Preliminary Study On EEG Measures To Predict Therapeutic Effects Of Modified Electric Convulsive Therapy For Depression

Objective: To preliminarily explore the predictive indicators of anti-depression effect of MECT and provide subjective basis for optimizing the therapeutic schedule for severe depression through analysis and comparison of the general data,clinical data and EEG data at resting state of the subjects with different ECT anti-depression effects before and after the treatment,so as to increase the efficiency of MECT anti-depression treatment and improve the prognosis of depression.Methods: Totally 71 subjects who meet ICD-10 for severe depression episode as specified in China Guidelines on Treating Depressive Disorders,with a HAMD score ?24 points,an age of 18-65 years old and the indications of ECT therapy.Evaluate the HAMD,HAMA,MADRS,SSI and other scales of 3 days before the MECT treatment and 1 week,6 weeks and 3 months after the MECT treatment of those subjects and complete the pre-treatment EEG data and clinical data collection.Compare the clinical scale points before and 1week after the treatment of the subjects to study the anti-depression effect of MECT and divide the subjects into groups based on the curative effect 6 weeks and 3 months after the MECT treatment(subjects with HAMD scale <7 points and no depression symptoms in the clinical assessment are classified as cured groups,otherwise as the relapsed groups).Respectively study the differences in clinical data and EEG data of the subjects with different curative effects before and after the treatment and then incorporate the indicators that differ in single factor analysis into the binary logistic regression,so as to determine the shortand medium-term independent predictive indicators of MECT anti-depression treatment.Results: 1.A total of 71 patients with major depression were included in this study to complete modified electroconvulsive therapy.After the treatment,the score of AMD scale(p=0.000),HAMA scale(p=0.000),MADRS scale(p=0.000),SSI scale(p=0.000)were obviously lower than before.In the mean time,the differences were significant.2.A total of 64 subjects completed the 6 weeks' follow-up,including 47 cases in the recovery group and 17 cases in the recurrence group,with a recurrence rate of 26.6%.Single factor comparisons between the two groups revealed: the negative life events(p=0.022),episodes(p=0.043),the“dysphoria”factors(p=0.006),?band absolute power in FP2(p= 0.035),?2band absolute power in T5(p=0.030),?1 band relative power in F4(p=0.042),? 1 band relative power in C4(p=0.042),? band relative power in FP1(p=0.033),? band relative power in FP2(p=0.014),and ? band relative power in F4(p=0.047)were statistically significant between the two groups.Taking the recurrence of depression as the dependent variable,the binary logistic regression analysis was made with the single factor analysis of the significant index as the independent variable.The results showed that the negative life events(OR=0.156,p=0.013)?the“dysphoria”factors(OR=1.531,p=0.017)and the relative power of the ? band of FP2 leads(OR=0.967,p=0.014)were independent predictors of antidepressant efficacy at 6 weekends.3.A total of 54 subjects completed 3 months of follow-up,including 32 patients in the recovery group and 22 in the relapse group,with a recurrence rate of 40.7%.Single factor comparisons between the two groups revealed whether the negative life events(p=0.004),the“dysphoria”factors(p=0.002),the“vegetative symptom”factors(p=0.013),?2 band relative power in T6(p=0.043)was statistically significant between the two groups.Taking the recurrence of depression as the dependent variable,the binary logisticregression analysis was made with the single factor analysis of the significant index as the independent variable.The results showed that the negative life events(OR=0.149,p=0.006)and the“dysphoria”factors(OR=1.631,p=0.007)were independent predictors of antidepressant efficacy at 3 months.Conclusions:1.The negative life events and scores of“dysphoria”factors before the onset of the disease,the absolute power of the ? band of the T5 lead may be the short-term prognostic indicator of MECT.2.The negative life events and scores of“dysphoria”factors before onset may be medium-term predictive indicators for the treatment of MECT.