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https://hdl.handle.net/2440/121795
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Type: | Journal article |
Title: | Altered transcranial magnetic stimulation–electroencephalographic markers of inhibition and excitation in the dorsolateral prefrontal cortex in major depressive disorder |
Author: | Voineskos, D. Blumberger, D.M. Zomorrodi, R. Rogasch, N.C. Farzan, F. Foussias, G. Rajji, T.K. Daskalakis, Z.J. |
Citation: | Biological Psychiatry, 2019; 85(6):477-486 |
Publisher: | Elsevier |
Issue Date: | 2019 |
ISSN: | 0006-3223 1873-2402 |
Statement of Responsibility: | Daphne Voineskos, Daniel M.Blumberger, Reza Zomorrodi, Nigel C.Rogasch, Faranak Farzan, George Foussias, Tarek K.Rajji, Zafiris J.Daskalakis |
Abstract: | BACKGROUND:The neurophysiology of major depressive disorder (MDD) has become a particular focus of transcranial magnetic stimulation (TMS) investigational studies. TMS combined with electroencephalography (TMS-EEG) affords a window to directly measure evoked activity from the dorsolateral prefrontal cortex (DLPFC), which is of considerable interest in MDD. Our study examined TMS-EEG responses from the DLPFC in persons with MDD compared with those in healthy participants. Specifically, we examined TMS-EEG markers linked to inhibitory and excitatory neurophysiological processes and their balance. METHODS:In all, 30 participants with MDD and 30 age- and sex-matched healthy participants underwent single-pulse TMS-EEG to assess inhibition and excitation from DLPFC. TMS-EEG waveforms were analyzed through global mean field amplitude. RESULTS:MDD participants demonstrated abnormalities in TMS-EEG markers in the DLPFC. Inhibitory measures-N45 and N100-were larger in the MDD group than in healthy participants (N45 [t = -4.894, p < .001] and N100 [t = -3.496, p = .001]). In a receiver operating characteristic analysis, N45 amplitude predicted depression illness state with 80% sensitivity, 73.3% specificity, and 76.6% accuracy (area under the curve = 0.829, p < .001). The global mean field amplitude area under the curve, a neurophysiological measure of cortical reactivity, was significantly larger in persons with MDD (t = -3.114, p = .003), as was P60 (t = -3.260, p = .002). In healthy participants, there was a positive correlation between inhibitory N45 and excitatory global mean field amplitude area under the curve (r = .711, p < .001) that was not present in persons with MDD (r = .149, p = .43), demonstrating a potential imbalance between inhibition and excitation in MDD. CONCLUSIONS:As the TMS-EEG waveform and its components index inhibitory and excitatory activity from the cortex, our results suggest abnormalities in these neurophysiological processes of DLPFC in persons with MDD. |
Keywords: | EEG Excitation GABA Inhibition Major depressive disorder TMS |
Rights: | © 2018 Society of Biological Psychiatry. |
DOI: | 10.1016/j.biopsych.2018.09.032 |
Published version: | http://dx.doi.org/10.1016/j.biopsych.2018.09.032 |
Appears in Collections: | Aurora harvest 4 Psychiatry publications |
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