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Strafella R, Chen R, Rajji TK, Blumberger DM, Voineskos D. Resting and TMS-EEG markers of treatment response in major depressive disorder: A systematic review. Front Hum Neurosci 2022; 16:940759. [PMID: 35992942 PMCID: PMC9387384 DOI: 10.3389/fnhum.2022.940759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022] Open
Abstract
Electroencephalography (EEG) is a non-invasive method to identify markers of treatment response in major depressive disorder (MDD). In this review, existing literature was assessed to determine how EEG markers change with different modalities of MDD treatments, and to synthesize the breadth of EEG markers used in conjunction with MDD treatments. PubMed and EMBASE were searched from 2000 to 2021 for studies reporting resting EEG (rEEG) and transcranial magnetic stimulation combined with EEG (TMS-EEG) measures in patients undergoing MDD treatments. The search yielded 966 articles, 204 underwent full-text screening, and 51 studies were included for a narrative synthesis of findings along with confidence in the evidence. In rEEG studies, non-linear quantitative algorithms such as theta cordance and theta current density show higher predictive value than traditional linear metrics. Although less abundant, TMS-EEG measures show promise for predictive markers of brain stimulation treatment response. Future focus on TMS-EEG measures may prove fruitful, given its ability to target cortical regions of interest related to MDD.
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Affiliation(s)
- Rebecca Strafella
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Robert Chen
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tarek K. Rajji
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Daniel M. Blumberger
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daphne Voineskos
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Daphne Voineskos
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2
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Mosabbir AA, Braun Janzen T, Al Shirawi M, Rotzinger S, Kennedy SH, Farzan F, Meltzer J, Bartel L. Investigating the Effects of Auditory and Vibrotactile Rhythmic Sensory Stimulation on Depression: An EEG Pilot Study. Cureus 2022; 14:e22557. [PMID: 35371676 PMCID: PMC8958118 DOI: 10.7759/cureus.22557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 12/18/2022] Open
Abstract
Background Major depressive disorder (MDD) is a persistent psychiatric condition and one of the leading causes of global disease burden. In a previous study, we investigated the effects of a five-week intervention consisting of rhythmic gamma frequency (30-70 Hz) vibroacoustic stimulation in 20 patients formally diagnosed with MDD. In that study, the findings suggested a significant clinical improvement in depression symptoms as measured using the Montgomery-Asberg Depression Rating Scale (MADRS), with 37% of participants meeting the criteria for clinical response. The goal of the present research was to examine possible changes from baseline to posttreatment in resting-state electroencephalography (EEG) recordings using the same treatment protocol and to characterize basic changes in EEG related to treatment response. Materials and methods The study sample consisted of 19 individuals aged 18-70 years with a clinical diagnosis of MDD. The participants were assessed before and after a five-week treatment period, which consisted of listening to an instrumental musical track on a vibroacoustic device, delivering auditory and vibrotactile stimulus in the gamma-band range (30-70 Hz, with particular emphasis on 40 Hz). The primary outcome measure was the change in Montgomery-Asberg Depression Rating Scale (MADRS) from baseline to posttreatment and resting-state EEG. Results Analysis comparing MADRS score at baseline and post-intervention indicated a significant change in the severity of depression symptoms after five weeks (t = 3.9923, df = 18, p = 0.0009). The clinical response rate was 36.85%. Resting-state EEG power analysis revealed a significant increase in occipital alpha power (t = -2.149, df = 18, p = 0.04548), as well as an increase in the prefrontal gamma power of the responders (t = 2.8079, df = 13.431, p = 0.01442). Conclusions The results indicate that improvements in MADRS scores after rhythmic sensory stimulation (RSS) were accompanied by an increase in alpha power in the occipital region and an increase in gamma in the prefrontal region, thus suggesting treatment effects on cortical activity in depression. The results of this pilot study will help inform subsequent controlled studies evaluating whether treatment response to vibroacoustic stimulation constitutes a real and replicable reduction of depressive symptoms and to characterize the underlying mechanisms.
