The Effects of Major Depressive Disorder on the Sequential

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The Effects of Major Depressive Disorder on the Sequential brain sciences Article The Effects of Major Depressive Disorder on the Sequential Organization of Information Processing Stages: An Event-Related Potential Study Daniel Kwasi Ahorsu 1 , Ken Chung 1, Ho Hon Wong 2, Michael Gar Chung Yiu 2, Yat Fung Mok 1, Ka Shun Lei 1 and Hector Wing Hong Tsang 1,* 1 Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China; [email protected] (D.K.A.); [email protected] (K.C.); [email protected] (Y.F.M.); [email protected] (K.S.L.) 2 Yung Fung Shee Psychiatric Center, Department of Psychiatry of United Christian Hospital, The Hong Kong Hospital Authority, Hong Kong SAR, China; [email protected] (H.H.W.); [email protected] (M.G.C.Y.) * Correspondence: [email protected]; Tel.: +852-2766-6750 Received: 23 October 2020; Accepted: 1 December 2020; Published: 4 December 2020 Abstract: The adverse effects of depression on patients’ life have been reported but information about its effects on the sequential organization of the information processing stages remains poorly understood as previous studies focused only on distinct stages. This study adds to existing knowledge by examining the effect of major depressive disorder (MDD) on the sequential organization of information processing, executive and community functioning. Fifty-seven participants with 19 participants each for first episode depression (FMDD), recurrent episodes depression (RMDD), and healthy controls (HCs) participated in this study. They completed assessments on executive and community functioning measures, and choice reaction time task (CRTT) for the event-related potential (ERP) data. Findings revealed no significant between-group difference in executive functioning but participants with depression (FMDD and RMDD) were found to be more depressed, with FMDD participants having worse community functioning skills compared with HCs. There was no significant between-group main effect on behavioral data. ERP data showed significantly less positive-going P3b among RMDD participants compared with HCs. FMDD participants used a different information processing strategy at P1, while HCs and RMDD participants used a different processing strategy at N2b compared with the other group(s), respectively. The results suggest the use of multifaceted assessment to get a holistic view of the health status of people with MDD in order to inform clinicians on the appropriate interventional strategies needed for the patient. Keywords: major depressive disorder; information processing; executive function; community function; event-related potential; choice reaction time task; cognitive-energetical linear stage model; parallel model; linear model 1. Introduction Depression, especially major depressive disorder (MDD), has been reported to affect all facets of a patient’s life, particularly cognitive processes and functions. More specifically, perception, attention, inhibition, executive function, and memory were reported to be compromised [1–4]. It is also well documented in behavioral studies that MDD patients suffer impaired decision making or response choices during tasks which may be attributed to their inability to perform or psychomotor retardation [5,6]. Psychomotor retardation, a major symptom of depression, is associated with general slowness and poor performance [7] which can be separated from the effect of arousal or sleepiness [8–11]. Despite these findings, the effect of depression along information processing stages [12,13] remains poorly understood, Brain Sci. 2020, 10, 935; doi:10.3390/brainsci10120935 www.mdpi.com/journal/brainsci Brain Sci. 2020, 10, x FOR PEER REVIEW 2 of 19 Braingeneral Sci. 2020 slowness, 10, 935 and poor performance [7] which can be separated from the effect of arousal2 of 18or sleepiness [8–11]. Despite these findings, the effect of depression along information processing stages [12,13] remains poorly understood, especially retardation. This information, however, is very useful especiallyfor the formulation retardation. of This more information, targeted and however, personalized is very treatment useful for for the people formulation with depression. of more targeted and personalizedThe information treatment processing for people model with (IPM) depression. enables a better understanding of how signals are transformedThe information and transferred processing through model (IPM)various enables stages ainto better a understandingfinal response. ofSanders’ how signals cognitive are - transformedenergetical andlinear transferred stage model through forms various the stagesoverall into theoretical a final response. basis of Sanders’ this study cognitive-energetical (for an extensive linearreview, stage see Sanders model forms[12,13] the). This overall model theoretical has a three basis-tier mechanism of this study that (for accommodates an extensive the review, merger seebetween Sanders behavioral [12,13]). and This electrophysiological model has a three-tier (event-related mechanism potential; that ERP) accommodates data (see Figure the merger1 for the betweenIPM—enhanced). behavioral Following and electrophysiological this, ERP’s amplitude (event-related is linked potential; to the ERP)energetical data (see mechanisms Figure1 for of the the IPM—enhanced).model, while ERP’s Following latency is this, linked ERP’s to computational amplitude is linked processing to the stages energetical which mechanismsare time-based. of theERP model,is a well while-established ERP’s latency method is linked for examining to computational cognition processing [14,15] and stages for this which reason are time-based.its data may ERPfurther is aenhance well-established our understanding method for of examining information cognition processing [14, 15according] and for to this Sanders’ reason model. its data Of may much further more enhanceinterest ourto this understanding study is the of computational information processing processing according stages of to the Sanders’ Sanders’ model. cognitive Of much-energetical more interestlinear stage to this model study. Two is the additional computational models, processing the linear and stages the ofparallel, the Sanders’ are further cognitive-energetical used to explain the linearoperations stage model.of the computational Two additional processing models, the stages. linear The and linear the parallel, (also called are furtherdiscrete used or serial) to explain stage themodel operations posits that of the information computational moves processing serially from stages. one stage The linearto another (also with called only discrete one stage or serial) being stageactive model at a positstime. The that parallel information (also moves called seriallyoverlapping, from one continuous, stage to anotheror cascade) with stage only onemodel, stage in beingcontrary, active postulates at a time. there The could parallel be parallel (also called processing overlapping, of information continuous, among or the cascade) stages stageinferred model, from inan contrary, interaction postulates between there the mani couldpulated be parallel variables processing of the stages of information (see Sanders among [12,13] the). stages inferred from an interaction between the manipulated variables of the stages (see Sanders [12,13]). FigureFigure 1. 1.A A hypothetical hypothetical information information processing processing model model (h-IPM). (h-IPM). This This model model is is adapted adapted from from Sanders’ Sanders’ (1983)(1983) cognitive-energetical cognitive-energetical model model but but it it has has been been modified modified to to include include event-related event-related potential potential (ERP) (ERP) componentscomponents (of (of visual-relatedvisual-related tasks) based based on on several several reviews, reviews, especially especially from from Luck Luck (2014) (2014) [14], [Luck14], Luckand andKappenman Kappenman (2012) (2012) [15], and [15], Woodman and Woodman (2010) (2010) [16]. This [16]. proposed This proposed model modelexplores explores and explains and explainswhy and why where and where there theremay maybe challenges be challenges in inprocessing processing informa informationtion using using a novelnovelinvestigation investigation technique that combines the behavioral and electrophysiological methodologies (perspectives) [14–16]. technique that combines the behavioral and electrophysiological methodologies (perspectives) [14– S: Stimulus, R: Response. *P1: Literature review on this component’s exact stage location is vague. 16]. S: Stimulus, R: Response. *P1: Literature review on this component’s exact stage location is vague. A common factor that underlies these two information processing models (i.e., the linear and A common factor that underlies these two information processing models (i.e., the linear and the parallel) is time (e.g., reaction time and latency). The models use defined task characteristics the parallel) is time (e.g., reaction time and latency). The models use defined task characteristics that that modify the time needed to execute the elementary operation of each stage. The stability and modify the time needed to execute the elementary operation of each stage. The stability and functionality of each information processing stage can, therefore, be tested by manipulating certain functionality of each information processing stage can, therefore, be tested by manipulating certain variables that are believed to affect a particular stage [13]. Furthermore,
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