Martijn Arns1, Gerard Bruder2, Ulrich Hegerl3, Chris Spooner4, Donna M Palmer5, Amit Etkin6, Kamran Fallahpour7, Justine M Gatt8, Laurence Hirshberg9, Evian Gordon4. 1. Dept. of Experimental Psychology, Utrecht University, Utrecht, The Netherlands; Research Institute Brainclinics, Nijmegen, The Netherlands. Electronic address: martijn@brainclinics.com. 2. Department of Psychiatry, Columbia University, New York, NY, USA. 3. Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany. 4. Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA. 5. Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA; Brain Dynamics Center, Sydney Medical School, The University of Sydney, Sydney, NSW and Westmead Millenium Institute, Westmead, NSW, Australia. 6. Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. 7. Department of Psychiatry, Columbia University, New York, NY, USA; Brain Resource Center, New York, USA. 8. Brain Dynamics Center, Sydney Medical School, The University of Sydney, Sydney, NSW and Westmead Millenium Institute, Westmead, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; School of Psychology, University of New South Wales, Sydney, NSW, Australia. 9. Alpert Medical School, Brown University, The Neuro Development Center, Inc, Providence, RI, USA.
Abstract
OBJECTIVE: To determine whether EEG occipital alpha and frontal alpha asymmetry (FAA) distinguishesoutpatients with major depression (MDD) from controls, predicts antidepressant treatment outcome, and to explore the role of gender. METHODS: 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 escitalopram, sertraline or venlafaxine-extended release. The study also recruited 336 healthy controls. Treatment response was established after eight weeks and resting EEG was measured at baseline (two minutes eyes open and eyes closed). RESULTS: No differences in EEG alpha for occipital and frontal cortex, or for FAA, were found in MDD participants compared to controls. Alpha in the occipital and frontal cortex was not associated with treatment outcome. However, a gender and drug-class interaction effect was found for FAA. Relatively greater right frontal alpha (less cortical activity) in women only was associated with a favorable response to the Selective Serotonin Reuptake Inhibitors escitalopram and sertraline. No such effect was found for venlafaxine-extended release. CONCLUSIONS:FAA does not differentiate between MDD and controls, but is associated with antidepressant treatment response and remission in a gender and drug-class specific manner. SIGNIFICANCE: Future studies investigating EEG alpha measures in depression should a-priori stratify by gender.
RCT Entities:
OBJECTIVE: To determine whether EEG occipital alpha and frontal alpha asymmetry (FAA) distinguishes outpatients with major depression (MDD) from controls, predicts antidepressant treatment outcome, and to explore the role of gender. METHODS: In the international Study to Predict Optimized Treatment in Depression (iSPOT-D), a multi-center, randomized, prospective open-label trial, 1008 MDDparticipants were randomized to escitalopram, sertraline or venlafaxine-extended release. The study also recruited 336 healthy controls. Treatment response was established after eight weeks and resting EEG was measured at baseline (two minutes eyes open and eyes closed). RESULTS: No differences in EEG alpha for occipital and frontal cortex, or for FAA, were found in MDDparticipants compared to controls. Alpha in the occipital and frontal cortex was not associated with treatment outcome. However, a gender and drug-class interaction effect was found for FAA. Relatively greater right frontal alpha (less cortical activity) in women only was associated with a favorable response to the Selective Serotonin Reuptake Inhibitors escitalopram and sertraline. No such effect was found for venlafaxine-extended release. CONCLUSIONS: FAA does not differentiate between MDD and controls, but is associated with antidepressant treatment response and remission in a gender and drug-class specific manner. SIGNIFICANCE: Future studies investigating EEG alpha measures in depression should a-priori stratify by gender.
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