1
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Yang C, Biswal B, Cui Q, Jing X, Ao Y, Wang Y. Frequency-dependent alterations of global signal topography in patients with major depressive disorder. Psychol Med 2024:1-10. [PMID: 38362834 DOI: 10.1017/s0033291724000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated not only with disorders in multiple brain networks but also with frequency-specific brain activities. The abnormality of spatiotemporal networks in patients with MDD remains largely unclear. METHODS We investigated the alterations of the global spatiotemporal network in MDD patients using a large-sample multicenter resting-state functional magnetic resonance imaging dataset. The spatiotemporal characteristics were measured by the variability of global signal (GS) and its correlation with local signals (GSCORR) at multiple frequency bands. The association between these indicators and clinical scores was further assessed. RESULTS The GS fluctuations were reduced in patients with MDD across the full frequency range (0-0.1852 Hz). The GSCORR was also reduced in the MDD group, especially in the relatively higher frequency range (0.0728-0.1852 Hz). Interestingly, these indicators showed positive correlations with depressive scores in the MDD group and relative negative correlations in the control group. CONCLUSION The GS and its spatiotemporal effects on local signals were weakened in patients with MDD, which may impair inter-regional synchronization and related functions. Patients with severe depression may use the compensatory mechanism to make up for the functional impairments.
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Affiliation(s)
- Chengxiao Yang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Bharat Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xiujuan Jing
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Yujia Ao
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Yifeng Wang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
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2
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Xie M, Huang Y, Cai W, Zhang B, Huang H, Li Q, Qin P, Han J. Neurobiological Underpinnings of Hyperarousal in Depression: A Comprehensive Review. Brain Sci 2024; 14:50. [PMID: 38248265 PMCID: PMC10813043 DOI: 10.3390/brainsci14010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/26/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024] Open
Abstract
Patients with major depressive disorder (MDD) exhibit an abnormal physiological arousal pattern known as hyperarousal, which may contribute to their depressive symptoms. However, the neurobiological mechanisms linking this abnormal arousal to depressive symptoms are not yet fully understood. In this review, we summarize the physiological and neural features of arousal, and review the literature indicating abnormal arousal in depressed patients. Evidence suggests that a hyperarousal state in depression is characterized by abnormalities in sleep behavior, physiological (e.g., heart rate, skin conductance, pupil diameter) and electroencephalography (EEG) features, and altered activity in subcortical (e.g., hypothalamus and locus coeruleus) and cortical regions. While recent studies highlight the importance of subcortical-cortical interactions in arousal, few have explored the relationship between subcortical-cortical interactions and hyperarousal in depressed patients. This gap limits our understanding of the neural mechanism through which hyperarousal affects depressive symptoms, which involves various cognitive processes and the cerebral cortex. Based on the current literature, we propose that the hyperconnectivity in the thalamocortical circuit may contribute to both the hyperarousal pattern and depressive symptoms. Future research should investigate the relationship between thalamocortical connections and abnormal arousal in depression, and explore its implications for non-invasive treatments for depression.
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Affiliation(s)
- Musi Xie
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (M.X.); (Y.H.)
| | - Ying Huang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (M.X.); (Y.H.)
| | - Wendan Cai
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (W.C.); (B.Z.); (H.H.)
| | - Bingqi Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (W.C.); (B.Z.); (H.H.)
| | - Haonan Huang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (W.C.); (B.Z.); (H.H.)
| | - Qingwei Li
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China;
| | - Pengmin Qin
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (M.X.); (Y.H.)
- Pazhou Laboratory, Guangzhou 510330, China
| | - Junrong Han
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China; (W.C.); (B.Z.); (H.H.)
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3
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Jawinski P, Markett S, Sander C, Huang J, Ulke C, Hegerl U, Hensch T. The Big Five Personality Traits and Brain Arousal in the Resting State. Brain Sci 2021; 11:brainsci11101272. [PMID: 34679337 DOI: 10.3390/brainsci11101272/s1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 05/25/2023] Open
Abstract
Based on Eysenck's biopsychological trait theory, brain arousal has long been considered to explain individual differences in human personality. Yet, results from empirical studies remained inconclusive. However, most published results have been derived from small samples and, despite inherent limitations, EEG alpha power has usually served as an exclusive indicator for brain arousal. To overcome these problems, we here selected N = 468 individuals of the LIFE-Adult cohort and investigated the associations between the Big Five personality traits and brain arousal by using the validated EEG- and EOG-based analysis tool VIGALL. Our analyses revealed that participants who reported higher levels of extraversion and openness to experience, respectively, exhibited lower levels of brain arousal in the resting state. Bayesian and frequentist analysis results were especially convincing for openness to experience. Among the lower-order personality traits, we obtained the strongest evidence for neuroticism facet 'impulsivity' and reduced brain arousal. In line with this, both impulsivity and openness have previously been conceptualized as aspects of extraversion. We regard our findings as well in line with the postulations of Eysenck and consistent with the recently proposed 'arousal regulation model'. Our results also agree with meta-analytically derived effect sizes in the field of individual differences research, highlighting the need for large (collaborative) studies.
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Affiliation(s)
- Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Christian Sander
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Christine Ulke
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
| | - Ulrich Hegerl
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Frankfurt, 60323 Frankfurt, Germany
| | - Tilman Hensch
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
- Department of Psychology, IU International University of Applied Science, 99084 Erfurt, Germany
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4
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Jawinski P, Markett S, Sander C, Huang J, Ulke C, Hegerl U, Hensch T. The Big Five Personality Traits and Brain Arousal in the Resting State. Brain Sci 2021; 11:brainsci11101272. [PMID: 34679337 PMCID: PMC8533901 DOI: 10.3390/brainsci11101272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/14/2022] Open
Abstract
Based on Eysenck's biopsychological trait theory, brain arousal has long been considered to explain individual differences in human personality. Yet, results from empirical studies remained inconclusive. However, most published results have been derived from small samples and, despite inherent limitations, EEG alpha power has usually served as an exclusive indicator for brain arousal. To overcome these problems, we here selected N = 468 individuals of the LIFE-Adult cohort and investigated the associations between the Big Five personality traits and brain arousal by using the validated EEG- and EOG-based analysis tool VIGALL. Our analyses revealed that participants who reported higher levels of extraversion and openness to experience, respectively, exhibited lower levels of brain arousal in the resting state. Bayesian and frequentist analysis results were especially convincing for openness to experience. Among the lower-order personality traits, we obtained the strongest evidence for neuroticism facet 'impulsivity' and reduced brain arousal. In line with this, both impulsivity and openness have previously been conceptualized as aspects of extraversion. We regard our findings as well in line with the postulations of Eysenck and consistent with the recently proposed 'arousal regulation model'. Our results also agree with meta-analytically derived effect sizes in the field of individual differences research, highlighting the need for large (collaborative) studies.
