scholarly journals Cortical inhibition, facilitation and plasticity in late-life depression: effects of venlafaxine pharmacotherapy

2020 ◽  
Vol 46 (1) ◽  
pp. E88-E96
Author(s):  
Jennifer I. Lissemore ◽  
Benoit H. Mulsant ◽  
Tarek K. Rajji ◽  
Jordan F. Karp ◽  
Charles F. Reynolds III ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Motor Cortex ◽  
Antidepressant Treatment ◽  
Short Interval ◽  
Late Life ◽  
Cortical Inhibition ◽  
Late Life Depression ◽  
Paired Pulse ◽  
Motor Cortical ◽  
Cortical Physiology

Background: Late-life depression is often associated with non-response or relapse following conventional antidepressant treatment. The pathophysiology of late-life depression likely involves a complex interplay between aging and depression, and may include abnormalities in cortical inhibition and plasticity. However, the extent to which these cortical processes are modifiable by antidepressant pharmacotherapy is unknown. Methods: Sixty-eight patients with late-life depression received 12 weeks of treatment with open-label venlafaxine, a serotonin-norepinephrine reuptake inhibitor (≤ 300 mg/d). We combined transcranial magnetic stimulation of the left motor cortex with electromyography recordings from the right hand to measure cortical inhibition using contralateral cortical silent period and paired-pulse short-interval intracortical inhibition paradigms; cortical facilitation using a paired-pulse intracortical facilitation paradigm; and short-term cortical plasticity using a paired associative stimulation paradigm. All measures were collected at baseline, 1 week into treatment (n = 23) and after approximately 12 weeks of treatment. Results: Venlafaxine did not significantly alter cortical inhibition, facilitation or plasticity after 1 or 12 weeks of treatment. Improvements in depressive symptoms during treatment were not associated with changes in cortical physiology. Limitations: The results presented here are specific to the motor cortex. Future work should investigate whether these findings extend to cortical areas more closely associated with depression, such as the dorsolateral prefrontal cortex. Conclusion: These findings suggest that antidepressant treatment with venlafaxine does not exert meaningful changes in motor cortical inhibition or plasticity in late-life depression. The absence of changes in motor cortical physiology, alongside improvements in depressive symptoms, suggests that age-related changes may play a role in previously identified abnormalities in motor cortical processes in late-life depression, and that venlafaxine treatment does not target these abnormalities.

scholarly journals Mirror illusion reduces motor cortical inhibition in the ipsilateral primary motor cortex during forceful unilateral muscle contractions

2015 ◽  
Vol 113 (7) ◽  
pp. 2262-2270 ◽  
Author(s):  
Tjerk Zult ◽  
Stuart Goodall ◽  
Kevin Thomas ◽  
Tibor Hortobágyi ◽  
Glyn Howatson
Keyword(s):  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Short Interval ◽  
Mirror Image ◽  
Corticospinal Excitability ◽  
Cortical Inhibition ◽  
Electromyographic Activity ◽  
Wrist Flexion ◽  
Motor Cortical ◽  
The Right

Forceful, unilateral contractions modulate corticomotor paths targeting the resting, contralateral hand. However, it is unknown whether mirror-viewing of a slowly moving but forcefully contracting hand would additionally affect these paths. Here we examined corticospinal excitability and short-interval intracortical inhibition (SICI) of the right-ipsilateral primary motor cortex (M1) in healthy young adults under no-mirror and mirror conditions at rest and during right wrist flexion at 60% maximal voluntary contraction (MVC). During the no-mirror conditions neither hand was visible, whereas in the mirror conditions participants looked at the right hand's reflection in the mirror. Corticospinal excitability increased during contractions in the left flexor carpi radialis (FCR) (contraction 0.41 mV vs. rest 0.21 mV) and extensor carpi radialis (ECR) (contraction 0.56 mV vs. rest 0.39 mV), but there was no mirror effect (FCR: P = 0.743, ηp2= 0.005; ECR: P = 0.712, ηp2= 0.005). However, mirror-viewing of the contracting and moving wrist attenuated SICI relative to test pulse in the left FCR by ∼9% compared with the other conditions ( P < 0.05, d ≥ 0.62). Electromyographic activity in the resting left hand prior to stimulation was not affected by the mirror (FCR: P = 0.255, ηp2= 0.049; ECR: P = 0.343, ηp2= 0.035) but increased twofold during contractions. Thus viewing the moving hand in the mirror and not just the mirror image of the nonmoving hand seems to affect motor cortical inhibitory networks in the M1 associated with the mirror image. Future studies should determine whether the use of a mirror could increase interlimb transfer produced by cross-education, especially in patient groups with unilateral orthopedic and neurological conditions.

scholarly journals Health and social care service utilisation and associated expenditure among community-dwelling older adults with depressive symptoms

2021 ◽  
Vol 30 ◽  
Author(s):  
Shiyu Lu ◽  
Tianyin Liu ◽  
Gloria H. Y. Wong ◽  
Dara K. Y. Leung ◽  
Lesley C. Y. Sze ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Symptom Severity ◽  
Social Care ◽  
Late Life ◽  
Community Dwelling ◽  
Service Utilisation ◽  
Late Life Depression ◽  
Social Care Service ◽  
Health And Social Care

Abstract Aims Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. Methods We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. Results The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). Conclusions The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.

