BEHAVIORAL, ERP AND EEG ASYMMETRY IN AFFECTIVE DISORDERS

描述（由申请人提供）：来自知觉不对称、电生理和神经影像学研究的汇聚证据支持抑郁症涉及左前额叶和右颞顶激活不足的假设。知觉和电生理不对称与抑郁症的重要临床特征有关，即，诊断亚型、焦虑共病和抗抑郁药反应性。下一个项目期间的主要重点将是开发和评估行为，脑电图和事件相关电位（ERP）的措施，用于预测抗抑郁药的临床反应。一个目的是评估对选择性5-羟色胺再摄取抑制剂（SSRI）有反应的患者和没有反应的患者之间半球不对称性的假设差异。在连续识别记忆测试期间，使用单词和面部刺激记录ERP，以提供偏侧内侧颞叶和额叶功能的生理测量。区域措施Df脑电图半球不对称性将检查不仅在休息状态下，而且在心理测量匹配的语言和空间任务。我们也将继续使用二分词和复杂的音调测试来评估知觉不对称。第二个目的是评估有关抗抑郁药反应的替代假设双侧额叶功能，特别是背外侧和内侧额叶功能。为此，将在新奇的古怪范例期间记录ERP，其提供了额叶功能的生理探针，即，新奇P3将独立进行神经心理学测试，以评估额叶功能。测试抑郁症患者的大样本将允许进一步评估这些行为和电生理测试作为抗抑郁药治疗反应的预测因子，并将提供更明确的性别影响的确定。我们还将利用正在进行的交叉研究，开始检查这些测试的潜力，预测SSRI无应答者对替代治疗的反应。这些目标有助于识别具有独特临床特征和区域脑不对称性特征改变的更同质的抑郁症亚型的长期目标。

DESCRIPTION (provided by applicant): Converging evidence from perceptual asymmetry, electrophysiologic, and neuroimaging studies support the hypothesis that depressive disorders involve both left prefrontal and right temporoparietal hypoactivation. Perceptual and electrophysiologic asymmetries are related to important clinical features of depression, i.e., diagnostic subtype, comorbidity with anxiety, and responsiveness to antidepressants. The major focus of the next project period will be on development and evaluation of behavioral, EEG and event-related potential (ERP) measures for predicting clinical response to antidepressants. One aim is to evaluate hypothesized differences in hemispheric asymmetry between patients who respond to a selective serotonin reuptake inhibitor (SSRI) and those who do not. ERPs will be recorded during continuous recognition memory tests with word and face stimuli to provide physiologic measures of lateralized medial temporal and frontal function. Regional measures Df EEG hemispheric asymmetry will be examined not only in a resting state but also during psychometrically matched verbal and spatial tasks. We will also continue to use dichotic word and complex tone tests for assessing perceptual asymmetries. A second aim is to evaluate alternative hypotheses relating antidepressant response to bilateral frontal lobe function, particularly to dorsolateral and medial frontal function. For this purpose ERPs will be recorded during a novelty oddball paradigm, which provides a physiologic probe of frontal function, i.e., the novelty P3. Neuropsychological tests will be independently performed to assess frontal lobe function. Testing a large sample of depressed patients will allow further evaluation of these behavioral and electrophysiologic tests as predictors of therapeutic response to antidepressants and will provide a more definitive determination of gender effects. We will also take advantage of ongoing crossover studies to begin to examine the potential of these tests for predicting response to alternative treatments for SSRI non-responders. These aims contribute to the long range goal of identifying more homogeneous subtypes of depression with distinctive clinical features and characteristic alterations of regional brain asymmetry.