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Affiliation(s)
| | | | | | - Susan Rotzinger
- Department of Psychiatry, University Health Network, Toronto, CAN
| | - Sidney H Kennedy
- Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto, CAN
| | - Faranak Farzan
- School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, CAN
| | - Jed Meltzer
- Rotman Research Institute, Baycrest Health Sciences, Toronto, CAN
| | - Lee Bartel
- Faculty of Music, University of Toronto, Toronto, CAN
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Zsido RG, Molloy EN, Cesnaite E, Zheleva G, Beinhölzl N, Scharrer U, Piecha FA, Regenthal R, Villringer A, Nikulin VV, Sacher J. One‐week escitalopram intake alters the excitation–inhibition balance in the healthy female brain. Hum Brain Mapp 2022; 43:1868-1881. [PMID: 35064716 PMCID: PMC8933318 DOI: 10.1002/hbm.25760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Rachel G. Zsido
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- International Max Planck Research School NeuroCom Leipzig Germany
- Max Planck School of Cognition Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Eóin N. Molloy
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- International Max Planck Research School NeuroCom Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- University Clinic for Radiology and Nuclear Medicine, Otto von Guericke University Magdeburg Magdeburg Germany
| | - Elena Cesnaite
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Gergana Zheleva
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Nathalie Beinhölzl
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Ulrike Scharrer
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Clinic for Cognitive Neurology Leipzig University Leipzig Germany
| | - Fabian A. Piecha
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Ralf Regenthal
- Division of Clinical Pharmacology, Rudolf Boehm Institute of Pharmacology and Toxicology Leipzig University Leipzig Germany
| | - Arno Villringer
- International Max Planck Research School NeuroCom Leipzig Germany
- Max Planck School of Cognition Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Clinic for Cognitive Neurology Leipzig University Leipzig Germany
- Berlin School of Mind and Brain Berlin Germany
| | - Vadim V. Nikulin
- International Max Planck Research School NeuroCom Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- International Max Planck Research School NeuroCom Leipzig Germany
- Max Planck School of Cognition Leipzig Germany
- Department of Neurology Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
- Clinic for Cognitive Neurology Leipzig University Leipzig Germany
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4
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de la Salle S, Jaworska N, Blier P, Smith D, Knott V. Using prefrontal and midline right frontal EEG-derived theta cordance and depressive symptoms to predict the differential response or remission to antidepressant treatment in major depressive disorder. Psychiatry Res Neuroimaging 2020; 302:111109. [PMID: 32480044 PMCID: PMC10773969 DOI: 10.1016/j.pscychresns.2020.111109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 02/21/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
There is a growing need for optimizing treatment selection and response prediction in individuals with major depressive disorder (MDD). Prior investigations have shown that changes in electroencephalographic (EEG)-based measures precede symptom improvement and could serve as biomarkers of treatment outcome. One such method is cordance, a computation of regional brain activity based on a combination of absolute and relative resting EEG activity. Specifically, early reduction in prefrontal (PF) and midline right frontal (MRF) theta (4-8Hz) cordance has been shown to predict response to various antidepressants, though replication is required. Thus, this study examined early changes (baseline to week 1) in PF and MRF cordance in 47 MDD patients undergoing antidepressant treatment. Early changes in cordance and in Montgomery Åsberg Depression Rating Scale (MADRS) scores were assessed alone, and in combination, to predict eventual (by week 12) treatment response and remission. Models combining early changes in theta cordance (PF and MRF) and depressive symptoms were most predictive of response to treatment at week 12; remission models (cordance, MADRS, and their combination) were weaker, though provided modest prediction values. These results suggest that antidepressant response may be optimally predicted by combining both EEG and symptom-based measures after one week of treatment.
