@article{e78395383b7245c291822183daefaa43,
title = "Association between increased theta cordance and early response to ECT in late-life depression",
abstract = "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.",
keywords = "ECT, depression, late life, neural marker, theta cordance",
author = "Ward, {Michael J.} and Karim, {Helmet T.} and Jessen, {Zachary F.} and Ghuman, {Avniel Singh} and Richardson, {R. Mark} and Reynolds, {Charles F.} and Karp, {Jordan F.}",
note = "Funding Information: This study was funded by National Institute of Mental Health P30 MH090333, R01MH107797, R21MH103592, and T32 MH019986. The authors are grateful to the participants and their families, without whom this work could not have been completed and for whom we will continue to seek methods to ease and prevent depression across the lifespan. J.F.K. received medication supplies from Indivior and Pfizer for investigator‐initiated work. J.F.K. receives research funding from NIH and Patient‐centered Outcomes Research Institute and American Foundation for Suicide Prevention and compensation for service on the editorial board of the American Journal of Geriatric Psychiatry and Journal of Clinical Psychiatry . C.F.R. has received research support from the NIH, the Patient‐centered Outcomes Research Institute, the Center for Medicare and Medicaid Services, the American Foundation for Suicide Prevention, the Brain and Behavior Research Foundation, and the Commonwealth of Pennsylvania. Bristol‐Myers Squibb and Pfizer have provided pharmaceutical supplies for his NIH sponsored research. Funding Information: This study was funded by National Institute of Mental Health P30 MH090333, R01MH107797, R21MH103592, and T32 MH019986. The authors are grateful to the participants and their families, without whom this work could not have been completed and for whom we will continue to seek methods to ease and prevent depression across the lifespan. J.F.K. received medication supplies from Indivior and Pfizer for investigator-initiated work. J.F.K. receives research funding from NIH and Patient-centered Outcomes Research Institute and American Foundation for Suicide Prevention and compensation for service on the editorial board of the American Journal of Geriatric Psychiatry and Journal of Clinical Psychiatry. C.F.R. has received research support from the NIH, the Patient-centered Outcomes Research Institute, the Center for Medicare and Medicaid Services, the American Foundation for Suicide Prevention, the Brain and Behavior Research Foundation, and the Commonwealth of Pennsylvania. Bristol-Myers Squibb and Pfizer have provided pharmaceutical supplies for his NIH sponsored research. Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons, Ltd.",
year = "2020",
month = feb,
day = "1",
doi = "10.1002/gps.5220",
language = "English (US)",
volume = "35",
pages = "147--152",
journal = "International Journal of Geriatric Psychiatry",
issn = "0885-6230",
publisher = "John Wiley and Sons Ltd",
number = "2",
}