Brain Activity Elicited by Negative Stimuli in Males with Recurrent and Bipolar Depression

Aim: To study the characteristics of brain activity in male patients with recurrent and bipolar depression.

Design: This was a comparative controlled non-randomized experimental clinical study.

Materials and Methods: 59 male patients took part in this study before their medication started: 30 with bipolar and 29 with unipolar (recurrent) depression. Control group consisted of 27 healthy male volunteers. All investigated persons were aged 20 to 59 years. The participants had to sort photos of people and animals, of which 80 were neutral images and 80 showed angry/aggressive people or animals. Simple patterns (cues) were displayed two seconds prior to the pictures, and their relationship was not explained. A 128-channel EEG was recorded and brain responses were analyzed in 0–700 ms from cue onset. Differences between the neutral and emotional conditions (emotional modulation, EM) were statistically evaluated.

Results: All components in this study (P100, N170/VPP, P200, P380, and LPC/LPP) in various degrees showed EM dependent on the group and on the type of threatening stimuli. Topography of EM for N170/VPP in all groups and both types of stimuli was quite similar. None of the components unambiguously distinguished between the controls and nosographically different depressions.

Conclusion: Our results show that in the study of affective disorders and the search for markers for diagnosis, it is necessary not only to take into account the gender of patients, but also to use various cognitive tasks when recording EEG, and also to consider a set of neurophysiological parameters.

1. Perris C. A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. Introduction. Acta Psychiatr. Scand. Suppl. 1966;194:9–14.

2. Angst J. On the etiology and nosology of endogenous depressive psychoses. A genetic, sociologic, and clinical study. Monogr. Gesamtgeb. Neurol. Psychiatr. 1966;112:1–118.

3. Han K.M., De Berardis D., Fornaro M., Kim Y.K. Differentiating between bipolar and unipolar depression in functional and structural MRI studies. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2019;91:20– 27. DOI: 10.1016/j.pnpbp.2018.03.022

4. Liu C., Pu W., Wu G. et al. Abnormal resting-state cerebral-limbic functional connectivity in bipolar depression and unipolar depression. BMC Neurosci. 2019;20(1):30. DOI: 10.1186/s12868-019-0508-6

5. Shao J., Dai Z., Zhu R. et al. Early identification of bipolar from unipolar depression before manic episode: Evidence from dynamic rfMRI. Bipolar Disord. 2019;21(8):774–784. DOI: 10.1111/bdi.12819

6. Siegel-Ramsay J.E., Bertocci M.A., Wu B. et al. Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review. Bipolar Disord. 2022;24(5):474–498. DOI: 10.1111/bdi.13176

7. Zhang A., Qiao D., Wang Y. et al. Distinguishing between bipolar depression and unipolar depression based on the reward circuit activities and clinical characteristics: a machine learning analysis. J. Affect. Disord. 2023;327:46–53. DOI: 10.1016/j.jad.2023.01.080

8. Jiang H., Dai Z., Lu Q., Yao Z. Magnetoencephalography resting-state spectral fingerprints distinguish bipolar depression and unipolar depression. Bipolar Disord. 2020;22(6):612–620. DOI: 10.1111/bdi.12871

9. Feuerriegel D., Churches O., Hofmann J., Keage H.A.D. The N170 and face perception in psychiatric and neurological disorders: A systematic review. Clin. Neurophysiol. 2015;126(6):1141–1158. DOI: 10.1016/j.clinph.2014.09.015

10. Zhong B.L., Xu Y.M., Xie W.X., Li Y. Can P300 aid in the differential diagnosis of unipolar disorder versus bipolar disorder depression? A meta-analysis of comparative studies. J. Affect. Disord. 2019;245:219–227. DOI: 10.1016/j.jad.2018.11.010

11. Wada M., Kurose S., Miyazaki T. et al. The P300 event-related potential in bipolar disorder: a systematic review and metaanalysis. J. Affect. Disord. 2019;256:234–249. DOI: 10.1016/j.jad.2019.06.010

12. MacNamara A., Joyner K., Klawohn J. Event-related potential studies of emotion regulation: A review of recent progress and future directions. Int. J. Psychophysiol. 2022;176:73–88. DOI: 10.1016/j.ijpsycho.2022.03.008