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Affiliation(s)
- Sara de la Salle
- University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa K1Z 7K4, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | - Natalia Jaworska
- University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa K1Z 7K4, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa K1Z 7K4, ON, Canada
| | - Dylan Smith
- University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa K1Z 7K4, ON, Canada
| | - Verner Knott
- University of Ottawa Institute of Mental Health Research, 1145 Carling Avenue, Ottawa K1Z 7K4, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
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5
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Prospective testing of a neurophysiologic biomarker for treatment decisions in major depressive disorder: The PRISE-MD trial. J Psychiatr Res 2020; 124:159-165. [PMID: 32169689 PMCID: PMC7141143 DOI: 10.1016/j.jpsychires.2020.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/03/2020] [Accepted: 02/24/2020] [Indexed: 12/12/2022]
Abstract
Management of Major Depressive Disorder (MDD) might be improved by a biomarker to predict whether a selected medication is likely to lead to remission. We previously reported on a quantitative electroencephalogram-based biomarker, the Antidepressant Treatment Response (ATR) index, that integrated recordings at baseline and after one week of treatment. The present study prospectively tested whether treatment directed by the biomarker increased the likelihood of remission; we hypothesized that continued treatment with a drug predicted to lead to remission (i.e., high ATR values) would be associated with better outcomes than if the drug was predicted not to lead to remission (i.e., low ATR values). We enrolled 180 adult outpatients with unipolar MDD from the community. After one week of escitalopram treatment to determine the biomarker, stratified randomization (high vs. low ATR) was used to assign subjects to either continued escitalopram or a switch to bupropion as a blinded control condition, for seven additional weeks. For the 73 evaluable subjects assigned to continued escitalopram treatment, the remission rate was significantly higher for those in whom ATR had predicted remission versus non-remission (60.4% vs. 30.0%, respectively, p = 0.01). Accuracy was enhanced by combining 1-week depressive symptom change with ATR (68.6% vs 28.9%). This prospective validation study supports further development of the ATR biomarker, alone or together with early symptom change, to improve care by identifying individuals unlikely to remit with their current treatment, and support the decision to change treatment after one week rather than after failing a full, prolonged course of medication.
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6
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Koshiyama D, Kirihara K, Usui K, Tada M, Fujioka M, Morita S, Kawakami S, Yamagishi M, Sakurada H, Sakakibara E, Satomura Y, Okada N, Kondo S, Araki T, Jinde S, Kasai K. Resting-state EEG beta band power predicts quality of life outcomes in patients with depressive disorders: A longitudinal investigation. J Affect Disord 2020; 265:416-422. [PMID: 32090768 DOI: 10.1016/j.jad.2020.01.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 11/23/2019] [Accepted: 01/05/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Quality of life is severely impaired in patients with depressive disorders. Previous studies have focused on biomarkers predicting depressive symptomatology; however, studies investigating biomarkers predicting quality of life outcomes are limited. Improving quality of life is important because it is related not only to mental health but also to physical health. We need to develop a biomarker related to quality of life as a therapeutic target for patients with depressive disorders. Resting-state electroencephalography (EEG) is easy to record in clinical settings. The index of bandwidth spectral power predicts treatment response in depressive disorders and thus may be a candidate biomarker. However, no longitudinal studies have investigated whether EEG-recorded power could predict quality of life outcomes in patients with depressive disorders. METHODS The resting-state EEG-recorded bandwidth spectral power at baseline and the World Health Organization Quality of Life (QOL)-26 scores at 3-year follow-up were measured in 44 patients with depressive disorders. RESULTS The high beta band power (20-30 Hz) at baseline significantly predicted QOL at the 3-year follow-up after considering depressive symptoms and medication effects in a longitudinal investigation in patients with depressive disorders (β = 0.38, p = 0.01). LIMITATIONS We did not have healthy subjects as a comparison group in this study. CONCLUSIONS Our findings suggest that resting-state beta activity has the potential to be a useful biomarker for predicting future quality of life outcomes in patients with depressive disorders.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shintaro Kawakami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mika Yamagishi
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hanako Sakurada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eisuke Sakakibara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Shinsuke Kondo
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Seichiro Jinde
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.
