Premium
Association between increased theta cordance and early response to ECT in late‐life depression
Author(s) -
Ward Michael J.,
Karim Helmet T.,
Jessen Zachary F.,
Ghuman Avniel Singh,
Richardson R. Mark,
Reynolds Charles F.,
Karp Jordan F.
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5220
Subject(s) - electroconvulsive therapy , depression (economics) , treatment resistant depression , magnetoencephalography , psychology , antidepressant , prefrontal cortex , frontal cortex , major depressive disorder , electroencephalography , medicine , psychiatry , neuroscience , schizophrenia (object oriented programming) , cognition , hippocampus , economics , macroeconomics
Objectives More than half of patients with major depression who do not respond to initial antidepressants become treatment resistant (TRD), and while electroconvulsive therapy (ECT) is effective, it involves anesthesia and other medical risks that are of concern in geriatric patients. Past studies have suggested that theta cordance (TC), a correlate of cerebral metabolism measured by electroencephalography, could guide treatment decisions related to patient selection and engagement of the therapeutic target. Methods/Design Eight patients with late‐life treatment resistant depression (LL‐TRD) underwent magnetoencephalography (MEG) at baseline and following seven sessions of ECT. We tested whether the mean and regional frontal cortex TC were able to differentiate early responders from nonresponders. Results Five patients whose depression severity decreased by >30% after seven sessions were considered early responders. We found no baseline differences in mean frontal TC between early responders compared with nonresponders, but early responders exhibited a significant increase in TC following ECT. Further, we found that compared with nonresponders, early responders exhibited a greater change in TC specifically within the right prefrontal cortex. Conclusions These results support the hypothesis that increases in frontal TC are associated with antidepressant response. We expand on previous findings by showing that this change is specific to the right prefrontal cortex. Validation of this neural marker could contribute to improved ECT outcomes, by informing early clinical decisions about the acute efficacy of this treatment.