BEHAVIORAL, ERP AND EEG ASYMMETRY IN AFFECTIVE DISORDERS

描述(申请人提供)：来自知觉不对称、电生理学和神经成像研究的综合证据支持抑郁障碍涉及左侧额叶前部和右侧顶叶低活性的假说。知觉和电生理的不对称与抑郁症的重要临床特征有关，即诊断亚型、焦虑共病和对抗抑郁药物的反应。下一个项目期的主要重点将是开发和评估行为、脑电和事件相关电位(ERP)指标，以预测抗抑郁药物的临床反应。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大脑半球不对称的假说差异。在文字和面部刺激的连续识别记忆测试中，将记录事件相关电位，以提供偏侧内侧、颞叶和额叶功能的生理测量。地区性测量脑电半球的不对称性将不仅在休息状态下被检查，而且在心理测量匹配的言语和空间任务中也被检查。我们还将继续使用两分词和复杂语调测试来评估知觉不对称。第二个目的是评估与双侧额叶功能，特别是与背外侧和内侧额叶功能相关的抗抑郁反应的替代假说。为此，将在新奇古怪的范式中记录事件相关电位，该范式提供了额叶功能的生理探针，即新奇的P3。神经心理测试将独立进行，以评估额叶功能。对抑郁症患者进行大样本测试将允许进一步评估这些行为和电生理测试作为抗抑郁药物治疗反应的预测指标，并将提供对性别影响的更明确确定。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，以预测SSRI无应答者对替代治疗的反应。这些目标有助于确定更多具有独特临床特征和局部脑不对称特征变化的同质性抑郁症亚型。

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.