Department of Psychiatry and Psychotherapy, Rostock University Medical Centre, Gehlsheimer Strasse 20, Rostock, 18147, Germany.
Institute for Experimental and Clinical Pharmacology and Toxicology, University of Luebeck, Ratzeburger Allee 160, Lübeck, 23562, Germany.
Eur Arch Psychiatry Clin Neurosci. 2019 Oct;269(7):823-832. doi: 10.1007/s00406-018-0952-9. Epub 2018 Nov 3.
The diagnosis of major depressive disorder (MDD) should be based on multimodal evidence, because MDD not only affects mood, but also psychomotor and cognitive functions. Clinical markers such as executive dysfunctions and a reduction in daily motor activity have been observed in MDD. Neurophysiological biomarkers have also been described. In this study, we investigate the utility of combining biomarkers related to executive dysfunctions, motor activity, neurophysiological patterns (i.e. alpha power asymmetry and EEG-vigilance as indicators of brain arousal), and the interaction of these parameters in the diagnosis of MDD. Twenty (female: 11) patients with MDD (age: 51.05 ± 10.50) and 20 (female: 13) healthy controls (HC; age: 47.15 ± 12.57) underwent a 10-min resting EEG. Executive dysfunctions were assessed using the Trail Making Test B (TMT B). Motor activity was analysed by actigraphy measurements. MDD patients displayed significant impairments in executive functions and reduced daily motor activity. In the EEG, MDD patients showed more right than left frontal activity and lower brain arousal relative to HC. TMT B and asymmetrical frontal alpha power alone discriminated between MDD patients and HC with an accuracy of 78%. The interaction of motor activity and the EEG-vigilance stage alongside TMT B increased the accuracy of the discrimination test to 81%. This improved accuracy suggests that the combination of these biomarkers in a discriminant analysis resulted in a more reliable identification of MDD patients.
重度抑郁症(MDD)的诊断应基于多模态证据,因为 MDD 不仅影响情绪,还影响心理运动和认知功能。在 MDD 中观察到临床标志物,如执行功能障碍和日常运动活动减少。也描述了神经生理学生物标志物。在这项研究中,我们研究了将与执行功能障碍、运动活动、神经生理模式(即α功率不对称和 EEG 警觉作为大脑唤醒的指标)相关的生物标志物以及这些参数的相互作用相结合在 MDD 的诊断中的效用。20 名(女性:11 名)MDD 患者(年龄:51.05±10.50)和 20 名(女性:13 名)健康对照组(HC;年龄:47.15±12.57)接受了 10 分钟的静息 EEG 检查。使用 Trail Making Test B(TMT B)评估执行功能障碍。通过动作计测量分析运动活动。MDD 患者的执行功能明显受损,日常运动活动减少。在 EEG 中,MDD 患者的前额右半球活动比左半球多,与 HC 相比大脑唤醒程度较低。TMT B 和不对称的额部α功率单独区分 MDD 患者和 HC 的准确率为 78%。运动活动和 EEG 警觉阶段与 TMT B 的相互作用将区分测试的准确性提高到 81%。这种准确性的提高表明,在判别分析中组合这些生物标志物可更可靠地识别 MDD 患者。
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