Changes in prefrontal activity characterize clinical response in SSRI nonresponders: a pilot study
Changes in prefrontal activity characterize clinical response in SSRI nonresponders: a pilot study
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DOI：
10.1016/j.jpsychires.2004.12.002
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发表时间：
2005-09-01
影响因子：
4.8
通讯作者：
Abrams, M
中科院分区：
文献类型：
--
作者：
Cook, IA;Leuchter, AF;Abrams, M
先前对单相抑郁症的研究表明，QEEG一致性测量的前额值的早期下降可以识别出药物治疗的反应者。这些研究都检查了在第一次生理评估之前无药物的个体，但在难治性抑郁症（TRD）的临床管理中，许多患者在治疗之间没有无药物间隔的情况下进行治疗变化。在此，我们研究了一致性降低是否与I期TRD受试者的缓解相关，治疗试验之间没有洗脱。记录了12例单相抑郁症成人的清醒脑电图。受试者正在接受自然主义治疗，SSRI单药治疗失败，并开始接受治疗精神科医生开出的新治疗。在开始新治疗前和约1周后记录EEG数据。12例受试者中有6例在8-10周后对治疗有反应。6名应答者中有5名显示早期一致性降低，而6名无应答者中有2名（75%的病例准确描述）。与以前的治疗试验一致，在这种情况下，前额叶皮质的减少也区分了反应者和无反应者。这些研究结果表明，cordance生物标志物可能是一个有用的工具，在有效性试验中，平行的临床实践中SSRI无应答者，可能不需要一个洗脱期治疗之间。(c)2005年由Elsevier Ltd.出版
Previous studies in unipolar depression have shown that early decreases in prefrontal values of the QEEG cordance measure identified responders to pharmacotherapy. These studies have all examined individuals who were drug-free prior to the first physiologic assessment, yet in the clinical management of treatment resistant depression (TRD), many patients undergo changes in treatment without a drug-free interval between treatments. Here, we investigated whether cordance decreases were associated with response in Stage I TRD subjects without wash-out between treatment trials. Awake EEGs were recorded from 12 adults with unipolar depression. Subjects were receiving naturalistic treatment, had failed SSRI monotherapy, and were starting a new treatment prescribed by their treating psychiatrists. EEG data were recorded before starting the new treatment and after approximately 1 week. Six of the 12 subjects responded to treatment after 8-10 weeks. Five of the six responders showed an early cordance decreases, compared with two of the six nonresponders (accurate characterization in 75% of the cases). Consistent with previous treatment trials, decreases in prefrontal cordance differentiated responders from nonresponders in this setting as well. These findings suggest that cordance biomarkers may be a useful tool in effectiveness trials that parallel clinical practices in SSRI nonresponders, and may not require a wash-out period between treatments. (c) 2005 Published by Elsevier Ltd.