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Identifying Ketamine Responses in Treatment-Resistant Depression Using a Wearable Forehead EEG

Zehong Cao, Chin-Teng Lin, Weiping Ding, Mu-Hong Chen, Cheng-Ta Li, Tung-Ping Su

arXiv Preprint Archive May 29, 2018 preprint

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Placebo-controlled Double-blind
Sample size 55
Population Outpatients with treatment-resistant depression
Intervention Ketamine
Dose 0.5 mg/kg, 0.2 mg/kg
Topics Depression Esketamine Ketamine
Keywords Eess.sp Biomedical-sensors Depression-treatment Brain-wave-analysis Ketamine-therapy
Key findings Baseline prefrontal EEG patterns, particularly weaker theta power, can predict ketamine response in treatment-resistant depression with over 80% accuracy.

Abstract

This study explores the responses to ketamine in patients with treatment-resistant depression (TRD) using a wearable forehead electroencephalography (EEG) device. We recruited fifty-five outpatients with TRD who were randomised into three approximately equal-sized groups (A: 0.5 mg/kg ketamine; B: 0.2 mg/kg ketamine; and C: normal saline) under double-blind conditions. The ketamine responses were measured by EEG signals and Hamilton Depression Rating Scale (HDRS) scores. At baseline, responders showed a significantly weaker EEG theta power than did non- responders (p < 0.05). Responders exhibited a higher EEG alpha power but lower EEG alpha asymmetry and theta cordance at post-treatment than at baseline (p < 0.05). Furthermore, our baseline EEG predictor classified responders and non-responders with 81.3 +- 9.5% accuracy, 82.1 +- 8.6% sensitivity and 91.9 +- 7.4% specificity. In conclusion, the rapid antidepressant effects of mixed doses of ketamine are associated with prefrontal EEG power, asymmetry and cordance at baseline and early post-treatment changes. The prefrontal EEG patterns at baseline may account for recognising ketamine effects in advance. Our randomised, double- blind, placebo-controlled study provides information regarding clinical impacts on the potential targets underlying baseline identification and early changes from the effects of ketamine in patients with TRD.

Comparable studies

Other randomized controlled trials on ketamine for depression, most cited first.

Study Year Design Participants
Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode 2013 Randomized controlled trial n = 73
Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study Adults with moderate to severe nonpsychotic depression and a history of nonresponse to... 2019 Phase 3, double-blind, active-controlled, multicenter randomized controlled trial n = 227
Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression Adults with treatment-resistant depression who achieved stable remission or stable... 2019 Phase 3, multicenter, double-blind, randomized withdrawal study n = 297
Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression Adults with DSM-IV-TR diagnosis of major depressive disorder and history of inadequate... 2017 Phase 2, double-blind, doubly randomized, delayed-start, placebo-controlled study n = 67
Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study Depressed patients at imminent risk for suicide 2018 Randomized controlled trial n = 68

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