Symptoms of Limbic Irritability and Chaotic Activity in the Autonomic Nervous System during Cognitive Conflict in the Patients with Unipolar Depression: a New Perspective for Anticonvulsant Treatment?
P. Bob; M. Šusta; A. Procházková-Večeřová; J. Pavlát; J. Raboch
Centrum pro neuropsychiatrický výzkum traumatického stresu, Praha
; Psychiatrická klinika 1. LF UK a VFN, Praha
přednosta prof. MUDr. J. Raboch, DrSc.
Čes. a slov. Psychiat., 103, 2007, No. 2, pp. 68-72.
Modern findings in neuroscience suggest that cognitive conflict is related to specific nonlinear chaotic changes of the signal generated by neural systems. According to recent findings, activation of anterior cingulate cortex (ACC) is related to detecting cognitive conflict. This conflict-related activation elicits autonomic responses which can be assessed by psychophysiological measures such as heart rate variability calculated as beat to beat R-R intervals (RRI). The present study used Stroop test as an experimental approach to psychophysiological study of cognitive conflict in 40 patients with unipolar depression. In this experimental approach RRI measurement, psychometric measurement of limbic irritability (LSCL-33), depression (BDI-II) and calculation of largest Lyapunov exponents in nonlinear data analysis of RRI time series were performed. Significant correlation coefficient of r=0.60 between largest Lyapunov exponents and LSCL-33 found in this study indicate that a defect of neural inhibition during conflicting Stroop task is closely related to limbic irritability. Since limbic irritability is probably closely related to epileptiform abnormalities in the temporo-limbic structures, this result might represent a useful instrument for indication of anticonvulsant treatment in depressive patients who are resistant to antidepressant medication.
depression, stress, limbic irritability, HRV, Lyapunov exponent, chaos, anticonvulsants.