Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Sleep EEG | Research article

Spatio-temporal dynamics of EEG features during sleep in major depressive disorder after treatment with escitalopram: a pilot study

Authors: Li Wu, Xue-Qin Wang, Yong Yang, Teng-Fei Dong, Ling Lei, Qi-Qi Cheng, Su-Xia Li

Published in: BMC Psychiatry | Issue 1/2020

Login to get access

Abstract

Background

Previous studies have shown escitalopram is related to sleep quality. However, effects of escitalopram on dynamics of electroencephalogram (EEG) features especially during different sleep stages have not been reported. This study may help to reveal pharmacological mechanism underlying escitalopram treatment.

Methods

The spatial and temporal responses of patients with major depressive disorder (MDD) to escitalopram treatment were analyzed in this study. Eleven MDD patients and eleven healthy control subjects who completed eight weeks’ treatment of escitalopram were included in the final statistics. Six-channel sleep EEG signals were acquired during sleep. Power spectrum and nonlinear dynamics were used to analyze the spatio-temporal dynamics features of the sleep EEG after escitalopram treatment.

Results

For temporal dynamics: after treatment, there was a significant increase in the relative energy (RE) of δ1 band (0.5 - 2 Hz), accompanied by a significant decrease in the RE of β2 band (20 - 30 Hz). Lempel-Ziv complexity and Co - complexity values were significantly lower. EEG changes at different sleep stages also showed the same regulation as throughout the night sleep. For spatio dynamics: after treatment, the EEG response of the left and right hemisphere showed asymmetry. Regarding band-specific EEG complexity estimations, δ1 and β2 in stage-1 and δ1 in stage-2 sleep stage in frontal cortex is found to be much more sensitive to escitalopram treatment in comparison to central and occipital cortices.

