Parieto-temporal alpha EEG band power at baseline as a predictor of antidepressant treatment response with repetitive Transcranial Magnetic Stimulation: A preliminary study

Background: The aim of this preliminary study was to determine the predictive value of absolute alpha band power measured during the rest EEG eyes closed task for responses to 20 sessions of high frequency repetitive transcranial stimulation (rTMS) in the left dorsolateral prefrontal cortex in patients with pharmacoresistant major depressive episode. Methods: 13 major depressive disorders (8 males) and 8 bipolar disorders (6 males) were included (mean age 58 years). Spearman correlations between pretreatment alpha band power in height regions of analysis and absolute improvement in Beck Depression Inventory Short Form (Delta BDI-SF) were analyzed. The predictive value of alpha band power for classifying patients as responders and non-responders to rTMS was determined using Receiver Operating Characteristic (ROC) curve. Results: Spearman correlation analysis revealed that Delta BDI-SF correlated significantly and negatively with alpha band power on the right (r = -.673, p = .001) and left parieto-temporal regions (r = -.638, p = .002). The area under the ROC curve for the right parieto-temporal was .815, p = .0037. The cut-off point that maximized both sensitivity and specificity was 1.49 mu V. Sensitivity, specificity, positive and negative predictive values were 100, 66, 80, 100% respectively. Limitations: The population was small and lacked homogeneity concerning affective disorders (unipolar and bipolar disorder). The use of a self-rating subjective scale (BDI-SF) to measure the severity of depression could be criticized. Conclusions: Pretreatment alpha band power on parieto-temporal regions could be a predictor for response to rTMS in patients with homogenous demographic/clinical features. The association between electrical activity and the perfusion under each electrode need to be examined. (C) 2011 Elsevier B.V. All rights reserved.