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Affiliation(s)
- Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany;
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Correspondence: ; Tel.: +49-30-2093-9391
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu Berlin, 10099 Berlin, Germany;
| | - Christian Sander
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
| | - Christine Ulke
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
| | - Ulrich Hegerl
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Depression Research Centre, German Depression Foundation, 04109 Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Frankfurt, 60323 Frankfurt, Germany
| | - Tilman Hensch
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103 Leipzig, Germany; (C.S.); (C.U.); (U.H.); (T.H.)
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Department of Psychology, IU International University of Applied Science, 99084 Erfurt, Germany
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5
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Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey. BMC Psychiatry 2021; 21:395. [PMID: 34372807 PMCID: PMC8352150 DOI: 10.1186/s12888-021-03400-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/29/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic continues to threaten the physical and mental health of people across the world. This study aimed to understand the psychological impact of this disease on adolescents with major depressive disorder (MDD) at 1 month after the start of the outbreak in China. METHODS Using the Children's Impact of Event Scale (CRIES-13) questionnaire, we investigated the occurrence of posttraumatic stress disorder (PTSD) in two groups of adolescents: MDD patients who were in continuous antidepressant therapy and healthy controls. Total scores and factor subscores were compared between the two groups and subgroups stratified by sex and school grade. Logistic regression was used to identify variables associated with high total CRIES-13 scores. RESULTS Compared to controls (n = 107), the MDD group (n = 90) had higher total CRIES-13 scores and a higher proportion with a total score ≥ 30. They also had a lower intrusion subscore and a higher arousal subscore. In the MDD group, males and females did not differ significantly in total CRIES-13 scores or factor subscores, but junior high school students had higher avoidance subscores than senior high school students. Logistic regression showed high total CRIES-13 scores to be associated with MDD and the experience of "flashbacks" or avoidance of traumatic memories associated with COVID-19. CONCLUSIONS It is crucial to understand the psychological impact of COVID-19 on adolescents with MDD in China, especially females and junior high school students. Long-term monitoring of adolescents with a history of mental illness is required to further understand these impacts. TRIAL REGISTRATION ChiCTR, ChiCTR2000033402 , Registered 31 May 2020.
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6
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Surova G, Ulke C, Schmidt FM, Hensch T, Sander C, Hegerl U. Fatigue and brain arousal in patients with major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2021; 271:527-536. [PMID: 33275166 PMCID: PMC7981331 DOI: 10.1007/s00406-020-01216-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/07/2020] [Indexed: 12/14/2022]
Abstract
Fatigue is considered a key symptom of major depressive disorder (MDD), yet the term lacks specificity. It can denote a state of increased sleepiness and lack of drive (i.e., downregulated arousal) as well as a state of high inner tension and inhibition of drive with long sleep onset latencies (i.e., upregulated arousal), the latter typically found in depression. It has been proposed to differentiate fatigue along the dimension of brain arousal. We investigated whether such stratification within a group of MDD patients would reveal a subgroup with distinct clinical features. Using an automatic classification of EEG vigilance stages, an arousal stability score was calculated for 15-min resting EEGs of 102 MDD patients with fatigue. 23.5% of the patients showed signs of hypoarousal with EEG patterns indicating drowsiness or sleep; this hypoaroused subgroup was compared with remaining patients (non-hypoaroused subgroup) concerning self-rated measures of depressive symptoms, sleepiness, and sleep. The hypoaroused subgroup scored higher on the Beck Depression Inventory items "loss of energy" (Z = - 2.13, p = 0.033; ɳ2 = 0.044, 90% CI 0.003-0.128) and "concentration difficulty" (Z = - 2.40, p = 0.017; ɳ2 = 0.056, 90% CI 0.009-0.139), and reported higher trait and state sleepiness (p < 0.05) as compared to the non-hypoaroused group. The non-hypoaroused subgroup, in contrast, reported more frequently the presence of suicidal ideation (Chi2 = 3.81, p = 0.051; ɳ2 = 0.037, 90% CI 0.0008-0.126). In this study, we found some evidence that stratifying fatigued MDD patients by arousal may lead to subgroups that are pathophysiologically and clinically more homogeneous. Brain arousal may be a worth while target in clinical research for better understanding the mechanisms underlying suicidal tendencies and to improve treatment response.
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Affiliation(s)
- Galina Surova
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103, Leipzig, Germany.
- Depression Research Center, German Depression Foundation, Leipzig, Germany.
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103, Leipzig, Germany
- Depression Research Center, German Depression Foundation, Leipzig, Germany
| | - Frank Martin Schmidt
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103, Leipzig, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103, Leipzig, Germany
- IUBH International University, Erfurt, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Semmelweisstrasse 10, 04103, Leipzig, Germany
| | - Ulrich Hegerl
- Depression Research Center, German Depression Foundation, Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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7
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Fatigue in Cancer and Neuroinflammatory and Autoimmune Disease: CNS Arousal Matters. Brain Sci 2020; 10:brainsci10090569. [PMID: 32824904 PMCID: PMC7564388 DOI: 10.3390/brainsci10090569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 01/20/2023] Open
Abstract
The term fatigue is not only used to describe a sleepy state with a lack of drive, as observed in patients with chronic physical illnesses, but also a state with an inhibition of drive and central nervous system (CNS) hyperarousal, as frequently observed in patients with major depression. An electroencephalogram (EEG)-based algorithm has been developed to objectively assess CNS arousal and to disentangle these pathophysiologically heterogeneous forms of fatigue. The aim of this study was to test the hypothesis that fatigued patients with CNS hyperarousal score higher on depressive symptoms than those without this neurophysiological pattern. METHODS Subjects with fatigue (Multidimensional Fatigue Inventory sum-score > 40) in the context of cancer, neuroinflammatory, or autoimmune diseases were drawn from the 60+ cohort of the Leipzig Research Center for Civilization Diseases. CNS arousal was assessed by automatic EEG-vigilance stage classification using the Vigilance Algorithm Leipzig (VIGALL 2.1) based on 20 min EEG recordings at rest with eyes closed. Depression was assessed by the Inventory of Depressive Symptomatology (IDS-SR). RESULTS Sixty participants (33 female; median age: 67.5 years) were included in the analysis. As hypothesized, fatigued patients with CNS hyperarousal had higher IDS-SR scores than those without hyperarousal (F1,58 = 18.34; p < 0.0001, η2 = 0.240). CONCLUSION hyperaroused fatigue in patients with chronic physical illness may be a sign of comorbid depression.
