Neurobiological Processing of Emotions in Major Depression
Status:
Recruiting
Trial end date:
2020-04-30
Target enrollment:
Participant gender:
Summary
Depression is a severe challenge to mental health systems worldwide, and has significant
neurobiological consequences involving structural, functional and molecular alterations in
several areas of the brain. Both drugs and psychotherapy have positive effects by acting
through different mechanisms. Recent studies have highlighted the potential benefit to
customize depression treatments upon neurobiological basis. This is crucial in the context of
depression, because many patients do not respond adequately to treatments, with substantial
individual, social and economic costs. Personalized therapy aims at identifying which
individual characteristics predict the outcome of a specific treatment in order to get a
better match between the individual and treatment received.
The aims of this project are 1) to compare the neurobiological effects of two different
therapeutic interventions Eye Movement Desensitization and Reprocessing (EMDR) and
Anti-Depressant Medication (ADM) on emotion processing in adult patients with Major
Depressive Disorder (MDD). Simultaneous fMRI and High Density-MR compatible EEG (hd-EEG)
recording during administration of images expressing different emotions (sadness, anger,
fear, joy, or neutral images) will be performed in order to investigate specific potential of
each treatment; 2) to evaluate the effects of EMDR and ADM by simultaneous hd-EEG/fMRI
measurements in resting state before and after treatments, in order to investigate specific
diagnostic potential of both single modalities and inter-modality correlation (as a measure
of time- and space-resolved functional connectivity); 3) to compare the efficacy of different
interventions on clinical symptoms, as assessed by psychological questionnaires, and their
correlation with neurobiological changes.
The study is designed as a randomized controlled clinical trial. Forty MDD patients will be
recruited and randomized in the two treatment conditions: (EMDR or ADM). Clinical and
neurobiological assessments will be performed at baseline (T0), after treatment (T1) and 6
months after the end of the treatment (T2).
The results of this project will help to improve the efficacy and effectiveness of the
treatment of the high-costly population of patients with depression. It is expected that
assessing specific effects of two different treatments for depression could also advance our
knowledge about the identification of which treatment could be more useful for a specific
patient.