Lee TW, Wu YT, Yu YW, Chen MC, Chen TJ. The implication of functional connectivity strength in predicting treatment response of major depressive disorder: a resting EEG study. Psychiatry Res 194: 372-377

Laureate Institute for Brain Research, Tulsa, OK, USA.
Psychiatry Research (Impact Factor: 2.47). 12/2011; 194(3):372-7. DOI: 10.1016/j.pscychresns.2011.02.009
Source: PubMed


Predicting treatment response in major depressive disorder (MDD) has been an important clinical issue given that the initial intent-to-treat response rate is only 50 to 60%. This study was designed to examine whether functional connectivity strengths of resting EEG could be potential biomarkers in predicting treatment response at 8 weeks of treatment. Resting state 3-min eyes-closed EEG activity was recorded at baseline and compared in 108 depressed patients. All patients were being treated with selective serotonin-reuptake inhibitors. Baseline coherence and power series correlation were compared between responders and non-responders evaluated at the 8th week by Hamilton Depression Rating Scale. Pearson correlation and receiver operating characteristic (ROC) analyses were applied to evaluate the performance of connectivity strengths in predicting/classifying treatment responses. The connectivity strengths of right fronto-temporal network at delta/theta frequencies differentiated responders and non-responders at the 8th week of treatment, such that the stronger the connectivity strengths, the poorer the treatment response. ROC analyses supported the value of these measures in classifying responders/non-responders. Our results suggest that fronto-temporal connectivity strengths could be potential biomarkers to differentiate responders and slow responders or non-responders in MDD.