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7
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The relationship between individual alpha peak frequency and clinical outcome with repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder (MDD). Brain Stimul 2019; 12:1572-1578. [DOI: 10.1016/j.brs.2019.07.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/04/2019] [Accepted: 07/23/2019] [Indexed: 02/01/2023] Open
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8
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Smith EE, Tenke CE, Deldin PJ, Trivedi MH, Weissman MM, Auerbach RP, Bruder GE, Pizzagalli DA, Kayser J. Frontal theta and posterior alpha in resting EEG: A critical examination of convergent and discriminant validity. Psychophysiology 2019; 57:e13483. [PMID: 31578740 DOI: 10.1111/psyp.13483] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 12/22/2022]
Abstract
Prior research has identified two resting EEG biomarkers with potential for predicting functional outcomes in depression: theta current density in frontal brain regions (especially rostral anterior cingulate cortex) and alpha power over posterior scalp regions. As little is known about the discriminant and convergent validity of these putative biomarkers, a thorough evaluation of these psychometric properties was conducted toward the goal of improving clinical utility of these markers. Resting 71-channel EEG recorded from 35 healthy adults at two sessions (1-week retest) were used to systematically compare different quantification techniques for theta and alpha sources at scalp (surface Laplacian or current source density [CSD]) and brain (distributed inverse; exact low resolution electromagnetic tomography [eLORETA]) level. Signal quality was evaluated with signal-to-noise ratio, participant-level spectra, and frequency PCA covariance decomposition. Convergent and discriminant validity were assessed within a multitrait-multimethod framework. Posterior alpha was reliably identified as two spectral components, each with unique spatial patterns and condition effects (eyes open/closed), high signal quality, and good convergent and discriminant validity. In contrast, frontal theta was characterized by one low-variance component, low signal quality, lack of a distinct spectral peak, and mixed validity. Correlations between candidate biomarkers suggest that posterior alpha components constitute reliable, convergent, and discriminant biometrics in healthy adults. Component-based identification of spectral activity (CSD/eLORETA-fPCA) was superior to fixed, a priori frequency bands. Improved quantification and conceptualization of frontal theta is necessary to determine clinical utility.
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Affiliation(s)
- Ezra E Smith
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA
| | - Craig E Tenke
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA.,Division of Cognitive Neuroscience, New York State Psychiatric Institute, New York, New York, USA
| | - Patricia J Deldin
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Myrna M Weissman
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Randy P Auerbach
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Gerard E Bruder
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Center for Depression, Anxiety & Stress Research, McLean Hospital, Belmont, Massachusetts, USA
| | - Jürgen Kayser
- Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York, USA.,Division of Cognitive Neuroscience, New York State Psychiatric Institute, New York, New York, USA
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9
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Cook IA, Congdon E, Krantz DE, Hunter AM, Coppola G, Hamilton SP, Leuchter AF. Time Course of Changes in Peripheral Blood Gene Expression During Medication Treatment for Major Depressive Disorder. Front Genet 2019; 10:870. [PMID: 31620172 PMCID: PMC6760033 DOI: 10.3389/fgene.2019.00870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 08/20/2019] [Indexed: 12/11/2022] Open
Abstract
Changes in gene expression (GE) during antidepressant treatment may increase understanding of the action of antidepressant medications and serve as biomarkers of efficacy. GE changes in peripheral blood are desirable because they can be assessed easily on multiple occasions during treatment. We report here on GE changes in 68 individuals who were treated for 8 weeks with either escitalopram alone, or escitalopram followed by bupropion. GE changes were assessed after 1, 2, and 8 weeks of treatment, with significant changes observed in 156, 121, and 585 peripheral blood gene transcripts, respectively. Thirty-one transcript changes were shared between the 1- and 8-week time points (seven upregulated, 24 downregulated). Differences were detected between the escitalopram- and bupropion-treated subjects, although there was no significant association between GE changes and clinical outcome. A subset of 18 genes overlapped with those previously identified as differentially expressed in subjects with MDD compared with healthy control subjects. There was statistically significant overlap between genes differentially expressed in the current and previous studies, with 10 genes overlapping in at least two previous studies. There was no enrichment for genes overexpressed in nervous system cell types, but there was a trend toward enrichment for genes in the WNT/β-catenin pathway in the anterior thalamus; three genes in this pathway showed differential expression in the present and in three previous studies. Our dataset and other similar studies will provide an important source of information about potential biomarkers of recovery and for potential dysregulation of GE in MDD.
