Treatment Resistant Depression
Conditions
Brief summary
Electroconvulsive therapy (ECT) alleviates treatment-resistant depression (TRD) through repeated generalized seizures. The goal of this study is to evaluate how ECT impacts sleep-wake regulation and efficiency of information transfer in functional networks in different states of arousal.
Detailed description
Graph-based network analyses of electroencephalographic (EEG) signals allow characterization of functional networks. The robustness of local networks to disruption is quantified as local efficiency (Elocal), while network integration is quantified as global information transfer (Eglobal). Aim 1: Assess relationships between sleep slow-wave activity (SWA) and awake Elocal over the course of ECT. Aim 2: Quantify relationships between depression severity and awake Elocal over the course of ECT.
Interventions
DIAGNOSTIC_TESTElectroencephalography (EEG)
High-density EEG will be acquired during resting wakefulness before each ECT session.
DIAGNOSTIC_TESTQuantitative Measurements of Sleep Microstructure
Overnight sleep EEG will be recorded one day before each ECT session using the DREEM device. The DREEM device allows continuous recording of multichannel EEG.
Sponsors
Washington University School of Medicine
National Institute of Mental Health (NIMH)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Inclusion criteria
* Referral for initial ECT index course for Treatment-Resistant Depression (TRD), unipolar major depressive disorder or bipolar depression. Historic failure of response or remission to at least two antidepressant medications of sufficient dose and duration will be used for TRD diagnostic.
Exclusion criteria
* Diagnoses of schizophrenia or schizoaffective disorders. * Subjects who are unable to tolerate the Dreem device for sleep recordings will be excluded from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Slow wave activity (SWA) during non-rapid eye movement sleep (NREM) stage N2/N3 | Up to 4 weeks during patients ECT treatment course | Total power of EEG slow waves per minute present during N2/N3 sleep |
| Graph-based neural connectivity measure of local efficiency of information transfer (Elocal) during wakefulness | Up to 4 weeks during patients ECT treatment course | Elocal will be calculated as the average inverse shortest path length among neighbors of a node within the network. Nodes will be constructed based on 5-minute recordings of eyes closed wakefulness theta band (4-8 Hz) EEG. |
| Graph-based neural connectivity measure of global information transfer (Eglobal) during ECT-induced seizure | Up to 4 weeks during patients ECT treatment course | Eglobal will be calculated as the average inverse shortest path length between node pairs in the networks. Nodes will be constructed based on ECT-induced seizure EEG data within the alpha band (8-13 Hz). |
Countries
United States
Contacts
CONTACTRobby Greenspan
CONTACTMohammadMehdi Kafashan
PRINCIPAL_INVESTIGATORMohammadMehdi Kafashan
Washington University School of Medicine in St. Louis
Outcome results
None listed