BEHAVIORAL, ERP AND EEG ASYMMETRY IN AFFECTIVE DISORDERS

描述（申请人提供）：来自知觉不对称、电生理学和神经影像学研究的越来越多的证据支持抑郁症涉及左前额叶和右颞顶低激活的假设。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、焦虑合并症和对抗抑郁药的反应性。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）措施，以预测抗抑郁药的临床反应。其中一个目的是评估对选择性血清素再摄取抑制剂（SSRI）有反应的患者和没有反应的患者之间半球不对称的假设差异。在单词和面部刺激的连续识别记忆测试中记录erp，以提供侧化内侧颞叶和额叶功能的生理测量。脑电半球不对称的区域测量不仅在静息状态下，而且在心理测量匹配的语言和空间任务中进行。我们还将继续使用二分词和复杂音调测试来评估感知不对称性。第二个目的是评估与双侧额叶功能，特别是背外侧和内侧额叶功能有关的抗抑郁药反应的其他假设。为此，将在新奇古怪范式中记录erp，该范式提供了额叶功能的生理探测，即新奇P3。神经心理学测试将独立进行，以评估额叶功能。对抑郁症患者进行大样本测试，可以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指标，并将更明确地确定性别影响。我们还将利用正在进行的交叉研究，开始检查这些试验在预测SSRI无反应者对替代治疗的反应方面的潜力。这些目标有助于确定具有独特临床特征和区域脑不对称特征改变的更多同质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.