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Affiliation(s)
- Ian A Cook
- Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Bioengineering, Henry Samueli School of Engineering at Applied Science, University of California, Los Angeles, Los Angeles, CA, United States
| | - Eliza Congdon
- Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - David E Krantz
- Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Aimee M Hunter
- Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Giovanni Coppola
- Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Steven P Hamilton
- Department of Psychiatry, Kaiser Permanente Northern California, San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew F Leuchter
- Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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10
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Estimating patient-specific treatment advantages in the 'Treatment for Adolescents with Depression Study'. J Psychiatr Res 2019; 112:61-70. [PMID: 30856378 DOI: 10.1016/j.jpsychires.2019.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 01/12/2019] [Accepted: 02/25/2019] [Indexed: 11/23/2022]
Abstract
The 'Treatment for Adolescents with Depression Study' (TADS, ClinicalTrials.gov, identifier: NCT00006286) was a cornerstone, randomized controlled trial evaluating the effectiveness of standard treatment options for major depression in adolescents. Whereas previous TADS analyses examined primarily effect modifications of treatment-placebo differences by various patient characteristics, less is known about the modification of inter-treatment differences, and hence, patient characteristics that might guide treatment selection. We sought to fill this gap by estimating patient-specific inter-treatment differences as a function of patients' baseline characteristics. We did so by applying the 'model-based random forest', a recently-introduced machine learning-based method for evaluating effect heterogeneity that allows for the estimation of patient-specific treatment effects as a function of arbitrary baseline characteristics. Treatment conditions were cognitive-behavioural therapy (CBT) alone, fluoxetine (FLX) alone, and the combination of CBT and fluoxetine (COMB). All inter-treatment differences (CBT vs. FLX; CBT vs. COMB; FLX vs. COMB) were evaluated across 23 potential effect modifiers extracted from previous studies. Overall, FLX was superior to CBT, while COMB was superior to both CBT and FLX. Evidence for effect heterogeneity was found for the CBT-FLX difference and the FLX-COMB difference, but not for the CBT-COMB difference. Baseline depression severity modified the CBT-FLX difference; whereas baseline depression severity, patients' treatment expectations, and childhood trauma modified the FLX-COMB difference. All modifications were quantitative rather than qualitative, however, meaning that the differences varied only in magnitude, but not direction. These findings imply that combining CBT with fluoxetine may be superior to either therapy used alone across a broad range of patients.
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11
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Dauwan M, Hoff JI, Vriens EM, Hillebrand A, Stam CJ, Sommer IE. Aberrant resting-state oscillatory brain activity in Parkinson's disease patients with visual hallucinations: An MEG source-space study. Neuroimage Clin 2019; 22:101752. [PMID: 30897434 PMCID: PMC6425119 DOI: 10.1016/j.nicl.2019.101752] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/18/2019] [Accepted: 03/09/2019] [Indexed: 12/31/2022]
Abstract
To gain insight into possible underlying mechanism(s) of visual hallucinations (VH) in Parkinson's disease (PD), we explored changes in local oscillatory activity in different frequency bands with source-space magnetoencephalography (MEG). Eyes-closed resting-state MEG recordings were obtained from 20 PD patients with hallucinations (Hall+) and 20 PD patients without hallucinations (Hall-), matched for age, gender and disease severity. The Hall+ group was subdivided into 10 patients with VH only (unimodal Hall+) and 10 patients with multimodal hallucinations (multimodal Hall+). Subsequently, neuronal activity at source-level was reconstructed using an atlas-based beamforming approach resulting in source-space time series for 78 cortical and 12 subcortical regions of interest in the automated anatomical labeling (AAL) atlas. Peak frequency (PF) and relative power in six frequency bands (delta, theta, alpha1, alpha2, beta and gamma) were compared between Hall+ and Hall-, unimodal Hall+ and Hall-, multimodal Hall+ and Hall-, and unimodal Hall+ and multimodal Hall+ patients. PF and relative power per frequency band did not differ between Hall+ and Hall-, and multimodal Hall+ and Hall- patients. Compared to the Hall- group, unimodal Hall+ patients showed significantly higher relative power in the theta band (p = 0.005), and significantly lower relative power in the beta (p = 0.029) and gamma (p = 0.007) band, and lower PF (p = 0.011). Compared to the unimodal Hall+, multimodal Hall+ showed significantly higher PF (p = 0.007). In conclusion, a subset of PD patients with only VH showed slowing of MEG-based resting-state brain activity with an increase in theta activity, and a concomitant decrease in beta and gamma activity, which could indicate central cholinergic dysfunction as underlying mechanism of VH in PD. This signature was absent in PD patients with multimodal hallucinations.
