Pretreatment anterior cingulate activity predicts antidepressant treatment response in major depressive episodes

TY - JOUR

T1 - Pretreatment anterior cingulate activity predicts antidepressant treatment response in major depressive episodes

AU - Rentzsch, Johannes

AU - Adli, Mazda

AU - Wiethoff, Katja

AU - Gómez-Carrillo de Castro, Ana

AU - Gallinat, Jürgen

PY - 2014/4

Y1 - 2014/4

N2 - Major depressive disorder leads to substantial individual and socioeconomic costs. Despite the ongoing efforts to improve the treatment for this condition, a trial-and-error approach until an individually effective treatment is established still dominates clinical practice. Searching for clinically useful treatment response predictors is one of the most promising strategies to change this quandary therapeutic situation. This study evaluated the predictive value of a biological and a clinical predictor, as well as a combination of both. Pretreatment EEGs of 31 patients with a major depressive episode were analyzed with neuroelectric brain imaging technique to assess cerebral oscillations related to treatment response. Early improvement of symptoms served as a clinical predictor. Treatment response was assessed after 4 weeks of antidepressant treatment. Responders showed more slow-frequency power in the right anterior cingulate cortex compared to non-responders. Slow-frequency power in this region was found to predict response with good sensitivity (82 %) and specificity (100 %), while early improvement showed lower accuracy (73 % sensitivity and 65 % specificity). Combining both parameters did not further improve predictive accuracy. Pretreatment activity within the anterior cingulate cortex is related to antidepressive treatment response. Our results support the search for biological treatment response predictors using electric brain activity. This technique is advantageous due to its low individual and socioeconomic burden. The benefits of combining both, a clinically and a biologically based predictor, should be further evaluated using larger sample sizes.

AB - Major depressive disorder leads to substantial individual and socioeconomic costs. Despite the ongoing efforts to improve the treatment for this condition, a trial-and-error approach until an individually effective treatment is established still dominates clinical practice. Searching for clinically useful treatment response predictors is one of the most promising strategies to change this quandary therapeutic situation. This study evaluated the predictive value of a biological and a clinical predictor, as well as a combination of both. Pretreatment EEGs of 31 patients with a major depressive episode were analyzed with neuroelectric brain imaging technique to assess cerebral oscillations related to treatment response. Early improvement of symptoms served as a clinical predictor. Treatment response was assessed after 4 weeks of antidepressant treatment. Responders showed more slow-frequency power in the right anterior cingulate cortex compared to non-responders. Slow-frequency power in this region was found to predict response with good sensitivity (82 %) and specificity (100 %), while early improvement showed lower accuracy (73 % sensitivity and 65 % specificity). Combining both parameters did not further improve predictive accuracy. Pretreatment activity within the anterior cingulate cortex is related to antidepressive treatment response. Our results support the search for biological treatment response predictors using electric brain activity. This technique is advantageous due to its low individual and socioeconomic burden. The benefits of combining both, a clinically and a biologically based predictor, should be further evaluated using larger sample sizes.

KW - Adult

KW - Analysis of Variance

KW - Antidepressive Agents

KW - Association Learning

KW - Case-Control Studies

KW - Depressive Disorder, Major

KW - Female

KW - Gyrus Cinguli

KW - Hippocampus

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Magnetic Resonance Imaging

KW - Male

KW - Memory Disorders

KW - Middle Aged

KW - Oxygen

KW - Predictive Value of Tests

KW - Psychomotor Performance

KW - Reaction Time

KW - Reading

KW - Sensitivity and Specificity

U2 - 10.1007/s00406-013-0424-1

DO - 10.1007/s00406-013-0424-1

M3 - SCORING: Journal article

C2 - 23873091

VL - 264

SP - 213

EP - 223

JO - EUR ARCH PSY CLIN N

JF - EUR ARCH PSY CLIN N

SN - 0940-1334

IS - 3

ER -