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All-night electroencephalographic sleep and cranial computed tomography in depression

A study of unipolar and bipolar patients

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Summary

All-night electroencephalographic (EEG) sleep recording and cranial computed tomography were performed in 24 inpatients with major depression (14 unipolar, 10 bipolar). The patients showed the characteristic “depression-like” EEG sleep alterations and their ventricular brain ratio (VBR) was increased compared with the control subjects. No major differences were found between the unipolar and the bipolar groups. There was a close and positive association between the VBR values and several measures of slow wave sleep. It is hypothesized that this relationship is due to an altered function of the limbic-hypothalamic-pituitary-adrenocortical axis in depression that affects both EEG sleep and brain morphology.

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References

  • Andreasen NC, Swayze V, Flaum M, Alliger R, Cohen G (1990) Ventricular abnormalities in affective disorder: clinical and demographic correlates. Am J Psychiatry 147:893–900

    Google Scholar 

  • Bardeleben von U, Lauer C, Wiedemann K, Holsboer F (1988) Nocturnal sleep-endocrine effects of cortisol infusions in normal controls. Neuroendocrine Lett 10:227

    Google Scholar 

  • Baron SA, Jacobs L, Kinkel WR (1976) Changes in size of normal lateral ventricles during aging determined by computerized tomography. Neurology 26:1011–1013

    Google Scholar 

  • Baxter LR, Phelps ME, Mazziotta JC, Schwartz JM, Gerner RH, Selin CE, Sumida RM (1985) Cerebral metabolic rates for glucose in mood disorders studied with positron emission tomography with FDG. Arch Gen Psychiatry 42:441–447

    Google Scholar 

  • Beersma DGM, Van den Hoofdakker RH (1992) Can Non-REM sleep be depressogenic? J Affect Disord 24:101–108

    Google Scholar 

  • Bentson J, Reza M, Winter J, Wilson G (1978) Steroids and apparent cerebral atrophy on computed tomography scans. J Comp Assist Tomogr 2:16–23

    Google Scholar 

  • Borbély AA (1987) The S-deficiency hypothesis of depression and the two-process model of sleep regulation. Pharmacopsychiatry 20:23–29

    Google Scholar 

  • Borbély AA, Tobler I, Kupfer DJ, Ulrich RF, Grochocinski V, Doman J, Matthews G (1984) All-night spectral analysis of the EEG in untreated depressives and normal controls. Psychiatry Res 12:27–35

    Google Scholar 

  • Born J, Spaeth-Schwalbe E, Schwakenhofer H, Kern W, Fehm HL (1989) Influence of corticotropin-releasing hormone, adrenocorticotropin, and cortisol on sleep in normal man. J Clin Endocrinol Metab 68:904–911

    Google Scholar 

  • Bossche van den B, Brussaard C, Schotte C, Cosyns P, De Moor J, De Schepper A (1991) Computed tomography of the brain in unipolar depression. J Affect Disord 21:67–74

    Google Scholar 

  • Buchsbaum MR, Wu J, DeLisi LE, Holcomb H, Kessler R, Johnson J, King AC, Hazlett E, Langston K, Post RM (1986) Frontal cortex and basal ganglia metabolic rates assessed by positron emission tomography with [18F]2-deoxyglucose in affective illness. J Affect Disord 10:137–152

    Google Scholar 

  • Cummings JL (1992) Depression and Parkinson's disease: a review. Am J Psychiatry 149:443–454

    Google Scholar 

  • Dewan MJ, Haldipur CV, Lane EE, Ispahani A, Boucher MF, Major LF (1988) Bipolar affective disorder: I. Comprehensive quantitative computed tomography. Acta Psychiatr Scand 77:670–676

    Google Scholar 

  • Dolan RJ, Calloway SP, Mann AH (1985) Cerebral ventricular size in depressed subjects. Psychol Med 15:873–878

    Google Scholar 

  • Duncan WC, Pettigrew KD, Gillin JC (1979) REM architecture changes in bipolar and unipolar depression. Am. J Psychiatry 136:1424–1427

    Google Scholar 

  • Feinberg M, Gillin JC, Carroll BJ, Greden JF, Zis AP (1982) EEG studies of sleep in the diagnosis of depression. Biol Psychiatry 17:305–316

    Google Scholar 

  • Giles DE, Rush AJ, Roffwarg HP (1986) Sleep parameters in bipolar I, bipolar II, and unipolar depressions. Biol Psychiatry 21:1340–1343

    Google Scholar 

  • Giles DE, Jarrett RB, Roffwarg HP, Rush AJ (1987) Reduced rapid eye movement latency: a predictor of re-occurrence in depression. Neuropsychopharmacology 1:33–39

