State-independent and -dependent behavioral and neuroelectrophysiological characteristics during dynamic decision-making in patients with current and remitted depression

Xinyuan Kong; Panwen Zhang; Fan Xiao; Shulin Fang; Xinlei Ji; Xiaosheng Wang; Pan Lin; Huanhuan Li; Shuqiao Yao; Xiang Wang

doi:10.1016/j.jad.2022.04.120

State-independent and -dependent behavioral and neuroelectrophysiological characteristics during dynamic decision-making in patients with current and remitted depression

J Affect Disord. 2022 Jul 15:309:85-94. doi: 10.1016/j.jad.2022.04.120. Epub 2022 Apr 25.

Authors

Xinyuan Kong¹, Panwen Zhang², Fan Xiao¹, Shulin Fang¹, Xinlei Ji¹, Xiaosheng Wang³, Pan Lin⁴, Huanhuan Li⁵, Shuqiao Yao¹, Xiang Wang⁶

Affiliations

¹ Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China.
² Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Shanghai Songjiang Jiuting Middle School, Shanghai, China.
³ Department of Human Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, China.
⁴ Department of Psychology and Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, Hunan 410081, China.
⁵ Department of Psychology, Renmin University of China, Beijing 100872, China.
⁶ Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha 410011, China. Electronic address: wangxiang0916@csu.edu.cn.

PMID: 35472481
DOI: 10.1016/j.jad.2022.04.120

Abstract

Background: It is unclear whether the altered decision-making (DM) observed in patients with major depressive disorder (MDD) is neurophysiological and whether it improves with remission of depressive symptoms. The aim of this study was to identify developmental patterns of DM behavior, related cognitive characteristics, and electrophysiological abnormalities in patients with MDD across clinical stages.

Methods: A sample of 48 first-episode MDD patients (FD group), 41 remitted MDD patients (RD group), and 43 healthy controls (HCs) completed psychometric assessments and performed the balloon analogue risk task (BART) while event-related potentials (ERPs) were recorded.

Results: The RD group had lower depressiveness, self-blame, rumination, and catastrophizing tendencies, and higher mental resilience scores than the FD group, but retained significant differences from HCs. MDD patients showed a more conservative DM strategy than HCs, with no significant difference between the FD and RD groups. Compared to the FD group, the RD group had a smaller FRN for negative feedback and a trend toward a smaller P3 for positive feedback. Compared with HCs, the RD group had a smaller P3 during the positive feedback phase. FRN amplitude correlated positively with depression level and negatively with mental resilience.

Limitations: Because a comparative cross-section design was employed, longitudinal studies are needed to make causal inferences.

Conclusion: MDD patients presented a stable risk-avoidance bias in actively depressed and remission periods, consistent with a state-independent impairment pattern. Significantly reduced FRN amplitudes during remission indicated a state-dependent impairment pattern, and FRN amplitudes correlated with depression level. An abnormal feedback P3 component may be a state-independent characteristic that may become more pronounced with MDD progression.

Keywords: Cognitive deficit; Decision making; Event-related potential; Major depressive disorder; State-dependent; State-independent.

Publication types

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

MeSH terms

Depression
Depressive Disorder, Major* / diagnosis
Evoked Potentials
Humans