抗抑郁治疗反应指数作为重度抑郁症中瑞波西汀治疗结果的预测指标。
The Antidepressant Treatment Response Index as a Predictor of Reboxetine Treatment Outcome in Major Depressive Disorder.
作者信息
Caudill Marissa M, Hunter Aimee M, Cook Ian A, Leuchter Andrew F
机构信息
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
出版信息
Clin EEG Neurosci. 2015 Oct;46(4):277-84. doi: 10.1177/1550059414532443. Epub 2014 Sep 24.
Biomarkers to predict clinical outcomes early during the treatment of major depressive disorder (MDD) could reduce suffering and improve outcomes. A quantitative electroencephalogram (qEEG) biomarker, the Antidepressant Treatment Response (ATR) index, has been associated with outcomes of treatment with selective serotonin reuptake inhibitor antidepressants in patients with MDD. Here, we report the results of a post hoc analysis initiated to evaluate whether the ATR index may also be associated with reboxetine treatment outcome, given that its putative mechanism of action is via norepinephrine reuptake inhibition (NRI). Twenty-five adults with MDD underwent qEEG studies during open-label treatment with reboxetine at doses of 8 to 10 mg daily for 8 weeks. The ATR index calculated after 1 week of reboxetine treatment was significantly associated with overall Hamilton Depression Rating Scale (HAM-D) improvement at week 8 (r=0.605, P=.001), even after controlling for baseline depression severity (P=.002). The ATR index predicted response (≥50% reduction in HAM-D) with 70.6% sensitivity and 87.5% specificity, and remission (final HAM-D≤7) with 87.5% sensitivity and 64.7% specificity. These results suggest that the ATR index may be a useful biomarker of clinical response during NRI treatment of adults with MDD. Future studies are warranted to investigate further the potential utility of the ATR index as a predictor of noradrenergic antidepressant treatment response.
在重度抑郁症（MDD）治疗早期预测临床结局的生物标志物可以减轻痛苦并改善治疗效果。一种定量脑电图（qEEG）生物标志物，即抗抑郁治疗反应（ATR）指数，已与MDD患者使用选择性5-羟色胺再摄取抑制剂抗抑郁药的治疗效果相关。在此，我们报告一项事后分析的结果，该分析旨在评估ATR指数是否也可能与瑞波西汀治疗效果相关，因为其假定的作用机制是通过去甲肾上腺素再摄取抑制（NRI）。25名患有MDD的成年人在接受瑞波西汀开放标签治疗期间进行了qEEG研究，剂量为每日8至10毫克，持续8周。即使在控制了基线抑郁严重程度后（P = 0.002），瑞波西汀治疗1周后计算出的ATR指数与第8周时汉密尔顿抑郁量表（HAM-D）的总体改善显著相关（r = 0.605，P = 0.001）。ATR指数预测反应（HAM-D降低≥50%）的敏感性为70.6%，特异性为87.5%，预测缓解（最终HAM-D≤7）的敏感性为87.5%，特异性为64.7%。这些结果表明，ATR指数可能是NRI治疗成年MDD患者临床反应的有用生物标志物。有必要进行进一步研究，以进一步探讨ATR指数作为去甲肾上腺素能抗抑郁治疗反应预测指标的潜在效用。
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