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Affiliation(s)
- M Dauwan
- Neuroimaging Center, University Medical Center Groningen, University of Groningen, Neuroimaging Center 3111, Antonius Deusinglaan 2, 9713 AW Groningen, the Netherlands; Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Neuroscience Campus Amsterdam, Postbus 7057, 1007 MB Amsterdam, the Netherlands; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, the Netherlands.
| | - J I Hoff
- Department of Neurology, St. Antonius Ziekenhuis, Nieuwegein, Utrecht, the Netherlands
| | - E M Vriens
- Department of Neurology, Diakonessenhuis Utrecht, the Netherlands
| | - A Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Neuroscience Campus Amsterdam, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - C J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Neuroscience Campus Amsterdam, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - I E Sommer
- Neuroimaging Center, University Medical Center Groningen, University of Groningen, Neuroimaging Center 3111, Antonius Deusinglaan 2, 9713 AW Groningen, the Netherlands; Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Norway
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12
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Perera MPN, Bailey NW, Herring SE, Fitzgerald PB. Electrophysiology of obsessive compulsive disorder: A systematic review of the electroencephalographic literature. J Anxiety Disord 2019; 62:1-14. [PMID: 30469123 DOI: 10.1016/j.janxdis.2018.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 10/04/2018] [Accepted: 11/03/2018] [Indexed: 01/04/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a chronic disease that causes significant decline in the quality of life of those affected. Due to our limited understanding of the underlying pathophysiology of OCD, successful treatment remains elusive. Although many have studied the pathophysiology of OCD through electroencephalography (EEG), limited attempts have been made to synthesize and interpret their findings. To bridge this gap, we conducted a comprehensive literature review using Medline/PubMed and considered the 65 most relevant studies published before June 2018. The findings are categorised into quantitative EEG, sleep related EEG and event related potentials (ERPs). Increased frontal asymmetry, frontal slowing and an enhancement in the ERP known as error related negativity (ERN) were consistent findings in OCD. However, sleep EEG and other ERP (P3 and N2) findings were inconsistent. Additionally, we analysed the usefulness of ERN as a potential candidate endophenotype. We hypothesize that dysfunctional frontal circuitry and overactive performance monitoring are the major underlying impairments in OCD. Additionally, we conceptualized that defective fronto-striato-thalamic circuitry causing poor cerebral functional connectivity gives rise to the OCD behavioural manifestations. Finally, we have discussed transcranial magnetic stimulation and EEG (TMS-EEG) applications in future research to further our knowledge of the underlying pathophysiology of OCD.
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Affiliation(s)
- M Prabhavi N Perera
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Level 4, 607, St. Kilda Road, Melbourne, Victoria 3004, Australia.
| | - Neil W Bailey
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Level 4, 607, St. Kilda Road, Melbourne, Victoria 3004, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare, 888 Toorak Rd, Camberwell, Victoria 3124, Australia.
| | - Sally E Herring
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare, 888 Toorak Rd, Camberwell, Victoria 3124, Australia.
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Level 4, 607, St. Kilda Road, Melbourne, Victoria 3004, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare, 888 Toorak Rd, Camberwell, Victoria 3124, Australia.
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13
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Thériault RK, Perreault ML. Hormonal regulation of circuit function: sex, systems and depression. Biol Sex Differ 2019; 10:12. [PMID: 30819248 PMCID: PMC6394099 DOI: 10.1186/s13293-019-0226-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/18/2019] [Indexed: 01/10/2023] Open
Abstract
Major depressive disorder (MDD) is a debilitating chronic illness that is two times more prevalent in women than in men. The mechanisms associated with the increased female susceptibility to depression remain poorly characterized. Aberrant neuronal oscillatory activity within the putative depression network is an emerging mechanism underlying MDD. However, innate sex differences in network activity and its contribution to depression vulnerability have not been well described. In this review, current evidence of sex differences in neuronal oscillatory activity, including the influence of sex hormones and female cycling, will first be described followed by evidence of disrupted neuronal circuit function in MDD and the effects of antidepressant treatment. Lastly, current knowledge of sex differences in MDD-associated aberrant circuit function and oscillatory activity will be highlighted, with an emphasis on the role of sex steroids and female cycling. Collectively, it is clear that there are significant gaps in the literature regarding innate and pathologically associated sex differences in network activity and that the elucidation of these differences is invaluable to our understanding of sex-specific vulnerabilities and therapies for MDD.
