Stolz Louise A, Kohn Jordan N, Smith Sydney E, Benster Lindsay L, Appelbaum Lawrence G
Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA 92093, USA.
Brain Sci. 2023 Nov 9;13(11):1570. doi: 10.3390/brainsci13111570.
Major depressive disorder (MDD) is a highly prevalent, debilitating disorder with a high rate of treatment resistance. One strategy to improve treatment outcomes is to identify patient-specific, pre-intervention factors that can predict treatment success. Neurophysiological measures such as electroencephalography (EEG), which measures the brain's electrical activity from sensors on the scalp, offer one promising approach for predicting treatment response for psychiatric illnesses, including MDD. In this study, a secondary data analysis was conducted on the publicly available Two Decades Brainclinics Research Archive for Insights in Neurophysiology (TDBRAIN) database. Logistic regression modeling was used to predict treatment response, defined as at least a 50% improvement on the Beck's Depression Inventory, in 119 MDD patients receiving repetitive transcranial magnetic stimulation (rTMS). The results show that both age and baseline symptom severity were significant predictors of rTMS treatment response, with older individuals and more severe depression scores associated with decreased odds of a positive treatment response. EEG measures contributed predictive power to these models; however, these improvements in outcome predictability only trended towards statistical significance. These findings provide confirmation of previous demographic and clinical predictors, while pointing to EEG metrics that may provide predictive information in future studies.
重度抑郁症(MDD)是一种高度流行且使人衰弱的疾病,治疗抵抗率很高。提高治疗效果的一种策略是确定可以预测治疗成功的患者特异性干预前因素。神经生理学测量方法,如脑电图(EEG),它通过头皮上的传感器测量大脑的电活动,为预测包括MDD在内的精神疾病的治疗反应提供了一种很有前景的方法。在本研究中,对公开可用的二十年脑诊所神经生理学洞察研究档案(TDBRAIN)数据库进行了二次数据分析。采用逻辑回归模型预测119名接受重复经颅磁刺激(rTMS)的MDD患者的治疗反应,治疗反应定义为贝克抑郁量表至少改善50%。结果表明,年龄和基线症状严重程度都是rTMS治疗反应的显著预测因素,年龄较大的个体和抑郁评分较高与积极治疗反应的几率降低相关。脑电图测量为这些模型提供了预测能力;然而,这些结果可预测性的改善仅趋于具有统计学意义。这些发现证实了先前的人口统计学和临床预测因素,同时指出了脑电图指标可能在未来研究中提供预测信息。