Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands; Research Institute Brainclinics, Nijmegen, The Netherlands.
Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Eur Neuropsychopharmacol. 2015 Aug;25(8):1190-200. doi: 10.1016/j.euroneuro.2015.03.007. Epub 2015 Apr 20.
In major depressive disorder (MDD), elevated theta current density in the rostral anterior cingulate (rACC), as estimated by source localization of scalp-recorded electroencenphalogram (EEG), has been associated with response to antidepressant treatments, whereas elevated frontal theta has been linked to non-response. This study used source localization to attempt to integrate these apparently opposite results and test, whether antidepressant response is associated with elevated rACC theta and non-response with elevated frontal theta and whether theta activity is a differential predictor of response to different types of commonly used antidepressants. In the international Study to Predict Optimized Treatment in Depression (iSPOT-D), a multi-center, international, randomized, prospective practical trial, 1008 MDD participants were randomized to escitalopram, sertraline or venlafaxine-XR. The study also recruited 336 healthy controls. Treatment response and remission were established after eight weeks using the 17-item Hamilton Rating Scale for Depression (HRSD17). The resting-state EEG was assessed at baseline with eyes closed and source localization (eLORETA) was employed to extract theta from the rACC and frontal cortex. Patients with MDD had elevated theta in both frontal cortex and rACC, with small effect sizes. High frontal and rACC theta were associated with treatment non-response, but not with non-remission, and this effect was most pronounced in a subgroup with previous treatment failures. Low theta in frontal cortex and rACC are found in responders to antidepressant treatments with a small effect size. Future studies should investigate in more detail the role of previous treatment (failure) in the association between theta and treatment outcome.
在重度抑郁症（MDD）中，通过头皮记录的脑电图（EEG）源定位估计，前扣带皮质（rACC）的theta 电流密度升高与抗抑郁治疗的反应有关，而额叶 theta 升高与无反应有关。这项研究使用源定位试图整合这些明显相反的结果，并测试抗抑郁反应是否与 rACC theta 升高有关，无反应是否与额叶 theta 升高有关，以及 theta 活动是否是对不同类型常用抗抑郁药反应的差异预测指标。在国际预测抑郁症优化治疗研究（iSPOT-D）中，一项多中心、国际、随机、前瞻性实用试验，1008 名 MDD 参与者被随机分为依地普仑、舍曲林或文拉法辛 XR。该研究还招募了 336 名健康对照者。使用 17 项汉密尔顿抑郁量表（HRSD17），在八周后建立治疗反应和缓解。静息状态 EEG 在闭眼时进行评估，并采用源定位（eLORETA）从 rACC 和额叶皮层中提取 theta。MDD 患者的额叶皮层和 rACC 中均存在 theta 升高，效应量较小。高额叶和 rACC theta 与治疗无反应有关，但与无缓解无关，这一效应在以前治疗失败的亚组中最为明显。在抗抑郁药物治疗的反应者中，额叶皮层和 rACC 的 theta 较低，效应量较小。未来的研究应更详细地研究以前治疗（失败）在 theta 与治疗结果之间的关系中的作用。
