Rostral Anterior Cingulate Cortex Oscillatory Power Indexes Treatment-Resistance to Multiple Therapies in Major Depressive Disorder.

IF 2.3 4区心理学 Q3 NEUROSCIENCES

Neuropsychobiology Pub Date : 2023-01-01 Epub Date: 2023-10-17 DOI:10.1159/000533853

Amourie Prentice, Ana Rita Barreiros, Nikita van der Vinne, Sven Stuiver, Hanneke van Dijk, Jeroen Antonius van Waarde, Mayuresh Korgaonkar, Alexander T Sack, Martijn Arns

{"title":"Rostral Anterior Cingulate Cortex Oscillatory Power Indexes Treatment-Resistance to Multiple Therapies in Major Depressive Disorder.","authors":"Amourie Prentice, Ana Rita Barreiros, Nikita van der Vinne, Sven Stuiver, Hanneke van Dijk, Jeroen Antonius van Waarde, Mayuresh Korgaonkar, Alexander T Sack, Martijn Arns","doi":"10.1159/000533853","DOIUrl":null,"url":null,"abstract":"Introduction: High rostral anterior cingulate cortex (rACC) activity is proposed as a nonspecific prognostic marker for treatment response in major depressive disorder, independent of treatment modality. However, other studies report a negative association between baseline high rACC activation and treatment response. Interestingly, these contradictory findings were also found when focusing on oscillatory markers, specifically rACC-theta power. An explanation could be that rACC-theta activity dynamically changes according to number of previous treatment attempts and thus is mediated by level of treatment-resistance.Methods: Primarily, we analyzed differences in rACC- and frontal-theta activity in large national cross-sectional samples representing various levels of treatment-resistance and resistance to multimodal treatments in depressed patients (psychotherapy [n = 175], antidepressant medication [AD; n = 106], repetitive transcranial magnetic stimulation [rTMS; n = 196], and electroconvulsive therapy [ECT; n = 41]), and the respective difference between remitters and non-remitters. For exploratory purposes, we also investigated other frequency bands (delta, alpha, beta, gamma).Results: rACC-theta activity was higher (p < 0.001) in the more resistant rTMS and ECT patients relative to the less resistant psychotherapy and AD patients (psychotherapy-rTMS: d = 0.315; AD-rTMS: d = 0.320; psychotherapy-ECT: d = 1.031; AD-ECT: d = 1.034), with no difference between psychotherapy and AD patients. This association was even more pronounced after controlling for frontal-theta. Post hoc analyses also yielded effects for delta, beta, and gamma bands.Conclusion: Our findings suggest that by factoring in degree of treatment-resistance during interpretation of the rACC-theta biomarker, its usefulness in treatment selection and prognosis could potentially be improved substantially in future real-world practice. Future research should however also investigate specificity of the theta band.","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"373-383"},"PeriodicalIF":2.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropsychobiology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1159/000533853","RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/17 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: High rostral anterior cingulate cortex (rACC) activity is proposed as a nonspecific prognostic marker for treatment response in major depressive disorder, independent of treatment modality. However, other studies report a negative association between baseline high rACC activation and treatment response. Interestingly, these contradictory findings were also found when focusing on oscillatory markers, specifically rACC-theta power. An explanation could be that rACC-theta activity dynamically changes according to number of previous treatment attempts and thus is mediated by level of treatment-resistance.

Methods: Primarily, we analyzed differences in rACC- and frontal-theta activity in large national cross-sectional samples representing various levels of treatment-resistance and resistance to multimodal treatments in depressed patients (psychotherapy [n = 175], antidepressant medication [AD; n = 106], repetitive transcranial magnetic stimulation [rTMS; n = 196], and electroconvulsive therapy [ECT; n = 41]), and the respective difference between remitters and non-remitters. For exploratory purposes, we also investigated other frequency bands (delta, alpha, beta, gamma).

Results: rACC-theta activity was higher (p < 0.001) in the more resistant rTMS and ECT patients relative to the less resistant psychotherapy and AD patients (psychotherapy-rTMS: d = 0.315; AD-rTMS: d = 0.320; psychotherapy-ECT: d = 1.031; AD-ECT: d = 1.034), with no difference between psychotherapy and AD patients. This association was even more pronounced after controlling for frontal-theta. Post hoc analyses also yielded effects for delta, beta, and gamma bands.

Conclusion: Our findings suggest that by factoring in degree of treatment-resistance during interpretation of the rACC-theta biomarker, its usefulness in treatment selection and prognosis could potentially be improved substantially in future real-world practice. Future research should however also investigate specificity of the theta band.

查看原文本刊更多论文

重度抑郁症患者对多种治疗的抵抗力。

引言：高额前扣带皮层（rACC）活性被认为是重度抑郁症治疗反应的非特异性预后标志，与治疗方式无关。然而，其他研究报告了基线高rACC激活与治疗反应之间的负相关。有趣的是，当关注振荡标记物，特别是rACCθ功率时，也发现了这些相互矛盾的发现。一种解释可能是rACCθ，我们分析了代表抑郁症患者对多模式治疗（心理治疗[n=175]、抗抑郁药物[AD；n=106]、重复经颅磁刺激[rTMS；n=196]和电休克治疗[ECT；n=41]）的不同治疗抵抗和抵抗水平的大型全国横断面样本中rACC-和额角θ活性的差异，以及汇款人和非汇款人之间的各自差异。出于探索目的，我们还研究了其他频带（δ、α、β、γ）。结果：与抵抗力较低的心理治疗和AD患者相比，抵抗力较强的rTMS和ECT患者的rACCθ活性更高（p＜0.001）（心理治疗rTMS:d=0.315；AD-rTMS:d=0.320；心理治疗ECT：d=1.031；AD-ECT:d=1.034），而心理治疗和AD患者之间没有差异。在控制了额叶θ后，这种关联更加明显。事后分析也产生了德尔塔、贝塔和伽马波段的影响。结论：我们的研究结果表明，在rACC theta生物标志物的解释过程中，通过考虑治疗耐药性的程度，其在治疗选择和预后方面的有用性可能会在未来的现实实践中得到显著改善。然而，未来的研究也应该研究θ带的特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neuropsychobiology 医学-精神病学

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： The biological approach to mental disorders continues to yield innovative findings of clinical importance, particularly if methodologies are combined. This journal collects high quality empirical studies from various experimental and clinical approaches in the fields of Biological Psychiatry, Biological Psychology and Neuropsychology. It features original, clinical and basic research in the fields of neurophysiology and functional imaging, neuropharmacology and neurochemistry, neuroendocrinology and neuroimmunology, genetics and their relationships with normal psychology and psychopathology. In addition, the reader will find studies on animal models of mental disorders and therapeutic interventions, and pharmacoelectroencephalographic studies. Regular reviews report new methodologic approaches, and selected case reports provide hints for future research. ''Neuropsychobiology'' is a complete record of strategies and methodologies employed to study the biological basis of mental functions including their interactions with psychological and social factors.