Major depressive disorder in adolescents (MDD) is a substantial public health problem. Existing treatments are often ineffective and do not target relevant neurobiological markers. It has been hypothesized that neurobiological mechanism underlying depression involves a dysfunction of the excitatory/inhibitory neurotransmitters. Here, the neurochemical profile from the occipital lobe of twenty adolescents with MDD and twenty-four age-matched healthy volunteers (HV) were acquired at 7 T. Larger SDs were observed for some metabolites in MDD versus HV and suggest heterogeneity of depression severity in the MDD cohort. Positive correlation in MDD between aspartate and GABA could be indicative of a neurotransmitter imbalance.
The cortical silent period (CSP) and long-interval intracortical inhibition (LICI) are putative markers of γ-aminobutyric acid receptor type B (GABAB)-mediated inhibitory neurotransmission. We aimed to assess the association between LICI and CSP in youths.We analyzed data from three previous studies of youth who underwent CSP and LICI measurements with transcranial magnetic stimulation and electromyography. We assessed CSP and LICI association using Spearman rank correlation tests and multiple linear regression analyses adjusted for demographic and clinical covariates.The sample included 16 healthy participants and 45 participants with depression. The general mean (SD) age was 15.5 (1.7), 14.3 (1.7) for healthy participants, and 15.9 (1.6) years for participants with depression. Measures were nonnormally distributed (Shapiro-Wilk, p < 0.001). CSP and LICI were not correlated at 100-millisecond (ρ = -0.2421, p = 0.06), 150-millisecond (ρ = -0.1612, p = 0.21), or 200-millisecond (ρ = -0.0507, p = 0.70) interstimulus intervals using Spearman rank correlation test. No correlations were found in the multiple regression analysis (p = 0.35).Although previous studies suggest that cortical silent period and long-interval intracortical inhibition measure GABAB receptor-mediated activity, these biomarkers were not associated in our sample of youths. Future studies should focus on the specific physiologic and pharmacodynamic properties assessed by CSP and LICI in younger populations.
Abstract Background Suicide is a leading cause of death in adolescents worldwide. Previous research findings suggest that suicidal adolescents with depression have pathophysiological dorsolateral prefrontal cortex (DLPFC) deficits in γ-aminobutyric acid neurotransmission. Interventions with transcranial magnetic stimulation (TMS) directly address these underlying pathophysiological deficits in the prefrontal cortex. Theta burst stimulation (TBS) is newer dosing approach for TMS. Accelerated TBS (aTBS) involves administering multiple sessions of TMS daily as this dosing may be more efficient, tolerable, and rapid acting than standard TMS. Methods: This is a randomized, double-blind, sham-controlled trial of sequential bilateral aTBS in adolescents with MDD and suicidal ideation. Three sessions are administered daily for 10 days. During each session, continuous TBS is administered first to the right DPFC, in which 1,800 pulses are delivered continuously over 120 seconds. Then intermittent TBS is applied to the left DPFC, in which 1,800 pulses are delivered in 2-second bursts and repeated every 10 seconds for 570 seconds. The TBS parameters were adopted from prior research, with 3-pulse, 50-Hz bursts given every 200 ms (at 5 Hz) with an intensity of 80% active motor threshold. The comparison group will receive 3 daily sessions of bilateral sham TBS treatment for 10 days. All participants will receive the standard of care for patients with depression and suicidal ideation including daily psychotherapeutic skill sessions. Long-interval intracortical inhibition (LICI) biomarkers will be measured before and after treatment. Exploratory measures will be collected with TMS and electroencephalography for biomarker development. Discussion This is the first known randomized controlled trial to examine the efficacy of sequential bilateral aTBS for treating suicidal ideation in adolescents with MDD. Results from this study will also provide opportunities to further understand the neurophysiological and molecular mechanisms of suicidal ideation in adolescents. Trial registration Investigational device exemption (IDE) Number: G200220, ClinicalTrials.gov (ID: NCT04701840 ). Registered August 6, 2020. https://clinicaltrials.gov/ct2/show/NCT04502758?term=NCT04701840&draw=2&rank=1
Abstract Introduction Invasive neuromodulation interventions such as deep brain stimulation (DBS) and vagal nerve stimulation (VNS) are important treatments for movement disorders and epilepsy, but literature focused on young patients treated with DBS and VNS is limited. This retrospective study aimed to examine naturalistic outcomes of VNS and DBS treatment of epilepsy and dystonia in children, adolescents, and young adults. Methods We retrospectively assessed patient demographic and outcome data that were obtained from electronic health records. Two researchers used the Clinical Global Impression scale to retrospectively rate the severity of neurologic and psychiatric symptoms before and after patients underwent surgery to implant DBS electrodes or a VNS device. Descriptive and inferential statistics were used to examine clinical effects. Results Data from 73 patients were evaluated. Neurologic symptoms improved for patients treated with DBS and VNS ( p < .001). Patients treated with DBS did not have a change in psychiatric symptoms, whereas psychiatric symptoms worsened for patients treated with VNS ( p = .008). The frequency of postoperative complications did not differ between VNS and DBS groups. Conclusion Young patients may have distinct vulnerabilities for increased psychiatric symptoms during treatment with invasive neuromodulation. Child and adolescent psychiatrists should consider a more proactive approach and greater engagement with DBS and VNS teams that treat younger patients.
We sought to understand the common interaction between music, information and visual art. The evoked affect of college students (N = 47, F = 35, M = 11, NB = 1) were measured via The Implicit Positive and Negative Affect Test (IPANAT) after a presentation of Francisco Goya's Black Paintings. There were three randomly assigned groups with a narration about the artist's life and the significance of his paintings (group N), classical music (group M) and both (group NM). Participant's art knowledge was also assessed, as determined by the Vienna Art Interest and Art Knowledge Questionnaire (VAIAK). Group NM reported significantly lower affect scores, indicating more intense emotional experiences as opposed to other two groups (N = 47, F(2)= 4.099, p = .023). The knowledge and interest scores had no effect on the affect score. The implications of the findings and potential explanations are discussed through the lens of different models of art perception.