Conclusions

The sleep quality of MDD patients improved, EEG response occurred asymmetry in left and right hemispheres due to escitalopram treatment, and frontal cortex is found to be much more sensitive to escitalopram treatment. These findings may contribute to a comprehensive understanding of the pharmacological mechanism of escitalopram in the treatment of depression.
Literature
1.
Abasolo D, Hornero R, Gomez C, Garcia M, Lopez M. Analysis of EEG background activity in Alzheimer's disease patients with Lempel-Ziv complexity and central tendency measure. Med Eng Phys. 2006;28:315–22.PubMedCrossRef
2.
Alhaj H, Wisniewski G, McAllister-Williams RH. The use of the EEG in measuring therapeutic drug action: focus on depression and antidepressants. J Psychopharmacol. 2011;25:1175–91.PubMedCrossRef
3.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Washington, D.C: American Psychiatric Publishing; 2013.
4.
Anna CÉ, Lucila K, Pau C, Analía B, Francesc A. 5-HT2A receptors are involved in cognitive but not antidepressant effects of fluoxetine. Eur Neuropsychopharmacol. 2015;25:1353–61.
5.
Azorin JM, Llorca PM, Despiegel N, Verpillat P. Escitalopram is more effective than citalopram for the treatment of severe major depressive disorder. Encephale. 2004;30:158–66.
6.
Babiloni C, Lizio R, Marzano N, Capotosto P, Soricelli A, Triggiani AI, Cordone S, Gesualdo L, Del PC. Brain neural synchronization and functional coupling in Alzheimer's disease as revealed by resting state EEG rhythms. Int J Psychophysiol. 2016;103:88–102.PubMedCrossRef
7.
Baghai TC, Varallo-Bedarida G, Born C, Hafner S, Schule C, Eser D, Zill P, Manook A, Weigl J, Jooyandeh S, Nothdurfter C, von Schacky C, Bondy B, Rupprecht R. Classical risk factors and inflammatory biomarkers: one of the missing biological links between cardiovascular disease and major depressive disorder. Int J Mol Sci. 2018;19(6):1740.PubMedCentralCrossRef
8.
Baskaran A, Farzan F, Milev R, Brenner CA, Alturi S, Pat MM, Blier P, Evans K, Foster JA, Frey BN, Giacobbe P, Lam RW, Leri F, MacQueen GM, Muller DJ, Parikh SV, Rotzinger S, Soares CN, Strother SC, Turecki G, Kennedy SH. The comparative effectiveness of electroencephalographic indices in predicting response to escitalopram therapy in depression: a pilot study. J Affect Disord. 2018;227:542–9.PubMedCrossRef
9.
Berry B, et al. The AASM manual for the scoring of sleep and associated events. In: Rules, Terminology and Technical Specifications. Darien, Illinois: American Academy of Sleep Medicine; 2012. p. 176.
10.
Bruder GE, Stewart JW, McGrath PJ. Right brain, left brain in depressive disorders: clinical and theoretical implications of behavioral, electrophysiological and neuroimaging findings. Neurosci Biobehav Rev. 2017;78:178–91.PubMedCrossRef
11.
Chapotot F, Gronfier C, Jouny C, Muzet A, Brandenberger G. Cortisol secretion is related to electroencephalographic alertness in human subjects during daytime wakefulness. J Clin Endocrinol Metab. 1998;83:4263–8.PubMed
12.
Chen F, Xu J, Gu F, Yu X, Meng X, Qiu Z. Dynamic process of information transmission complexity in human brains. Biol Cybern. 2000;83:355–66.PubMedCrossRef
13.
Christian S, Jonathan M, Schmidt R, Mergl F, Ulrich M. Changes in brain arousal (EEG-vigilance) after therapeutic sleep deprivation in depressive patients and healthy controls. Sci Rep. 2018;8:1–10.CrossRef
14.
Cheng Q, Yang W, Liu K, Zhao W, Wu L, Lei L, Dong T, Hou N, Yang F, Qu Y, Yang Y. Increased sample entropy in EEGs during the functional rehabilitation of an injured brain. Entropy. 2019;21:698.CrossRefPubMedCentral
15.
de Aguiar Neto FS, Rosa JLG. Depression biomarkers using non-invasive EEG: a review. Neurosci Biobehav Rev. 2019;105:83–93.PubMedCrossRef
16.
Delorme A, Makeig S. EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis. J Neurosci Methods. 2004;134:9–21.PubMedCrossRef
17.
Faust O, Acharya RU, Allen AR, Lin CM. Analysis of EEG signals during epileptic and alcoholic states using AR modeling techniques. Irbm. 2008;29:44–52.CrossRef
18.
First MB, Williams JBW, Karg RS, Spitzer RL. Structured clinical interview for DSM-5: research version. Arlington: American Psychiatric Association; 2015.
19.
George MS, Ketter TA, Post RM. Prefrontal cortex dysfunction in clinical depression. Depression. 2010;2:59–72.CrossRef
20.
Hillhouse TM, Porter JH. A brief history of the development of antidepressant drugs: from monoamines to glutamate. Exp Clin Psychopharmacol. 2015;23:1–21.PubMedPubMedCentralCrossRef
21.
Hlinka J, Alexakis C, Diukova A, Liddle PF, Auer DP. Slow EEG pattern predicts reduced intrinsic functional connectivity in the default mode network: an inter-subject analysis. Neuroimage. 2010;53:239–46.PubMedCrossRef
22.
Hunter AM, Cook IA, Leuchter AF. The promise of the quantitative electroencephalogram as a predictor of antidepressant treatment outcomes in major depressive disorder. Psychiatr Clin North Am. 2007;30:105–24.PubMedCrossRef
23.
Iznak AF, Sorokin SA. Changes in EEG and reaction times during the treatment of apathetic depression. Neurosci Behav Physiol. 2013;43:79–83.CrossRef
24.
Janjarasjitt S, Scher MS, Loparo KA. Nonlinear dynamical analysis of the neonatal EEG time series: the relationship between neurodevelopment and complexity. Clin Neurophysiol. 2008;119:822–36.PubMedCrossRef