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8
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Peña-Ortega F. Brain Arrhythmias Induced by Amyloid Beta and Inflammation: Involvement in Alzheimer’s Disease and Other Inflammation-related Pathologies. Curr Alzheimer Res 2020; 16:1108-1131. [DOI: 10.2174/1567205017666191213162233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 10/29/2019] [Accepted: 11/05/2019] [Indexed: 12/13/2022]
Abstract
A variety of neurological diseases, including Alzheimer’s disease (AD), involve amyloid beta (Aβ) accumulation and/or neuroinflammation, which can alter synaptic and neural circuit functions. Consequently, these pathological conditions induce changes in neural network rhythmic activity (brain arrhythmias), which affects many brain functions. Neural network rhythms are involved in information processing, storage and retrieval, which are essential for memory consolidation, executive functioning and sensory processing. Therefore, brain arrhythmias could have catastrophic effects on circuit function, underlying the symptoms of various neurological diseases. Moreover, brain arrhythmias can serve as biomarkers for a variety of brain diseases. The aim of this review is to provide evidence linking Aβ and inflammation to neural network dysfunction, focusing on alterations in brain rhythms and their impact on cognition and sensory processing. I reviewed the most common brain arrhythmias characterized in AD, in AD transgenic models and those induced by Aβ. In addition, I reviewed the modulations of brain rhythms in neuroinflammatory diseases and those induced by immunogens, interleukins and microglia. This review reveals that Aβ and inflammation produce a complex set of effects on neural network function, which are related to the induction of brain arrhythmias and hyperexcitability, both closely related to behavioral alterations. Understanding these brain arrhythmias can help to develop therapeutic strategies to halt or prevent these neural network alterations and treat not only the arrhythmias but also the symptoms of AD and other inflammation-related pathologies.
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Affiliation(s)
- Fernando Peña-Ortega
- Departamento de Neurobiologia del Desarrollo y Neurofisiologia, Instituto de Neurobiologia, Universidad Nacional Autonoma de Mexico, Queretaro, Qro., 76230, Mexico
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9
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Schmidt FM, Mergl R, Minkwitz J, Holdt LM, Teupser D, Hegerl U, Himmerich H, Sander C. Is There an Association or Not?-Investigating the Association of Depressiveness, Physical Activity, Body Composition and Sleep With Mediators of Inflammation. Front Psychiatry 2020; 11:563. [PMID: 32670105 PMCID: PMC7330708 DOI: 10.3389/fpsyt.2020.00563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 06/02/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cytokines are mediators of inflammation that contribute to a low-grade inflammation in different disorders like major depression and obesity. It still remains unclear which psychological and medical factors interact with cytokine regulation. In the current investigation, the association between levels of pro-and anti-inflammatory cytokines and anthropometrics, mood state (depressiveness), physical activity and sleep were investigated in a sample of community-dwelled adults. METHODS Forty-nine subjects met the inclusion criteria for analyses and were assessed at two time-points (baseline (T1) and follow-up (T2), average T1-T2-interval = 215 days). Serum cytokine measures included the pro-inflammatory cytokines interleukin (IL)-2, IL-12, IFN-γ and TNF-α, the anti-inflammatory cytokines IL-4, IL-5, IL-10 and IL-13 and the granulocyte-macrophage colony-stimulating factor (GM-CSF); anthropometrics were assessed via physical examination, depressiveness was assessed via Beck Depression Inventory (BDI)2, parameters of physical activity (steps, METs) and sleep (night/total sleep duration) were measured via a 1-week actigraphy. RESULTS Correlation analyses showed low-to moderate significant relationships between the majority of cytokines and the BDI2 at T1, positive correlation with weight and BMI at T1 and T2, and negative correlations with the number of steps and METs at T2 and T2. Regression analyses for T1 revealed that the BDI2 score was the best positive predictor for the concentrations of all nine cytokines, followed by the number of steps and the nightsleep duration as negative predictors. At T2, the amount of steps was found to be negatively associated with IL-4, IL5, IL-10, GM-CSF, IFN-γ, and TNF-α, whereas the BMI could significantly predict IL-12 and IL-13. The BDI2-score was not significantly associated with any of the cytokines. No associations could be found between dynamics in cytokines from T1 and T2 and changes in any of the variables. DISCUSSION The present results indicate an influence of physical activity, subjective well-being and body composition on inflammatory mediators. Since there was no standardized intervention targeting the independent variables between T1 and T2, no assumptions on causality can be drawn from the association results.
