25. 9. 2008
1. 3rd Faculty Of Medicine, Charles University and Prague Psychiatric Centre, Department of Psychiatry and Medical Psychology, Prague, Czech Republic
2. Bulovka Hospital, Department of Neurology, Prague, Czech Republic
3. University of North Carolina, Department of Psychiatry and CERT-BD, Chapel Hill, United States
1. Miloslav Kopecek 1,2,3, MD, PhD, firstname.lastname@example.org,
2. Martin Bares 1, MD, email@example.com
3. Martin Brunovsky 1,2, MD, PhD, firstname.lastname@example.org,
4. Tomas Novak 1, MD, email@example.com
5. Pavla Stopkova 1, MD, PhD, firstname.lastname@example.org,
6. Petr Sos 1, MD, email@example.com,
7. Jiri Kozeny 1, Dr., CSc
8. Vladimir Krajca 2, Ing., CSc,
9. Cyril Hoschl 1, MD, DrSc., FRCPsyc
Objectives: Three small-scale studies have shown that a decrease of theta prefrontal EEG cordance after 1 week on antidepressant medication can predict clinical response to treatment. To obtain information about basic predictive characteristics of prefrontal EEG cordance decrease, we pooled data from published and unpublished studies.
Methods: We used a categorization of decrease to predict response and non-decrease to predict non-response. There was the total of 107 patients. Thirty-seven outpatients were treated in the USA and 70 inpatients were treated in the Czech Republic. Eighty-two out of the 107 patients did not respond to a minimal 1 antidepressant trial. Eighty-seven patients were treated with antidepressants and 20 with rTMS monotherapy.
Results: In 40 out of the 47responders, a decrease of prefrontal cordance was detected. There was no decrease of prefrontal cordance in 43 patients out of 60 non-responders. Computed sensitivity of prefrontal cordance decrease was 0.851, (95% confident interval [CI] 0.720-0.929), specificity was 0.716; (95% CI 0.591-0.815), positive predictive value was 0.701; (95% CI 0.572-0.805) and negative predictive value was 0.860; (95% CI 0.735-0.933). The Number Need to Diagnosis (NND) was 1.76; (95% CI 1.45-2.52).
Conclusion: Pooled analysis results support preliminary findings showing that QEEG cordance might be a useful test in early prediction of antidepressive response. The EEG cordance test are at leat comparable to results of exercise ECG for coronary ischaemia. The prospective interventional study is needed to evaluate real cost and benefit in daily clinical practice.
Supported by the grant MZCR NR9330