Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Catholic University of Applied Sciences North-Rhine-Westphalia/Cologne, Cologne, Germany.
J Neural Transm (Vienna). 2022 Nov;129(11):1339-1352. doi: 10.1007/s00702-022-02539-9. Epub 2022 Aug 27.
Studies using transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) revealed an imbalance between cortical excitation and inhibition (E/I) in the dorsolateral prefrontal cortex (DLPFC) in depression. As adolescence is a developmental period with an increase in depression prevalence and profound neural changes, it is crucial to study the relationship between depression and cortical excitability in adolescence. We aimed to investigate the cortical excitability of the DLPFC in adolescents with depression and a dependency of the TMS-evoked potential N100 on the depression severity. 36 clinical patients (12-18 years of age; 21 females) with a major depressive episode were assessed twice in a longitudinal design: shortly after admission (T0) and after six weeks of intervention (T1). GABA-B-mediated cortical inhibition in the left and right DLPFC, as assessed by the N100, was recorded with EEG. Significantly higher depression scores were reported at T0 compared to T1 (p < 0.001). N100 amplitudes were significantly increased (i.e., more negative) at T0 compared to T1 (p = 0.03). No significant hemispheric difference was found in the N100 component. The correlation between the difference in depression severity and the difference in N100 amplitudes (T0-T1) obtained during stimulation of the left DLPFC did not remain significant after correction for testing in both hemispheres. Higher N100 amplitudes during a state of greater depression severity are suggestive of an E/I imbalance in the DLPFC in adolescents with an acute depressive episode. The N100 reduction potentially reflects a normalization of DLPFC over inhibition in association with decreased depressive symptomatology, indicating severity dependency.
使用经颅磁刺激与脑电图（TMS-EEG）同步的研究揭示了抑郁患者背外侧前额叶皮层（DLPFC）皮质兴奋和抑制（E/I）失衡。由于青春期是一个抑郁发病率增加和神经深刻变化的发展阶段，因此研究青春期抑郁与皮质兴奋性之间的关系至关重要。我们旨在研究抑郁青少年的 DLPFC 皮质兴奋性，以及 TMS 诱发的 N100 电位是否取决于抑郁严重程度。36 名临床患者（12-18 岁；21 名女性）采用纵向设计进行了两次评估：入院后不久（T0）和六周干预后（T1）。通过 EEG 记录左、右 DLPFC 的 GABA-B 介导的皮质抑制，以 N100 评估。与 T1 相比，T0 时报告的抑郁评分显着更高（p<0.001）。与 T1 相比，T0 时 N100 振幅显着增加（即更负）（p=0.03）。在 N100 成分中未发现明显的半球差异。在刺激左 DLPFC 时，抑郁严重程度差异与 N100 振幅差异（T0-T1）之间的相关性在对两个半球进行测试校正后不再显着。在抑郁严重程度更高的状态下，N100 振幅更高表明急性抑郁发作的青少年 DLPFC 中存在 E/I 失衡。N100 减少可能反映了 DLPFC 过度抑制的正常化与抑郁症状减轻有关，表明严重程度的依赖性。
