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Gao M, Sang W, Mi K, Liu J, Liu Y, Zhen W, An B. The Relationship Between Theta Power, Theta Asymmetry and the Effect of Escitalopram in the Treatment of Depression. Neuropsychiatr Dis Treat 2023; 19:2241-2249. [PMID: 37900670 PMCID: PMC10612517 DOI: 10.2147/ndt.s425506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023] Open
Abstract
Objective Only about one-third of depressed patients respond to initial antidepressant treatment. Therefore, it is crucial to find effective predictors of antidepressants. The purpose of our study was to learn the relationship between EEG theta power, theta asymmetry, and the efficacy of escitalopram. Methods The study included 34 patients with depression. Before and after each patient's course of treatment, EEG data was gathered. Both the Hamilton Anxiety Scale (HAMA) and the 17-item Hamilton Depression Scale (HAMD-17) were evaluated simultaneously. The natural logarithm of right frontal theta power minus left frontal theta power was used to calculate inter-electrode theta asymmetry (AT). Results First, our study found no statistically significant difference between intra-electrode theta power and inter-electrode AT before and after treatment (P ≥ 0.05). When we later looked at the data regarding treatment effects, the findings revealed that patients (n = 9) who did not respond to treatment had lower baseline theta power at C4 [6.190 (2.000, 12.990) vs 15.800 (7.255, 22.330), z = -2.166, P = 0.030]. The two groups had no difference in other electrodes (P ≥ 0.05). The AT of C3/C4 in non-responders (n = 9) was lower [0.012 (0.795) vs 0.733 (0.539), t = -3.224, P = 0.005]. However, there was no difference in inter-electrode AT between the two groups in F3/F4 and F7/F8 (P ≥ 0.05). We finally show that the theta power at C4 was negatively correlated with HAMD scores before treatment (r = -0.346, P = 0.045). Conclusion Our findings determined that increased theta power and positive asymmetry in the right frontal-central area correlate with favourable escitalopram treatment, providing a basis for finding predictive markers for antidepressants.
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Affiliation(s)
- Min Gao
- Department of Affective Disorders II, Hebei Provincial Mental Health Center, Baoding, People’s Republic of China
- Xianyang Central Hospital, Xianyang Mental Health Center, Xianyang, People’s Republic of China
| | - Wenhua Sang
- Department of Affective Disorders II, Hebei Provincial Mental Health Center, Baoding, People’s Republic of China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, People's Republic of China
- The Sixth Clinical Medical College of Hebei University, Baoding, People's Republic of China
| | - Kun Mi
- Department of Affective Disorders II, Hebei Provincial Mental Health Center, Baoding, People’s Republic of China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, People's Republic of China
- The Sixth Clinical Medical College of Hebei University, Baoding, People's Republic of China
| | - Jiancong Liu
- Department of Affective Disorders II, Hebei Provincial Mental Health Center, Baoding, People’s Republic of China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, People's Republic of China
- The Sixth Clinical Medical College of Hebei University, Baoding, People's Republic of China
| | - Yudong Liu
- Department of Affective Disorders II, Hebei Provincial Mental Health Center, Baoding, People’s Republic of China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, People's Republic of China
- The Sixth Clinical Medical College of Hebei University, Baoding, People's Republic of China
| | - Wenge Zhen
- Department of Affective Disorders II, Hebei Provincial Mental Health Center, Baoding, People’s Republic of China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, People's Republic of China
- The Sixth Clinical Medical College of Hebei University, Baoding, People's Republic of China
| | - Bang An
- Xianyang Central Hospital, Xianyang Mental Health Center, Xianyang, People’s Republic of China
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Sheu YH, Magdamo C, Miller M, Das S, Blacker D, Smoller JW. AI-assisted prediction of differential response to antidepressant classes using electronic health records. NPJ Digit Med 2023; 6:73. [PMID: 37100858 PMCID: PMC10133261 DOI: 10.1038/s41746-023-00817-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Antidepressant selection is largely a trial-and-error process. We used electronic health record (EHR) data and artificial intelligence (AI) to predict response to four antidepressants classes (SSRI, SNRI, bupropion, and mirtazapine) 4 to 12 weeks after antidepressant initiation. The final data set comprised 17,556 patients. Predictors were derived from both structured and unstructured EHR data and models accounted for features predictive of treatment selection to minimize confounding by indication. Outcome labels were derived through expert chart review and AI-automated imputation. Regularized generalized linear model (GLM), random forest, gradient boosting machine (GBM), and deep neural network (DNN) models were trained and their performance compared. Predictor importance scores were derived using SHapley Additive exPlanations (SHAP). All models demonstrated similarly good prediction performance (AUROCs ≥ 0.70, AUPRCs ≥ 0.68). The models can estimate differential treatment response probabilities both between patients and between antidepressant classes for the same patient. In addition, patient-specific factors driving response probabilities for each antidepressant class can be generated. We show that antidepressant response can be accurately predicted from real-world EHR data with AI modeling, and our approach could inform further development of clinical decision support systems for more effective treatment selection.
