Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Clinical Implication of Loudness Dependence of Auditory Evoked Potential (LDAEP) in Psychiatic Illness

정신질환에서 Loudness Dependence of Auditory Evoked Potential (LDAEP)의 임상적 의미

  • Lee, Seung-Hwan (Department of Psychiatry, Inje University College of Medicine, Ilsan Paik Hospital)
  • 이승환 (인제대학교 의과대학 일산백병원 정신건강의학교실)
  • Received : 2012.01.13
  • Accepted : 2012.02.02
  • Published : 2012.02.29
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Abstract

The loudness dependence of the auditory evoked potential (LDAEP) has been proposed as a valid biomarker of central serotoninergic activity in humans. The specificity and sensitivity of the LDAEP to changes in serotonergic neurotransmission have recently been explored in many studies about pharmacology and genetics. The majority of evidence for an association between the LDAEP and serotonin activity has come from animal studies. Genetic association studies with the LDAEP have provided conflicting reports with additional evidence outlining sensitivity to other neurotransmitter systems including the dopamine and glutamatergic systems. The LDAEP has been revealed to reflect the pathophysiology of various psychiatric illnesses. There is supporting evidence that major psychiatric disorders have differential LDAEP activities. Overall, the LDAEP shows strong evidence as a potential predictor of antidepressant treatment response. It need to be explored whether the LDAEP could be a biological marker of various psychiatric diseases and treatment prediction of antidepressants and serotonin related drugs.

LDAEP와 세로토닌 기능 간의 직접적인 관계의 초기 증거들은 동물 실험으로부터 도출되었고 이후 세로토닌성 장애에 기반한 질병들의 임상 실험을 통하여 간접적인 뒷받침이 이루어 져왔다. 현재까지 LDAEP와 세로토닌 사이의 연관성을 확인해주는 증거는, 우선 세로토닌 시스템 내에서 유전적 polymorphism을 연구하는 것을 통해, 그리고 직접적으로 약물을 투여 하는 방식으로 확보되었다. LDAEP가 연관된 대부분의 연구는 모노아민 시스템에 초점을 맞춰왔으나 LDAEP에 대한 다른 신경전달 시스템의 효과는 거의 알려진 바가 없다. 향후 세로토닌 외에도 도파민, 노르에피네프린, 아세틸콜린 등 다른 신경전달물질과의 연관성에 대한 연구가 필요하다. In vivo 중추 세로토닌 기능의 유효한 비침습적 표지자로서 LDAEP를 확정짓기 전에, 단기적 조절뿐 아니라 장기적 세로토닌성 조절이 포함된 더 많은 연구가 필요하다. 현재까지의 증거로 보면 LDAEP의 가장 유망한 활용은 초기 항우울 치료반응과 관련된 생물학적 지료서의 활용이다. 최근의 연구들은 LDAEP의 노르아드레날린성 그리고 세로토닌성 항우울제 반응에 대한 민감도를 확인했으며 이러한 긍정적인 기초 결과들을 재현하기 위하여 더 많은 연구들이 필요하다.

Keywords

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