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Affiliation(s)
- Frank M Schmidt
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Roland Mergl
- Department of Clinical Psychology and Psychotherapy, Bundeswehr University Munich, Munich, Germany
| | - Juliane Minkwitz
- IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry (MPI), Munich, Germany
| | - Lesca M Holdt
- Institute of Laboratory Medicine, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, Frankfurt am Main, Germany
| | - Hubertus Himmerich
- IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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10
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Minkwitz J, Sander C, Himmerich H, Thormann J, Chittka T, Hegerl U, Schmidt F, Murray M, Albayrak N, Campbell IC, Scheipl F. Reported and Recorded Sleepiness in Obesity and Depression. Front Psychiatry 2020; 11:200. [PMID: 32300312 PMCID: PMC7144401 DOI: 10.3389/fpsyt.2020.00200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 03/02/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Obesity and depression are both associated with changes in sleep/wake regulation, with potential implications for individualized treatment especially in comorbid individuals suffering from both. However, the associations between obesity, depression, and subjective, questionnaire-based and objective, EEG-based measurements of sleepiness used to assess disturbed sleep/wake regulation in clinical practice are not well known. OBJECTIVES The study investigates associations between sleep/wake regulation measures based on self-reported subjective questionnaires and EEG-derived measurements of sleep/wake regulation patterns with depression and obesity and how/whether depression and/or obesity affect associations between such self-reported subjective questionnaires and EEG-derived measurements. METHODS Healthy controls (HC, NHC = 66), normal-weighted depressed (DEP, NDEP = 16), non-depressed obese (OB, NOB = 68), and obese depressed patients (OBDEP, NOBDEP = 43) were included from the OBDEP (Obesity and Depression, University Leipzig, Germany) study. All subjects completed standardized questionnaires related to daytime sleepiness (ESS), sleep quality and sleep duration once as well as questionnaires related to situational sleepiness (KSS, SSS, VAS) before and after a 20 min resting state EEG in eyes-closed condition. EEG-based measurements of objective sleepiness were extracted by the VIGALL algorithm. Associations of subjective sleepiness with objective sleepiness and moderating effects of obesity, depression, and additional confounders were investigated by correlation analyses and regression analyses. RESULTS Depressed and non-depressed subgroups differed significantly in most subjective sleepiness measures, while obese and non-obese subgroups only differed significantly in few. Objective sleepiness measures did not differ significantly between the subgroups. Moderating effects of obesity and/or depression on the associations between subjective and objective measures of sleepiness were rarely significant, but associations between subjective and objective measures of sleepiness in the depressed subgroup were systematically weaker when patients comorbidly suffered from obesity than when they did not. CONCLUSION This study provides some evidence that both depression and obesity can affect the association between objective and subjective sleepiness. If confirmed, this insight may have implications for individualized diagnosis and treatment approaches in comorbid depression and obesity.
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Affiliation(s)
- Juliane Minkwitz
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, München, Germany.,IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Hubertus Himmerich
- IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Julia Thormann
- IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Tobias Chittka
- IFB Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Frankfurt, Germany
| | - Frank Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Monique Murray
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Nihan Albayrak
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Iain C Campbell
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Fabian Scheipl
- Institute for Statistics, Ludwig-Maximilians-Universität München, München, Germany
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11
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Stoppe M, Meyer K, Schlingmann M, Olbrich S, Then Bergh F. Hyperstable arousal regulation in multiple sclerosis. Psychoneuroendocrinology 2019; 110:104417. [PMID: 31546115 DOI: 10.1016/j.psyneuen.2019.104417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fatigue is common in multiple sclerosis (MS) patients. Exhaustion of physiological reserves and mental stress are postulated causes, the latter supported by more pronounced hypothalamic-pituitary-adrenal (HPA) axis activation in fatigued patients. Divergent dysregulation of arousal appears to play important roles in depression- (hyperstable arousal) and in cancer-related (unstable arousal) fatigue, where HPA axis is hyperactive or hypoactive, respectively. OBJECTIVE This study assessed arousal regulation in multiple sclerosis patients, explored if fatigue can be physiologically described by altered arousal regulation, and if HPA axis activity corresponds to the type(s) of arousal regulation. METHODS 51 mildly-affected patients with relapsing-remitting MS (86% on disease-modifying treatment) and 20 healthy controls were analysed via Vigilance Algorithm Leipzig and combined dexamethasone/corticotropin releasing hormone test. RESULTS Hyperstable arousal pattern was significantly more frequent in patients than in controls (62.7% vs. 45.0%, p = 0.011). Patients scored higher on all fatigue, but not on sleepiness scales. All patients combined showed mild activation of the hypothalamic-pituitary-adrenal axis (p < 0.05 for post-CRH ACTH and AUC ACTH; cortisol n.s.). While fatigue was numerically more pronounced in both hyperstable and unstable arousal, HPA axis activity was highest in hyperstable and lowest in unstable arousal (p = 0.013 for post-CRH ACTH; p = 0.087 for AUC ACTH; cortisol n.s.). CONCLUSION Frequency of arousal patterns are altered in MS. An association with HPA axis activity was weak, possibly because the present sample was stable on immunotherapy.
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Affiliation(s)
- Muriel Stoppe
- Department of Neurology, University of Leipzig, Germany; Translational Centre for Regenerative Medicine, University of Leipzig, Germany
| | - Klara Meyer
- Department of Neurology, University of Leipzig, Germany
| | | | | | - Florian Then Bergh
- Department of Neurology, University of Leipzig, Germany; Translational Centre for Regenerative Medicine, University of Leipzig, Germany.
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12
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Jawinski P, Kirsten H, Sander C, Spada J, Ulke C, Huang J, Burkhardt R, Scholz M, Hensch T, Hegerl U. Human brain arousal in the resting state: a genome-wide association study. Mol Psychiatry 2019; 24:1599-1609. [PMID: 29703947 DOI: 10.1038/s41380-018-0052-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/22/2018] [Accepted: 02/19/2018] [Indexed: 12/20/2022]
Abstract
Arousal affects cognition, emotion, and behavior and has been implicated in the etiology of psychiatric disorders. Although environmental conditions substantially contribute to the level of arousal, stable interindividual characteristics are well-established and a genetic basis has been suggested. Here we investigated the molecular genetics of brain arousal in the resting state by conducting a genome-wide association study (GWAS). We selected N = 1877 participants from the population-based LIFE-Adult cohort. Participants underwent a 20-min eyes-closed resting state EEG, which was analyzed using the computerized VIGALL 2.1 (Vigilance Algorithm Leipzig). At the SNP-level, GWAS analyses revealed no genome-wide significant locus (p < 5E-8), although seven loci were suggestive (p < 1E-6). The strongest hit was an expression quantitative trait locus (eQTL) of TMEM159 (lead-SNP: rs79472635, p = 5.49E-8). Importantly, at the gene-level, GWAS analyses revealed significant evidence for TMEM159 (p = 0.013, Bonferroni-corrected). By mapping our SNPs to the GWAS results from the Psychiatric Genomics Consortium, we found that all corresponding markers of TMEM159 showed nominally significant associations with Major Depressive Disorder (MDD; 0.006 ≤ p ≤ 0.011). More specifically, variants associated with high arousal levels have previously been linked to an increased risk for MDD. In line with this, the MetaXcan database suggests increased expression levels of TMEM159 in MDD, as well as Autism Spectrum Disorder, and Alzheimer's Disease. Furthermore, our pathway analyses provided evidence for a role of sodium/calcium exchangers in resting state arousal. In conclusion, the present GWAS identifies TMEM159 as a novel candidate gene which may modulate the risk for psychiatric disorders through arousal mechanisms. Our results also encourage the elaboration of the previously reported interrelations between ion-channel modulators, sleep-wake behavior, and psychiatric disorders.
