Prediction of neuroleptic on-drug response in schizophrenic in-patients by EEG

Abstract

The subjects were 34 acutely ill in-patients who met the RDC criteria of schizophrenic psychosis, and 4 EEGs were recorded from each patient before, 2 h and 24 h after oral intake of a single dose of 150 mg perazine, and on the 28th day of the neuroleptic treatment period. As a criterion of clinical response a decrease of at least 66% in the schizophrenia-specific sum score of the Brief Psychiatric Rating Scale on day 28 relative to the baseline value was decided upon. The EEGs were assessed using a newly developed procedure which takes into consideration 4 derivations simultaneously. As we tried to search out EEG variables with predictive value the statistical data analysis underlying our findings should largely by regarded as exploratory. Independent of day, responders (R) showed a tendency towards more low voltage desynchronized epochs (non-A stage) than non-responders (NR). Thus, R exhibited a higher degree of dynamic variability or a broader range of control of the spontaneous vigilance fluctuation (dynamic lability) than NR (dynamic rigidity). Furthermore, R and NR differed with respect to their time-dependent changes of non-A epoch frequencies before medication. While R showed a monotonous increase which is typical for normals, NR did not. Because of considerable inter-individual variability these group differences could not be used for individual prediction of the therapy response. By means of a qualitative data analysis R could be distinguished from NR with regard to various test dose-induced changes of the topographical distribution of absolute alpha power. All the group differentiating variables showed a time course of the same kind: R showed a prompt and ample deflection and the same recovery of baseline; NR, in contrast, showed no significant deflections at all. These findings are in line with the results concerning the dynamics of vigilance and certain claims of earlier authors according to which EEG changeability should be decisive for therapeutic outcome.(ABSTRACT TRUNCATED AT 400 WORDS)

Pharmaco-EEG in Psychiatry

“…Moore et al 68 observed that an increase of alpha after 6 weeks of treatment with haloperidol or remoxipride was associated with a favorable clinical response. Other studies comparing responders (R) and nonresponders (NR) to treatment with neuroleptics reported an increase of alpha activity only in R 57,69 and changes in the opposite direction in NR. 57 Our group used the test dose procedure to predict short-term response to treatment with either haloperidol or clopentixol in 29 patients with schizophrenia.…”

Pharmaco-EEG of antipsychotic treatment response: a systematic review

“…Ulrich et al 91 focused on the individuation of alpha and non-alpha epochs (i.e. relative power spectrum density of alpha-band > or < 50%) in acutely ill, drug-free patients.…”

“…At baseline theta power, either low 86 or high 87 was related to a favorable treatment outcome. A high alpha power predicted a poorer response in most of the studies 66,86,87,[89][90][91] ; moreover, alpha functional connectivity in frontal and temporal regions was inversely related to response 93 . A diminished betapower on a pre-treatment RS-EEG was related to a worse treatment outcome 66,85,86,90,93 , such as a reduced functional connectivity after treatment 93 .…”