Kandilarova Sevdalina S, Terziyski Kiril V, Draganova Aneliya I, Stoyanov Drozdstoy S, Akabaliev Valentin H, Kostianev Stefan S
Department of Psychiatry and Medical Psychology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
Department of Pathophysiology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
Folia Med (Plovdiv). 2017 Sep 1;59(3):318-325. doi: 10.1515/folmed-2017-0040.
Pharmacological treatment of depression is currently led by the trial and error principle mainly because of lack of reliable biomarkers. Earlier findings suggest that baseline alpha power and asymmetry could differentiate between responders and non-responders to specific antidepressants.
The current study investigated quantitative electroencephalographic (QEEG) measures before and early in treatment as potential response predictors to various antidepressants in a naturalistic sample of depressed patients. We were aiming at developing markers for early prediction of treatment response based on different QEEG measures.
EEG data from 25 depressed subjects were acquired at baseline and after one week of treatment. Mean and total alpha powers were calculated at eight electrode sites F3, F4, C3, C4, P3, P4, O1, O2. Response to treatment was defined as 50% decrease in MADRS score at week 4.
Mean P3 alpha predicted response with sensitivity and specificity of 80%, positive and negative predictive values of 92.31% and 71.43%, respectively. The combined model of response prediction using mean baseline P3 alpha and mean week 1 C4 alpha values correctly identified 80% of the cases with sensitivity of 84.62%, and specificity of 71.43%.
Simple QEEG measures (alpha power) acquired before initiation of antidepressant treatment could be useful in outcome prediction with an overall accuracy of about 80%. These findings add to the growing body of evidence that alpha power might be developed as a reliable biomarker for the prediction of antidepressant response.
由于缺乏可靠的生物标志物,目前抑郁症的药物治疗主要遵循试错原则。早期研究结果表明,基线α波功率和不对称性可区分特定抗抑郁药的反应者和无反应者。
本研究调查了抑郁症患者自然样本中治疗前及治疗早期的定量脑电图(QEEG)指标,作为各种抗抑郁药潜在反应预测指标。我们旨在基于不同的QEEG指标开发治疗反应早期预测标志物。
采集25名抑郁症患者基线及治疗1周后的脑电图数据。计算F3、F4、C3、C4、P3、P4、O1、O2八个电极位点的平均α波功率和总α波功率。治疗反应定义为第4周时蒙哥马利-艾森伯格抑郁量表(MADRS)评分降低50%。
平均P3α波对反应的预测敏感性和特异性分别为80%,阳性预测值和阴性预测值分别为92.31%和71.43%。使用平均基线P3α波和第1周平均C4α波值的反应预测联合模型正确识别了80%的病例,敏感性为84.62%,特异性为71.43%。
在开始抗抑郁治疗前采集的简单QEEG指标(α波功率)可用于结果预测,总体准确率约为80%。这些发现进一步证明α波功率可能被开发为预测抗抑郁反应的可靠生物标志物。