Nobakhsh B, Shalbaf A, Rostami R, Kazemi R. Graph-based Analysis to Predict Repetitive Transcranial Magnetic Stimulation Treatment Response in Patients With Major Depressive Disorder Using EEG Signals. BCN 2024; 15 (2) :199-210
URL:
http://bcn.iums.ac.ir/article-1-2628-en.html
1- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Department of Psychology, Faculty of Education and Psychology, University of Tehran, Tehran, Iran.
3- Department of Entrepreneurship Development, Faculty of Entrepreneurship, University of Tehran, Tehran, Iran.
Abstract:
Introduction: Repetitive transcranial magnetic stimulation (rTMS) is a non-pharmacological treatment for drug-resistant major depressive disorder (MDD) patients. Since the success rate of rTMS treatment is about 50%-55%, it is essential to predict the treatment outcome before starting based on electroencephalogram (EEG) signals, leading to identifying effective biomarkers and reducing the burden of health care centers.
Methods: To this end, pretreatment EEG data with 19 channels in the resting state from 34 drug-resistant MDD patients were recorded. Then, all patients received 20 sessions of rTMS treatment, and a reduction of at least 50% in the total beck depression inventory (BDI-II) score before and after the rTMS treatment was defined as a reference. In the current study, effective brain connectivity features were determined by the direct directed transfer function (dDTF) method from patients’ pretreatment EEG data in all frequency bands separately. Then, the brain functional connectivity patterns were modeled as graphs by the dDTF method and examined with the local graph theory indices, including degree, out-degree, in-degree, strength, out-strength, in-strength, and betweenness centrality.
Results: The results indicated that the betweenness centrality index in the Fp2 node and the δ frequency band are the best biomarkers, with the highest area under the receiver operating characteristic curve value of 0.85 for predicting the rTMS treatment outcome in drug-resistant MDD patients.
Conclusion: The proposed method investigated the significant biomarkers that can be used to predict the rTMS treatment outcome in drug-resistant MDD patients and help clinical decisions.
Full-Text [PDF 1237 kb]
| |
Full-Text (HTML)
• Fp2 region as a significant biomarker was significantly different for non-responders as compared to responders to repetitive transcranial magnetic stimulation (rTMS) treatment.
• The proposed graph theory methodology based on the effective connectivity of electroencephalogram (EEG) signals improved prediction performance.
• This innovative approach to predict rTMS treatment outcome in major depressive disorder (MDD) patients could improve treatment efficacy and reduce health care costs.
Plain Language Summary
In this study, we innovate a new method to predict how repetitive transcranial magnetic stimulation (rTMS) could be effective in drug-resistant major depressive disorder (MDD) patients. By analyzing brain activity (EEG) in 34 MDD patients before starting the rTMS treatment, we identified specific brain patterns, particularly in the delta frequency band, that were associated with treatment success. We found that a measure called betweenness centrality in Fp2 (a specific brain region) could predict better the rTMS treatment outcome. These findings could help healthcare centers to personalize treatment plans for MDD patients, potentially saving time and resources while improving patient care.
Type of Study:
Original |
Subject:
Cognitive Neuroscience Received: 2022/12/22 | Accepted: 2023/07/2 | Published: 2024/03/1