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EPA-0973 – Disturbed Regulation of Wakefulness as a Pathogenetic Factor in Affective Disorders and ADHD

Published online by Cambridge University Press:  15 April 2020

U. Hegerl ,
P. Schönknecht ,
T. Hensch ,
S. Olbrich ,
M. Kluge ,
H. Himmerich  and
C. Sander
U. Hegerl
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
P. Schönknecht
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
T. Hensch
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
S. Olbrich
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
M. Kluge
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
H. Himmerich
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
C. Sander
Affiliation:
Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany

Abstract

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Within the vigilance regulation model the hyperactivity and sensation seeking observed in overtired children, ADHD and mania are interpreted as an autoregulatory attempt to stabilize vigilance (central nervous arousal) by increasing external stimulation. Correspondingly the withdrawal and sensation avoidance in major depression is interpreted as a reaction to a state of tonically high vigilance (1, 2). Using an EEG-based algorithm to classify automatically short EEG-segments into different vigilance stages as observed during the transition from active wakefulness to drowsiness and sleep onset (VIGALL), both patients with ADHD and mania show an unstable vigilance regulation with rapid drops to lower vigilance stages under quiet rest. The contrary was found in unmedicated patients with major depression (2). Studies will be presented supporting the validity of VIGALL (simulataneous EEG-fMRI and EEG/FDG-PET studies, as well as the neurophysiological, clinical and predictive validity of the vigilance regulation model of affective disorders. Among the far reaching consequences of the vigilance model is the question whether psychostimulants have similar beneficial effects in mania as observed in ADHD (3), an aspect which is presently studied in an international, randomized controlled trial (4).

Type
S502 - Symposium: The regulation of CNS-arousal and wakefulness in affective disorders and ADHD: relevance for pathogenesis and therapy
Information
European Psychiatry , Volume 29 , Issue S1: Abstracts of the 22nd European Congress of Psychiatry , 2014 , pp. 1
Copyright
Copyright © European Psychiatric Association 2014

References

Hegerl, U & Hensch T 2012, Neurosci Bionehav RevGoogle Scholar
Hegerl, U et al 2011, World J Biol PsychiatGoogle Scholar
Schönknecht, P et al 2011, Biol Psychiatry (in press)Google Scholar
Kluge, M et al 2013, BMC Psychiatry, doi: 10.1186/1471-244X-13-71CrossRefGoogle Scholar
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