The Neurophysiological Substrate of the Decision-Making Process in Depressed Patients

Silvia Gomes Laurentino,Everton Botelho Sougey,Sandra Lopes De Souza

doi:10.4236/ojd.2020.93005

Silvia Gomes Laurentino, Everton Botelho Sougey + Show 1 more

Open Access

https://doi.org/10.4236/ojd.2020.93005

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Abstract

Background: The neural circuits involved in the decision-making process and social emotion participate in the same circuits seen in major depressive disorder. This study aimed to investigate in depressed patients, the decision making process in risk/reward situations using neurophysiological methods for a better assessment of functional aspects related to decision making deficit that are seen in major depression. Methods: Forty patients were studied, 20 with depression and 20 without. After applied the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and Hamilton Depression scale (HAM-D), the Iowa Gambling Task (IGT) was applied to analyze the risk/ reward decision-making behavior. The Skin Conductance Response (SCR) was recorded to analyze the emotional anticipatory learning effect during the IGT. Besides, an EEG was recorded to measure the Frontal Alpha Asymmetry Index (FAAI). Results: Depressed patients presented a lower Net score and a deficit in anticipatory learning effect in the IGT. Furthermore, the FAAI revealed more frontal right activation as have described in previous studies. Conclusion: Patients with major depression have a dysfunction in the circuits that modulate cognitive, emotional and social behavior, and also, impairment in cognitive fluidity for evaluating strategies for risk-reward. The EEG helps to confirm that asymmetry in frontal areas and oscillation of alpha frequencies participate in the regulation of emotion in depressed patients.

Highlights

Depressive disorders affect around a fifth of the world population at some time in their lives (Barger, Messerli-Burgy, & Barth, 2014; Gavin et al, 2010) and, it may seriously impair the performance of everyday and work-related activities (Barger et al, 2014; Cusi, Nazarov, Holshausen, Macqueen, & McKinnon, 2012)
The neural circuits involved in the decision-making process and social emotion participate in the same circuits seen in major depressive disorder
This study aimed to investigate in depressed patients, the decision making process in risk/reward situations using neurophysiological methods for a better assessment of functional aspects related to decision making deficit that are seen in major depression

Summary

Introduction

Depressive disorders affect around a fifth of the world population at some time in their lives (Barger, Messerli-Burgy, & Barth, 2014; Gavin et al, 2010) and, it may seriously impair the performance of everyday and work-related activities (Barger et al, 2014; Cusi, Nazarov, Holshausen, Macqueen, & McKinnon, 2012). The neuro-anatomical substrate involved in the decision-making process (analysis in situations of certainty, cost-benefit analysis in situations of uncertainty) may have various routes in common with those found in neurocircuit dysfunctions observed in depressed individuals (Fellows & Farah, 2007; Harle et al, 2010; Holmes & Pizzagalli, 2008; Radford et al, 1991; Takahashi et al, 2008). The EEG helps to confirm that asymmetry in frontal areas and oscillation of alpha frequencies participate in the regulation of emotion in depressed patients

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