EEG Biomarkers for Predicting Response to Antidepressant Therapy
Condition: Major Depressive Disorder
MeSH terms: Depressive Disorder; Depression; Depressive Disorder, Major
Study type: Observational

Summary: 
      The purpose of this study is to evaluate the potential early EEG predictors of an
      individual's response to treatment with antidepressant medications.

      Objectives:

        -  Prospectively confirm accuracy of current EEG biomarker algorithm

        -  Determine preferred clinical intervention for subjects with negative indicator

        -  Identify predictors of worsening suicide ideation
    

Detailed description: 
      According to recent clinical studies sponsored by the NIH, fewer than half of subjects
      diagnosed with a major depressive episode respond to the first trial of an antidepressant
      medication. While the majority of subjects eventually respond to treatment with an
      antidepressant, failure with the first line medication puts subjects at increased risk for
      never receiving adequate treatment of their depression.

      Several lines of reasoning support the rationale for further investigating EEG as a means of
      predicting response and resistance to antidepressants. Prior studies suggest that changes in
      neuronal activity in the anterior cingulate and prefrontal regions are related to depression
      and that changes in brain response to treatment may also produce alterations that can be
      detected by recoding frontal EEG activity.

      In this protocol, we proposed to identify possible neurophysiologic indicators of treatment
      outcome in depression, particularly indicators of brain response that appear early (within 7
      days) during treatment with antidepressants. We will test whether quantitative EEG (QEEG)
      biomarkers can be reliably associated with response or non-response to treatment with
      antidepressant medications, using both monotherapy and combination drug treatments.

      Comparison(s):

      Selecting the best treatment for subjects with resistance to an initial antidepressant poses
      a considerable challenge for clinicians. The most widely prescribed antidepressants usually
      require 4-6 weeks of therapeutic dosing before a marked clinical improvement in symptoms is
      observed. Therefore, determining the optimal regimen can take several weeks or months for
      subjects who are resistant to the first line antidepressant. A tool for predicting eventual
      clinical response to antidepressants could help inform and accelerate the process of
      identifying the most efficacious treatment option for a given subject.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        A total of 375 subjects with major depressive disorder (MDD) between the ages of 18 - 75
        with no other primary neuropsychiatric illnesses were recruited from the population
        presenting for ongoing treatment in a primary care clinic, or for depression in a
        psychiatric clinic at each site.
      
Keywords: Major Depressive Disorder, Depressive Disorder, Unipolar Depression, Antidepressants, Electroencephalography