Different patterns of cortical excitability in major depression and vascular depression: a transcranial magnetic stimulation study

BMC Psychiatry

Research Article

Manuela Pennisi¹  Concetto Spampinato²  Daniela Giordano²  Giuseppe Lanza³  Riccardo Ricceri³  Giovanni Pennisi³  Mariagiovanna Cantone³  Rita Bella³  Eugenio Aguglia⁴  Carmen Concerto⁴ 

[1] Department of Chemistry, University of Catania, Viale Andrea Doria 6, 95125, Catania, Italy;Department of Electrical, Electronics and Informatics Engineering, University of Catania, Viale Andrea Doria 6, 95125, Catania, Italy;Department “G.F. Ingrassia”, Section of Neurosciences, University of Catania, Via Santa Sofia, 78-95123, Catania, Italy;Unit of Psychiatry, Department of Clinical and Molecular Biomedicine, University of Catania, Via Santa Sofia, 78-95123, Catania, Italy;

关键词: Late-onset depression;    Cortical excitability;    Subcortical vascular disease;    Neuroplasticity;   

DOI  :  10.1186/1471-244X-13-300

 received in 2013-05-31, accepted in 2013-10-29,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundClinical 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.MethodsEleven 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.ResultsScores 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.ConclusionsThis 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.

【 授权许可】

Unknown   
© Concerto et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.