van Dinteren Rik, Arns Martijn, Kenemans Leon, Jongsma Marijtje L A, Kessels Roy P C, Fitzgerald Paul, Fallahpour Kamran, Debattista Charles, Gordon Evian, Williams Leanne M
Donders Institute for Brain Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands; Research Institute Brainclinics, Nijmegen, The Netherlands.
Research Institute Brainclinics, Nijmegen, The Netherlands; Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands.
Eur Neuropsychopharmacol. 2015 Nov;25(11):1981-90. doi: 10.1016/j.euroneuro.2015.07.022. Epub 2015 Aug 6.
It is essential to improve antidepressant treatment of major depressive disorder (MDD) and one way this could be achieved is by reducing the number of treatment steps by employing biomarkers that can predict treatment outcome. This study investigated differences between MDD patients and healthy controls in the P3 and N1 component from the event-related potential (ERP) generated in a standard two-tone oddball paradigm. Furthermore, the P3 and N1 are investigated as predictors for treatment outcome to three different 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. P3 and N1 latencies and amplitudes were analyzed using a peak-picking approach and further replicated by using exact low resolution tomography (eLORETA). A reduced P3 was found in MDD patients compared to controls by a peak-picking analysis. This was validated in a temporal global field power analysis. Source density analysis revealed that the difference in cortical activity originated from the posterior cingulate and parahippocampal gyrus. Male non-responders to venlafaxine-XR had significantly smaller N1 amplitudes than responders. This was demonstrated by both analytical methods. Male non-responders to venlafaxine-XR had less activity originating from the left insular cortex. The observed results are discussed from a neural network viewpoint.
改善重度抑郁症(MDD)的抗抑郁治疗至关重要,实现这一目标的一种方法是通过使用能够预测治疗结果的生物标志物来减少治疗步骤。本研究调查了在标准双音oddball范式中产生的事件相关电位(ERP)的P3和N1成分中,MDD患者与健康对照之间的差异。此外,还研究了P3和N1作为三种不同抗抑郁药治疗结果预测指标的情况。在国际抑郁症优化治疗预测研究(iSPOT-D)——一项多中心、国际、随机、前瞻性实用试验中,1008名MDD参与者被随机分配接受艾司西酞普兰、舍曲林或文拉法辛缓释剂治疗。该研究还招募了336名健康对照。使用17项汉密尔顿抑郁评定量表在八周后确定治疗反应和缓解情况。使用峰值提取方法分析P3和N1潜伏期及波幅,并通过精确低分辨率断层扫描(eLORETA)进一步重复验证。通过峰值提取分析发现,与对照组相比,MDD患者的P3降低。这在时间全域场功率分析中得到了验证。源密度分析表明,皮层活动差异源于后扣带回和海马旁回。对文拉法辛缓释剂无反应的男性N1波幅明显小于有反应者。两种分析方法均证实了这一点。对文拉法辛缓释剂无反应的男性左岛叶皮质的活动较少。从神经网络的角度对观察结果进行了讨论。