Electroencephalogram Source Connectivity in the Prediction of Electroconvulsive Therapy Outcome in Major Depressive Disorder

Kirsten, Alexandra; Seifritz, Erich; Olbrich, Sebastian

doi:10.1177/1550059419888338

Cited by 12 publications

(9 citation statements)

References 67 publications

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“…participants at baseline, with significantly decreased alpha and nominally decreased theta connectivity post-treatment in male responders only (50). In an electroconvulsive therapy (ECT) study, responders showed reduced resting-state alpha connectivity compared to non-responders (51). While these studies are not consistent with ours, the mechanism of action of each treatment is likely different.…”

Section: Discussioncontrasting

confidence: 52%

The Effect of Ketamine on Electrophysiological Connectivity in Major Depressive Disorder

et al. 2020

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Major depressive disorder (MDD) is highly prevalent and frequently disabling. Only about 30% of patients respond to a first-line antidepressant treatment, and around 30% of patients are classified as "treatment-resistant" after failing to respond to multiple adequate trials. While most antidepressants target monoaminergic targets, ketamine is an Nmethyl-D-aspartate (NMDA) antagonist that has shown rapid antidepressant effects when delivered intravenously or intranasally. While there is evidence that ketamine exerts its effects via enhanced a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) throughput, its mechanism for relieving depressive symptoms is largely unknown. This study acquired resting-state magnetoencephalography (MEG) recordings after both ketamine and placebo infusions and investigated functional connectivity using a multilayer amplitude-amplitude correlation technique spanning the canonical frequency bands. Twenty-four healthy volunteers (HVs) and 27 unmedicated participants with MDD took part in a double-blind, placebo-controlled, crossover trial of 0.5 mg/kg IV ketamine. Order of infusion was randomized, and participants crossed over to receive the second infusion after two weeks. The results indicated widespread ketamine-induced reductions in connectivity in the alpha and beta bands that did not correlate with magnitude of antidepressant response. In contrast, the magnitude of ketamine's antidepressant effects in MDD participants was associated with cross-frequency connectivity for deltaalpha and delta-gamma bands, with HVs and ketamine non-responders showing connectivity decreases post-ketamine and ketamine responders demonstrating small increases in connectivity. These results may indicate functional subtypes of MDD and also suggest that neural responses to ketamine are fundamentally different between responders and non-responders.

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Section: Discussioncontrasting

confidence: 52%

The Effect of Ketamine on Electrophysiological Connectivity in Major Depressive Disorder

et al. 2020

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“…For example, a large EEG study by Iseger et al 62 showed reduced alpha connectivity in male responders to a trial of antidepressant medication (Escitalopram, Sertraline, or Venlafaxine-XR). Pre-treatment alpha, beta, and gamma band connectivity has also been shown to moderate antidepressant (sertraline hydrochloride or placebo) treatment outcome in a recent large multi-centre study using a novel power envelope connectivity approach 63 ; while lower pre-treatment alpha-band connectivity has been observed in responders to ECT 64 . Although further work is needed to better elucidate the underlying mechanisms responsible for the observed connectivity changes in the present study, a recently proposed connectivity resetting hypothesis 9 might aid in partially explaining these findings.…”

Section: Discussionmentioning

confidence: 99%

Modulation of functional network properties in major depressive disorder following electroconvulsive therapy (ECT): a resting-state EEG analysis

Hill

Hadas

Zomorrodi

et al. 2020

Sci Rep

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Electroconvulsive therapy (ECT) is a highly effective neuromodulatory intervention for treatment-resistant major depressive disorder (MDD). Presently, however, understanding of its neurophysiological effects remains incomplete. In the present study, we utilised resting-state electroencephalography (RS-EEG) to explore changes in functional connectivity, network topology, and spectral power elicited by an acute open-label course of ECT in a cohort of 23 patients with treatment-resistant MDD. RS-EEG was recorded prior to commencement of ECT and again within 48 h following each patient’s final treatment session. Our results show that ECT was able to enhance connectivity within lower (delta and theta) frequency bands across subnetworks largely confined to fronto-central channels, while, conversely, more widespread subnetworks of reduced connectivity emerged within faster (alpha and beta) bands following treatment. Graph-based topological analyses revealed changes in measures of functional segregation (clustering coefficient), integration (characteristic path length), and small-world architecture following ECT. Finally, post-treatment enhancement of delta and theta spectral power was observed, which showed a positive association with the number of ECT sessions received. Overall, our findings indicate that RS-EEG can provide a sensitive measure of dynamic neural activity following ECT and highlight network-based analyses as a promising avenue for furthering mechanistic understanding of the effects of convulsive therapies.

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“…Regarding alpha 2 frequency band, Kirsten and colleagues found a lower linear connectivity in responders and a role of frontal left side associations and frontal interhemispheric correlations in clinical improvement. Results on alpha 1 frequency band were not significant ( 28 ). Stubbeman and colleagues found a significant association between the decrease in HDRS and central cordance; other regions and QEEG measures were not significant ( 26 ).…”

Section: Resultsmentioning

confidence: 92%

“…Three studies used EEG among other polysomnographic recordings ( 19 , 21 , 22 ). The oldest study, published in 1989, used EEG intermittent photic stimulation and hyperventilation ( 23 ), and the five other studies used eyes-closed resting-state EEG ( 24 – 28 ). Two eyes-closed EEG studies computed three-dimensional space with low-resolution electromagnetic tomography (LORETA) to analyze data.…”

Section: Resultsmentioning

confidence: 99%

Using EEG to Predict Clinical Response to Electroconvulsive Therapy in Patients With Major Depression: A Comprehensive Review

2021

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Introduction: An important approach to improve the therapeutic effect of electroconvulsive therapy (ECT) may be to early characterize patients who are more likely to respond. Our objective was to explore whether baseline electroencephalography (EEG) settings before the beginning of ECT treatment can predict future clinical response to ECT in patients with depressive disorder.Methods: We conducted a systematic search in the MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify studies using EEG in adults with depressive disorder treated by ECT. To investigate the predictive value of baseline EEG on clinical outcomes of ECT, we extracted from the retrieved studies and qualitatively described the association between the baseline EEG markers characteristics and the rates of future responders and/or remitters to ECT.Results: The primary search yielded 2,531 potentially relevant citations, and 12 articles were selected according to inclusion criteria. Most of the studies were prospective studies with small sample size. Sociodemographic and clinical characteristics of patients, ECT settings, EEG settings, and outcomes were heterogeneous. Event-related potential (ERP) paradigms were used in three studies, polysomnography was used in three studies, and the six other studies used EEG to measure cerebral connectivity and activity.Conclusions: P300 amplitude, coherence, and connectivity measures were correlated with remission in patients with depression treated by ECT. Sleep EEG recordings seemed not to be correlated with remission after ECT. Further prospective studies with large sample size are needed to determine optimal EEG parameters associated with clinical response to ECT in depressive disorder.Systematic Review Registration: PROSPERO CRD42020181978.

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Electroencephalogram Source Connectivity in the Prediction of Electroconvulsive Therapy Outcome in Major Depressive Disorder

Cited by 12 publications

References 67 publications

The Effect of Ketamine on Electrophysiological Connectivity in Major Depressive Disorder

The Effect of Ketamine on Electrophysiological Connectivity in Major Depressive Disorder

Modulation of functional network properties in major depressive disorder following electroconvulsive therapy (ECT): a resting-state EEG analysis

Using EEG to Predict Clinical Response to Electroconvulsive Therapy in Patients With Major Depression: A Comprehensive Review

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