with fMRI signal changes, the healthy subjects showed a positive correlation with the right ventrolateral prefrontal cortex and the right orbitofrontal cortex. MDD subjects, in contrast, showed a positive correlation in right dorsolateral prefrontal cortex (DLPFC) and a negative correlation in the left dorsomedial prefrontal cortex (DMPFC). CONCLUSION We hypothesise that the differential correlation in healthy controls and MDD patients may reflect the use of different strategies in their performance. The impaired executive functions, as reflected by altered processing in right DLPFC and left DMPFC, may implicitly influence emotional processing in patients suffering from MDD.
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Affiliation(s)
- Alexander Heinzel
- 1Department of Nuclear Medicine, University of Düsseldorf, Jülich, Germany
| | - Georg Northoff
- 2Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Heinz Boeker
- 3Department of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Peter Boesiger
- 4Institute of Biomedical Engineering, ETH and University of Zurich, Zurich, Switzerland
| | - Simone Grimm
- 3Department of Psychiatry, University of Zurich, Zurich, Switzerland
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Shen Q, Lal R, Luellen BA, Earnheart JC, Andrews AM, Luscher B. gamma-Aminobutyric acid-type A receptor deficits cause hypothalamic-pituitary-adrenal axis hyperactivity and antidepressant drug sensitivity reminiscent of melancholic forms of depression. Biol Psychiatry 2010; 68:512-20. [PMID: 20579975 PMCID: PMC2930197 DOI: 10.1016/j.biopsych.2010.04.024] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 04/16/2010] [Accepted: 04/18/2010] [Indexed: 12/27/2022]
Abstract
BACKGROUND The gamma-aminobutyric acid (GABA) Type A receptor deficits that are induced by global or forebrain-specific heterozygous inactivation of the gamma2 subunit gene in mouse embryos result in behavior indicative of trait anxiety and depressive states. By contrast, a comparable deficit that is delayed to adolescence is without these behavioral consequences. Here we characterized gamma2-deficient mice with respect to hypothalamic-pituitary-adrenal (HPA) axis abnormalities and antidepressant drug responses. METHODS We analyzed the behavioral responses of gamma2(+/-) mice to desipramine and fluoxetine in novelty suppressed feeding, forced swim, tail suspension, and sucrose consumption tests as well as GABA(A) receptor deficit- and antidepressant drug treatment-induced alterations in serum corticosterone. RESULTS Baseline corticosterone concentrations in adult gamma2-deficient mice were elevated independent of whether the genetic lesion was induced during embryogenesis or delayed to adolescence. However, the manifestation of anxious-depressive behavior in different gamma2-deficient mouse lines was correlated with early onset HPA axis hyperactivity during postnatal development. Chronic but not subchronic treatment of gamma2(+/-) mice with fluoxetine or desipramine normalized anxiety-like behavior in the novelty suppressed feeding test. Moreover, desipramine had antidepressant-like effects in that it normalized HPA axis function and depression-related behavior of gamma2(+/-) mice in the forced swim, tail suspension, and sucrose consumption tests. By contrast, fluoxetine was ineffective as an antidepressant and failed to normalize HPA axis function. CONCLUSIONS Developmental deficits in GABAergic inhibition in the forebrain cause behavioral and endocrine abnormalities and selective antidepressant drug responsiveness indicative of anxious-depressive disorders such as melancholic depression, which are frequently characterized by HPA axis hyperactivity and greater efficacy of desipramine versus fluoxetine.
