Stability of frontal alpha asymmetry in depressed patients during antidepressant treatment.

Nikita Van Der Vinne,Michel J.A.M Van Putten,Martijn Arns,Madelon A Vollebregt

doi:10.1016/j.nicl.2019.102056

Abstract

Frontal alpha asymmetry (FAA) is a proposed prognostic biomarker in major depressive disorder (MDD), conventionally acquired with electroencephalography (EEG). Although small studies attributed trait-like properties to FAA, a larger sample is needed to reliably asses this characteristic. Furthermore, to use FAA to predict treatment response, determining its stability, including the potential dependency on depressive state or medication, is essential. In the international Study to Predict Optimized Treatment in Depression (iSPOT-D), a multi-center, randomized, prospective open-label trial, 1008 MDD participants were randomized to treatment with escitalopram, sertraline or venlafaxine-extended release. Treatment response was established eight weeks after treatment initiation and resting state EEG was measured both at baseline and after eight weeks (n = 453). FAA did not change significantly after eight weeks of treatment (n = 453, p = .234), nor did we find associations with age, sex, depression severity, or change in depression severity. After randomizing females to escitalopram or sertraline, for whom treatment response could be predicted in an earlier study, FAA after eight weeks resulted in equivalent response prediction as baseline FAA (one tailed p = .028). We demonstrate that FAA is a stable trait, robust to time, state and pharmacological status. This confirms FAA stability. Furthermore, as prediction of treatment response is irrespective of moment of measurement and use of medication, FAA can be used as a state-invariant prognostic biomarker with promise to optimize MDD treatments.

Highlights

Frontal alpha asymmetry (FAA) is a proposed prognostic biomarker in major depressive disorder (MDD), conventionally acquired with electroencephalography (EEG)
Type 3: Cross-sectional study. ⁎⁎ No explicit statements on state or trait were made by the authors, based on other literature we suggest our own conclusion to these results
Of the 1008 MDD patients enrolled, the final MDD sample for the FAA Change analyses consisted of 453 MDD patients

Summary

Introduction

Frontal alpha asymmetry (FAA) is a proposed prognostic biomarker in major depressive disorder (MDD), conventionally acquired with electroencephalography (EEG). To use FAA to predict treatment response, determining its stability, including the potential dependency on depressive state or medication, is essential. Conclusion: We demonstrate that FAA is a stable trait, robust to time, state and pharmacological status. As prediction of treatment response is irrespective of moment of measurement and use of medication, FAA can be used as a state-invariant prognostic biomarker with promise to optimize MDD treatments. Frontal alpha asymmetry (FAA) is a proposed biomarker conventionally acquired with electroencephalography (EEG). A small subgroup of severely depressed females over 53 years of age showed more rightsided alpha activity and severely depressed males over 53 years of age more left-sided alpha than control peers

Methods

Results

Discussion

Conclusion