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Affiliation(s)
- Philippe Jawinski
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. .,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany. .,Depression Research Centre, German Depression Foundation, Leipzig, Germany.
| | - Holger Kirsten
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.,Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany
| | - Christian Sander
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Janek Spada
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christine Ulke
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ralph Burkhardt
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Markus Scholz
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Tilman Hensch
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.,Depression Research Centre, German Depression Foundation, Leipzig, Germany
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13
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Edes AE, McKie S, Szabo E, Kokonyei G, Pap D, Zsombok T, Hullam G, Gonda X, Kozak LR, McFarquhar M, Anderson IM, Deakin JFW, Bagdy G, Juhasz G. Spatiotemporal brain activation pattern following acute citalopram challenge is dose dependent and associated with neuroticism: A human phMRI study. Neuropharmacology 2019; 170:107807. [PMID: 31593709 DOI: 10.1016/j.neuropharm.2019.107807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The initial effects of selective serotonin reuptake inhibitors (SSRIs) in the human living brain are poorly understood. We carried out a 3T resting state fMRI study with pharmacological challenge to determine the brain activation changes over time following different dosages of citalopram. METHODS During the study, 7.5 mg i.v. citalopram was administered to 32 healthy subjects. In addition, 11.25 mg citalopram was administered to a subset of 9 subjects to investigate the dose-response. Associations with neuroticism (assessed by the NEO PI-R) of the emerging brain activation to citalopram was also investigated. RESULTS Citalopram challenge evoked significant activation in brain regions that are part of the default mode network, the visual network and the sensorimotor network, extending to the thalamus, and midbrain. Most effects appeared to be dose-dependent and this was statistically significant in the middle cingulate gyrus. Individual citalopram-induced brain responses were positively correlated with neuroticism scores and its subscales in specific brain areas; anxiety subscale scores in thalamus and midbrain and self-consciousness scores in middle cingulate gyrus. There were no sex differences. LIMITATIONS We investigated only healthy subjects and we used a relatively low sample size in the 11.25 mg citalopram analysis. DISCUSSION Our results suggest that SSRIs acutely induce an increased arousal-like state of distributed cortical and subcortical systems that is mediated by enhanced serotonin neurotransmission according to levels of neuroticism and underpins trait sensitivity to environmental stimuli and stressors. Studies in depression are needed to determine how therapeutic effects eventually emerge. This article is part of the special issue entitled 'Serotonin Research: Crossing Scales and Boundaries'.
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Affiliation(s)
- Andrea Edit Edes
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Shane McKie
- Faculty of Biological, Medical and Human Sciences Platform Sciences, Enabling Technologies & Infrastructure, Faculty of Biological, Medical and Human Sciences Research and Innovation, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Edina Szabo
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; Doctoral School of Psychology, ELTE Eotvos Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eotvos Loránd University, Budapest, Hungary
| | - Gyongyi Kokonyei
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; Institute of Psychology, ELTE Eotvos Loránd University, Budapest, Hungary
| | - Dorottya Pap
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Terezia Zsombok
- Department of Neurology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Gabor Hullam
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Faculty of Electrical Engineering and Informatics, Budapest, Hungary
| | - Xenia Gonda
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Lajos R Kozak
- MR Research Center, Semmelweis University, Budapest, Hungary
| | - Martyn McFarquhar
- Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biological, Medical and Human Sciences, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Ian M Anderson
- Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biological, Medical and Human Sciences, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - J F William Deakin
- Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biological, Medical and Human Sciences, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Gyorgy Bagdy
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Gabriella Juhasz
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; Neuroscience and Psychiatry Unit, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biological, Medical and Human Sciences, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
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14
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Himmerich H, Patsalos O, Lichtblau N, Ibrahim MAA, Dalton B. Cytokine Research in Depression: Principles, Challenges, and Open Questions. Front Psychiatry 2019; 10:30. [PMID: 30792669 PMCID: PMC6374304 DOI: 10.3389/fpsyt.2019.00030] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/18/2019] [Indexed: 01/18/2023] Open
Abstract
Cytokines have been implicated in the pathology of depression. Currently, the evidence is based on cross-sectional studies and meta-analytic research comparing blood concentrations of T helper type 1 (TH1), T helper type 2 (TH2), pro-inflammatory or anti-inflammatory cytokines of patients with a depressive disorder to those of healthy controls. Additionally, multiple longitudinal studies have investigated cytokine levels during antidepressant treatment. According to the current literature, it seems that peripheral levels of interleukin (IL)-6, IL-10, IL-12, IL-13, and tumor necrosis factor (TNF)-α are elevated and that interferon (IFN)-γ levels are lower in patients with depression compared to healthy controls. However, the overlap of cytokine values between acutely depressed patients, remitted and recovered patients and healthy controls is considerable. Thus, the discriminative power of cytokine concentrations between depressed and non-depressed people is likely weak. Treatment with certain antidepressants appears to decrease peripheral levels of IL-6, IL-10, and TNF-α. However, weight gain-inducing psychopharmacological substances, such as the antidepressant mirtazapine, have been reported to potentially increase the production of pro-inflammatory cytokines. Even though cytokines are often discussed as biomarkers for depression, they have also been shown to be altered in other psychiatric disorders. Moreover, many environmental, social, psychological, biological, and medical factors are also associated with cytokine changes. Thus, cytokine alterations seem extremely unspecific. The interpretation of the results of these studies remains a challenge because it is unknown which type of cells are most responsible for cytokine changes measured in the blood nor have the main target cells or target tissues been identified. The same cytokine can be produced by multiple cell types, and the same cell can produce various cytokines. Additionally, redundancy, synergy, antagonism, and signaling cascades of cytokine signaling must be considered. Cytokines might not be associated with the diagnosis of depression according to the currently used diagnostic manuals, but rather with specific subtypes of depression, or with depressive symptoms across different psychiatric diagnoses. Therefore, the currently available diagnostic systems may not be the ideal starting point for psychiatric cytokine research.