P029 Direct evaluation of intra-cortical inhibition and facilitation balance in human motor cortex: an EEG-paired pulse TMS study

2008 ◽  
Vol 119 ◽  
pp. S78
Author(s):  
Florinda Ferreri ◽  
Patrizio Pasqualetti ◽  
David Ponzo ◽  
Sara Maatta ◽  
Fabio Ferrarelli ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Cortical Inhibition ◽  
Direct Evaluation ◽  
Human Motor Cortex ◽  
Paired Pulse ◽  
Human Motor

scholarly journals Cognitive Functioning and Late-Life Depression

2014 ◽  
Vol 20 (5) ◽  
pp. 461-467 ◽  
Author(s):  
Aaron M. Koenig ◽  
Rishi K. Bhalla ◽  
Meryl A. Butters
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Functioning ◽  
Neuropsychological Assessment ◽  
Cognitive Deficits ◽  
Late Life ◽  
Cognitive Outcomes ◽  
Review Of The Literature ◽  
Late Life Depression ◽  
The Relationship

AbstractThis brief report provides an introduction to the topic of cognitive functioning in late-life depression (LLD). In addition to providing a review of the literature, we present a framework for understanding the heterogeneity of cognitive outcomes in this highly prevalent disorder. In addition, we discuss the relationship between LLD and dementia, and highlight the importance of regularly assessing cognitive functioning in older adults who present with depressive symptoms. If cognitive deficits are discovered during a neuropsychological assessment, we recommend referral to a geriatric psychiatrist or cognitive neurologist, for evaluation and treatment of the patient’s symptoms. (JINS, 2014, 20, 1–7)

scholarly journals Systematic examination of low-intensity ultrasound parameters on human motor cortex excitability and behavior

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Anton Fomenko ◽  
Kai-Hsiang Stanley Chen ◽  
Jean-François Nankoo ◽  
James Saravanamuttu ◽  
Yanqiu Wang ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Short Interval ◽  
Motor Evoked Potential ◽  
Cortical Inhibition ◽  
Transcranial Ultrasound ◽  
Human Motor Cortex ◽  
Low Intensity ◽  
Visuomotor Task ◽  
Motor Cortex Excitability ◽  
And Behavior

Low-intensity transcranial ultrasound (TUS) can non-invasively modulate human neural activity. We investigated how different fundamental sonication parameters influence the effects of TUS on the motor cortex (M1) of 16 healthy subjects by probing cortico-cortical excitability and behavior. A low-intensity 500 kHz TUS transducer was coupled to a transcranial magnetic stimulation (TMS) coil. TMS was delivered 10 ms before the end of TUS to the left M1 hotspot of the first dorsal interosseous muscle. Varying acoustic parameters (pulse repetition frequency, duty cycle, and sonication duration) on motor-evoked potential amplitude were examined. Paired-pulse measures of cortical inhibition and facilitation, and performance on a visuomotor task was also assessed. TUS safely suppressed TMS-elicited motor cortical activity, with longer sonication durations and shorter duty cycles when delivered in a blocked paradigm. TUS increased GABAA-mediated short-interval intracortical inhibition and decreased reaction time on visuomotor task but not when controlled with TUS at near-somatosensory threshold intensity.

Culturally adapted and lay-delivered cognitive behaviour therapy for older adults with depressive symptoms in rural China: a pilot trial

2020 ◽  
pp. 1-5
Author(s):  
Jiaqi Yuan ◽  
Yi Yin ◽  
Xinfeng Tang ◽  
Tan Tang ◽  
Qinshu Lian ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Workers ◽  
Pilot Trial ◽  
Depression Scale ◽  
Late Life ◽  
Late Life Depression ◽  
Mixed Effect ◽  
Culturally Adapted ◽  
Cognitive Behaviour

Abstract Background: Late-life depression issues in developing countries are challenging because of understaffing in mental health. Cognitive behavioural therapy (CBT) is effective for treating depression. Aim: This pilot trial examined the adherence and effectiveness of an eight-session adapted CBT delivered by trained lay health workers for older adults with depressive symptoms living in rural areas of China, compared with the usual care. Method: Fifty with screen-positive depression were randomly assigned to the CBT arm or the care as usual (CAU) arm. The primary outcomes were the session completion of older adults and changes in depressive symptoms, assessed using the Geriatric Depression Scale (GDS). Results: The majority (19/24) of participants in the CBT arm completed all sessions. Mixed-effect linear regression showed that the CBT reduced more GDS scores over time compared with CAU. Conclusion: Lay-delivered culturally adapted CBT is potentially effective for screen-positive late-life depression.

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