    Google Scholar 

  • Gillin JC, Duncan WC, Murphy DL, Post RM, Wehr TA, Goodwin FK, Wyatt RJ, Bunney WE (1981) Age-related changes in sleep in depression and normal subjects. Psychiatry Res 4:73–78

    Google Scholar 

  • Gillin JC, Sitaram N, Wehr T, Duncan W, Post R, Murphy DL, Mendelson WB, Wyatt RJ, Bunney WE (1984) Sleep and affective illness. In: Post RM and Ballenger JC (eds) Neurobiology of Mood Disorder. Williams and Wilkins, Baltimore, MD, pp 157–189

    Google Scholar 

  • Hiller W, von Zerssen D, Mombour W, Wittchen HU (1986) Inpatients Multidimensional Psychiatric Scale. Eine multidimensionale Skala zur Erfassung des psychopathologischen Befundes (German Version). Beltz, Weinheim

    Google Scholar 

  • Holsboer F (1992) The hypothalamo-pituitary-adrenocortical system. In: Paykel ES (ed) Handbook of Affective Disorders. Churchill, Livingstone, UK, in press

    Google Scholar 

  • Holsboer F, von Bardeleben U, Steiger A (1988) Effects of intravenous corticotropin-releasing hormone upon sleep-related growth hormone surge and sleep EEG in man. Neuroendocrinology 48:32–38

    Google Scholar 

  • Iacono WG, Smith GM, Moreau M, Beiser M, Fleming JAE, Lin T, Flak B (1988) Ventricular and sulcal size at the onset of psychosis. Am J Psychiatry 145:820–824

    Google Scholar 

  • Ishibashi M, Nakazawa Y, Yokoyama T, Koga Y, Miyahara Y, Hayashida N, Ohse K (1987) Cerebral atrophy and slow wave sleep of abstinent chronic alcoholics. Drug Alcohol Depend 19:325–332

    Google Scholar 

  • Jernajczyk W (1986) Latency of eye movement and other REM sleep parameters in bipolar depression. Biol Psychiatry 21:465–472

    Google Scholar 

  • Jeste DV, Lohr JB, Goodwin FK (1988), Neuroantomical studies of major affective disorder: a review and suggestions for further research. Br J Psychiatry 153:444–459

    Google Scholar 

  • Jones BE (1989) Basic mechanisms of sleep-wake cycle. In: Kryger MH, Roth T, Dement WC (eds) Principles and Practice of Sleep Medicine. Saunders, Philadelphia, pp 121–138

    Google Scholar 

  • Kammen van DP, Mann LS, Sternberg DE, Scheinin M, Ninan PT, Marder SR, van Kammen W, Rieder RO, Linnoila M (1983) Dopamine-B-hydroxylase activity and homovanillic acid in spinal fluid of schizophrenics with brain atrophy. Science 220:974–977

    Google Scholar 

  • Kammen van DP, van Kammen WB, Peters J, Goetz K, Neyland T (1988) Decreased slow-wave sleep and enlarged ventricles in schizophrenia. Neuropsychopharmacology 1:265–271

    Google Scholar 

  • Kellner CH, Rubinow DR, Gold PW, Post RM (1983) Relationship of cortisol hypersecretion to brain CT scan alterations in depressed patients. Psychiatry Res 8:191–197

    Google Scholar 

  • Kerkhofs M, Kempenaers C., Linkowski P, de Maertelaer V, Mendlewicz J (1988) Multivariate study of sleep EEG in depression. Acta Psychiatr Scand 77:463–468

    Google Scholar 

  • Keshavan MS, Reynolds CF, Ganguli R, Brar J, Houck P (1991) Electroencephalographic sleep and cerebral morphology in functional psychoses. A preliminary study with computed tomography. Psychiatry Res 39:293–301

    Google Scholar 

  • Klein HE (1982) Forschungs-Diagnose Kriterien (RDC). Beltz, Weinheim

    Google Scholar 

  • Knowles JB, MacLean AW (1990) Age-related changes in sleep in depressed and healthy subjects: a meta-analysis. Neuropsychopharmacology 3:251–260

    Google Scholar 

  • Knowles JB, Cairns J, MacLean AW, Delva N, Prowse A, Waldron J, Letemendia FJ (1986) The sleep of remitted bipolar depressives: comparison with sex and age-matched controls. Can J Psychiatry 31:295–299

    Google Scholar 

  • Koella WA (1967) Sleep: Its nature and physiological organization. Thomas, Springfield, IL.