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Affiliation(s)
- Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Nicole Lichtblau
- Maidstone and Tunbridge Wells NHS Trust, Maidstone, United Kingdom
| | - Mohammad A. A. Ibrahim
- Department of Clinical Immunological Medicine and Allergy, King's Health Partners, King's College Hospital, London, United Kingdom
| | - Bethan Dalton
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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15
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Brain arousal regulation in SSRI-medicated patients with major depression. J Psychiatr Res 2019; 108:34-39. [PMID: 30448695 DOI: 10.1016/j.jpsychires.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/29/2018] [Accepted: 11/02/2018] [Indexed: 12/27/2022]
Abstract
EEG measures of arousal have been suggested as diagnostic and predictive biomarkers for major depression. The aim of the present study was to examine whether self-rated depression severity in SSRI-medicated patients with major depression (MD) is associated with EEG measures of brain arousal. Based on previous studies, we expected that a higher level of brain arousal and a slower arousal decline during a 15-min EEG recording are associated with higher symptom severity as assessed with the Beck Depression Inventory (BDI) at the time of the EEG recording. EEGs of 78 MD patients and 46 healthy controls were analyzed. Brain arousal was assessed using the Vigilance Algorithm Leipzig (VIGALL 2.1). Based on automatically classified 1-s segments (EEG-vigilance Stages 0, A1, A2, A3, B1, B2/3 or C) we computed indices to assess the level (mean EEG-vigilance) and the decline of arousal (slope index) during the 15-min resting state EEG under eyes-closed condition. We found that a higher arousal level and a slower arousal decline corresponded to higher severity of depressive symptoms (rho = 0.238, p = .018; and rho = 0.236; p = .019). Self-rated non-remitters (BDI>12) had a higher arousal level (mean EEG-vigilance: t76 = -2.19, p = .016) and slower arousal decline (slope index: Z = -2.08, p = .019) during the 15-min recording as compared to remitters. Similar results were obtained between non-remitters and healthy controls (mean EEG-vigilance: t102 = -2.75, p = .004; slope index: Z = -1.92, p = .028), but not between remitters and controls (p > .260). The findings support the model that brain arousal regulation plays an important role in the pathophysiology and treatment of MD.
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16
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Ulke C, Tenke CE, Kayser J, Sander C, Böttger D, Wong LYX, Alvarenga JE, Fava M, McGrath PJ, Deldin PJ, Mcinnis MG, Trivedi MH, Weissman MM, Pizzagalli DA, Hegerl U, Bruder GE. Resting EEG Measures of Brain Arousal in a Multisite Study of Major Depression. Clin EEG Neurosci 2019; 50:3-12. [PMID: 30182751 PMCID: PMC6384132 DOI: 10.1177/1550059418795578] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Several studies have found upregulated brain arousal during 15-minute EEG recordings at rest in depressed patients. However, studies based on shorter EEG recording intervals are lacking. Here we aimed to compare measures of brain arousal obtained from 2-minute EEGs at rest under eyes-closed condition in depressed patients and healthy controls in a multisite project-Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC). We expected that depressed patients would show stable and elevated brain arousal relative to controls. Eighty-seven depressed patients and 36 healthy controls from four research sites in the United States were included in the analyses. The Vigilance Algorithm Leipzig (VIGALL) was used for the fully automatic classification of EEG-vigilance stages (indicating arousal states) of 1-second EEG segments; VIGALL-derived measures of brain arousal were calculated. We found that depressed patients scored higher on arousal stability ( Z = -2.163, P = .015) and A stages (dominant alpha activity; P = .027) but lower on B1 stages (low-voltage non-alpha activity, P = .008) compared with healthy controls. No significant group differences were observed in Stage B2/3. In summary, we were able to demonstrate stable and elevated brain arousal during brief 2-minute recordings at rest in depressed patients. Results set the stage for examining the value of these measures for predicting clinical response to antidepressants in the entire EMBARC sample and evaluating whether an upregulated brain arousal is particularly characteristic for responders to antidepressants.
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Affiliation(s)
- Christine Ulke
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,2 Research Centre of the German Depression Foundation, Leipzig, Germany
| | - Craig E Tenke
- 3 Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.,4 New York State Psychiatric Institute, New York, NY, USA
| | - Jürgen Kayser
- 3 Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.,4 New York State Psychiatric Institute, New York, NY, USA
| | - Christian Sander
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,2 Research Centre of the German Depression Foundation, Leipzig, Germany
| | - Daniel Böttger
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,2 Research Centre of the German Depression Foundation, Leipzig, Germany
| | - Lidia Y X Wong
- 4 New York State Psychiatric Institute, New York, NY, USA
| | | | - Maurizio Fava
- 5 Depression Clinical and Research Program, MA General Hospital, Boston, Massachusetts, USA
| | - Patrick J McGrath
- 3 Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.,4 New York State Psychiatric Institute, New York, NY, USA
| | - Patricia J Deldin
- 6 Departments of Psychology and Psychiatry, The University of Michigan, Ann Arbor, MI, USA
| | - Melvin G Mcinnis
- 7 Department of Psychiatry, The University of Michigan, Ann Arbor, MI, USA
| | - Madhukar H Trivedi
- 8 Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Myrna M Weissman
- 3 Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.,4 New York State Psychiatric Institute, New York, NY, USA
| | - Diego A Pizzagalli
- 9 Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - Ulrich Hegerl
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,2 Research Centre of the German Depression Foundation, Leipzig, Germany
| | - Gerard E Bruder
- 3 Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.,4 New York State Psychiatric Institute, New York, NY, USA
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17
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Changes in brain arousal (EEG-vigilance) after therapeutic sleep deprivation in depressive patients and healthy controls. Sci Rep 2018; 8:15087. [PMID: 30305649 PMCID: PMC6180108 DOI: 10.1038/s41598-018-33228-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/21/2018] [Indexed: 01/16/2023] Open
Abstract
Depressed patients frequently exhibit a hyperstable brain arousal regulation. According to the arousal regulation model of affective disorders, the antidepressant effect of therapeutic sleep deprivation could be achieved by counter-acting this dysregulation. We investigated the impact of partial sleep deprivation (PSD) on EEG-vigilance (an indicator of brain arousal regulation) in depressed patients (n = 27) and healthy controls (n = 16). PSD was hypothesized to cause a more prominent destabilisation of brain arousal regulation in depressed patients (reflected by increased occurrence of lower EEG-vigilance stages). Furthermore, it was studied whether responders (n = 17) exhibit a more stable baseline brain arousal regulation and would show a more prominent arousal destabilisation after PSD than non-responders (n = 10). Before PSD, patients showed a more stable EEG-vigilance with less declines to lower vigilance stages compared to controls. Contrary to the hypothesis, a greater destabilisation of brain arousal after PSD was seen in controls. Within the patient sample, responders generally showed a less stable EEG-vigilance, especially after PSD when we found significant differences compared to non-responders. EEG-vigilance in non-responders showed only little change from baseline to after PSD. In summary, PSD had a destabilizing impact on brain arousal regulation in healthy controls whereas depressed patients reacted heterogeneously depending on the outcome of treatment.
