HORMONAL, SYNDROMAL AND EEG MAPPING STUDIES IN MENOPAUSAL SYNDROME PATIENTS WITH AND WITHOUT DEPRESSION AS COMPARED WITH CONTROLS

The aim of the study was to investigate brain function in menopausal d epression by EEG mapping, as compared with menopausal syndrome patient s without depression and normal controls, and to correlate neurophysio logical with clinical and hormonal findings in order to elucidate the pathogenesis of depression in the menopause. Methods: One hundred and twenty-nine menopausal women, aged 45-60 years, with no previous hormo nal replacement therapy were investigated in regard to hormones (estra diol [E(2)], follicle stimulating hormone [FSH]), clinical symptomatol ogy (Kupperman Index [KI], Hamilton depression score [HAMD]) and brain function (EEG mapping). Based on KI and DSM-III-R research criteria f or major depression, 3 groups were available for statistics (after rem oval of protocol violators): group A had a KI of <15 and no depression (n = 29); group B had a KI of greater than or equal to 15 and no depr ession (n = 29) and group C had a KI of greater than or equal to 15 an d fulfilled the criteria for major depression (n = 60). Results: EEG m aps of depressed patients demonstrated less total power and absolute p ower in the delta, theta and beta band, more relative delta and less a lpha power as well as a slower delta/theta and faster alpha and beta c entroid than controls, suggesting a vigilance decrement. Group B did n ot differ from group A. Correlation maps showed significant relationsh ips between estradiol levels and EEG measures (the lower the E(2), the worse the vigilance) and between the EEG measures and the Hamilton de pression (HAMD) score (the worse the vigilance, the higher the depress ion score). There were no correlations between the hormones E(2) and F SH and the syndromes KI and HAMD. In the target variable, the asymmetr y index, depressed patients showed less alpha power over the right tha n left frontal lobe, whereas normal controls exhibited the opposite. G roup B did not differ from group A. The frontal asymmetry index was si gnificantly correlated with the Hamilton depression score and suggests right frontal hyper- and left frontal hypoactivation in depression. C onclusions: Although hormonal findings are not directly linked to psyc hic changes, low estradiol levels do contribute to a decreased vigilan ce at the neurophysiological level, which is in turn correlated with h igher depressive and menopausal symptomatology at the behavioural leve l. Depression is furthermore correlated to a right frontal hyper- and left frontal hypoactivation.