EP 108. EEG-based arousal markers for individualized treatment in obsessive compulsive disorder

Abstract

Objectives Cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs) and their combination are effective in the treatment of obsessive–compulsive disorder (OCD). Based on findings of increased levels of central nervous system (CNS)-arousal in OCD, aim of this study was to test the hypothesis that electroencephalogram (EEG)-based CNS- arousal markers differ for responders compared to non-responders to a therapy. Further goal was to identify specific response- predictors for either CBT, SSRI treatment or a combined therapy. Methods CNS-arousal during a fifteen-minute resting state condition was assessed by means of electroencephalogram (EEG)-vigilance stages using VIGALL (Vigilance Algorithm Leipzig) from 51 unmedicated patients suffering from OCD. Clinical Global Impression (CGI) and Yale-Brown Obsessive Compulsive Scale (YBOCS) were used to assess response or non-response after three to six months following therapy with either CBT ( n = 22), SSRI ( n = 12) or combination of both ( n = 17). Results Responders showed significant lower amounts of high CNS-arousal stage W (ANOVA F = 4.8; p 0.02 ). The percentage of W-stages also negatively correlated with YBOCS changes after treatment ( r = −0.32, p 0.03 ). Further, CNS-arousal as assessed by amounts of vigilance stages also allowed discrimination between response to one of the three different treatment arms CBT, SSRIs or the combination of both. Discussion The results of lower CNS-arousal in responders in comparison to non-responders in treatment of OCD suggest, that EEG-based markers might be useful for individualizing treatment in OCD, e.g. for decisions of early augmentation. Especially the fact that CNS-arousal markers were different for responders to either CBT, SSRI or combined therapy underlines the possible predictive value of EEG-based markers. Prospective studies in this field are strongly warranted.