    Google Scholar 

  • Krieg JC, Lauer C, Pirke KM (1989) Structural brain abnormalities in patients with bulimia nervosa. Psychiatry Res 27:39–48

    Google Scholar 

  • Krieg JC, Pirke KM, Lauer CJ, Backmund H (1988) Endocrine, metabolic, and cranial computed tomographic findings in anorexia nervosa. Biol Psychiatry 23:377–387

    Google Scholar 

  • Lauer CJ, Krieg JC (1992a) Sleep electroencephalographic patterns and cranial computed tomography in anxiety disorders. Compr Psychiatry 33:213–219

    Google Scholar 

  • Lauer CJ, Krieg JC (1992b) Weight gain and all-night EEG sleep in anorexia nervosa. Biol Psychiatry 31:622–625

    Google Scholar 

  • Lauer CJ, Pollmächer T (1992) On the issue of drug washout prior to polysomnographic studies in depressed patients. Neuropsychopharmacology 6:11–16

    Google Scholar 

  • Lauer C, Schreiber W, Berger M, Pirke KM, Holsboer F, Krieg JC (1989) The effect of neuroendocrine secretion on brain morphology and EEG sleep in patients with eating disorders. Eur Arch Psychiatry Neurosci 238:208–212

    Google Scholar 

  • Lauer CJ, Riemann D, Wiegand M, Berger M (1991) From early to late adulthood: changes in EEG sleep of depressed patients and healthy volunteers. Biol Psychiatry 29:979–993

    Google Scholar 

  • Luchins DJ, Levine RJ, Meltzer HY (1984) Lateral ventricular size, psychopathology and medication response in the psychoses. Biol Psychiatry 19:29–44

    Google Scholar 

  • Maertelaer de V, Hoffmann G, Lemaiere M, Mendlewicz J (1987) Sleep spindle activity changes in patients with affective disorder. Sleep 10:443–451

    Google Scholar 

  • McDonald WM, Krishnan KRR (1992) Magnetic resonance changes in affective illness. Eur Arch Psychiatry Clin Neurosci 241:283–290

    Google Scholar 

  • McGinty DJ (1985) Physiological equilibrium and the control of sleep states. In: McGinty DJ (ed) Brain Mechanisms of Sleep. Raven Press, New York, pp 361–384

    Google Scholar 

  • McNamara ME (1991) Psychological factors affecting neurological conditions: depression and stroke, multiple sclerosis, Parkinson's disease, and epilepsy. Psychosomatics 32:255–267

    Google Scholar 

  • Meltzer HY, Tong C, Luchins DJ (1984) Serum dopamine betahydroxylase activity and lateral ventricular size in affective disorders and schizophrenia. Biol Psychiatry 19:1395–1402

    Google Scholar 

  • Mendelson WB, Sack DA, James SP, Martin JV, Wagner R, Garnett D, Milton J, Wehr TA (1987) Frequency analysis of the sleep EEG in depression. Psychiatry Res 21:89–94

    Google Scholar 

  • Momose KJ, Kjellberg RN, Kliman B (1971) High incidence of cortical atrophy of the cerebral and cerebellar hemispheres in Cushing's disease. Radiology 99:341–348

    Google Scholar 

  • Nasrallah HA, McCalley-Whitters M, Jacoby CG (1982) Cerebral ventricular enlargement in young manic males. J Affect Disord 4:15–19

    Google Scholar 

  • Okuno T, Ito M, Konishi Y, Yoshicka M, Nakano Y (1980) Cerebral atrophy following ACTH therapy. J Comput Assist Tomogr 4:20–23

    Google Scholar 

  • Parkes JD (1985) Sleep and its Disorders, Saunders, London

    Google Scholar 

  • Pearlson GD, Garbacz DJ, Tompkins RH, Ahn HS, Guttermann DF, Veroff AE, De Paulo JR (1984) Clinical correlates of lateral ventricular enlargement in bipolar affective disorder. Am J Psychiatry 141:153–256

    Google Scholar 

  • Peters J, van Kammen DP, van Kammen WB, Neylan T (1990) Sleep disturbance and computerized axial tomographic scan findings in former prisoners of war. Compr Psychiatry 31:535–539

    Google Scholar 

  • Rechtschaffen A, Kales A (eds) (1968) A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects. Department of Health, Education, and Welfare, Washington, DC

    Google Scholar 

  • Reynolds CF, Kupfer DJ(1987) Sleep research in affective illness: state of the art circa 1987. Sleep 10:199–215

    Google Scholar 

  • Riemann D, Berger M (1989) EEG sleep in depression and in remission and the REM sleep response to the cholinergic agonist RS86. Neuropsychopharmacology 2:145–152

