Midline and right frontal brain function as a physiologic biomarker of remission in major depression

Abstract

Prior investigations have reported that changes in the prefrontal electroencephalogram (EEG) precede symptom improvement from antidepressant medications, and could serve as a biomarker of treatment outcome in major depressive disorder (MDD). A new physiologically-defined region of interest, overlying the midline and right frontal (MRF) cortical area, was examined here for a relationship between early decreases in theta-band cordance and remission. Subjects were 72 adults with unipolar MDD who had completed placebo-controlled antidepressant treatment trials, with 37 randomized to medication and 35 to placebo. We assessed changes in cordance and absolute and relative power in the MRF region at 48 hours, 1 week, and 2 weeks after start of drug, as potential predictors of remission (final Ham-D 17 ≤5). Eleven of 37 medication subjects (30%) remitted vs 6 of 35 placebo subjects (17%). Change in MRF cordance one and two weeks after start of drug was significantly associated with remission in medication subjects (P=0.02 at 1 week), with Receiver Operating Characteristic (ROC) analysis yielding 0.76 area under the curve. Decreases in MRF cordance at 1 week predicted remission with medication with 69% overall accuracy (90% sensitivity; 60% specificity). MRF cordance changes were not associated with remission with placebo. Absolute and relative power did not differentiate groups. These results suggest that remission may be predictable from physiologic measurements after 1 week of treatment, and that this region merits further investigation in the neurobiology of treatment response.

Sleep electroencephalography as a biomarker in depression

“…98,99 A considerable body of research during resting state EEG supports the assertion that an early reduction in prefrontal EEG cordance can serve as a predictor of the response to antidepressant medication and that this is particularly the case for theta frequency ranges. [100][101][102][103][104][105][106] Cordance derived from sleep EEG was examined after 1 week of treatment with antidepressants. 107 An association of first week theta cordance with the HAM-D score at the last treatment of 4 weeks was found.…”

Multiweek Resting EEG Cordance Change Patterns from Repeated Olfactory Activation with Two Constitutionally Salient Homeopathic Remedies in Healthy Young Adults

“…Then, the EEG segments were subjected to fast Fourier transformation, setting the frequency range for EEG band frequencies as d (0.5power at each electrode site. The Fp1 and Fp2 sites were chosen for analysis in this article because of previous cordance study findings at these prefrontal sites in both antidepressant [50][51][52][53] and homeopathy 1 research.…”

Towards a neuroimaging biomarker of depression vulnerability

“…Another machine learning study achieved 86% accuracy in distinguishing between the fMRI signal associated with viewing of emotional faces [162]. Decreases in PFC midline and right lateral EEG concordance at the start of treatment predicted patient remission with 69% accuracy [163]. In a physiological analysis, sustained cortisol response in the weeks following hospitalization predicted poorer treatment responses [164], as does the dysregulation of timing between nocturnal melatonin and cortisol release [165].…”