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

TitleMidline and right frontal brain function as a physiologic biomarker of remission in major depression.
Publication TypeJournal Article
Year of Publication2009
AuthorsCook, IA, Hunter AM, Abrams M, Siegman B, Leuchter AF
JournalPsychiatry research
Date Published2009 Nov 30
KeywordsAdult, Analysis of Variance, Antidepressive Agents, Biological Markers, Depressive Disorder, Major, Double-Blind Method, Electroencephalography, Female, Frontal Lobe, Functional Laterality, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Recurrence, ROC Curve, Severity of Illness Index, Spectrum Analysis, Time Factors, Treatment Outcome

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 (ROI), 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 h, 1 week, and 2 weeks after start of drug, as potential predictors of remission (final score on the 17-item Hamilton Depression Rating Scale of 5 or below. Out of 37 medication-treated subjects, 11 (30%) remitted versus 6 of 35 placebo subjects (17%). Change in MRF cordance 1 and 2 weeks after the beginning of treatment was significantly associated with remission in medication-treated subjects 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.

Alternate JournalPsychiatry Res