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首页> 外文期刊>The journal of clinical psychiatry >Quantitative electroencephalogram Biomarkers for predicting likelihood and speed of achieving sustained remission in Major Depression: A report from the Biomarkers for Rapid Identification of Treatment Effectiveness in Major Depression (BRITE-MD) trial
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Quantitative electroencephalogram Biomarkers for predicting likelihood and speed of achieving sustained remission in Major Depression: A report from the Biomarkers for Rapid Identification of Treatment Effectiveness in Major Depression (BRITE-MD) trial

机译：脑电图定量生物标志物，用于预测重度抑郁症实现持续缓解的可能性和速度：快速识别重度抑郁症治疗效果的生物标志物（BRITE-MD）试验的报告

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Objective: Clinical trials in major depressive disorder (MDD) commonly assess remission at a single endpoint. Complementary, clinically relevant metrics include the likelihood and speed of achieving sustained remission. A neurophysiologic measure, the Antidepressant Treatment Response (ATR) index, previously predicted 8-week outcomes of pharmacotherapy. We retrospectively examined data from the Biomarkers for Rapid Identification of Treatment Effectiveness in Major Depression (BRITE-MD) trial to evaluate this biomarker's properties in predicting sustained remission and time to achieve sustained remission. Method: In the BRITE-MD trial, 67 adults with DSM-IV MDD received escitalopram continuously for 13 weeks. The 17-item Hamilton Depression Rating Scale (HDRS17) was used to define sustained remission as achieving remission (HDRS17 score ?? 7) at a series of consecutive assessments, including week 13. The onset of sustained remission was defined as the earliest time from which all subsequent HDRS17 assessments were ?? 7. The ATR was evaluated by using frontal quantitative electroencephalogram recordings at baseline and week 1. Subjects were stratified based on ATR status (ie, ATR+/ATR). Kaplan-Meier survival analysis evaluated group differences in time to sustained remission. Higher ATR was hypothesized to predict sustained remission and time to sustained remission. Subjects participated between January 2006 and July 2007. Results: Of 67 subjects, 36 achieved remission by week 13, and ATR predicted this single endpoint in receiver operating characteristic analyses (P = .016; sensitivity, 52.8%; positive predictive value, 76.0%). Remitters had a higher mean (SD) ATR value than those who did not remit (57.9 [10.0] vs 51.9 [8.7], P = .012). Sixteen of the 31 individuals with sustained remission had ATR+ status, while 28 of the 36 who were not sustained remitters had ATR- status (P = .012). The mean time to reach sustained remission was significantly shorter among ATR+ subjects than ATR- individuals (38 vs 53 days, P = .038). Conclusions: The ATR index predicted remission at 13 weeks as well as the speed of achieving sustained remission with antidepressant monotherapy. This finding suggests that the ATR biomarker may predict stable longer-term outcomes. ? 2012
机译：目的：重度抑郁症（MDD）的临床试验通常评估单个终点的缓解。与临床相关的补充指标包括实现持续缓解的可能性和速度。一种神经生理学指标，即抗抑郁治疗反应（ATR）指数，先前预测了药物治疗的8周结果。我们回顾性研究了从生物标志物中快速鉴定出主要抑郁症治疗效果的数据（BRITE-MD），以评估该生物标志物在预测持续缓解和实现持续缓解的时间方面的特性。方法：在BRITE-MD试验中，有67名DSM-IV MDD成人连续13周接受艾司西酞普兰治疗。汉密尔顿抑郁评估量表（HDRS17）是17个项目，用于在一系列连续评估（包括第13周）中将持续缓解定义为达到缓解（HDRS17得分?? 7）。持续缓解的发生定义为自随后的所有HDRS17评估是哪一项？ 7.通过在基线和第1周使用额度脑电图记录来评估ATR。根据ATR的状态（即ATR + / ATR）对受试者进行分层。 Kaplan-Meier生存分析评估了持续缓解时间的组别差异。假设较高的ATR可以预测持续缓解和持续缓解的时间。受试者参加了2006年1月至2007年7月之间的研究。结果：在67名受试者中，有36名在第13周前获得缓解，ATR在接受者的操作特征分析中预测了这一单一终点（P = .016;敏感性为52.8％;阳性预测值为76.0％ ）。汇款者的平均（SD）ATR值高于未汇款者（57.9 [10.0]对51.9 [8.7]，P = .012）。在持续缓解的31位患者中，有16位具有ATR +状态，而在没有持续缓解的36位患者中，有28位具有ATR-状态（P = 0.012）。在ATR +受试者中，达到持续缓解的平均时间明显短于ATR-个体（38天对53天，P = .038）。结论：ATR指数可预测13周缓解，以及抗抑郁单一疗法持续缓解的速度。这一发现表明，ATR生物标志物可以预测稳定的长期结果。 ？ 2012年

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