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Affiliation(s)
- Qiuying Shen
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, University Park, PA 16802
| | - Rachnanjali Lal
- Department of Biology, Pennsylvania State University, University Park, PA 16802
| | - Beth A. Luellen
- Department of Biology, Pennsylvania State University, University Park, PA 16802
| | - John C. Earnheart
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, University Park, PA 16802
| | - Anne Milasincic Andrews
- Department of Veterinary and Biomedical Sciences, Pennsylvania State University, University Park, PA 16802, Department of Chemistry, Pennsylvania State University, University Park, PA 16802, Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA 16802
| | - Bernhard Luscher
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, University Park, PA 16802, Department of Biology, Pennsylvania State University, University Park, PA 16802, Department of Psychiatry, Pennsylvania State University, College of Medicine, Hershey, PA 17033, Corresponding Author: Bernhard Luscher, Ph. D., Department of Biology Penn State University 301 Life Sciences Building University Park, PA 16801 Phone office: 814-865 5549 Phone lab: 814-865 5563
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Withall A, Harris LM, Cumming SR. A longitudinal study of cognitive function in melancholic and non-melancholic subtypes of major depressive disorder. J Affect Disord 2010; 123:150-7. [PMID: 19698995 DOI: 10.1016/j.jad.2009.07.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 07/17/2009] [Accepted: 07/17/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Research concerning cognition in depression has often yielded inconsistent findings. The presence of mixed melancholic and non-melancholic subtypes of major depressive disorder (MDD) in most previous research may explain some of the contradictory results (Hickie, 1996). METHODS This longitudinal study compared the cognitive performance of people with melancholic (n=17) and non-melancholic (n=17) MDD admitted to one of two university hospitals. Participants received an extensive clinical and cognitive assessment at admission and again 3 months after recovery and discharge. RESULTS Overall, participants with melancholia had selective memory deficits with broader impairment of executive control skills. Specifically, after correcting for depression severity, they performed more poorly on tests requiring memory acquisition, mental flexibility, set-shifting, selective attention, concept-formation and multi-tasking compared to those with non-melancholic depression. These deficits were present at both assessments suggesting that the increased initial severity of cognitive deficits for those with melancholia mean that they require a longer time to recovery. LIMITATIONS The clinical homogeneity of the study sample may underestimate the extent of cognitive impairment for those presenting with comorbid illness and/or significant drug/alcohol histories. CONCLUSIONS These findings indicate that the depressed group with melancholia have a distinctly different and more impaired cognitive profile to those without melancholic features and suggest that these clinical subtypes should be considered separately in future research concerning MDD. Furthermore, the melancholic group appears to require longer periods for cognitive recovery and this has implications for return to work and daily functioning following clinical discharge.
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Affiliation(s)
- Adrienne Withall
- Primary Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, 45 Beach Street (cnr Battery Street), Coogee 2034, Australia.
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Kertzman S, Reznik I, Hornik-Lurie T, Weizman A, Kotler M, Amital D. Stroop performance in major depression: selective attention impairment or psychomotor slowness? J Affect Disord 2010; 122:167-73. [PMID: 19732958 DOI: 10.1016/j.jad.2009.08.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 08/17/2009] [Accepted: 08/17/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Numerous neuropsychological studies reported impaired Stroop performance in major depressive disorder (MDD) patients. METHODS The present study attempted to identify possible neuropsychological mechanisms involved in this impairment in untreated MDD outpatients (n=75) as compared to healthy subjects (n=83). Inspection Time, Finger Tapping, Simple and Choice Reaction Time were considered as measures of perceptual, motor, psychomotor speed, and response selection, respectively. RESULTS MDD patients performed significantly slower than healthy controls in the neutral and the congruent conditions, but not in the incongruent ones. In order to identify predictors of Stroop performance, linear hierarchical regressions analyses were performed. Age, motor and psychomotor speed were predictors of response time and accuracy on Stroop performance. Significant correlations between response time and the number of errors in all three Stroop conditions were found in MDD patients, while such a correlation was obtained in the healthy controls only in the incongruent condition. LIMITATIONS Although education was included as a covariate in our analyses, suggesting that the observed effects could not be ascribed to education differences, further testing with education-matched samples is warranted. CONCLUSIONS Our study shows that the Stroop task performance is affected by both aging and MDD. Impairment in the Stroop performance can be predicted by psychomotor slowness and by vigilance level in MDD outpatients, but not by impairment of selective attention per se.
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Stadler C, Poustka F, Sterzer P. The heterogeneity of disruptive behavior disorders - implications for neurobiological research and treatment. Front Psychiatry 2010; 1:21. [PMID: 21423432 PMCID: PMC3059624 DOI: 10.3389/fpsyt.2010.00021] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 06/30/2010] [Indexed: 12/03/2022] Open
Abstract
Disruptive behavior disorders (DBDs) are reflected by a great variety of symptoms ranging from impulsive-hot-tempered quarrels to purposeful and goal-directed acts of cruelty. A growing body of data indicates that there are neurobiological factors that increase the risk for developing DBDs. In this review, we give a broad overview of recent studies investigating physiological, neural, genetic factors, and specific neurotransmitter systems. We also discuss the impact of psychosocial risk and consider the effects of gene-environment interactions. Due to the heterogeneity of DBDs, it is concluded that specific subtypes of disruptive behavior should be considered both in terms their biological basis and in regard to specific treatment needs.
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Affiliation(s)
- Christina Stadler
- Department of Child and Adolescent Psychiatry, Johann Wolfgang Goethe University Frankfurt am Main, Germany
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Exner C, Lange C, Irle E. Impaired implicit learning and reduced pre-supplementary motor cortex size in early-onset major depression with melancholic features. J Affect Disord 2009; 119:156-62. [PMID: 19345999 DOI: 10.1016/j.jad.2009.03.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 03/16/2009] [Accepted: 03/16/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depression is a heterogeneous disorder. Biological markers and cognitive tasks have been employed to distinguish clinical subtypes but results have been inconclusive. METHODS The current study assessed implicit learning with the Serial Reaction Time Task (SRTT) known to be sensitive to frontostriatal dysfunctions and regional brain volumes of the anterior supplementary motor area (pre-SMA) in participants with early-onset major depression (MD) of either melancholic (n=26) or non-melancholic (n=9) subtype, and 26 matched controls. RESULTS Depressive subjects with melancholic features but not those with non-melancholic depression showed implicit learning deficits. This deficit could not be explained in terms of more severe depression or psychomotor retardation. Regional volumes of the right pre-SMA were reduced in depressive subjects with melancholic features. LIMITATIONS Medication effects in depressive subjects and the small size of the non-melancholic sample should be taken into consideration when reviewing the implications of these results. CONCLUSIONS Deficits in implicit motor sequence learning seem to be an additional characteristic of the melancholic subtype of depression. It might be linked to dysfunction within structural or functionally altered frontostriatal circuits. Use of implicit sequence learning tasks could offer useful diagnostic and aetiological cues for future research.
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Affiliation(s)
- Cornelia Exner
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Gutenbergstr. 18, D-35032, Germany.
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Abstract
OBJECTIVE Over a decade ago, Jamison noted the lack of studies that identify patient profiles or specific groups that might be best suited for opioid treatment of chronic noncancer pain. METHODS This paper reviews the studies that provide evidence for individual differences in opioid analgesia for chronic noncancer pain. RESULTS What we have found is that few investigations have addressed these important aspects of pain treatment. The most consistent finding is that depression and anxiety are associated with increased risk for drug abuse and decreased opioid efficacy. DISCUSSION The question remains whether the psychologic disorders antedated the pain condition or whether the experience of chronic pain exerts psychologic pressures that cause changes in behavior and psychologic processes. Additionally, the overall pattern suggests that younger age is predictive of opioid abuse and greater opioid efficacy. We also present a brief review of biologic mechanisms that support individual differences on opioid analgesia.
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Michopoulos I, Zervas IM, Pantelis C, Tsaltas E, Papakosta VM, Boufidou F, Nikolaou C, Papageorgiou C, Soldatos CR, Lykouras L. Neuropsychological and hypothalamic-pituitary-axis function in female patients with melancholic and non-melancholic depression. Eur Arch Psychiatry Clin Neurosci 2008; 258:217-25. [PMID: 18297425 DOI: 10.1007/s00406-007-0781-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 10/22/2007] [Indexed: 12/16/2022]
Abstract
BACKGROUND Executive function deficits in depression implicate involvement of frontal-striatal circuits. However, studies of hypothalamic-pituitary-axis (HPA) function suggest that stress-related brain changes of hippocampus may also implicate prefrontal-hippocampal circuits, which may explain the profile of both executive dysfunction and memory deficits. In this study we examined the performance of patients with major depressive disorder (MDD) on tasks of memory and executive function in relation to melancholic features and to cortisol levels. Our hypothesis was that raised cortisol levels in melancholic patients would correlate with these deficits. METHOD Forty female MDD patients, 20 having melancholic features (MEL vs. Non-MEL), and 20 sex-age- and education-matched normal controls were investigated using the Cambridge neuropsychological test automated battery (CANTAB), to assess memory (paired associative learning, PAL; short-term recognition memory, SRM) and executive (intradimensional/extradimensional set-shifting, ID/ED; Stockings of Cambridge, SOC) functions. Plasma and salivary cortisol levels were measured. RESULTS The MDD patients performed worse than controls on PAL and both executive tasks. The MEL group differed from controls on all tests, and differed from the non-MEL only at the ED stage of the ID/ED task. Patient cortisol levels were within the normal range and did not correlate with neuropsychological performance for any group. CONCLUSIONS MDD patients showed neuropsychological deficits on tasks of executive function and memory, supporting the model of frontal-temporal dysfunction. MEL vs. non-MEL performed worse overall and demonstrated a qualitative difference in set shifting, perhaps implicating more extensive prefrontal involvement. Cortisol levels did not correlate with depression severity or the observed deficits.
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Affiliation(s)
- Ioannis Michopoulos
- 2nd Department of Psychiatry, Athens University Medical School, "Attikon" General Hospital, 1 Rimini Street, 124 62 Athens, Greece
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Enticott PG, Ogloff JRP, Bradshaw JL, Fitzgerald PB. Cognitive inhibitory control and self-reported impulsivity among violent offenders with schizophrenia. J Clin Exp Neuropsychol 2008; 30:157-62. [DOI: 10.1080/13803390701290055] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Peter G. Enticott
- a School of Psychology, Psychiatry and Psychological Medicine , Monash University , Clayton, Victoria, Australia
- b Alfred Psychiatry Research Centre, the Alfred and Monash University , Melbourne, Victoria, Australia
| | - James R. P. Ogloff
- a School of Psychology, Psychiatry and Psychological Medicine , Monash University , Clayton, Victoria, Australia
- c Victorian Institute of Forensic Mental Health , Fairfield, Victoria, Australia
| | - John L. Bradshaw
- a School of Psychology, Psychiatry and Psychological Medicine , Monash University , Clayton, Victoria, Australia
| | - Paul B. Fitzgerald
- a School of Psychology, Psychiatry and Psychological Medicine , Monash University , Clayton, Victoria, Australia
- b Alfred Psychiatry Research Centre, the Alfred and Monash University , Melbourne, Victoria, Australia
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Mössner R, Mikova O, Koutsilieri E, Saoud M, Ehlis AC, Müller N, Fallgatter AJ, Riederer P. Consensus paper of the WFSBP Task Force on Biological Markers: biological markers in depression. World J Biol Psychiatry 2007; 8:141-74. [PMID: 17654407 DOI: 10.1080/15622970701263303] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Biological markers for depression are of great interest to aid in elucidating the causes of major depression. We assess currently available biological markers to query their validity for aiding in the diagnosis of major depression. We specifically focus on neurotrophic factors, serotonergic markers, biochemical markers, immunological markers, neuroimaging, neurophysiological findings, and neuropsychological markers. We delineate the most robust biological markers of major depression. These include decreased platelet imipramine binding, decreased 5-HT1A receptor expression, increase of soluble interleukin-2 receptor and interleukin-6 in serum, decreased brain-derived neurotrophic factor in serum, hypocholesterolemia, low blood folate levels, and impaired suppression of the dexamethasone suppression test. To date, however, none of these markers are sufficiently specific to contribute to the diagnosis of major depression. Thus, with regard to new diagnostic manuals such as DSM-V and ICD-11 which are currently assessing whether biological markers may be included in diagnostic criteria, no biological markers for major depression are currently available for inclusion in the diagnostic criteria.
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Affiliation(s)
- Rainald Mössner
- Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
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Abstract
OBJECTIVE To examine the evidence that dopamine (DA) dysfunction contributes to melancholic depression. METHOD Database (EMBASE, PsychLit and MEDLINE) searches using relevant key words were conducted and citations were scrutinized. RESULTS In this paper, we assume that the definition of melancholia is contingent upon the presence of psychomotor disturbance (PMD). In melancholic depression PMD comprises both a cognitive and motor component and DA is found to be important in both. DA neurotransmission modulates cognition in particular in attention, adaptation and motivational processes and has a pivotal role in motor function. CONCLUSION DA is a credible aetiological candidate for the PMD in melancholic depression. However, melancholia needs first to be characterized both clinically and in terms of its pathophysiology. In this regard, illnesses such as bipolar depression and Parkinson's disease warrant consideration as they provide suitable models of both the cognitive and motor aspects of PMD, and hold the necessary markers to better define melancholia.