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18
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Dohrmann AL, Stengler K, Jahn I, Olbrich S. EEG-arousal regulation as predictor of treatment response in patients suffering from obsessive compulsive disorder. Clin Neurophysiol 2017; 128:1906-1914. [PMID: 28826021 DOI: 10.1016/j.clinph.2017.07.406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/09/2017] [Accepted: 07/15/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Aim of this study was to analyze whether electroencephalogram (EEG)-based CNS-arousal markers differ for patients suffering from obsessive compulsive disorder (OCD) that either respond or do not respond to cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs) or their combination. Further the study aimed to identify specific response-predictors for the different therapy approaches. METHODS CNS-arousal from 51 unmedicated patients during fifteen-minute resting state was assessed using VIGALL (Vigilance Algorithm Leipzig). Clinical Global Impression (CGI) scores were used to assess response or non-response after three to six months following therapy (CBT, n=18; SSRI, n=11 or combination, n=22). Differences between Responders (R) and Non-Responders (NR) were identified using multivariate analysis of covariance (MANCOVA) models. RESULTS MANCOVA revealed that Responders spent significant less time at the highest CNS-arousal stage 0. Further, low amounts of the highest CNS-arousal stages were specifically predictive for a response to a combined treatment approach. CONCLUSIONS The fact that CNS-arousal markers allowed discrimination between Responders and Non-Responders and also between Responders of different treatment arms underlines a possible clinical value of EEG-based markers. SIGNIFICANCE These results encourage further research on EEG-arousal regulation for determining pathophysiological subgroups for treatment response.
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Affiliation(s)
- Anna-Lena Dohrmann
- Department for Psychiatry and Psychotherapy, University Leipzig, Germany.
| | - Katarina Stengler
- Department for Psychiatry and Psychotherapy, University Leipzig, Germany
| | - Ina Jahn
- Department for Psychiatry and Psychotherapy, University Leipzig, Germany
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19
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A closer look at the relationship between the default network, mind wandering, negative mood, and depression. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2017; 17:697-711. [DOI: 10.3758/s13415-017-0506-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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20
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Schmidt FM, Sander C, Dietz ME, Nowak C, Schröder T, Mergl R, Schönknecht P, Himmerich H, Hegerl U. Brain arousal regulation as response predictor for antidepressant therapy in major depression. Sci Rep 2017; 7:45187. [PMID: 28345662 PMCID: PMC5366924 DOI: 10.1038/srep45187] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 02/20/2017] [Indexed: 12/11/2022] Open
Abstract
A tonically high level of brain arousal and its hyperstable regulation is supposed to be a pathogenic factor in major depression. Preclinical studies indicate that most antidepressants may counteract this dysregulation. Therefore, it was hypothesized that responders to antidepressants show a) a high level of EEG-vigilance (an indicator of brain arousal) and b) a more stable EEG-vigilance regulation than non-responders. In 65 unmedicated depressed patients 15-min resting-state EEGs were recorded off medication (baseline). In 57 patients an additional EEG was recorded 14 ± 1 days following onset of antidepressant treatment (T1). Response was defined as a ≥50% HAMD-17-improvement after 28 ± 1 days of treatment (T2), resulting in 29 responders and 36 non-responders. Brain arousal was assessed using the Vigilance Algorithm Leipzig (VIGALL 2.1). At baseline responders and non-responders differed in distribution of overall EEG-vigilance stages (F2,133 = 4.780, p = 0.009), with responders showing significantly more high vigilance stage A and less low vigilance stage B. The 15-minutes Time-course of EEG-vigilance did not differ significantly between groups. Exploratory analyses revealed that responders showed a stronger decline in EEG-vigilance levels from baseline to T1 than non-responders (F2,130 = 4.978, p = 0.005). Higher brain arousal level in responders to antidepressants supports the concept that dysregulation of brain arousal is a possible predictor of treatment response in affective disorders.
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Affiliation(s)
- Frank M. Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
- Research Center of the German Depression Foundation, Leipzig, Germany
| | - Marie-Elisa Dietz
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
| | - Claudia Nowak
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
| | - Thomas Schröder
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
| | - Roland Mergl
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
| | - Peter Schönknecht
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
- Saxonian Hospital Arnsdorf, Arnsdorf, Germany
| | - Hubertus Himmerich
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany
- Research Center of the German Depression Foundation, Leipzig, Germany
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Huang J, Hensch T, Ulke C, Sander C, Spada J, Jawinski P, Hegerl U. Evoked potentials and behavioral performance during different states of brain arousal. BMC Neurosci 2017; 18:21. [PMID: 28122495 PMCID: PMC5267455 DOI: 10.1186/s12868-017-0340-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/20/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Previous studies compared evoked potentials (EPs) between several sleep stages but only one uniform wake state. However, using electroencephalography (EEG), several arousal states can be distinguished before sleep onset. Recently, the Vigilance Algorithm Leipzig (VIGALL 2.0) has been developed, which automatically attributes one out of seven EEG-vigilance stages to each 1-s EEG segment, ranging from stage 0 (associated with cognitively active wakefulness), to stages A1, A2 and A3 (associated with relaxed wakefulness), to stages B1 and B2/3 (associated with drowsiness) up to stage C (indicating sleep onset). Applying VIGALL, we specified the effects of these finely differentiated EEG-vigilance stages (indicating arousal states) on EPs (P1, N1, P2, N300, MMN and P3) and behavioral performance. Subjects underwent an ignored and attended condition of a 2-h eyes-closed oddball-task. Final analysis included 43 subjects in the ignored and 51 subjects in the attended condition. First, the effect of brain arousal states on EPs and performance parameters were analyzed between EEG-vigilance stages A (i.e. A1, A2 and A3 combined), B1 and B2/3&C (i.e. B2/3 and C combined). Then, in a second step, the effects of the finely differentiated EEG-vigilance stages were further specified. RESULTS Comparing stages A versus B1 versus B2/3&C, a significant effect of EEG-vigilance stages on all behavioral parameters and all EPs, with exception of MMN and P3, was found. By applying VIGALL, a more detailed view of arousal effects on EP and performance was possible, such as the finding that the P2 showed no further significant increase in stages deeper than B1. Stage 0 did not differ from any of the A-stages. Within more fine-graded stages, such as the A-substages, EPs and performance only partially differed. However, these analyses were partly based on small sample sizes and future studies should take effort to get enough epochs of rare stages (such as A3 and C). CONCLUSIONS A clear impact of arousal on EPs and behavioral performance was obtained, which emphasize the necessity to consider arousal effects when interpreting EPs.
