Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 12;14(1):432.
doi: 10.1038/s41398-024-03110-8.

Modulation of neural oscillations in escitalopram treatment: a Canadian biomarker integration network in depression study

Benjamin Schwartzmann  1 , Raaj Chatterjee  1 , Yasaman Vaghei  1 , Lena C Quilty  2   3 , Timothy A Allen  3 , Stephen R Arnott  4 , Sravya Atluri  3 , Pierre Blier  5 , Prabhjot Dhami  1   2   3 , Jane A Foster  6   7 , Benicio N Frey  7   8 , Stefan Kloiber  2   3 , Raymond W Lam  9 , Roumen Milev  10 , Daniel J Müller  2   3 , Claudio N Soares  10 , Chloe Stengel  1 , Sagar V Parikh  11 , Gustavo Turecki  12 , Rudolf Uher  13 , Susan Rotzinger  2   8 , Sidney H Kennedy  2   14 , Faranak Farzan  15   16   17
Affiliations

Modulation of neural oscillations in escitalopram treatment: a Canadian biomarker integration network in depression study

Benjamin Schwartzmann et al. Transl Psychiatry. .

Abstract

Current pharmacological agents for depression have limited efficacy in achieving remission. Developing and validating new medications is challenging due to limited biological targets. This study aimed to link electrophysiological data and symptom improvement to better understand mechanisms underlying treatment response. Longitudinal changes in neural oscillations were assessed using resting-state electroencephalography (EEG) data from two Canadian Biomarker Integration Network in Depression studies, involving pharmacological and cognitive behavioral therapy (CBT) trials. Patients in the pharmacological trial received eight weeks of escitalopram, with treatment response defined as ≥ 50% decrease in Montgomery-Åsberg Depression Rating Scale (MADRS). Early (baseline to week 2) and late (baseline to week 8) changes in neural oscillation were investigated using relative power spectral measures. An association was found between an initial increase in theta and symptom improvement after 2 weeks. Additionally, late increases in delta and theta, along with a decrease in alpha, were linked to a reduction in MADRS after 8 weeks. These late changes were specifically observed in responders. To assess specificity, we extended our analysis to the independent CBT cohort. Responders exhibited an increase in delta and a decrease in alpha after 2 weeks. Furthermore, a late (baseline to week 16) decrease in alpha was associated with symptom improvement following CBT. Results suggest a common late decrease in alpha across both treatments, while modulatory effects in theta may be specific to escitalopram treatment. This study offers insights into electrophysiological markers indicating a favorable response to antidepressants, enhancing our comprehension of treatment response mechanisms in depression.

PubMed Disclaimer

Conflict of interest statement

T.A.A. was supported by NIMH Grant No. K01-MH123915. P.B. has received consulting and speaking honoraria from AbbVie, Allergan, Eisai, Janssen, Lundbeck, Merck, Pfizer, Otsuka, and research grants from CAN-BIND, CIHR, Janssen, OBI and Otsuka. J.A.F. has served on the Scientific Advisory Board for MRM Health NL and has received consulting/speaker fees from Alphasights, Novozymes, Klaire Labs, Takeda Canada, Rothman, Benson, Hedges Inc., and WebMD. S.K. reports grants from the Labatt Family Innovation Fund in Brain Health (Department of Psychiatry, University of Toronto), the Max Bell Foundation, the Canadian Centre on Substance Use and Addiction, the Ontario Ministry of Health and Long-Term Care (MOHLTC), and the Canadian Institutes of Health Research (CIHR). S.K. has received honorarium for past consultation from EmpowerPharm. R.W.L. has received honoraria for ad hoc speaking or advising/consulting, or received research funds, from: Asia-Pacific Economic Cooperation, BC Leading Edge Foundation, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Grand Challenges Canada, Healthy Minds Canada, Janssen, Lundbeck, Lundbeck Institute, Medscape, Michael Smith Foundation for Health Research, MITACS, Myriad Neuroscience, Ontario Brain Institute, Otsuka, Pfizer, Sanofi, Unity Health, Vancouver Coastal Health Research Institute, and VGH-UBCH Foundation. R.M. has received consulting and speaking honoraria from AbbVie, Allergan, Eisai, Janssen, KYE, Lallemand, Lundbeck, Neonmind, Otsuka, and Sunovion, and research grants from CAN-BIND, CIHR, Janssen, Lallemand, Lundbeck, Nubiyota, OBI and OMHF. C.N.S. reported receiving personal fees from Otsuka and Sunovion and grants from Ontario Brain Institute, SEAMO Innovation Funds, and Ontario Research Fund–Research Excellence outside the submitted work. D.J.M. reports grants from the Canadian Institutes of Health Research (CIHR) and the Alternative Funding Plan (CAMH-AFP). D.J.M. has received a speaker honorarium rom Novagenic. S.R. reported receiving grants from Ontario Brain Institute and the Canadian Institutes of Health Research during the conduct of the study and having a patent to Teneurin C-Terminal Associated Peptides and Methods and Uses Thereof issued. S.H.K. - Grant received/grants pending - Abbott, Allergan, Brain Canada, Canadian Institutes for Health Research (CIHR), Janssen, Lundbeck, Ontario Brain Institute, Ontario Research Fund (ORF), Otsuka, Pfizer, Servier, Sunovion and Xian-Janssen. Consulting fees or honorarium - Abbott, Alkermes, Allergan, Boehringer Ingelheim, Brain Canada, Canadian Institutes for Health Research (CIHR), Janssen, Lundbeck, Lundbeck Institute, Ontario Brain Institute, Ontario Research. Stock/Stock Options – Field Trip Health. F.F. reported receiving funding from Michael Smith Foundation for Health Research, Natural Sciences and Engineering Research Council of Canada Discovery, and Canadian Institutes of Health Research. All other authors report no biomedical financial interests or potential conflicts of interest.