25.
Kang JH, Chung YG, Kim SP. An efficient detection of epileptic seizure by differentiation and spectral analysis of electroencephalograms. Comput Biol Med. 2015;66:352–6.PubMedCrossRef
26.
Kas MJ, Penninx B, Sommer B, Serretti A, Arango C, Marston H. A quantitative approach to neuropsychiatry: the why and the how. Neurosci Biobehav Rev. 2019;97:3–9.PubMedCrossRef
27.
Kennedy SH, Andersen HF, Thase ME. Escitalopram in the treatment of major depressive disorder: a meta-analysis. Curr Med Res Opin. 2009;25:161–75.PubMedCrossRef
28.
Knyazev GG. EEG delta oscillations as a correlate of basic homeostatic and motivational processes. Neurosci Biobehav Rev. 2012;36:677–95.PubMedCrossRef
29.
Kostyalik D, Vas S, Katai Z, Kitka T, Gyertyan I, Bagdy G, Tothfalusi L. Chronic escitalopram treatment attenuated the accelerated rapid eye movement sleep transitions after selective rapid eye movement sleep deprivation: a model-based analysis using Markov chains. BMC Neurosci. 2014;15:120.PubMedPubMedCentralCrossRef
30.
Lader M, Andersen HF, Baekdal T. The effect of escitalopram on sleep problems in depressed patients. Hum Psychopharmacol. 2005;20:349–54.PubMedCrossRef
31.
Lanquart J, Nardone P, Hubain P, Loas G, Linkowski P. The dichotomy between low frequency and delta waves in human sleep. J Neurosci Methods. 2018;293:234–46.PubMedCrossRef
32.
Li C, Wang J. Similarity analysis of DNA sequences based on the generalized LZ complexity of (0,1)-sequences. J Math Chem. 2008;43:26–31.CrossRef
33.
Mahato S, Paul S. Electroencephalogram (EEG) signal analysis for diagnosis of major depressive disorder (MDD): a review. In: Nath V, Mandal JK, editors. Lecture notes in electrical engineering. Singapore: Springer Singapore; 2019. p. 323–35.
34.
Maier W, Buller R, Philipp M, Heuser I. The Hamilton anxiety scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord. 1988;14:61–8.PubMedCrossRef
35.
Mikšovský J, Raidl A. Testing for nonlinearity in European climatic time series by the method of surrogate data. Theor Appl Climatol. 2006;83:21–33.CrossRef
36.
Montgomery SA, Baldwin DS, Blier P, Fineberg NA, Kasper S, Lader M, Lam RW, Lepine JP, Moller HJ, Nutt DJ, Rouillon F, Schatzberg AF, Thase ME. Which antidepressants have demonstrated superior efficacy? A review of the evidence. Int Clin Psychopharmacol. 2007;22:323–9.PubMedCrossRef
37.
Nofzinger EA, Price JC, Meltzer CC, Buysse DJ, Villemagne VL, Miewald JM, Sembrat RC, Steppe DA, Kupfer DJ. Towards a neurobiology of dysfunctional arousal in depression: the relationship between beta EEG power and regional cerebral glucose metabolism during NREM sleep. Psychiatry Res. 2000;98:71–91.PubMedCrossRef
38.
Pardey J, Roberts S, Tarassenko L. A review of parametric modelling techniques for EEG analysis. Med Eng Phys. 1996;18:2–11.PubMedCrossRef
39.
Sanchez C, Reines EH, Montgomery SA. A comparative review of escitalopram, paroxetine, and sertraline: are they all alike? Int Clin Psychopharmacol. 2014;29:185–96.PubMedPubMedCentralCrossRef
40.
Santangeli O, Porkka-Heiskanen T, Virkkala J, Castaneda AE, Urrila AS. Sleep and slow-wave activity in depressed adolescent boys: a preliminary study. Sleep Med. 2017;38:24–30.PubMedCrossRef
41.
42.
Stein DJ, Lopez AG. Effects of escitalopram on sleep problems in patients with major depression or generalized anxiety disorder. Adv Ther. 2011;28:1021–37.PubMedCrossRef
43.
Steve MG, Bruce A, Simon H, Simon O, Ian R, Frank S, Brian W, Iain C. Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: systematic review and meta-analysis. Bmj. 2003;326:1014–7.CrossRef
44.
Ulke C, Huang J, Schwabedal JTC, Surova G, Mergl R, Hensch T. Coupling and dynamics of cortical and autonomic signals are linked to central inhibition during the wake-sleep transition. Sci Rep. 2017;7:11804.PubMedPubMedCentralCrossRef
45.
Welch PD. The Fast Fourier Transform and Its Applications by E. Oran Brigham. Education IEEE Transactions on. 1988;12:27–34.
Metadata
Title
Spatio-temporal dynamics of EEG features during sleep in major depressive disorder after treatment with escitalopram: a pilot study
Authors
Li Wu
Xue-Qin Wang
Yong Yang
Teng-Fei Dong
Ling Lei
Qi-Qi Cheng
Su-Xia Li
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02519-x

Other articles of this Issue 1/2020

BMC Psychiatry 1/2020 Go to the issue

Research article

Associated factors of REM sleep without atonia in younger (≤ 50 years) hospitalized psychiatric patients

Research article

Should we increase the focus on diet when considering associations between lifestyle habits and deliberate self-harm?

Research article

Feasibility and outcome of metacognitive therapy for major depressive disorder: a pilot study

Research article

Relationship between Toxoplasma gondii seropositivity and schizophrenia in the Lebanese population: potential implication of genetic polymorphism of MMP-9

Correction

Correction to: Relationship between Toxoplasma gondii seropositivity and schizophrenia in the Lebanese population: potential implication of genetic polymorphism of MMP-9

Research article

Antipsychotic treatment experiences of people with bipolar I disorder: patient perspectives from an online survey