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Affiliation(s)
- Yi-Han Sheu
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Colin Magdamo
- Department of Neurology, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
| | - Matthew Miller
- Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sudeshna Das
- Department of Neurology, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
| | - Deborah Blacker
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jordan W Smoller
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Yan WJ, Ruan QN, Jiang K. Challenges for Artificial Intelligence in Recognizing Mental Disorders. Diagnostics (Basel) 2022; 13:diagnostics13010002. [PMID: 36611294 PMCID: PMC9818923 DOI: 10.3390/diagnostics13010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Artificial Intelligence (AI) appears to be making important advances in the prediction and diagnosis of mental disorders. Researchers have used visual, acoustic, verbal, and physiological features to train models to predict or aid in the diagnosis, with some success. However, such systems are rarely applied in clinical practice, mainly because of the many challenges that currently exist. First, mental disorders such as depression are highly subjective, with complex symptoms, individual differences, and strong socio-cultural ties, meaning that their diagnosis requires comprehensive consideration. Second, there are many problems with the current samples, such as artificiality, poor ecological validity, small sample size, and mandatory category simplification. In addition, annotations may be too subjective to meet the requirements of professional clinicians. Moreover, multimodal information does not solve the current challenges, and within-group variations are greater than between-group characteristics, also posing significant challenges for recognition. In conclusion, current AI is still far from effectively recognizing mental disorders and cannot replace clinicians' diagnoses in the near future. The real challenge for AI-based mental disorder diagnosis is not a technical one, nor is it wholly about data, but rather our overall understanding of mental disorders in general.
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Affiliation(s)
- Wen-Jing Yan
- Wenzhou Seventh People’s Hospital, Wenzhou 325005, China
- School of Mental Health, Wenzhou Medical University, Wenzhou 325015, China
| | - Qian-Nan Ruan
- Wenzhou Seventh People’s Hospital, Wenzhou 325005, China
| | - Ke Jiang
- School of Mental Health, Wenzhou Medical University, Wenzhou 325015, China
- The Social Work Service Center of Zhuji, Zhuji 311800, China
- Correspondence:
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Koller-Schlaud K, Ströhle A, Behr J, Bärwolf Dreysse E, Rentzsch J. Changes in Electric Brain Response to Affective Stimuli in the First Week of Antidepressant Treatment: An Exploratory Study. Neuropsychobiology 2022; 81:69-79. [PMID: 34515179 DOI: 10.1159/000517860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 06/14/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Asymmetrical alpha and frontal theta activity have been discussed as neurobiological markers for antidepressant treatment response. While most studies focus on resting-state EEG, there is evidence that task-related activity assessed at multiple time points might be superior in detecting subtle early differences. METHODS This was a naturalistic study design assessing participants in a psychiatric in- and outpatient hospital setting. We investigated stimulus-related EEG asymmetry (frontal and occipital alpha-1 and alpha-2) and power (frontal midline theta) assessed at baseline and 1 week after initiation of pharmacological depression treatment while presenting affective stimuli. We then compared week 4 responders and nonresponders to antidepressant treatment. RESULTS Follow-up analyses of a significant group × emotion × time interaction (p < 0.04) for alpha-1 asymmetry showed that responders differed significantly at baseline in their asymmetry scores in response to sad compared to happy faces with a change in this pattern 1 week later. Nonresponders did not show this pattern. No significant results were found for alpha-2, occipital alpha-1, and occipital alpha-2 asymmetry or frontal midline theta power. DISCUSSION Our study addresses the gap in comparisons of task-related EEG activity changes measured at two time points and supports the potential value of this approach in detecting early differences in responders versus nonresponders to pharmacological treatment. Important limitations include the small sample size and the noncontrolled study design.
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Affiliation(s)
- Kristin Koller-Schlaud
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Joachim Behr
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Faculty of Health Science Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School Theodor Fontane, Potsdam, Germany
| | - Elisabeth Bärwolf Dreysse
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Johannes Rentzsch
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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Wang Y, Li C, Liu X, Peng D, Wu Y, Fang Y. P300 event-related potentials in patients with different subtypes of depressive disorders. Front Psychiatry 2022; 13:1021365. [PMID: 36713910 PMCID: PMC9880031 DOI: 10.3389/fpsyt.2022.1021365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To explore the differences in event-related potentials (ERPs) of the subclinical types of major depressive disorders (MDD): melancholic (MEL), atypical (ATY), and anxious (ANX). METHODS Patients with MDD treated in the Clinical Department of Shanghai Mental Health Center between September 2017 and December 2020 were prospectively included. This study was approved by the Ethics Committee of the Shanghai Mental Health Center. They were evaluated using the Mini-International Neuropsychiatric Interview (MINI), 17-item Hamilton Depression Scale (HAMD-17), 30-item Self-rated Inventory of Depressive Symptomatology (IDS-30SR), 16-item Quick Inventory of Negative Symptom Scale (QIDS-16SR), and auditory and visual P300 ERPs. RESULTS Finally, 27, 14, and 20 patients with MEL, ATY, and ANX MDD were included in this study, respectively. There were no significant differences in demographic characteristics and HAMD-17, IDS-30SR, and QIDS-16SR total scores among the three groups (all P > 0.05). On the C3 lead, the latency for patients with MEL MDD was the longest, and the latency for patients with ATY MDD was the shortest (MEL vs. ATY vs. ANX: 373.89 ± 6.60 vs. 344.79 ± 9.78 vs. 359.33 ± 7.62, P = 0.039). On the Pz lead, the latency for patients with MEL MDD was the longest, and the latency for patients with ATY MDD was the shortest (MEL vs. ATY vs. ANX: 376.14 ± 6.51 vs. 347.21 ± 9.42 vs. 362.22 ± 8.63, P = 0.047). There were no differences in visual P300 ERPs among the three groups. CONCLUSION There are significant differences in auditory C3 and Pz latency among MEL, ATY, and ANX MDD. These differences could help diagnose the subtype of MDD.
