Bares Martin, Brunovsky Martin, Kopecek Miloslav, Stopkova Pavla, Novak Tomas, Kozeny Jiri, Höschl Cyril
Prague Psychiatric Centre, Ustavni 91, Prague 8 - Bohnice, 181 03, Czech Republic; 3rd Faculty of Medicine, Charles University, Ruska 87, Prague 10, 100 00, Czech Republic.
J Psychiatr Res. 2007 Apr-Jun;41(3-4):319-25. doi: 10.1016/j.jpsychires.2006.06.005. Epub 2006 Aug 4.
Previous studies of patients with unipolar depression have shown that early decreases of EEG cordance (a new quantitative EEG method) can predict clinical response. We examined whether early QEEG decrease represents a phenomenon associated with response to treatment with different antidepressants in patients with treatment resistant depression.
The subjects were 17 inpatients with treatment resistant depression. EEG data and response to treatment were monitored at baseline and after 1 and 4 weeks on an antidepressant treatment. QEEG cordance was computed at three frontal electrodes in theta frequency band. The prefrontal cordance combines complementary information from absolute and relative power of EEG spectra. Recent studies have shown that cordance correlates with cortical perfusion. Depressive symptoms were assessed using Montgomery-Asberg Depression Rating Scale (MADRS).
All 17 patients completed the 4-week study. All five responders showed decreases in prefrontal cordance after the first week of treatment. Only 2 of the 12 nonresponders showed early prefrontal cordance decrease. The decrease of prefrontal QEEG cordance after week 1 in responders as well as the increase in nonresponders were both statistically significant (p-value 0.03 and 0.01, respectively) and the changes of prefrontal cordance values were different between both groups (p-value 0.001).
Our results suggest that decrease in prefrontal cordance may indicate early changes of prefrontal activity in responders to antidepressants. QEEG cordance may become a useful tool in the prediction of response to antidepressants.
先前对单相抑郁症患者的研究表明，脑电图一致性（一种新的定量脑电图方法）的早期下降可预测临床反应。我们研究了早期定量脑电图下降是否代表难治性抑郁症患者对不同抗抑郁药治疗反应相关的一种现象。
受试者为17名难治性抑郁症住院患者。在抗抑郁药治疗的基线期、1周和4周后监测脑电图数据和治疗反应。在三个额部电极处计算θ频段的定量脑电图一致性。前额叶一致性结合了脑电图频谱绝对功率和相对功率的互补信息。最近的研究表明，一致性与皮质灌注相关。使用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评估抑郁症状。
所有17名患者完成了为期4周的研究。所有5名有反应者在治疗第一周后前额叶一致性均下降。12名无反应者中只有2名早期前额叶一致性下降。有反应者在第1周后前额叶定量脑电图一致性的下降以及无反应者的增加均具有统计学意义（p值分别为0.03和0.01），且两组之间前额叶一致性值的变化不同（p值0.001）。
我们的结果表明，前额叶一致性的下降可能表明抗抑郁药有反应者前额叶活动的早期变化。定量脑电图一致性可能成为预测抗抑郁药反应的有用工具。