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Affiliation(s)
- G S Malhi
- Psychological Medicine, Northern Clinical School, University of Sydney, NSW, Australia.
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Michopoulos I, Zervas IM, Papakosta VM, Tsaltas E, Papageorgiou C, Manessi T, Papakostas YG, Lykouras L, Soldatos CR. Set shifting deficits in melancholic vs. non-melancholic depression: preliminary findings. Eur Psychiatry 2006; 21:361-3. [PMID: 16814993 DOI: 10.1016/j.eurpsy.2006.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 03/13/2006] [Accepted: 03/15/2006] [Indexed: 11/25/2022] Open
Abstract
Twenty-two patients with major depressive disorder, 11 of them with melancholic features, and 11 controls were investigated with CANTAB subtests focusing in visual memory/learning and executive functions. Melancholic patients performed worse than the other groups in all tasks and manifested a significant impairment in set shifting. The results are discussed in association with prefrontal dysfunction.
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Affiliation(s)
- I Michopoulos
- 2nd Department of Psychiatry, Athens University Medical School, Attikon General Hospital, 1 Rimini Street, 124 62 Athens, Greece.
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Winograd-Gurvich C, Fitzgerald PB, Georgiou-Karistianis N, Bradshaw JL, White OB. Negative symptoms: A review of schizophrenia, melancholic depression and Parkinson's disease. Brain Res Bull 2006; 70:312-21. [PMID: 17027767 DOI: 10.1016/j.brainresbull.2006.06.007] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Revised: 06/08/2006] [Accepted: 06/12/2006] [Indexed: 11/23/2022]
Abstract
Negative symptoms generally refer to a reduction in normal functioning. In schizophrenia they encompass apathy, anhedonia, flat affect, avolition, social withdrawal and, on some accounts, psychomotor retardation. Negative symptoms have been identified in other psychiatric disorders, including melancholic depression, and also in neurological disorders, such Parkinson's disease. Achieving a better understanding of negative symptoms constitutes a priority in mental health. Primarily, negative symptoms represent an unrelenting, intractable and disabling feature for patients, often amounting to a severe burden on families, carers and the patients themselves. Identifying and understanding subgroups within disorders may also contribute to the clinical care and scientific understanding of the pathophysiology of these disorders. The purpose of this paper is to review the current literature on negative symptoms in schizophrenia and explore the idea that negative symptoms may play an important role not only in other psychiatric disorders such as melancholic depression, but also in neurological disorders, such as Parkinson's disease. In each disorder negative symptoms manifest with similar motor and cognitive impairments and are associated with comparable neuropathological and biochemical findings, possibly reflecting analogous impairments in the functioning of frontostriatal-limbic circuits.
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Affiliation(s)
- C Winograd-Gurvich
- Experimental Neuropsychology Research Unit, Psychology Department, Monash University, Melbourne, Victoria 3800, Australia.
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Winograd-Gurvich C, Georgiou-Karistianis N, Fitzgerald PB, Millist L, White OB. Ocular motor differences between melancholic and non-melancholic depression. J Affect Disord 2006; 93:193-203. [PMID: 16678910 DOI: 10.1016/j.jad.2006.03.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Revised: 03/23/2006] [Accepted: 03/24/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major depressive disorder may be a heterogeneous disorder, yet melancholic depression is the most consistently described subtype, regarded as qualitatively different to non-melancholic depression in terms of cognitive and motor impairments. Eye movement studies in depression are infrequent and findings are inconclusive. METHODS This study employed a battery of saccadic eye movement tasks to explore reflexive saccades, as well as higher order cognitive aspects of saccades including inhibitory control and spatial working memory. Nineteen patients with major depressive disorder (9 melancholic; 10 non-melancholic) and 15 healthy controls participated. RESULTS Differences were revealed between melancholic and non-melancholic patients. Melancholia was associated with longer latencies, difficulty increasing peak velocities as target amplitudes increased, and hypometric primary saccades during the predictable protocol. In contrast, the non-melancholic depression group performed similarly to controls on most tasks, but saccadic peak velocity was increased for reflexive saccades at larger amplitudes. LIMITATIONS Most patients were taking antidepressant medication. CONCLUSIONS The latency increases, reduced peak velocity and primary saccade hypometria with more severe melancholia may be explained by functional changes in the fronto-striatal-collicular networks, related to dopamine dysfunction. In contrast, the serotonergic system plays a greater role in non-melancholic symptoms and this may underpin the observed increases in saccadic peak velocity. These findings provide neurophysiological support for functional differences between depression subgroups that are consistent with previous motor and cognitive findings.