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Affiliation(s)
- Yun Wang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Canxin Li
- The Third People's Hospital of Foshan, Foshan Mental Health Center, Foshan, Guangdong, China
| | - Xiaohua Liu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
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Mismatch negativity in patients with major depressive disorder: A meta-analysis. Clin Neurophysiol 2021; 132:2654-2665. [PMID: 34456164 DOI: 10.1016/j.clinph.2021.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Deficits of mismatch negativity (MMN), a general index of echoic memory function, have been documented in patients with schizophrenia. However, it remains controversial whether patients with major depressive disorder (MDD) demonstrate MMN defects compared with healthy controls (HC). METHODS After screening 41 potential studies identified in PubMed and Medline, 13 studies consisting of 343 HC and 339 patients with MDD were included in the present meta-analysis. The effect sizes (Hedges's g) with a random-effect and inverse-variance weighted model were estimated for the MMN amplitudes and latencies. The effects of different deviant types (i.e., frequency and duration) and of different illness stages (i.e., acute and chronic) on MMN were also examined. RESULTS We found that 1) MMN amplitudes (g = 1.273, p < 0.001) and latencies (g = 0.303, p = 0.027) to duration, but not frequency deviants, were significantly impaired in patients with MDD compared to HC; 2), acute patients exhibited lower MMN amplitudes (g = 1.735, p < 0.001) and prolonged MMN latencies (g = 0.461, p = 0.007) for the duration deviants compared to HC. Only the attenuated duration MMN amplitudes were detected in patients with chronic MDD (g = 0.822, p = 0.027); and 3) depressive symptoms did not significantly correlate with MMN responses. CONCLUSIONS Patients with MDD demonstrated abnormal MMN responses to duration deviants compared to HC. SIGNIFICANCE Duration MMN may constitute an electrophysiological indicator to differentiate HC from patients with MDD, particularly those in the acute stage.
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Matias JN, Achete G, Campanari GSDS, Guiguer ÉL, Araújo AC, Buglio DS, Barbalho SM. A systematic review of the antidepressant effects of curcumin: Beyond monoamines theory. Aust N Z J Psychiatry 2021; 55:451-462. [PMID: 33673739 DOI: 10.1177/0004867421998795] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depression is a severe, chronic, and recurring mental health disorder, which prevalence and morbimortality have increased in recent years. Several theories are proposed to elucidate the mechanisms of depression, such as the involvement of inflammation and the release of cytokines. Alternative treatments have been developed to improve outcomes of the commonly used drugs, and the use of Curcuma longa stands out. Its primary compound is named curcumin that exhibits antioxidant and anti-inflammatory effects. AIMS Several studies have shown that curcumin may play antidepressant actions and, therefore, this study aimed to perform a systematic review of the antidepressant effects of curcumin to evaluate the impact of this compound in the treatment of this condition. METHODS This systematic review has included studies available in MEDLINE-PubMed, EMBASE, and Cochrane databases, and the final selection included 10 randomized clinical trials. CONCLUSION Curcumin improves depressant and anxiety behavior in humans. It can increase monoamines and brain-derived neurotrophic factor levels and may inhibit the production of pro-inflammatory cytokines and neuronal apoptosis in the brain. Systemically, curcumin enhanced insulin sensitivity, reduced cortisol levels, and reversed metabolic abnormalities. Studies with larger samples and standardized dose and formulation are required to demonstrate the benefits of curcumin in depression treatment since there are many variations in this compound's use.
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Affiliation(s)
- Julia Novaes Matias
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília, UNIMAR, São Paulo, Brazil
| | - Gabriela Achete
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília, UNIMAR, São Paulo, Brazil
| | | | - Élen Landgraf Guiguer
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília, UNIMAR, São Paulo, Brazil
| | - Adriano Cressoni Araújo
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília, UNIMAR, São Paulo, Brazil
| | - Daiene Santos Buglio
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília, UNIMAR, São Paulo, Brazil
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília, UNIMAR, São Paulo, Brazil
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