Abstract
Background: Recent studies have demonstrated that the assessment of postural performance may be a potentially reliable and objective marker of the psychomotor retardation (PMR) in the major depressive disorder (MDD). One of the important facets of MDD-related PMR is reflected in disrupted central mechanisms of psychomotor control, heavily influenced by compelling maladaptive depressive rumination. In view of this we designed a research paradigm that included sequential execution of simple single-posture task followed by more challenging divided attention posture tasks, involving concurring motor and ideomotor workloads. Another difficulty dimension assumed executing of all the tasks with eyes open (EO) (easy) and closed (EC) (difficult) conditions. We aimed at investigating the interplay between the severity of MDD, depressive rumination, and efficiency of postural performance.Methods: Compared with 24 age- and body mass index-matched healthy controls (HCs), 26 patients with MDD sequentially executed three experimental tasks: (1) single-posture task of maintaining a quiet stance (ST), (2) actual posture-motor dual task (AMT); and (3) mental/imaginary posture-motor dual task (MMT). All the tasks were performed in the EO and the EC conditions. The primary dependent variable was the amount of kinetic energy (E) expended for the center of pressure deviations (CoPDs), whereas the absolute divided attention cost index showed energy cost to the dual-tasking vs. the single-posture task according to the formula: ΔE = (EDual-task - ESingle-task).Results: The signs of PMR in the MDD group were objectively indexed by deficient posture control in the EC condition along with overall slowness of fine motor and ideomotor activity. Another important and probably more challenging feature of the findings was that the posture deficit manifested in the ST condition was substantially and significantly attenuated in the MMT and AMT performance dual-tasking activity. A multiple linear regression analysis evidenced further that the dual-tasking energy cost (i.e., ΔE) significantly predicted clinical scores of severity of MDD and depressive rumination.Conclusion: The findings allow to suggest that execution of concurrent actual or imaginary fine motor task with closed visual input deallocates attentional resources from compelling maladaptive depressive rumination thereby attenuating severity of absolute dual-tasking energy costs for balance maintenance in patients with MDD.Significance: Quantitative assessment of PMR through measures of the postural performance in dual-tasking may be useful to capture the negative impact of past depressive episodes, optimize the personalized treatment selection, and improve the understanding of the pathophysiological mechanisms underlying MDD.
Highlights
Psychomotor retardation (PMR) reflects one of the central dimensions of major depressive disorder (MDD)
We suggested that execution of the actual or even imaginary concurrent motor task would deallocate attentional resource from compelling depressive rumination, thereby attenuating the amount of dual-tasking absolute E costs in patients with MDD. (3) The third idea was to estimate predictive value of absolute E dual-tasking costs with respect to clinical scores of severity of depression and rumination
actual-timed finger motor tasks (AMTs) and mental motor task (MMT) Fluency Data Individual scores of the motor fluency in dual-tasking paradigms were subjected to a three-way ANOVA [2 (Group: healthy control (HC) vs. MDD) × 2 (Vision: eyes open (EO) vs. EC) × 2 (Task: AMT vs. MMT)]
Summary
Psychomotor retardation (PMR) reflects one of the central dimensions of major depressive disorder (MDD). Combination of different experimental techniques for measuring PMR with conventional clinical assessments by subjective observer-rated scales or by single items in specific depression rating scales could offer an increased understanding of PMR in depression In this respect, a more quantitative assessment of PMR through objective measures may be useful to capture the negative impact of past depressive episodes, optimize the personalized treatment selection, and improve the understanding of the pathophysiological mechanisms underlying different depressive subtypes of depression (Bennabi et al, 2013; Wallace et al, 2013; Liberg and Rahm, 2015; Thomas-Ollivier et al, 2017). One of the important facets of MDD-related PMR is reflected in disrupted central mechanisms of psychomotor control, heavily influenced by compelling maladaptive depressive rumination In view of this we designed a research paradigm that included sequential execution of simple singleposture task followed by more challenging divided attention posture tasks, involving concurring motor and ideomotor workloads. We aimed at investigating the interplay between the severity of MDD, depressive rumination, and efficiency of postural performance
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