Event Related Potentials in Major Depressive Disorder: The Relationship between P300 and Treatment Response
Although conflicting results have been obtained regarding P300 amplitude and latency in major depressive patients, most studies have reported that major depressive patients have smaller P300 amplitudes and longer latencies than healthy people. This study aimed to investigate the relationship between P300 and treatment response in major depressive disorder patients.
Twenty-eight patients suffering from major depression who completed 12 weeks of follow-up appointments and 28 healthy people, whose age and gender were matched with patients, were included in the study. Event-related potentials (P300) were recorded for patients before and after treatment with sertraline (50-200 mg/day) for 12 weeks. Treatment response was defined as a 50% or greater decrease in a given patient's total Hamilton Depression Rating Scale score. Pre-treatment and post-treatment P300 amplitude and latency values were compared for responders (n=18), non-responders (n=10) and healthy subjects.
No significant difference was found between the P300 amplitude values of responders, non-responders and healthy subjects before or after treatment. Pre-treatment P300 latencies of non-responders were significantly longer than latencies of responders and healthy subjects. After treatment for depression, P300 latency values of responders were normalized, but non-responders still maintained longer P300 latencies than responders and healthy subjects.
These findings suggest that delayed P300 latency may be related to a non-response to sertraline treatment. No relation was found between P300 amplitude and treatment response.
Available from: Martijn Arns
- "Regarding P3 latency, the results have been mixed as well. Some found no effect of P3 latency (Jaworska et al., 2013), while other studies found slower P3's in non-responders to antidepressants (Işıntaş et al., 2012; Kalayam and Alexopoulos, 1999; Vandoolaeghe et al., 1998). "
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ABSTRACT: It is essential to improve antidepressant treatment of major depressive disorder (MDD) and one way this could be achieved is by reducing the number of treatment steps by employing biomarkers that can predict treatment outcome. This study investigated differences between MDD patients and healthy controls in the P3 and N1 component from the event-related potential (ERP) generated in a standard two-tone oddball paradigm. Furthermore, the P3 and N1 are investigated as predictors for treatment outcome to three different antidepressants. In the international Study to Predict Optimized Treatment in Depression (iSPOT-D) - a multi-center, international, randomized, prospective practical trial - 1008 MDD participants were randomized to escitalopram, sertraline or venlafaxine-XR. The study also recruited 336 healthy controls. Treatment response and remission were established after eight weeks using the 17-item Hamilton Rating Scale for Depression. P3 and N1 latencies and amplitudes were analyzed using a peak-picking approach and further replicated by using exact low resolution tomography (eLORETA). A reduced P3 was found in MDD patients compared to controls by a peak-picking analysis. This was validated in a temporal global field power analysis. Source density analysis revealed that the difference in cortical activity originated from the posterior cingulate and parahippocampal gyrus. Male non-responders to venlafaxine-XR had significantly smaller N1 amplitudes than responders. This was demonstrated by both analytical methods. Male non-responders to venlafaxine-XR had less activity originating from the left insular cortex. The observed results are discussed from a neural network viewpoint.
Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.
European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology 08/2015; 25(11). DOI:10.1016/j.euroneuro.2015.07.022 · 4.37 Impact Factor
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ABSTRACT: Event-related potentials (ERPs), derived from electroencephalographic (EEG) recordings, can index electrocortical activity related to cognitive operations. The fronto-central P3a ERP is involved in involuntary processing of novel auditory information, whereas the parietal P3b indexes controlled attention processing. The amplitude of the auditory P3b has been found to be decreased in major depressive disorder (MDD). However, few studies have examined the relations between the P3b, the related P3a, and antidepressant treatment response. We tested 53 unmedicated individuals (25 females) with MDD, as well as 43 non-depressed controls (23 females) on the novelty oddball task, wherein infrequent deviant (target) and frequent standard (non-target) tones were presented, along with infrequent novel (non-target/distractor) sounds. The P3a and P3b ERPs were assessed to novel and target sounds, respectively, as were their accompanying behavioral performance measures. Depression ratings and the antidepressant response status were assessed following 12 weeks of pharmacotherapy with three different regimens. Antidepressant treatment non-responders had smaller baseline P3a/b amplitudes than responders and healthy controls. Baseline P3b amplitude also weakly predicted the extent of depression rating changes by week 12. Females exhibited larger P3a/b amplitudes than males. With respect to task performance, controls had more target hits than treatment non-responders. ERP measures correlated with clinical changes in males and with behavioral measures in females. These results suggest that greater (or control-like) baseline P3a/b amplitudes are associated with a positive antidepressant response, and that gender differences characterize the P3 and, by extension, basic attentive processes.
European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology 05/2013; 23(11). DOI:10.1016/j.euroneuro.2013.03.003 · 4.37 Impact Factor
Available from: Natalia Jaworska
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ABSTRACT: Major depressive disorder (MDD) is primarily characterized by decreased affect and accompanying behavioural consequences, but it is also associated with cognitive dysfunction. Assessment of electroencephalographic (EEG) activity and associated event-related potentials (ERPs; derived from averaged EEG activity in response to a stimulus) in the context of MDD has provided insights into the electrocortical abnormalities associated with the disorder. Importantly, EEG and ERPs also have emerged as candidates for predicting and optimizing antidepressant (AD) treatment outcome. This is critical in light of relatively low remission rates or a limited response to initial AD interventions. In contrast to other neuroimaging approaches, EEG and ERPs may be superior for predicting and monitoring AD response, as electrocortical measures are relatively inexpensive, easy to use, and have excellent temporal (that is, millisecond) resolution, enabling fine-grained assessment of basic cognitive and emotive processes. This review aims to highlight the most consistently noted EEG and ERP features in MDD, which may one day assist with diagnostic confirmation, as well as the potential clinical utility of specific electrocortical measures in aiding with response prediction.
Canadian journal of psychiatry. Revue canadienne de psychiatrie 09/2013; 58(9):509-514. · 2.55 Impact Factor
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