Modulation of neural oscillations in escitalopram treatment: a Canadian biomarker integration network in depression study.

IF 5.8 1区 医学 Q1 PSYCHIATRY
Benjamin Schwartzmann, Raaj Chatterjee, Yasaman Vaghei, Lena C Quilty, Timothy A Allen, Stephen R Arnott, Sravya Atluri, Pierre Blier, Prabhjot Dhami, Jane A Foster, Benicio N Frey, Stefan Kloiber, Raymond W Lam, Roumen Milev, Daniel J Müller, Claudio N Soares, Chloe Stengel, Sagar V Parikh, Gustavo Turecki, Rudolf Uher, Susan Rotzinger, Sidney H Kennedy, Faranak Farzan
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Abstract

Current pharmacological agents for depression have limited efficacy in achieving remission. Developing and validating new medications is challenging due to limited biological targets. This study aimed to link electrophysiological data and symptom improvement to better understand mechanisms underlying treatment response. Longitudinal changes in neural oscillations were assessed using resting-state electroencephalography (EEG) data from two Canadian Biomarker Integration Network in Depression studies, involving pharmacological and cognitive behavioral therapy (CBT) trials. Patients in the pharmacological trial received eight weeks of escitalopram, with treatment response defined as ≥ 50% decrease in Montgomery-Åsberg Depression Rating Scale (MADRS). Early (baseline to week 2) and late (baseline to week 8) changes in neural oscillation were investigated using relative power spectral measures. An association was found between an initial increase in theta and symptom improvement after 2 weeks. Additionally, late increases in delta and theta, along with a decrease in alpha, were linked to a reduction in MADRS after 8 weeks. These late changes were specifically observed in responders. To assess specificity, we extended our analysis to the independent CBT cohort. Responders exhibited an increase in delta and a decrease in alpha after 2 weeks. Furthermore, a late (baseline to week 16) decrease in alpha was associated with symptom improvement following CBT. Results suggest a common late decrease in alpha across both treatments, while modulatory effects in theta may be specific to escitalopram treatment. This study offers insights into electrophysiological markers indicating a favorable response to antidepressants, enhancing our comprehension of treatment response mechanisms in depression.

艾司西酞普兰治疗对神经振荡的调节:加拿大抑郁症生物标志物整合网络研究。
目前治疗抑郁症的药物在实现缓解方面的疗效有限。由于生物靶点有限,开发和验证新药具有挑战性。本研究旨在将电生理数据与症状改善联系起来,以更好地了解治疗反应的内在机制。研究人员利用两项加拿大抑郁症生物标记物整合网络研究(包括药物治疗和认知行为治疗试验)中的静息态脑电图(EEG)数据,对神经振荡的纵向变化进行了评估。药物试验中的患者接受为期八周的艾司西酞普兰治疗,治疗反应的定义是蒙哥马利-阿斯伯格抑郁量表(MADRS)下降≥50%。研究人员使用相对功率谱测量方法调查了神经振荡的早期(基线至第 2 周)和晚期(基线至第 8 周)变化。结果发现,θ的初期增加与两周后症状改善之间存在关联。此外,delta 和 theta 的后期增加以及 alpha 的减少与 8 周后 MADRS 的降低有关。这些晚期变化在应答者中被特别观察到。为了评估特异性,我们将分析扩展到独立的 CBT 群体。反应者在 2 周后表现出 delta 增加和 alpha 减少。此外,晚期(基线至第 16 周)α下降与 CBT 后症状改善有关。研究结果表明,在两种治疗方法中,α的后期下降是共同的,而θ的调节作用可能是艾司西酞普兰治疗所特有的。这项研究深入揭示了表明对抗抑郁药物产生良好反应的电生理标志物,从而加深了我们对抑郁症治疗反应机制的理解。
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来源期刊
CiteScore
11.50
自引率
2.90%
发文量
484
审稿时长
23 weeks
期刊介绍: Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.
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