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Affiliation(s)
- Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Janek Spada
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Philippe Jawinski
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstrasse 10, 04103 Leipzig, Germany
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
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22
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Schmidt FM, Kirkby KC, Lichtblau N. Inflammation and Immune Regulation as Potential Drug Targets in Antidepressant Treatment. Curr Neuropharmacol 2017; 14:674-87. [PMID: 26769225 PMCID: PMC5050395 DOI: 10.2174/1570159x14666160115130414] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 10/20/2015] [Accepted: 11/04/2015] [Indexed: 12/21/2022] Open
Abstract
Growing evidence supports a mutual relationship between inflammation and major depression. A variety of mechanisms are outlined, indicating how inflammation may be involved in the pathogenesis, course and treatment of major depression. In particular, this review addresses 1) inflammatory cytokines as markers of depression and potential predictors of treatment response, 2) findings that cytokines interact with antidepressants and non-pharmacological antidepressive therapies, such as electroconvulsive therapy, deep brain stimulation and physical activity, 3) the influence of cytokines on the cytochrome (CYP) p450-system and drug efflux transporters, and 4) how cascades of inflammation might serve as antidepressant drug targets. A number of clinical trials have focused on agents with immunmodulatory properties in the treatment of depression, of which this review covers nonsteroidal anti-inflammatory drugs (NSAIDs), cytokine inhibitors, ketamine, polyunsaturated fatty acids, statins and curcumin. A perspective is also provided on possible future immune targets for antidepressant therapy, such as toll-like receptor-inhibitors, glycogen synthase kinase-3 inhibitors, oleanolic acid analogs and minocycline. Concluding from the available data, markers of inflammation may become relevant factors for more personalised planning and prediction of response of antidepressant treatment strategies. Agents with anti-inflammatory properties have the potential to serve as clinically relevant antidepressants. Further studies are required to better define and identify subgroups of patients responsive to inflammatory agents as well as to define optimal time points for treatment onset and duration.
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Affiliation(s)
- Frank M Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, D-04103 Leipzig, Germany
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23
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Abstract
Stimulants have been suggested as therapeutics in depression for 80 years now, but there is still no evidence from randomized controlled trials that stimulants, in general, possess specific antidepressant effects. Also, several recent large randomized controlled trials which tried to establish an indication for stimulants as add-on in depression failed, and the companies no longer proceed with regulatory filings. One reason why the common belief of an antidepressant effect has survived over decades is a lack of clarity in psychopathology. Tiredness in the sense of sleepiness (downregulation of arousal) and lack of drive are mixed up with tiredness in the sense of exhaustion with high inner tension (upregulation of arousal) and inhibition of drive. The latter is found in typical depression, and according to the recently introduced arousal regulation model of affective disorders, upregulation of arousal is considered to be an important pathogenetic factor. Psychostimulants are unlikely to have beneficial effects in those patients with upregulated arousal. However, there might be subgroups of depressed patients, such as atypical depression, which suffer from sleepiness and lack of drive and might respond to stimulants. Arousal, a dimension included in the Research Domain Criteria project of the National Institute of Mental Health, can be assessed with an electroencephalography-based algorithm (the Vigilance Algorithm Leipzig) and is a promising biomarker to identify subgroups of patients, which might respond to stimulants.
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Affiliation(s)
- Ulrich Hegerl
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany.,2 German Depression Foundation, Leipzig, Germany
| | - Tilman Hensch
- 1 Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
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Wittekind DA, Spada J, Gross A, Hensch T, Jawinski P, Ulke C, Sander C, Hegerl U. Early report on brain arousal regulation in manic vs depressive episodes in bipolar disorder. Bipolar Disord 2016; 18:502-510. [PMID: 27759213 DOI: 10.1111/bdi.12440] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/09/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The arousal regulation model of affective disorders attributes an important role in the pathophysiology of affective disorders to dysregulation of brain arousal regulation. According to this model, sensation avoidance and withdrawal in depression and sensation seeking and hyperactivity in mania can be explained as auto-regulatory attempts to counteract a tonically high (depression) or unstable (mania) arousal. The aim of this study was to compare brain arousal regulation between manic and depressive bipolar patients and healthy controls. We hypothesized that currently depressed patients with bipolar disorder show hyperstable arousal regulation, while currently manic patients show unstable arousal regulation. METHODS Twenty-eight patients with bipolar disorder received a 15-min resting electroencephalogram (EEG) during a depressive episode and 19 patients received the same during a manic/hypomanic episode. Twenty-eight healthy control subjects were matched for age and sex. The Vigilance Algorithm Leipzig (VIGALL), which classifies 1-s EEG segments as one of seven EEG-vigilance substages, was used to measure brain arousal regulation. RESULTS Manic patients showed more unstable EEG-vigilance regulation as compared to the control sample (P = .004) and to patients with a depressive episode (P ≤ .001). Depressive patients had significantly higher mean vigilance levels (P = .045) than controls. CONCLUSIONS A clear difference was found in the regulation of brain arousal of manic patients vs depressive patients and controls. These data suggest that brain arousal might depend on the current mood state, which would support the arousal regulation model of affective disorders.
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Affiliation(s)
| | - Janek Spada
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany.,Research Centre of the German Depression Foundation, Universität Leipzig, Leipzig, Germany
| | - Alexander Gross
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany
| | - Philippe Jawinski
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany.,Research Centre of the German Depression Foundation, Universität Leipzig, Leipzig, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany.,Research Centre of the German Depression Foundation, Universität Leipzig, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany.,Research Centre of the German Depression Foundation, Universität Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, Universität Leipzig, Leipzig, Germany.,Research Centre of the German Depression Foundation, Universität Leipzig, Leipzig, Germany
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