Comparable efficacy of prefrontal theta cordance in the prediction of response to antidepressants and rTMS

Abstract

Previous studies have demonstrated the efficacy of reduction of prefrontal theta cordance (RC) after 1week of treatment in the prediction of antidepressant response. Our study aimed to compare the ability of RC in the prediction of response to various treatments. In total, 167 inpatients with MDD were treated with various antidepressants and low-frequency rTMS for 4 weeks. The primary efficacy measure was MADRS score, assessed at baseline, weeks − 1, − 2, and at the end of study. The EEG was recorded at baseline and after 1 week. Prefrontal theta cordance was calculated as an average from Fp1, Fp2 and Fz electrodes. Logistic regression identified RC as a predictor of response to SSRI, SNRI, NDRI and rTMS but not for NaSSA. Predictive parameters of RC for response to mentioned antidepressant classes were as follows: For SSRI (N = 58), the AUC of ROC analysis yielded value of 0.77, positive predictive value (PPV) of RC at week 1 was 0.81 and negative predictive values (NPV) of RC at week 1 was 0.73. For SNRI (N = 47), the AUC of ROC analysis yielded value of 0.77, PPV of RC at week 1 was 0.72 and NPV of RC at week 1 was 0.84. For NDRI (N = 22), the AUC of ROC analysis yielded value of 0.87, PPV of RC at week 1 was 0.91 and NPV of RC at week 1 was 0.82. For rTMS (N = 25), the AUC of ROC analysis yielded value of 0.75, PPV of RC at week 1 was 0.6 and NPV of RC at week 1 was 1.0. AUC of ROC analysis of RC were not significantly different among antidepressants. Prefrontal QEEG cordance is a promising tool predicting the response to various antidepressive interventions. In this study, the predictive efficacy of 1-week reduction of QEEG prefrontal theta cordance for response to SSRI, SNRI, NDRI and rTMS was comparable.