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Affiliation(s)
- Rachel-Karson Thériault
- Department of Molecular and Cellular Biology, University of Guelph (ON), 50 Stone Rd. E, Guelph, Ontario N1G 2W1 Canada
- Collaborative Neuroscience Program, University of Guelph (ON), Guelph, Canada
| | - Melissa L. Perreault
- Department of Molecular and Cellular Biology, University of Guelph (ON), 50 Stone Rd. E, Guelph, Ontario N1G 2W1 Canada
- Collaborative Neuroscience Program, University of Guelph (ON), Guelph, Canada
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14
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Hunter AM, Nghiem TX, Cook IA, Krantz DE, Minzenberg MJ, Leuchter AF. Change in Quantitative EEG Theta Cordance as a Potential Predictor of Repetitive Transcranial Magnetic Stimulation Clinical Outcome in Major Depressive Disorder. Clin EEG Neurosci 2018; 49:306-315. [PMID: 29224411 DOI: 10.1177/1550059417746212] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has demonstrated efficacy in major depressive disorder (MDD), although clinical outcome is variable. Change in the resting-state quantitative electroencephalogram (qEEG), particularly in theta cordance early in the course of treatment, has been linked to antidepressant medication outcomes but has not been examined extensively in clinical rTMS. This study examined change in theta cordance over the first week of clinical rTMS and sought to identify a biomarker that would predict outcome at the end of 6 weeks of treatment. Clinically stable outpatients (n = 18) received nonblinded rTMS treatment administered to the dorsolateral prefrontal cortex (DLPFC). Treatment parameters (site, intensity, number of pulses) were adjusted on an ongoing basis guided by changes in symptom severity rating scale scores. qEEGs were recorded at pretreatment baseline and after 1 week of left DLPFC (L-DLPFC) rTMS using a 21-channel dry-electrode headset. Analyses examined the association between week 1 regional changes in theta band (4-8 Hz) cordance, and week 6 patient- and physician-rated outcomes. Theta cordance change in the central brain region predicted percent change in Inventory of Depressive Symptomology-Self-Report (IDS-SR) score, and improvement versus nonimprovement on the Clinical Global Impression-Improvement Inventory (CGI-I) ( R2 = .38, P = .007; and Nagelkerke R2 = .78, P = .0001, respectively). The cordance biomarker remained significant when controlling for age, gender, and baseline severity. Treatment-emergent change in EEG theta cordance in the first week of rTMS may predict acute (6-week) treatment outcome in MDD. This oscillatory synchrony biomarker merits further study in independent samples.
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Affiliation(s)
- Aimee M Hunter
- 1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA.,2 Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Thien X Nghiem
- 1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA
| | - Ian A Cook
- 1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA.,2 Department of Psychiatry, University of California, Los Angeles, CA, USA.,3 Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - David E Krantz
- 1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA.,2 Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Michael J Minzenberg
- 1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA.,2 Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Andrew F Leuchter
- 1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA.,2 Department of Psychiatry, University of California, Los Angeles, CA, USA
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15
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Acute and chronic escitalopram alter EEG gamma oscillations differently: relevance to therapeutic effects. Eur J Pharm Sci 2018; 121:347-355. [DOI: 10.1016/j.ejps.2018.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/24/2018] [Accepted: 06/13/2018] [Indexed: 12/13/2022]
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16
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Riga MS, Lladó-Pelfort L, Artigas F, Celada P. The serotonin hallucinogen 5-MeO-DMT alters cortico-thalamic activity in freely moving mice: Regionally-selective involvement of 5-HT 1A and 5-HT 2A receptors. Neuropharmacology 2017; 142:219-230. [PMID: 29221792 DOI: 10.1016/j.neuropharm.2017.11.049] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/21/2017] [Accepted: 11/30/2017] [Indexed: 01/26/2023]
Abstract
