Abstract
The evaluation of response to pharmacological treatment in MDD requires 4-8 weeks. Therefore, the ability to predict response, and especially lack of response to treatment, as early as possible after treatment onset or change, is of prime significance. Many studies have demonstrated significant results regarding the ability to use EEG and ERP markers, including attention-associated markers such as P300, for early prediction of response to treatment. But these markers are derived from long EEG/ERP samples, often from multiple channels, which render them impractical for frequent sampling. We developed a new electrophysiological attention-associated marker from a single channel (two electrodes), using 1-min samples with auditory oddball stimuli. This work presents an initial evaluation of the ability to use this marker's dynamics between repetitive measures for early (<2 weeks) differentiation between responders and non-responders to antidepressive treatment, in 26 patients with various levels of depression and heterogeneous treatment interventions. The slope of change in the marker between early consecutive samples was negative in the non-responders, but not in the responders. This differentiation was stronger for patients suffering from severe depression (p < 0.001). This pilot study supports the feasibility of the EEG marker for early recognition of treatment-resistant depression. If verified in large-scale prospective studies, it can contribute to research and clinical work.
Highlights
The evaluation of response to pharmacological treatment in MDD requires 4–8 weeks, after which response rates are of the order of 50% and remission rate of 30% [1]
Because attention is greatly affected by depression severity [10], attention-associated markers seem to be relevant to the clinical condition, regardless of the specific treatment and its mechanism of action [7]
An early (~12 days) drop in the Brain Engagement Index (BEI) of a depressed patient following a treatment change correlated with an 8-week non-response, regardless of the specifics of the treatment intervention
Summary
The evaluation of response to pharmacological treatment in MDD requires 4–8 weeks, after which response rates are of the order of 50% and remission rate of 30% [1]. A biomarker of clinical significance is expected to be based on scientific understanding of the. An Easy-to-Use Electrophysiological Index for Depression pathology, must have a sensitivity and specificity that contribute to the clinical work and must be applicable. We expect the biomarker to be accessible and to be useful in the complex and heterogeneous clinical settings. ERP attention markers, such as P300, are sensitive to the patient’s condition. Because attention is greatly affected by depression severity [10], attention-associated markers seem to be relevant to the clinical condition, regardless of the specific treatment and its mechanism of action [7]. Markers for attention accord with scientific understanding on one hand and may be relevant within the complex and heterogeneous environment of clinical practice on the other
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