Цель исследования: изучение различий в активности мозга у пациентов с депрессивным эпизодом в рамках рекуррентной (РД) и биполярной депрессии (БД). Дизайн: контролируемое нерандомизированное экспериментальное исследование. Материалы и методы. Выделены три группы: с РД (n = 16; 10 женщин), БД (n = 16; 8 женщин) и здоровых добровольцев (n = 16; 9 женщин). Группы пациентов с депрессией не получали лекарств и не различались по шкалам тревоги и депрессии Гамильтона. Испытуемые сортировали 160 фотографий людей и животных: на 80 снимках были представлены нейтральные образы, на 80-образы злых/агрессивных людей и животных. Простые фигуры (ключи) подавались за 2 сек до картинок, их связь с фотографиями не объяснялась. Выполняли запись 128-канальной электроэнцефалограммы и анализ вызванных ключом ответов мозга. Получили разностные волны между нейтральными и эмоциональными условиями (эмоциональную модуляцию-ЭМ) и проводили их попарные сравнения между группами испытуемых. Результаты. Обнаружены статистически значимые различия в компоненте Р100 в задних отделах мозга между пациентами с депрессией и контролем (p < 0,05). ЭМ компонентов N150, P220 и P380 проявила специфичность относительно группы и типа стимулов. Заключение. Неосознанная ЭМ определенных компонентов вызванной активности мозга может быть перспективным биомаркером для различения РД и БД. Ключевые слова: электроэнцефалограмма, рекуррентная депрессия, биполярная депрессия, имплицитный, лицевая экспрессия.
Study Objective: To study characteristic features of brain activity in women with recurrent depression (RD) using the tasks with emotional stimuli possessing biological or social importance. Study Design: Controlled randomized experimental trial. Materials and Methods. There were two groups: 42 patients with RD and 72 healthy women. Patients did not take medications before electroencephalogram (EEG) recording. The task was to differentiate between people and animals at 160 pictures: 80 pictures were neutral, and 80 pictures depicted angry/aggressive people or animals. Simple figures (clues) were demonstrated 2s before pictures, and no association was explained. A 128-channel EEG was recorded, and evoked brain reactions were analysed (0–700 ms from the clue). Differences between neutral and emotional pairs of conditions were determined (emotional modulation, EM). Study Results. Previous results for women with RD obtained in a larger sampling size and with a higher level of significance were confirmed. In healthy patients, EM was noted from 50 ms to 500 ms, whereas in patients with RD – from 130 ms to 700 ms for conditions where the clue was associated with neutral or ominous pictures of people. In clues with animals, EM was normally noted for components N170 and P200, while in patients with RD – for P200. Conclusion. Unconscious EM to socially important stimuli is preserved in RD, but it differs from the norm. Unconscious processing of emotional information associated with a biological threat causes lower component modulation. We observed a displacement of an “inert” EM towards posterior sections of the right hemisphere in women with RD. It can be assumed that such pattern demonstrates typical rigidity, an inclination to “stick” to unpleasant impressions; there are similar to pessimistic rumination. Keywords: emotional modulation, electroencephalogram, recurrent depression, visually evoked potentials.
Study Objective: To study gender-related characteristics of brain activity in patients with recurrent depression, while they perform a cognitive task with emotional stimulation. Study Design: This was a controlled non-randomized experimental study. Materials and Methods: Four groups were formed: two groups consisted of patients with recurrent depression (24 men and 24 women) and two groups were made up of healthy volunteers (25 men and 25 women). The patients were not taking any medications and did not differ in their Hamilton Depression Rating Scale or Hamilton Anxiety Rating Scale scores. The subjects were asked to sort 160 photos of people or animals, of which 80 were neutral images and 80 showed angry/aggressive people or animals. Simple patterns (cues) were presented two seconds prior to the pictures, and their relationship with the photographs was not explained. A 128-channel electroencephalogram was recorded and cue-elicited brain responses analyzed. Differences between the neutral and emotional conditions (emotional modulation, EM) were statistically evaluated for each group. Study Results: Gender-related differences in EM were greater in the patients than in the control-group subjects. The male patients had no EM of the P100 component, while EM of the P200 component and slow-wave activity after 400 msec was partially absent. In the female patients EM was consistently observed in the right posterior cortex. There were minimal differences in topographic distribution of EM of the N170 and P380 components between men and women as well as between patients and healthy subjects. Conclusion: Gender-related differences in unconscious EM of certain components of evoked brain activity suggest that mechanisms involved in the processing of emotional information are somewhat different in men and women. This suggests a need for a differentiated approach to examination and treatment of patients. Keywords: emotional modulation, electroencephalogram, recurrent depression, implicit education, visual evoked potentials, facial expression, anger.
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