5-MeO-DMT is a natural hallucinogen acting as serotonin 5-HT1A/5-HT2A receptor agonist. Its ability to evoke hallucinations could be used to study the neurobiology of psychotic symptoms and to identify new treatment targets. Moreover, recent studies revealed the therapeutic potential of serotonin hallucinogens in treating mood and anxiety disorders. Our previous results in anesthetized animals show that 5-MeO-DMT alters cortical activity via 5-HT1A and 5-HT2A receptors. Here, we examined 5-MeO-DMT effects on oscillatory activity in prefrontal (PFC) and visual (V1) cortices, and in mediodorsal thalamus (MD) of freely-moving wild-type (WT) and 5-HT2A-R knockout (KO2A) mice. We performed local field potential multi-recordings evaluating the power at different frequency bands and coherence between areas. We also examined the prevention of 5-MeO-DMT effects by the 5-HT1A-R antagonist WAY-100635. 5-MeO-DMT affected oscillatory activity more in cortical than in thalamic areas. More marked effects were observed in delta power in V1 of KO2A mice. 5-MeO-DMT increased beta band coherence between all examined areas. In KO2A mice, WAY100635 prevented most of 5-MeO-DMT effects on oscillatory activity. The present results indicate that hallucinatory activity of 5-MeO-DMT is likely mediated by simultaneous alteration of prefrontal and visual activities. The prevention of these effects by WAY-100635 in KO2A mice supports the potential usefulness of 5-HT1A receptor antagonists to treat visual hallucinations. 5-MeO-DMT effects on PFC theta activity and cortico-thalamic coherence may be related to its antidepressant activity. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- Maurizio S Riga
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, CSIC-IDIBAPS, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Laia Lladó-Pelfort
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, CSIC-IDIBAPS, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Francesc Artigas
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, CSIC-IDIBAPS, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Pau Celada
- Department of Neurochemistry and Neuropharmacology, Institut d'Investigacions Biomèdiques de Barcelona, CSIC-IDIBAPS, Spain; CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain.
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17
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Leuchter MK, Donzis EJ, Cepeda C, Hunter AM, Estrada-Sánchez AM, Cook IA, Levine MS, Leuchter AF. Quantitative Electroencephalographic Biomarkers in Preclinical and Human Studies of Huntington's Disease: Are They Fit-for-Purpose for Treatment Development? Front Neurol 2017; 8:91. [PMID: 28424652 PMCID: PMC5371600 DOI: 10.3389/fneur.2017.00091] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 02/27/2017] [Indexed: 01/30/2023] Open
Abstract
A major focus in development of novel therapies for Huntington's disease (HD) is identification of treatments that reduce the burden of mutant huntingtin (mHTT) protein in the brain. In order to identify and test the efficacy of such therapies, it is essential to have biomarkers that are sensitive to the effects of mHTT on brain function to determine whether the intervention has been effective at preventing toxicity in target brain systems before onset of clinical symptoms. Ideally, such biomarkers should have a plausible physiologic basis for detecting the effects of mHTT, be measureable both in preclinical models and human studies, be practical to measure serially in clinical trials, and be reliably measurable in HD gene expansion carriers (HDGECs), among other features. Quantitative electroencephalography (qEEG) fulfills many of these basic criteria of a "fit-for-purpose" biomarker. qEEG measures brain oscillatory activity that is regulated by the brain structures that are affected by mHTT in premanifest and early symptom individuals. The technology is practical to implement in the laboratory and is well tolerated by humans in clinical trials. The biomarkers are measureable across animal models and humans, with findings that appear to be detectable in HDGECs and translate across species. We review here the literature on recent developments in both preclinical and human studies of the use of qEEG biomarkers in HD, and the evidence for their usefulness as biomarkers to help guide development of novel mHTT lowering treatments.
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Affiliation(s)
- Michael K Leuchter
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Elissa J Donzis
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Intellectual and Developmental Disabilities Research Center, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Carlos Cepeda
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Intellectual and Developmental Disabilities Research Center, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Aimee M Hunter
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Neuromodulation Division, Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ana María Estrada-Sánchez
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Intellectual and Developmental Disabilities Research Center, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ian A Cook
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Neuromodulation Division, Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Bioengineering, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michael S Levine
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Intellectual and Developmental Disabilities Research Center, David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Andrew F Leuchter
- David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.,Neuromodulation Division, Laboratory of Brain, Behavior, and Pharmacology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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