The Dynamic Relationship Between Alpha and Beta Power and Next-Day Suicidal Ideation in Individuals With Treatment-Resistant Depression

Ballard, Elizabeth D.; Greenstein, Deanna; Duncan, W. Raymond; Hejazi, Nadia; Gerner, Jessica; Zarate, Carlos A.

doi:10.1016/j.bpsgos.2021.07.003

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…Previous work by our group demonstrated that nocturnal wakefulness was associated with next-day suicidal thoughts [ 20 ] and that responders to ketamine with suicidal ideation (SI) demonstrated decreased nocturnal wakefulness the night after ketamine administration compared to ketamine responders without SI [ 21 ]. More recently, our group demonstrated that oscillations in overnight beta power were associated with next day SI, supporting a relationship between the sleep-related arousal process and suicide risk [ 22 ]. Despite the evidence supporting ketamine’s therapeutic effects on sleep physiology, depression, and SI, the impact of ketamine on sleep-arousal markers remains undefined; this includes temporally-dependent oscillations in arousal-related frequency bands such as alpha and beta as well as macroarchitecture measures of arousal such as sleep efficiency or time spent awake after sleep onset.…”

Section: Introductionmentioning

confidence: 90%

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

Ballard,

Greenstein,

Reiss

et al. 2024

Transl Psychiatry

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The glutamatergic modulator ketamine is associated with changes in sleep, depression, and suicidal ideation (SI). This study sought to evaluate differences in arousal-related sleep metrics between 36 individuals with treatment-resistant major depression (TRD) and 25 healthy volunteers (HVs). It also sought to determine whether ketamine normalizes arousal in individuals with TRD and whether ketamine’s effects on arousal mediate its antidepressant and anti-SI effects. This was a secondary analysis of a biomarker-focused, randomized, double-blind, crossover trial of ketamine (0.5 mg/kg) compared to saline placebo. Polysomnography (PSG) studies were conducted one day before and one day after ketamine/placebo infusions. Sleep arousal was measured using spectral power functions over time including alpha (quiet wakefulness), beta (alert wakefulness), and delta (deep sleep) power, as well as macroarchitecture variables, including wakefulness after sleep onset (WASO), total sleep time (TST), rapid eye movement (REM) latency, and Post-Sleep Onset Sleep Efficiency (PSOSE). At baseline, diagnostic differences in sleep macroarchitecture included lower TST (p = 0.006) and shorter REM latency (p = 0.04) in the TRD versus HV group. Ketamine’s temporal dynamic effects (relative to placebo) in TRD included increased delta power earlier in the night and increased alpha and delta power later in the night. However, there were no significant diagnostic differences in temporal patterns of alpha, beta, or delta power, no ketamine effects on sleep macroarchitecture arousal metrics, and no mediation effects of sleep variables on ketamine’s antidepressant or anti-SI effects. These results highlight the role of sleep-related variables as part of the systemic neurobiological changes initiated after ketamine administration. Clinical Trials Identifier: NCT00088699.

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Section: Introductionmentioning

confidence: 90%

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

Ballard,

Greenstein,

Reiss

et al. 2024

Transl Psychiatry

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Alpha oscillation mediates the interaction between suicide risk and symptom severity in Major Depressive Disorder

Zhang,

Liu,

et al. 2024

Front. Neurosci.

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ObjectiveThe aim of our study was to explore the relationship between changes in neural oscillatory power in the EEG, the severity of depressive-anxiety symptoms, and the risk of suicide in MDD.Methods350 MDD patients’ demographic and clinical data were collected, and their depressive and anxious symptoms were evaluated using HDRS-17 and HAMA-14, along with a suicide risk assessment using the Nurses’ Global Assessment of Suicide Risk (NGASR). EEG data were captured, processed, and analyzed to study brain activity patterns related to MDD. The participants were divided based on suicide risk levels, and statistical analyses, including chi-square, t-tests, Pearson’s correlations were used to explore the associations between brain activity, symptom severity, and suicide risk. Closely related variables were identified and ultimately the optimal model was screened using stepwise regression analysis with a forward strategy, and mediation effects were further used to determine the possible interactions between the variables in the regression model.ResultsThe regression model showed a significant effect of HDRS-17 and alpha power of Medial Occipital Cortex (MOC) on suicide risk, with elevated HDRS-17 increasing suicide risk and elevated alpha power decreasing suicide risk. Mediation effect analyses showed that MOC alpha power partially mediated the effect of depression level on suicide risk, and that an increase in depression severity may lead to a decrease in MOC alpha power, while a decrease in MOC alpha power may lead to an increase in suicide risk.ConclusionThe severity of depression directly increases suicide risk, whereas higher alpha power in the MOC serves as a protective factor, reducing this risk. Notably, MOC alpha power not only directly impacts suicide risk but also mediates the effects of both depression severity and anxiety levels on this risk.LimitationsThe relatively small sample size of this study may limit the representativeness of the overall MDD patient population and the detailed analysis of different subgroups. This study did not delve into the relationship between the severity of cognitive symptoms in MDD patients and suicide risk.

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The Dynamic Relationship Between Alpha and Beta Power and Next-Day Suicidal Ideation in Individuals With Treatment-Resistant Depression

Cited by 2 publications

References 39 publications

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

Alpha oscillation mediates the interaction between suicide risk and symptom severity in Major Depressive Disorder

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