Figures

Fig. 1
Fig. 1. Late changes (from baseline to week 8) in relative power in responders to escitalopram.
Cold colors show lower relative power at week 8 compared to baseline. Warm colors show higher relative power at week 8 compared to baseline. A, B The x-axis shows frequencies from 0.5 to 50 Hz. The y-axis shows all electrodes from 1 to 58. Image A shows uncorrected t-value map, image B shows significant clusters (p < 0.025, single-tailed, cluster corrected for multiple comparisons). C, E, G Topographies illustrate t-values at different frequencies with stars indicating electrodes that belonged to the significant cluster. D, F, H Cortical maps depict source-localized regions (p < 0.05, uncorrected) in the frequency band in which the cluster was found at the sensor space level.
Fig. 2
Fig. 2. Late changes (from baseline to week 8) in relative power in non-responders to escitalopram.
Cold colors show lower relative power at week 8 compared to baseline. Warm colors show higher relative power at week 8 compared to baseline. A, B The x-axis shows frequencies from 0.5 to 50 Hz. The y-axis shows all electrodes from 1 to 58. Image A shows uncorrected t-value map, image B shows significant clusters (p < 0.025, single-tailed, cluster corrected for multiple comparisons). C Topographies illustrate t-values at different frequencies with stars indicating electrodes that belonged to the significant cluster. D Cortical maps depict source-localized regions (p < 0.05, uncorrected) in the frequency band in which the cluster was found at the sensor space level.
Fig. 3
Fig. 3. Associations between early changes in relative power and improvement in depressive symptoms after 2 weeks of escitalopram.
Cold colors show a negative correlation. Warm colors show a positive correlation. A, B The x-axis shows frequencies from 0.5 to 50 Hz. The y-axis shows all electrodes from 1 to 58. Image A shows uncorrected Spearman’s correlation coefficients, image B shows significant clusters (p < 0.025, single-tailed, cluster corrected for multiple comparisons). C, E Topographies illustrate correlation coefficients at different frequencies with stars indicating electrodes that belonged to the significant cluster. D, F Cortical maps depict source-localized regions (p < 0.05, uncorrected) in the frequency band in which the cluster was found at the sensor space level.
Fig. 4
Fig. 4. Associations between late changes in relative power and improvement in depressive symptoms after 8 weeks of escitalopram.
Cold colors show a negative correlation. Warm colors show a positive correlation. A, B The x-axis shows frequencies from 0.5 to 50 Hz. The y-axis shows all electrodes from 1 to 58. Image A shows uncorrected Spearman’s correlation coefficients, image B shows significant clusters (p < 0.025, single-tailed) using cluster-based correction. C, E, G Topographies illustrate correlation coefficients at different frequencies with stars indicating electrodes that belonged to the significant cluster. D, F, H Cortical maps depict source-localized regions (p < 0.05) in the frequency band in which the cluster was found at the sensor space level.
See this image and copyright information in PMC

References

    1. Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, De Graaf R, Vollebergh W, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003;12:3–21. - DOI - PMC - PubMed
    1. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The Epidemiology of Major Depressive Disorder: Results From the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105. - DOI - PubMed
    1. Hardeveld F, Spijker J, De Graaf R, Nolen WA, Beekman ATF. Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatr Scand 2010;122:184–91. - DOI - PubMed
    1. World Health Organization. Depression and Other Common Mental Disorders Global Health Estimates. (2017).
    1. Solomon DA, Keller MB, Leon AC, Mueller TI, Shea MT, Warshaw M, et al. Recovery from major depression. A 10-year prospective follow-up across multiple episodes. Arch Gen Psychiatry. 1997;54:1001–6. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources