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Pretreatment Rostral Anterior Cingulate Cortex Theta Activity in Relation to Symptom Improvement in Depression: A Randomized Clinical Trial
- Publication Year :
- 2018
- Publisher :
- American Medical Association, 2018.
-
Abstract
- IMPORTANCE: Major depressive disorder (MDD) remains challenging to treat. Although several clinical and demographic variables have been found to predict poor antidepressant response, these markers have not been robustly replicated to warrant implementation in clinical care. Increased pretreatment rostral anterior cingulate cortex (rACC) theta activity has been linked to better antidepressant outcomes. However, no prior study has evaluated whether this marker has incremental predictive validity over clinical and demographic measures. OBJECTIVE: To determine whether increased pretreatment rACC theta activity would predict symptom improvement regardless of randomization arm. DESIGN, SETTING, AND PARTICIPANTS: A multicenter randomized clinical trial enrolled outpatients without psychosis and with chronic or recurrent MDD between July 29, 2011, and December 15, 2015 (Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care [EMBARC]). Patients were consecutively recruited from 4 university hospitals: 634 patients were screened, 296 were randomized to receive sertraline hydrochloride or placebo, 266 had electroencephalographic (EEG) recordings, and 248 had usable EEG data. Resting EEG data were recorded at baseline and 1 week after trial onset, and rACC theta activity was extracted using source localization. Intent-to-treat analysis was conducted. Data analysis was performed from October 7, 2016, to January 19, 2018. INTERVENTIONS: An 8-week course of sertraline or placebo. MAIN OUTCOMES AND MEASURES: The 17-item Hamilton Rating Scale for Depression score (assessed at baseline and weeks 1, 2, 3, 4, 6, and 8). RESULTS: The 248 participants (160 [64.5%] women, 88 [35.5%] men) with usable EEG data had a mean (SD) age of 36.75 (13.15) years. Higher rACC theta activity at both baseline (b = −1.05; 95% CI, −1.77 to −0.34; P = .004) and week 1 (b = −0.83; 95% CI, −1.60 to −0.06; P
- Subjects :
- Adult
Male
medicine.medical_specialty
Randomization
Electroencephalography
Placebo
Gyrus Cinguli
law.invention
03 medical and health sciences
Young Adult
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
Sertraline
medicine
Humans
Theta Rhythm
Anterior cingulate cortex
Original Investigation
Depressive Disorder, Major
medicine.diagnostic_test
business.industry
Hamilton Rating Scale for Depression
Middle Aged
medicine.disease
Prognosis
Antidepressive Agents
030227 psychiatry
Psychiatry and Mental health
medicine.anatomical_structure
Treatment Outcome
Major depressive disorder
Female
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....4dffcb88541631959a8a197595487b3b