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information on Quantitative EEG (QEEG)
information on the prefrontal cortex
A simple one-hour brain scan could predict who will respond to an antidepressant
and who will not.
As this ScienCentral News video reports, it might help depressed people find
the right drug that makes them feel better much sooner.
Brain Scans Predict Antidepressant Effectiveness
In any given year about one in six Americans suffer from clinical depression,
according to Ian
Cook, assistant professor of psychiatry at the University
of California Los Angelesâ€™ Neuropsychiatric Institute.
About 30 to 40 percent of depressed people who try a drug to relieve their
symptoms will have to try another medication or a combination of medications
before they find the antidepressant that works for them. It may take anywhere
between “a couple of weeks and sometimes several months to see whether
a person is going to respond to a particular medication,” says Cook.
He warns that during that time the person may develop new symptoms, or their
symptoms may intensify. They may even start to have suicidal thoughts or psychotic
symptoms like hallucinations or paranoid delusions.
But now Cook is testing an imaging technique called quantitative electroencephalography,
that can predict whether a person will respond to an antidepressant or not,
within just 48 hours. The scan uses an algorithm to process the brainâ€™s
electrical signals. These electrical signals emanate from communication between
brain cells. Electrodes attached to the patientâ€™s scalp with a gel monitor
the communication in the prefrontal
cortex, the area of the brain that controls motivation and judgment. The
signals are then converted into easy to read, color brain maps.
In a nine-week trial, Cook and colleagues tested 51 patients who had major
depression or clinical depression. Their brainâ€™s electrical activity
was first recorded before they had any treatment. Then, half were treated
with an antidepressant medicine, which was known to work, and the other half
received a placebo.
“We then monitored them over the next weeks to see who would respond
and who wouldnâ€™t. And then we looked back to see what patterns of brain
activity were present at the start and in the first week or two, that would
be predictive of their clinical response”, says Cook. When Cookâ€™s
team compared their earlier brain scans to their clinical response, they found
that a decrease in activity in the prefrontal cortex was a marker for those
who would eventually respond clinically to the medication; people who did
not show this decreased marker were those who would not respond clinically
to the medication.
Cook says that this is an experimental study and other researchers need to
replicate it to test its reliability. Similar findings would indicate that
this scanning technique could be used to monitor depression treatment response
and it might dramatically shorten the amount of time that it takes patients
to get effective treatment, thereby helping people to get well much faster.
An unexpected finding of the study was that people who received the placebo
and showed a clinical response, also showed a change in brain activity.
“But this time it was an increase in activity rather than a decrease,
and it wasnâ€™t seen early on," says Cook. "It was seen after
two weeks or more of treatment. So indeed people who are taking placebo are
showing changes in their brain activity as well, but they are very different
from what we see in people who successfully respond to medications in treatment.”
Although he does not know why this happens, he and his colleagues have been
“sufficiently intrigued” to start a new research project to study
This study was published in the journal Neuropsychopharmacology
and was supported by grants from the the National
Institute of Mental Health and the National
Alliance for Research in Schizophrenia and Depression. Additional support
was received from Eli Lilly
and Company and Wyeth-Ayerst
Laboratories, makers of Prozac and Effexor, respectively.