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Affiliation(s)
- C Winograd-Gurvich
- Experimental Neuropsychology Research Unit, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne 3800, Australia.
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Simmons RW, Thomas JD, Levy SS, Riley EP. Motor response selection in children with fetal alcohol spectrum disorders. Neurotoxicol Teratol 2006; 28:278-85. [PMID: 16527448 DOI: 10.1016/j.ntt.2006.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Revised: 12/06/2005] [Accepted: 01/10/2006] [Indexed: 10/24/2022]
Abstract
Previous work has reported timing delays in motor response selection in children with prenatal exposure to alcohol when the information load involved responding to two stimulus choices. The present study examined whether the delay in response selection extends to conditions in which the information load is increased to four and eight stimulus choices. Twenty children aged between 12 and 17 years with fetal alcohol spectrum disorders (FASD) were compared to 17 non-alcohol-exposed controls (NC) on a reaction time (RT) task involving 1, 2, 4 or 8 visual stimulus choices. The task demands required the participant to release a response key as fast as possible when the stimulus light electronically paired with the response key was activated. With the number of stimulus choices expressed on a logarithmic scale, there was a significant and linear increase in RT for the FASD children as predicted by information processing theory. Additionally, the increase in RT for the FASD group was comparable to that observed for the NC children at each level of stimulus choice examined. It was concluded that FASD adolescents require additional time to process increasing amount of information, but that the time required for motor response selection is not delayed relative to control group performance.
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Affiliation(s)
- Roger W Simmons
- Motor Control Laboratory, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, USA.
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Salomon RM, Kennedy JS, Johnson BW, Urbano Blackford J, Schmidt DE, Kwentus J, Gwirtsman HE, Gouda JF, Shiavi RG. Treatment enhances ultradian rhythms of CSF monoamine metabolites in patients with major depressive episodes. Neuropsychopharmacology 2005; 30:2082-91. [PMID: 15856079 DOI: 10.1038/sj.npp.1300746] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Unipolar and bipolar depressions show abnormal behavioral manifestations of ultradian (less than 24 h) rhythms, but abnormal rhythms of the central neurotransmitters thought to be important for depression pathophysiology (eg dopamine (DA) and serotonin (5-HT)) have not been shown in this time frame. Since antidepressant treatments normalize disrupted rhythms in depression (eg rapid-eye-movement sleep and hormonal rhythms), we hypothesized that depression-related changes in ultradian oscillations of DA and 5-HT might be revealed during antidepressant treatment. Cerebrospinal fluid (CSF) samples collected q10 min for 24 h in 13 patients experiencing major depressive episodes (MDE) before and after treatment for 5 weeks with sertraline or bupropion were assayed for levels of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA), and their ratio was calculated. Data were analyzed in the frequency domain using Fourier transforms and multivariate permutation testing. Antidepressant treatments were associated with decreased variance for 5-HIAA, increased variance for HVA, and markedly increased variance for the HVA : 5-HIAA ratio (p<0.05, p<0.02, and p<0.003, respectively). With treatment, the correlations between 5-HIAA and HVA weakened (p=0.06). Power spectral density (PSD-the Fourier magnitude squared) of the 5-HIAA signals at periods of 1.75 and 3.7 h (both p<0.05) decreased, while circadian cycling of HVA levels (p<0.05) and of the ratio (p<0.005) increased after treatment. The PSD of the full-length HVA : 5-HIAA ratio series after treatment increased in rapid variability (20-103 min periods, p<0.05). Spectrographic windowing demonstrated a focal span of enhanced HVA : 5-HIAA ratio variability following antidepressant treatment, in an approximately 84-min period through the evening (p<0.05). Periodic neurotransmitter relationships in depressed patients were altered by treatment in this analysis of a small data set. This may represent a baseline abnormality in the regulation of periodic functions involved in the depression pathophysiology, but it could also be due to an unrelated antidepressant effect. Further studies including comparisons with healthy subject data are in progress.
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Affiliation(s)
- Ronald M Salomon
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN , USA.
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