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    • "Several metaanalyses have reported that clinical status observed at 2 weeks into conventional antidepressant treatment is predictive of subsequent clinical response (Szegedi et al., 2009; Gorwood et al., 2013), allowing for clinical management decisions to be made earlier in the course of treatment. Clinical symptomatology and functional neuroimaging measures have been evaluated as markers of antidepressant response to conventional treatments such as SSRI's (Harmer, 2008; Korb et al., 2009; MacQueen, 2009; Lee et al., 2011; Pizzagalli, 2011; Furey et al., 2012), cognitive behavior therapy (Siegle et al., 2006), and transcranial magnetic stimulation (Gershon et al., 2003) as well as more experimental approaches that produce a rapid-onset of antidepressant action, including ketamine (Salvadore et al., 2009, 2010) and scopolamine (Furey et al., 2012). The identification of pretreatment biological measures that correlate with treatment response may prove particularly useful for guiding treatment decisions and hastening clinical response. "
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    ABSTRACT: Faster acting antidepressants and biomarkers that predict treatment response are needed to facilitate the development of more effective treatments for patients with major depressive disorders (MDD). Here we evaluate implicitly and explicitly processed emotional faces using neuroimaging to identify potential biomarkers of treatment response to the antimuscarinic, scopolamine. Healthy participants (n=15) and unmedicated-depressed MDD patients (n=16) participated in a double-blind, placebo-controlled crossover infusion study using scopolamine (4ug/kg). Before and following scopolamine, blood oxygen-level dependent (BOLD) signal was measured using fMRI during a selective attention task. Two stimuli comprised of superimposed pictures of faces and houses were presented. Participants attended to one stimulus component and performed a matching task. Face emotion was modulated (happy/sad) creating implicit (attend-houses) and explicit (attend-faces) emotion processing conditions. The pre-treatment difference in BOLD response to happy and sad faces under implicit and explicit conditions (emotion processing biases) within a-priori regions-of-interest (ROIs), was correlated with subsequent treatment response in MDD. Correlations were observed exclusively during implicit emotion processing in the ROIs, which included the subgenual anterior cingulate (sgACC) (p<0.02) and middle occipital cortices (MOC) (p<0.02). The magnitude and direction of differential BOLD response to implicitly processed emotional faces prior to treatment reflect the potential to respond to scopolamine. These findings replicate earlier results, highlighting the potential for pre-treatment neural activity in the MOC and sgACC to inform us about the potential to respond clinically to scopolamine. Published by Oxford University Press on behalf of CINP 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
    The International Journal of Neuropsychopharmacology 03/2015; 18(8). DOI:10.1093/ijnp/pyv028 · 4.01 Impact Factor
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    • " to - moment control and allocation of sensory resources and specialised processing ( Sadaghiani et al . 2012 ) . Related findings show enhanced right - intra - hemi - spheric coherence over fronto - temporal low frequency bands , i . e . delta and theta frequencies have been connected to poorer treatment response to anti - depressant medication ( Lee et al . 2011 ) . Therefore , it is reasonable to surmise that enhanced left - hemispheric α - coherence possibly served as an ' enabling mechanism ' towards the cohesive imple - mentation of conjoining action pathways ."
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    ABSTRACT: To illuminate candidate neural working mech-anisms of Mindfulness-Based Cognitive Therapy (MBCT) in the treatment of recurrent depressive disorder, parallel to the potential interplays between modulations in electro-cortical dynamics and depressive symptom severity and self-compassionate experience. Linear and nonlinear α and γ EEG oscillatory dynamics were examined concomitant to an affective Go/NoGo paradigm, pre-to-post MBCT or natural wait-list, in 51 recurrent depressive patients. Spe-cific EEG variables investigated were; (1) induced event-related (de-) synchronisation (ERD/ERS), (2) evoked power, and (3) inter-/intra-hemispheric coherence. Sec-ondary clinical measures included depressive severity and experiences of self-compassion. MBCT significantly downregulated α and γ power, reflecting increased cortical excitability. Enhanced α-desynchronisation/ERD was observed for negative material opposed to attenuated α-ERD towards positively valenced stimuli, suggesting acti-vation of neural networks usually hypoactive in depression, related to positive emotion regulation. MBCT-related increase in left-intra-hemispheric α-coherence of the fron-to-parietal circuit aligned with these synchronisation dynamics. Ameliorated depressive severity and increased self-compassionate experience pre-to-post MBCT corre-lated with α-ERD change. The multi-dimensional neural mechanisms of MBCT pertain to task-specific linear and non-linear neural synchronisation and connectivity network dynamics. We propose MBCT-related modulations in dif-fering cortical oscillatory bands have discrete excitatory (enacting positive emotionality) and inhibitory (disengag-ing from negative material) effects, where mediation in the α and γ bands relates to the former. Keywords Major Depressive Disorder (MDD) · Mindfulness-Based Cognitive Therapy (MBCT) · ERD/ERS · Oscillatory EEG · α-Band coherence · γ-Band · EEG power Introduction
    Cognitive Neurodynamics 02/2015; 9(1):13-29. DOI:10.1007/s11571-014-9308-y · 1.67 Impact Factor
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    • "These differences can be explained in part by differences in the connectivity measures used: While Lee et al. and Leuchter et al. used a coherence measure that is not totally independent of amplitude, the phase-synchronization measure used in the present study did not rely on any amplitude information . Fingelkurts et al. (2007) and also Lee et al. (2011) used a measure that calculated connectivity based on power rather than phase synchronization. Therefore, their results reflect different aspects of neuronal interaction. "
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    ABSTRACT: Structural and metabolic alterations in prefrontal brain areas, including the subgenual (SGPFC), medial (MPFC) and dorsolateral prefrontal cortex (DLPFC), have been shown in major depressive disorder (MDD). Still it remains largely unknown how brain connectivity within these regions is altered at the level of neuronal oscillations. Therefore, the goal was to analyze prefrontal electroencephalographic phase synchronization in MDD and its changes after antidepressant treatment. In 60 unmedicated patients and 60 healthy controls (HC), a 15-min resting electroencephalogram (EEG) was recorded in subjects at baseline and in a subgroup of patients after 2 weeks of antidepressant medication. EEG functional connectivity between the SGPFC and the MPFC/DLPFC was assessed with eLORETA (low resolution brain electromagnetic tomography) by means of lagged phase synchronization. At baseline, patients revealed increased prefrontal connectivity at the alpha frequency between the SGPFC and the left DLPFC/MPFC. After treatment, an increased connectivity between the SGPFC and the right DLPFC/MPFC at the beta frequency was found for MDD. A positive correlation was found for baseline beta connectivity and reduction in scores on the Hamilton Depression Rating Scale. MDD is characterized by increased EEG functional connectivity within frontal brain areas. These EEG markers of disturbed neuronal communication might have potential value as biomarkers.
    Psychiatry Research: Neuroimaging 03/2014; 222(1). DOI:10.1016/j.pscychresns.2014.02.010 · 2.42 Impact Factor
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