Neurophysiological markers of depression detection and severity prediction in first-episode major depressive disorder

• Published in: Journal of affective disorders Vol. 331; pp. 8 - 16
• Main Authors: Liu, Shuang, Liu, Xiaoya, Chen, Sitong, Su, Fangyue, Zhang, Bo, Ke, Yufeng, Li, Jie, Ming, Dong
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.06.2023
• Subjects: Acoustic Stimulation; ASSR; Depression; Depressive Disorder, Major - diagnosis; EEG; Electroencephalography; Evoked Potentials, Auditory - physiology; First-episode major depressive disorder; Humans; Neurophysiological markers; Psychiatric/Mental Health; ROC Curve; γ oscillation; First-episode major depressive disorder; Neurophysiological markers; γ oscillation; EEG; ASSR
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2023.03.038

Deviant γ auditory steady-state responses (γ-ASSRs) have been documented in some psychiatric disorders. Nevertheless, the role of γ-ASSR in drug-naïve first-episode major depressive disorder (FEMD) patients remains equivocal. This study aimed to examine whether γ-ASSRs are impaired in FEMD patients and predict depression severity. Cortical reactivity was assessed in a cohort of 28 FEMD patients relative to 30 healthy control (HC) subjects during an ASSR paradigm randomly presented at 40 and 60 Hz. Event-related spectral perturbation and inter-trial phase coherence (ITC) were calculated to quantify dynamic changes of the γ-ASSR. Receiver operating characteristic curve combined with binary logistic regression were then employed to summarize ASSR variables that maximally differentiated groups. FEMD patients exhibited significantly inferior 40 Hz-ASSR-ITC in the right hemisphere versus HC subjects (p = 0.007), along with attenuated θ-ITC that reflected underlying impairments in θ responses during 60 Hz clicks (p < 0.05). Moreover, the 40 Hz-ASSR-ITC and θ-ITC in the right hemisphere can be used as a combinational marker to detect FEMD patients with 84.0 % sensitivity and 81.5 % specificity (area under the curve was 0.868, 95 % CI: 0.768–0.968). Pearson's correlations between the depression severity and ASSR variables were further conducted. The symptom severity of FEMD patients was negatively correlated with 60 Hz-ASSR-ITC in the midline and right hemisphere, possibly indicating that depression severity mediated high γ neural synchrony. Our findings provide critical insight into the pathological mechanism of FEMD, suggesting first that 40 Hz-ASSR-ITC and θ-ITC in right hemisphere constitute potential neurophysiological markers for early depression detection, and second, that high γ entrainment deficits may contribute to underlying symptom severity in FEMD patients. •This is the first attempt to reveal impaired ASSR in FEMD patients based on EEG.•Deficits of ASSR were concentrated in the right hemisphere in FEMD patients.•40 Hz-ASSR-ITC combined with θ-ITC constitute a potential marker for early depression detection.•High-γ entrainment abnormality could aid in predicting symptom severity.