IEEE Trans Biomed Eng. 2019 Jun;66(6):1668-1679. doi: 10.1109/TBME.2018.2877651. Epub 2018 Oct 23.
This study explores responses to ketamine in patients with treatment-resistant depression (TRD) using a wearable forehead electroencephalography (EEG) device. We recruited and randomly assigned 55 outpatients with TRD into three approximately equal-sized groups (A: 0.5-mg/kg ketamine; B: 0.2-mg/kg ketamine; and C: normal saline) under double-blind conditions. The ketamine responses were measured by EEG signals and Hamilton depression rating scale scores. At baseline, the responders showed significantly weaker EEG theta power than the non-responders (p < 0.05). Compared to the baseline, the responders exhibited higher EEG alpha power but lower EEG alpha asymmetry and theta cordance post-treatment (p < 0.05). Furthermore, our baseline EEG predictor classified the responders and non-responders with 81.3 ± 9.5% accuracy, 82.1 ± 8.6% sensitivity, and 91.9 ± 7.4% specificity. In conclusion, the rapid antidepressant effects of mixed doses of ketamine are associated with prefrontal EEG power, asymmetry, and cordance at baseline and early post-treatment changes. Prefrontal EEG patterns at baseline may serve as indicators of ketamine effects. Our randomized double-blind placebo-controlled study provides information regarding the clinical impacts on the potential targets underlying baseline identification and early changes from the effects of ketamine in patients with TRD.
本研究使用可穿戴式前额脑电图（EEG）设备，探讨了治疗抵抗性抑郁症（TRD）患者对氯胺酮的反应。我们招募并随机将 55 名 TRD 门诊患者分为三组（A：0.5mg/kg 氯胺酮；B：0.2mg/kg 氯胺酮；C：生理盐水），采用双盲条件。通过 EEG 信号和汉密尔顿抑郁评定量表评分来衡量氯胺酮的反应。在基线时，反应者的 EEGθ 功率明显弱于非反应者（p < 0.05）。与基线相比，反应者在治疗后表现出更高的 EEGα 功率，但更低的 EEGα 不对称性和θ协调性（p < 0.05）。此外，我们的基线 EEG 预测器以 81.3 ± 9.5%的准确率、82.1 ± 8.6%的灵敏度和 91.9 ± 7.4%的特异性区分了反应者和非反应者。总之，混合剂量氯胺酮的快速抗抑郁作用与前额叶 EEG 功率、基线和早期治疗后变化的不对称性和协调性有关。基线时的前额叶 EEG 模式可能是氯胺酮作用的指标。我们的随机双盲安慰剂对照研究提供了关于在 TRD 患者中，氯胺酮潜在作用靶点的基线识别和早期变化的临床影响的信息。