13. McNally R.J. Attentional bias for threat: crisis or opportunity? Clin. Psychol. Rev. 2019;69:4–13. DOI: 10.1016/j.cpr.2018.05.005

14. Gupta R.S., Kujawa A., Vago D.R. The Neural Chronometry of Threat-Related Attentional Bias: Event-Related Potential (ERP) Evidence for Early and Late Stages of Selective Attentional Processing. Int. J. Psychophysiol. 2019;146:20–42. DOI: 10.1016/j.biopsycho.2007.11.006

15. Schindler S., Bublatzky F. Attention and emotion: An integrative review of emotional face processing as a function of attention. Cortex. 2020;130:362–386. DOI: 10.1016/j.cortex.2020.06.010

16. Lu J., Kemmerer S.K., Riecke L., de Gelder B. Early threat perception is independent of later cognitive and behavioral control. A virtual reality-EEG-ECG study. Cereb. Cortex. 2023;33(13):8748–8758. DOI: 10.1093/cercor/bhad156

17. Stolz C., Endres D., Mueller E.M. Threat-conditioned contexts modulate the late positive potential to faces — a mobile EEG/virtual reality study. Psychophysiology. 2019;56(4):e13308. DOI: 10.1111/psyp.13308

18. Mnatsakanyan E.V., Kryukov V.V., Krasnov V.N. Modulation of evoked brain responses to biologically and socially important stimuli in women with recurrent depression. Doctor.Ru. 2021;20(9):48–53. (in Russian). DOI: 10.31550/1727-2378-2021-20-9-48-53

19. Sakaki M., Niki K., Mather M. Beyond arousal and valence: The importance of the biological versus social relevance of emotional stimuli. Cogn. Affect Behav. Neurosci. 2012;12:115–139. DOI: 10.3758/s13415-011-0062-x

20. Mnatsakanian E.V., Krjukov V.V., Krasnov V.N. Gender-related differences in emotional modulation of visual brain responses in patients with recurrent depression. Doctor.Ru. 2020;19(9):77–82. (in Russian). DOI: 10.31550/1727-2378-2020-19-9-77-82

21. Mnatsakanian E.V., Kryukov V.V., Zharkova A.S., Krasnov V.N. Differences in modulation of brain responses to emotional stimuli in men and women with bipolar depression. Doctor.Ru. 2022;21(8):72–77. (in Russian). DOI: 10.31550/1727-2378-2022-21-8-72-77

22. Zigmond A.S., Snaith R.P. The Hospital Anxiety and Depression scale. Acta Psychiatr. Scand. 1983;67:361–370.

23. Hamilton M. Development of a rating scale for primery depressive illness. Br. J. Soc. Clin. Psychol. 1967;6(4):278–296. DOI: 10.1111/ j.2044-8260.1967.tb00530.x

24. Hamilton M. Standardizedassessment and recording of depressive symptoms. Psychiatr. Neural Neurochi. 1969;72:201–205.

25. Hamilton M. The assessment of anxiety states by rating. Br. J. Med. Psychol. 1959;32(1):50–52. DOI: 10.1111/j.2044-8341.1959.tb00467.x

26. Bedwell J.S., Spencer C.C., Chan C.C. et al. The P1 visual-evoked potential, red light, and transdiagnostic psychiatric symptoms. Brain Res. 2018;1687:144–154. DOI: 10.1016/j.brainres.2018.03.002

27. Hinojosa J.A., Mercado F., Carretiе L. N170 sensitivity to facial expression: a meta-analysis. Neurosci. Biobehav. Rev. 2015;55:498– 509. DOI: 10.1016/j.neubiorev.2015.06.002

28. Yang Y.F., Brunet-Gouet E., Burca M. et al. Brain processes while struggling with evidence accumulation during facial emotion recognition: an ERP study. Front. Hum Neurosci. 2020;14:340. DOI: 10.3389/fnhum.2020.00340

29. Barry R.J., Steiner G.Z., De Blasio F.M. et al. Components in the P300: don't forget the Novelty P3! Psychophysiology. 2020;57(7):e13371. DOI: 10.1111/psyp.13371

30. Hajcak G., Foti D. Significance?... Significance! Empirical, methodological, and theoretical connections between the late positive potential and P300 as neural responses to stimulus significance: an integrative review. Psychophysiology. 2020;57(5):e13570. DOI: 10.1111/psyp.13570