Electroencephalogram patterns in patients comorbid with major depressive disorder and anxiety symptoms: Proposing a hypothesis based on hypercortical arousal and not frontal or parietal alpha asymmetry

I-Mei Lin; Ting-Chun Chen; Hsin-Yi Lin; San-Yu Wang; Jia-Li Sung; Chen-Wen Yen

doi:10.1016/j.jad.2021.01.001

Electroencephalogram patterns in patients comorbid with major depressive disorder and anxiety symptoms: Proposing a hypothesis based on hypercortical arousal and not frontal or parietal alpha asymmetry

J Affect Disord. 2021 Mar 1:282:945-952. doi: 10.1016/j.jad.2021.01.001. Epub 2021 Jan 6.

Authors

I-Mei Lin¹, Ting-Chun Chen², Hsin-Yi Lin³, San-Yu Wang⁴, Jia-Li Sung⁵, Chen-Wen Yen⁶

Affiliations

¹ Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan; Pervasive Artificial Intelligence Research (PAIR) Labs, Taiwan. Electronic address: psyiml@kmu.edu.tw.
² Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan; Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan.
³ Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan; Department of Clinical Psychology, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
⁴ Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan.
⁵ Department of Mechanical and Electromechanical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan.
⁶ Department of Mechanical and Electromechanical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan; Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: cmurobot@gmail.com.

PMID: 33601739
DOI: 10.1016/j.jad.2021.01.001

Abstract

Background: Major depressive disorder (MDD) is often comorbid with anxiety disorders or symptoms. Brain hyperactivity, frontal alpha asymmetry (FAA), and parietal alpha asymmetry (PAA) have been considered as trait markers in patients with MDD. This study investigated the electroencephalogram (EEG) patterns among patients with MDD comorbid with anxiety symptoms.

Methods: One hundred and thirty-five patients with MDD comorbid with anxiety (MDD group) and 135 healthy controls (HC group) were analyzed. The Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) were completed, and 19 EEG channels were measured during the resting state, depressive recall and recovery tasks, and happiness recall and recovery tasks. FAA and PAA were computed by log (F4 alpha)-log (F3 alpha) and log (P4 alpha)-log (P3 alpha).

Results: The FAA and PAA indices between the two groups showed no significant differences; however, compared with the HC group, the MDD group had lower total delta and theta values, and higher total beta, low beta, and high beta values in the resting state. The total beta value positively correlated with the BDI-II and BAI scores in the MDD group.

Limitations: Most patients had anxious MDD and taking prescriptions, antidepressants or benzodiazepine may affect EEG patterns.

Conclusion: Compared with HCs, patients with MDD comorbid with anxiety had a higher beta activity in the entire brain region, supporting the role of brain hyperactivity, instead of FAA or PAA, as a trait marker in these patients. A neurofeedback protocol could be developed in future based on the brain hyperactivity findings.

Keywords: Anxiety symptoms; Brain hyperactivity; Electroencephalogram; Frontal alpha asymmetry; Major depressive disorders; Parietal alpha asymmetry.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / epidemiology
Anxiety Disorders / epidemiology
Arousal
Depressive Disorder, Major* / epidemiology
Electroencephalography
Humans