NeuroPharm study: EEG wakefulness regulation as a biomarker in MDD

• Published in: Journal of psychiatric research 2021-09, Vol.141, p.57-65
• Main Authors: Ip, Cheng-Teng, Ganz, Melanie, Dam, Vibeke H., Ozenne, Brice, Rüesch, Annia, Köhler-Forsberg, Kristin, Jørgensen, Martin B., Frokjaer, Vibe G., Søgaard, Birgitte, Christensen, Søren R., Knudsen, Gitte M., Olbrich, Sebastian
• Format: Article
• Language: English
• Subjects: Antidepressant treatment effect; Biomarker; EEG; MDD; SSRI; VIGALL
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2021.06.021

While several electroencephalogram (EEG)-based biomarkers have been proposed as diagnostic or predictive tools in major depressive disorder (MDD), there is a clear lack of replication studies in this field. Markers that link clinical features such as disturbed wakefulness regulation in MDD with neurophysiological patterns are particularly promising candidates for e.g., EEG-informed choices of antidepressive treatment. We investigate if we in an independent MDD sample can replicate abnormal findings of EEG-vigilance regulation during rest and as a predictor for antidepressive treatment response. EEG-resting state was recorded in 91 patients and 35 healthy controls from the NeuroPharm trial. EEG-vigilance was assessed using the Vigilance Algorithm Leipzig (VIGALL). We compared the vigilance regulation during rest between patients and healthy controls and between remitters/responders and non-remitters/non-responders after eight weeks of SSRI/SNRI treatment using two different sets of response criteria (NeuroPharm and iSPOT-D). We replicated previous findings showing hyperstable EEG-wakefulness regulation in patients in comparison to healthy subjects. Responders defined by the iSPOT-D criteria showed a higher propensity toward low vigilance stages in comparison to patients with no response at pretreatment, however, this did not apply when using the NeuroPharm criteria. EEG-wakefulness regulation patterns normalized toward patterns of healthy controls after 8 weeks of treatment. This replication study supports the diagnostic value of EEG-vigilance regulation and its usefulness as a biomarker for the choice of treatment in MDD. •MDD show a more rigid vigilance regulation during rest compared to healthy control.•Patients with the hyperstable vigilance regulation profit less from escitalopram and duloxetine.•The wakefulness regulation of responders and remitters normalizes towards healthy controls after treatment.