Application of EEG Wavelet Power to Prediction of Antidepressant Treatment Response

Authors: Dorota Witkowska, Paweł Gosek, Lukasz Swiecicki, Wojciech Jernajczyk, Bruce J. West, Miroslaw Latka

Abstract:

In clinical practice, the selection of an antidepressant often degrades to lengthy trial-and-error. In this work we employ a normalized wavelet power of alpha waves as a biomarker of antidepressant treatment response. This novel EEG metric takes into account both non-stationarity and intersubject variability of alpha waves. We recorded resting, 19-channel EEG (closed eyes) in 22 inpatients suffering from unipolar (UD, n=10) or bipolar (BD, n=12) depression. The EEG measurement was done at the end of the short washout period which followed previously unsuccessful pharmacotherapy. The normalized alpha wavelet power of 11 responders was markedly different than that of 11 nonresponders at several, mostly temporoparietal sites. Using the prediction of treatment response based on the normalized alpha wavelet power, we achieved 81.8% sensitivity and 81.8% specificity for channel T4.

Keywords: Alpha waves, antidepressant, treatment outcome, wavelet.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1336366

References:

[1] M. H. Trivedi, a J. Rush, S. R. Wisniewski, A. a Nierenberg, D. Warden, L. Ritz, G. Norquist, R. H. Howland, B. Lebowitz, P. J. McGrath, K. Shores-Wilson, M. M. Biggs, G. K. Balasubramani, and M. Fava, "Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice.,” Am. J. Psychiatry, vol. 163, no. 1, pp. 28–40, Jan. 2006.
[2] M. Bauer, T. Bschor, A. Pfennig, P. C. Whybrow, J. Angst, M. Versiani, and H.-J. Möller, "World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders in Primary Care.,” World J. Biol. Psychiatry, vol. 8, no. 2, pp. 67–104, Jan. 2007.
[3] D. V. Iosifescu, "Electroencephalography-derived biomarkers of antidepressant response.,” Harv. Rev. Psychiatry, vol. 19, no. 3, pp. 144–54, 2011.
[4] A. Baskaran, R. Milev, and R. S. McIntyre, "The neurobiology of the EEG biomarker as a predictor of treatment response in depression.,” Neuropharmacology, vol. 63, no. 4, pp. 507–13, Sep. 2012.
[5] J. C. Shaw, The Brain’s Alpha Rhythms and the Mind. Amsterdam: Elsevier, 2003.
[6] Ernst Niedermeyer, "The normal EEG of the Waking Adult,” in in Electroencephalography: basic principles, clinical applications, and related fields, Fifth., E. Niedermeyer and F. L. Da Silva, Eds. Philadelphia: Lippincott Williams & Wilkins, 2005, pp. 167–192.
[7] A. F. Leuchter, I. a Cook, W. S. Gilmer, L. B. Marangell, K. S. Burgoyne, R. H. Howland, M. H. Trivedi, S. Zisook, R. Jain, M. Fava, D. Iosifescu, and S. Greenwald, "Effectiveness of a quantitative electroencephalographic biomarker for predicting differential response or remission with escitalopram and bupropion in major depressive disorder.,” Psychiatry Res., vol. 169, no. 2, pp. 132–8, Sep. 2009.
[8] A. F. Leuchter, I. a Cook, L. B. Marangell, W. S. Gilmer, K. S. Burgoyne, R. H. Howland, M. H. Trivedi, S. Zisook, R. Jain, J. T. McCracken, M. Fava, D. Iosifescu, and S. Greenwald, "Comparative effectiveness of biomarkers and clinical indicators for predicting outcomes of SSRI treatment in Major Depressive Disorder: results of the BRITE-MD study.,” Psychiatry Res., vol. 169, no. 2, pp. 124–31, Sep. 2009.
[9] J. A. Hanley, "Receiver operating characteristic (ROC) methodology: the state of the art.,” Crit. Rev. Diagn. Imaging, vol. 29, no. 3, pp. 307–35, Jan. 1989.