    Google Scholar 

  • Rossi AP, Stratta P, Petruzzi C, De Donatis M, Nistico R, Casachia M (1987) A computerized tomographic study in DSM-III affective disorders. J Affect Disord 12:259–262

    Google Scholar 

  • Rothschild AJ, Langlais PJ, Schatzberg AF, Walsh FX, Cole JO, Bird ED (1984) Dexamethasone increases plasma free dopamine in man. J Psychiatry Res 3:217–223

    Google Scholar 

  • Rothschild AJ, Benes F, Hebben N, Woods BW, Luciana M, Bakanas E, Samson JA, Schatzberg AF (1989) Relationships between brain CT scan findings and cortisol in psychotic and nonpsychotic depressed patients. Biol Psychiatry 26:565–575

    Google Scholar 

  • Roy-Byrne PP, Post RM, Kellner CH, Joffe RT, Uhde TW (1988) Ventricular brain ratio and life course of illness in patients with affective disorder. Psychiatry Res 23:277–284

    Google Scholar 

  • Rush AJ, Erman MK, Giles DE, Schlesser MA, Carpender G, Vasavada N, Roffwarg HP (1986) Polysomnographic findings in recently drug-free and clinically remitted depressed patients. Arch Gen Psychiatry 43:878–884

    Google Scholar 

  • Schlegel S, Kretzschmar K (1987) Computed tomography in affective disorders: Part I: Ventricular and sulcal measurements. Biol Psychiatry 22:4–14

    Google Scholar 

  • Schlegel S, Maier W, Philipp M, Aldenhoff JB, Heuser I, Kretzschmar K, Benkert O (1989a) CT in depression: associations between ventricular size and psychopathology. Psychiatry Res 29:221–230

    Google Scholar 

  • Schlegel S, von Bardeleben U, Wiedemann K, Frommberger U, Holsboer F (1989b) Computerized brain tomography measures compared with spontaneous and suppressed plasma cortisol levels in major depression. Psychoneuroendocrinology 14:209–216

    Google Scholar 

  • Schmauss C, Krieg JC (1987) Enlargement of cerebrospinal fluid spaces in long-term benzodiazepine abusers. Psychol Med 17:869–873

    Google Scholar 

  • Scott ML, Golden CJ, Ruedrich SL, Bishop RJ (1983) Ventricular enlargement in major depression. Psychiatry Res 8:91–93

    Google Scholar 

  • Shima S, Shikano T, Kitamura T, Masuda Y, Tsukumo T, Kanba S, Asai M (1984) Depression and ventricular enlargement. Acta Psychiatr Scand 70:275–277

    Google Scholar 

  • Steiger A, von Bardeleben U, Herth T, Holsboer F (1989) Sleep-EEG and nocturnal secretion of cortisol and human growth hormone in male patients with endogenous depression before treatment and after recovery. J Affective Disord 16:189–195

    Google Scholar 

  • Targum SD, Rosen LN, DeLisi LE, Weinberger DR, Critin CM (1983) Cerebral ventricular size in major depressive disorder: association with delusional symptoms. Biol Psychiatry 18:329–333

    Google Scholar 

  • Thase ME, Himmelhoch JM, Mallinger AG, Jarrett DB, Kupfer DJ (1989) Sleep EEG and DST findings in anergic bipolar depression. Am. J Psychiatry 146:329–333

    Google Scholar 

  • Wiegand M, Möller AA, Schreiber W, Lauer C, Krieg JC (1991a) Brain morphology and sleep EEG in patients with Huntington's disease. Eur Arch Psychiatry Clin Neurosci 240:148–152

    Google Scholar 

  • Wiegand M, Möller AA, Schreiber W, Krieg JC, Fuchs D, Wachter H, Holsboer F (1991b) Nocturnal sleep in patients with HIV infection. Eur Arch Psychiatry Clin Neurosci 240:153–158

    Google Scholar 

  • Wittchen HU, Schramm E, Zaudig M, Spengler P, Rummler R, Mombour W (1990) Strukturiertes Klinisches Interview für DSM-III-R. Beltz, Weinheim

    Google Scholar 

  • Zatz LM, Jernigan TL, Ahumada AJ (1982) Changes on computed cranial tomography with aging: intracranial fluid volume. Am J Neuroradiol 3:1–11

    Google Scholar 

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Lauer, C.J., Wiegand, M. & Krieg, JC. All-night electroencephalographic sleep and cranial computed tomography in depression. Eur Arch Psychiatry Clin Nuerosci 242, 59–68 (1992). https://doi.org/10.1007/BF02191547

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