Abstract
Background: Clinical and functional studies consider major depression (MD) and vascular depression (VD) as different neurobiological processes. Hypoexcitability of the left frontal cortex to transcranial magnetic stimulation (TMS) is frequently reported in MD, whereas little is known about the effects of TMS in VD. Thus, we aimed to assess and compare motor cortex excitability in patients with VD and MD.Methods: Eleven VD patients, 11 recurrent drug-resistant MD patients, and 11 healthy controls underwent clinical, neuropsychological and neuroimaging evaluations in addition to bilateral resting motor threshold, cortical silent period, and paired-pulse TMS curves of intracortical excitability. All patients continued on psychotropic drugs, which were unchanged throughout the study.Results: Scores on one of the tests evaluating frontal lobe abilities (Stroop Color-Word interference test) were worse in patients compared with controls. The resting motor threshold in patients with MD was significantly higher in the left hemisphere compared with the right (p <0.05), and compared with the VD patients and controls. The cortical silent period was bilaterally prolonged in MD patients compared with VD patients and controls, with a statistically significant difference in the left hemisphere (p <0.01). No differences were observed in the paired-pulse curves between patients and controls.Conclusions: This study showed distinctive patterns of motor cortex excitability between late-onset depression with subcortical vascular disease and early-onset recurrent drug resistant MD. The data provide a TMS model of the different processes underlying VD and MD. Additionally, our results support the " Vascular depression hypothesis" at the neurophysiological level, and confirm the inter-hemispheric asymmetry to TMS in patients with MD. We were unable to support previous findings of impaired intracortical inhibitory mechanisms to TMS in patients with MD, although a drug-induced effect on our results cannot be excluded. This study may aid the understanding of the pathogenetic differences underlying the clinical spectrum of depressive disorders.
| Original language | English |
|---|---|
| Article number | 300 |
| Journal | BMC Psychiatry |
| Volume | 13 |
| DOIs | |
| Publication status | Published - Nov 9 2013 |
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Keywords
- Cortical excitability
- Late-onset depression
- Neuroplasticity
- Subcortical vascular disease
ASJC Scopus subject areas
- Psychiatry and Mental health
- Medicine(all)
Cite this
Different patterns of cortical excitability in major depression and vascular depression : A transcranial magnetic stimulation study. / Concerto, Carmen; Lanza, Giuseppe; Cantone, Mariagiovanna; Pennisi, Manuela; Giordano, Daniela; Spampinato, Concetto; Ricceri, Riccardo; Pennisi, Giovanni; Aguglia, Eugenio; Bella, Rita.
In: BMC Psychiatry, Vol. 13, 300, 09.11.2013.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Different patterns of cortical excitability in major depression and vascular depression
T2 - A transcranial magnetic stimulation study
AU - Concerto, Carmen
AU - Lanza, Giuseppe
AU - Cantone, Mariagiovanna
AU - Pennisi, Manuela
AU - Giordano, Daniela
AU - Spampinato, Concetto
AU - Ricceri, Riccardo
AU - Pennisi, Giovanni
AU - Aguglia, Eugenio
AU - Bella, Rita
PY - 2013/11/9
Y1 - 2013/11/9
N2 - Background: Clinical and functional studies consider major depression (MD) and vascular depression (VD) as different neurobiological processes. Hypoexcitability of the left frontal cortex to transcranial magnetic stimulation (TMS) is frequently reported in MD, whereas little is known about the effects of TMS in VD. Thus, we aimed to assess and compare motor cortex excitability in patients with VD and MD.Methods: Eleven VD patients, 11 recurrent drug-resistant MD patients, and 11 healthy controls underwent clinical, neuropsychological and neuroimaging evaluations in addition to bilateral resting motor threshold, cortical silent period, and paired-pulse TMS curves of intracortical excitability. All patients continued on psychotropic drugs, which were unchanged throughout the study.Results: Scores on one of the tests evaluating frontal lobe abilities (Stroop Color-Word interference test) were worse in patients compared with controls. The resting motor threshold in patients with MD was significantly higher in the left hemisphere compared with the right (p <0.05), and compared with the VD patients and controls. The cortical silent period was bilaterally prolonged in MD patients compared with VD patients and controls, with a statistically significant difference in the left hemisphere (p <0.01). No differences were observed in the paired-pulse curves between patients and controls.Conclusions: This study showed distinctive patterns of motor cortex excitability between late-onset depression with subcortical vascular disease and early-onset recurrent drug resistant MD. The data provide a TMS model of the different processes underlying VD and MD. Additionally, our results support the " Vascular depression hypothesis" at the neurophysiological level, and confirm the inter-hemispheric asymmetry to TMS in patients with MD. We were unable to support previous findings of impaired intracortical inhibitory mechanisms to TMS in patients with MD, although a drug-induced effect on our results cannot be excluded. This study may aid the understanding of the pathogenetic differences underlying the clinical spectrum of depressive disorders.
AB - Background: Clinical and functional studies consider major depression (MD) and vascular depression (VD) as different neurobiological processes. Hypoexcitability of the left frontal cortex to transcranial magnetic stimulation (TMS) is frequently reported in MD, whereas little is known about the effects of TMS in VD. Thus, we aimed to assess and compare motor cortex excitability in patients with VD and MD.Methods: Eleven VD patients, 11 recurrent drug-resistant MD patients, and 11 healthy controls underwent clinical, neuropsychological and neuroimaging evaluations in addition to bilateral resting motor threshold, cortical silent period, and paired-pulse TMS curves of intracortical excitability. All patients continued on psychotropic drugs, which were unchanged throughout the study.Results: Scores on one of the tests evaluating frontal lobe abilities (Stroop Color-Word interference test) were worse in patients compared with controls. The resting motor threshold in patients with MD was significantly higher in the left hemisphere compared with the right (p <0.05), and compared with the VD patients and controls. The cortical silent period was bilaterally prolonged in MD patients compared with VD patients and controls, with a statistically significant difference in the left hemisphere (p <0.01). No differences were observed in the paired-pulse curves between patients and controls.Conclusions: This study showed distinctive patterns of motor cortex excitability between late-onset depression with subcortical vascular disease and early-onset recurrent drug resistant MD. The data provide a TMS model of the different processes underlying VD and MD. Additionally, our results support the " Vascular depression hypothesis" at the neurophysiological level, and confirm the inter-hemispheric asymmetry to TMS in patients with MD. We were unable to support previous findings of impaired intracortical inhibitory mechanisms to TMS in patients with MD, although a drug-induced effect on our results cannot be excluded. This study may aid the understanding of the pathogenetic differences underlying the clinical spectrum of depressive disorders.
KW - Cortical excitability
KW - Late-onset depression
KW - Neuroplasticity
KW - Subcortical vascular disease
UR - http://www.scopus.com/inward/record.url?scp=84887120879&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84887120879&partnerID=8YFLogxK
U2 - 10.1186/1471-244X-13-300
DO - 10.1186/1471-244X-13-300
M3 - Article
VL - 13
JO - BMC Psychiatry
JF - BMC Psychiatry
SN - 1471-244X
M1 - 300
ER -