[10] G. E. Bruder, J. P. Sedoruk, J. W. Stewart, P. J. McGrath, F. M. Quitkin, and C. E. Tenke, "Electroencephalographic alpha measures predict therapeutic response to a selective serotonin reuptake inhibitor antidepressant: pre- and post-treatment findings.,” Biol. Psychiatry, vol. 63, no. 12, pp. 1171–7, Jun. 2008.
[11] M. Bares, T. Novak, M. Brunovsky, M. Kopecek, P. Stopkova, V. Krajca, and C. Höschl, "The change of QEEG prefrontal cordance as a response predictor to antidepressive intervention in bipolar depression. A pilot study.,” J. Psychiatr. Res., vol. 46, no. 2, pp. 219–25, Feb. 2012.
[12] I. a Cook, a F. Leuchter, E. Witte, M. Abrams, S. H. Uijtdehaage, W. Stubbeman, S. Rosenberg-Thompson, C. Anderson-Hanley, and J. J. Dunkin, "Neurophysiologic predictors of treatment response to fluoxetine in major depression.,” Psychiatry Res., vol. 85, no. 3, pp. 263–73, Mar. 1999.
[13] I. a Cook, A. F. Leuchter, M. Morgan, E. Witte, W. F. Stubbeman, M. Abrams, S. Rosenberg, and S. H. J. Uijtdehaage, "Early changes in prefrontal activity characterize clinical responders to antidepressants.,” Neuropsychopharmacology, vol. 27, no. 1, pp. 120–31, Jul. 2002.
[14] I. A. Cook, A. F. Leuchter, M. L. Morgan, W. Stubbeman, B. Siegman, and M. Abrams, "Changes in prefrontal activity characterize clinical response in SSRI nonresponders: a pilot study.,” J. Psychiatr. Res., vol. 39, no. 5, pp. 461–6, Sep. 2005.
[15] A. F. Leuchter, I. A. Cook, A. Hunter, and A. Korb, "Use of clinical neurophysiology for the selection of medication in the treatment of major depressive disorder: the state of the evidence.,” Clin. EEG Neurosci., vol. 40, no. 2, pp. 78–83, Apr. 2009.
[16] I. a Cook, A. M. Hunter, M. Abrams, B. Siegman, and A. F. Leuchter, "Midline and right frontal brain function as a physiologic biomarker of remission in major depression.,” Psychiatry Res., vol. 174, no. 2, pp. 152–7, Nov. 2009.
[17] M. Bares, M. Brunovsky, M. Kopecek, P. Stopkova, T. Novak, J. Kozeny, and C. Höschl, "Changes in QEEG prefrontal cordance as a predictor of response to antidepressants in patients with treatment resistant depressive disorder: a pilot study.,” J. Psychiatr. Res., vol. 41, no. 3–4, pp. 319–25, Jan. 2007.
[18] M. Bares, M. Brunovsky, M. Kopecek, T. Novak, P. Stopkova, J. Kozeny, P. Sos, V. Krajca, and C. Höschl, "Early reduction in prefrontal theta QEEG cordance value predicts response to venlafaxine treatment in patients with resistant depressive disorder.,” Eur. Psychiatry, vol. 23, no. 5, pp. 350–5, Aug. 2008.
[19] M. Bares, M. Brunovsky, T. Novak, M. Kopecek, P. Stopkova, P. Sos, V. Krajca, and C. Höschl, "The change of prefrontal QEEG theta cordance as a predictor of response to bupropion treatment in patients who had failed to respond to previous antidepressant treatments.,” Eur. Neuropsychopharmacol., vol. 20, no. 7, pp. 459–66, Jul. 2010.
[20] D. V Iosifescu, S. Greenwald, P. Devlin, D. Mischoulon, J. W. Denninger, J. E. Alpert, and M. Fava, "Frontal EEG predictors of treatment outcome in major depressive disorder.,” Eur. Neuropsychopharmacol., vol. 19, no. 11, pp. 772–7, Dec. 2009.
[21] G. E. Bruder, C. E. Tenke, V. Warner, Y. Nomura, C. Grillon, J. Hille, P. Leite, and M. M. Weissman, "Electroencephalographic measures of regional hemispheric activity in offspring at risk for depressive disorders.,” Biol. Psychiatry, vol. 57, no. 4, pp. 328–35, Feb. 2005.