Electrical activity in the brain can help gauge whether a patient will benefit from a selective serotonin reuptake inhibitor,
....according to a study published online in JAMA Psychiatry.
The multi-center randomized clinical trial included 248 patients with major depressive disorder who underwent electroencephalographic (EEG) monitoring at baseline and 1 week after trial onset. Patients received an 8-week course of sertraline or placebo.
Higher rostral anterior cingulate cortex theta activity at both baseline and week 1 predicted greater depressive symptom improvement, researchers found. The ability of the EEG data to predict antidepressant response held even after researchers controlled for clinical and demographic variables previously linked with treatment response.
“Increased pretreatment rostral anterior cingulate cortex theta activity represents a nonspecific prognostic marker of treatment outcome that has now been replicated in several studies,” researchers wrote, “and thus warrants consideration for implementation in clinical care.”
The study results are the first to emerge from EMBARC, a national research trial initiated at the University of Texas (UT) Southwestern, Dallas, in 2012. In the coming months, EMBARC is expected to produce 4 more studies evaluating the effectiveness of other predictive tests.
“When the results from these tests are combined, we hope to have up to 80% accuracy in predicting whether common antidepressants will work for a patient,” said Madhukar Trivedi, MD, who oversees EMBARC and is founding director of UT Southwestern's Center for Depression Research and Clinical Care. “This research is very likely to alter the mindset of how depression should be diagnosed and treated.”
More than a decade ago, Dr. Trivedi led the STAR*D studies, which found that up to two-thirds of patients fail to respond to their first antidepressant.
“Like STAR*D, I expect these studies will have a widespread effect on how we design and plan treatment approaches,” Dr. Trivedi said. “My goal is to establish blood tests and brain imaging as standard strategies in the treatment of depression.”
