title: Brain arousal regulation as response predictor for antidepressant therapy in major depression.
abstract: A tonically high level of brain arousal and its hyperstable regulation is supposed to be a pathogenic factor in major depression. Preclinical studies indicate that most antidepressants may counteract this dysregulation. Therefore, it was hypothesized that responders to antidepressants show a) a high level of EEG-vigilance (an indicator of brain arousal) and b) a more stable EEG-vigilance regulation than non-responders. In 65 unmedicated depressed patients 15-min resting-state EEGs were recorded off medication (baseline). In 57 patients an additional EEG was recorded 14 ± 1 days following onset of antidepressant treatment (T1). Response was defined as a ≥50% HAMD-17-improvement after 28 ± 1 days of treatment (T2), resulting in 29 responders and 36 non-responders. Brain arousal was assessed using the Vigilance Algorithm Leipzig (VIGALL 2.1). At baseline responders and non-responders differed in distribution of overall EEG-vigilance stages (F2,133= 4.780, p = 0.009), with responders showing significantly more high vigilance stage A and less low vigilance stage B. The 15-minutes Time-course of EEG-vigilance did not differ significantly between groups. Exploratory analyses revealed that responders showed a stronger decline in EEG-vigilance levels from baseline to T1 than non-responders (F2,130= 4.978, p = 0.005). Higher brain arousal level in responders to antidepressants supports the concept that dysregulation of brain arousal is a possible predictor of treatment response in affective disorders.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Schmidt
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.|Research Center of the German Depression Foundation, Leipzig, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Sander
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
authors.forename: Marie-Elisa
authors.initials: ME
authors.lastname: Dietz
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Nowak
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schröder
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Mergl
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.|Saxonian Hospital Arnsdorf, Arnsdorf, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Schönknecht
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.|Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Hubertus
authors.initials: H
authors.lastname: Himmerich
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.|Research Center of the German Depression Foundation, Leipzig, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
mesh_terms: D000328:Adult; D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001143:Arousal / Q000502:physiology*; D001921:Brain / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D004569:Electroencephalography / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents