title: EEG alpha asymmetry as a gender-specific predictor of outcome to acute treatment with different antidepressant medications in the randomized iSPOT-D study.
abstract: OBJECTIVE
  To determine whether EEG occipital alpha and frontal alpha asymmetry (FAA) distinguishes outpatients with major depression (MDD) from controls, predicts antidepressant treatment outcome, and to explore the role of gender.
  
  
  METHODS
  In the international Study to Predict Optimized Treatment in Depression (iSPOT-D), a multi-center, randomized, prospective open-label trial, 1008 MDD participants were randomized to escitalopram, sertraline or venlafaxine-extended release. The study also recruited 336 healthy controls. Treatment response was established after eight weeks and resting EEG was measured at baseline (two minutes eyes open and eyes closed).
  
  
  RESULTS
  No differences in EEG alpha for occipital and frontal cortex, or for FAA, were found in MDD participants compared to controls. Alpha in the occipital and frontal cortex was not associated with treatment outcome. However, a gender and drug-class interaction effect was found for FAA. Relatively greater right frontal alpha (less cortical activity) in women only was associated with a favorable response to the Selective Serotonin Reuptake Inhibitors escitalopram and sertraline. No such effect was found for venlafaxine-extended release.
  
  
  CONCLUSIONS
  FAA does not differentiate between MDD and controls, but is associated with antidepressant treatment response and remission in a gender and drug-class specific manner.
  
  
  CONCLUSIONS
  Future studies investigating EEG alpha measures in depression should a-priori stratify by gender.
authors.affiliation: Dept. of Experimental Psychology, Utrecht University, Utrecht, The Netherlands; Research Institute Brainclinics, Nijmegen, The Netherlands. Electronic address: martijn@brainclinics.com.
authors.forename: Martijn
authors.initials: M
authors.lastname: Arns
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY, USA.
authors.forename: Gerard
authors.initials: G
authors.lastname: Bruder
authors.affiliation: Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
authors.affiliation: Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Spooner
authors.affiliation: Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA; Brain Dynamics Center, Sydney Medical School, The University of Sydney, Sydney, NSW and Westmead Millenium Institute, Westmead, NSW, Australia.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Palmer
authors.affiliation: Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Etkin
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY, USA; Brain Resource Center, New York, USA.
authors.forename: Kamran
authors.initials: K
authors.lastname: Fallahpour
authors.affiliation: Brain Dynamics Center, Sydney Medical School, The University of Sydney, Sydney, NSW and Westmead Millenium Institute, Westmead, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; School of Psychology, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Justine M
authors.initials: JM
authors.lastname: Gatt
authors.affiliation: Alpert Medical School, Brown University, The Neuro Development Center, Inc, Providence, RI, USA.
authors.forename: Laurence
authors.initials: L
authors.lastname: Hirshberg
authors.affiliation: Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA.
authors.forename: Evian
authors.initials: E
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000513:Alpha Rhythm / Q000187:drug effects* / Q000502:physiology; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D004569:Electroencephalography / Q000187:drug effects / Q000379:methods; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012727:Sex Characteristics; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: Alpha; Alpha asymmetry; Antidepressant; Depression; EEG; Gender; Major depressive disorder; Personalized medicine; QEEG; iSPOT-D