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Brain mapping may help depressed

By Jennifer Lauren Lee

Sept. 21, 2002 9:00 p.m.

UCLA psychiatrists are using brain waves to predict their
patients’ futures.

A new study conducted by researchers at the UCLA
Neuropsychiatric Institute suggests that doctors may be able to
analyze a clinically depressed patient’s brain wave activity.
Then, they can determine whether a particular antidepressant will
be effective for a patient ““ weeks before the patient shows
signs of getting better.

A good 30 to 40 percent of people diagnosed with depression
don’t respond to the first drug they take, according to Dr.
Ian Cook, a psychiatrist at the UCLA Neuropsychiatric Institute and
lead author of the study. Patients sometimes don’t respond to
the drugs, but it takes months for them to realize that the drug
isn’t working for them.

“All that time, they’re still suffering from
depression,” Cook said. “They might attempt suicide,
they might fail out of a class, they might lose a job.”

With this method of brain mapping, which was discovered and
developed at UCLA, people with depression can find out whether a
drug will help them only a few days after they have begun
treatment.

“It’s to get people on the right drug faster,”
Cook said. “That’s what makes this such an
exciting discovery.”

The study began in 1997, when a dozen patients diagnosed with
depression took medications prescribed by their doctors.
Researchers mapped their brain waves regularly to see if they found
a correspondence between brain activity and the effectiveness of a
drug. They did.

“People who ended up getting better showed these changes,
and people who didn’t show changes didn’t end up
getting better,” Cook said.

The painless procedure of mapping brain activity on patients led
to a formal study soon after.

In the study, 51 patients were treated for two months. Half of
them were given one of two antidepressants, either fluoxetine or
venlafaxine; the other 26 were given placebos. The
patients’ brain waves were mapped at intervals over the
two-month period.

Doctors observed a decrease in cordance, or brain activity,
behind the forehead after just two doses of medication in 64
percent of patients for whom the treatments were effective. After
one week of treatment, 72 percent of these patients had the
characteristic decrease in cordance. This strongly suggested that
there was a correspondence between brain wave activity in this area
and the effectiveness of the drug for that patient.

“Our study shows that if a patient is eventually going to
benefit from treatment with a medication, their brain function will
change within two days of starting the drug ““ even though
their symptoms may not improve for some time,” said Dr.
Andrew Leuchter, senior investigator of the study and a
psychiatrist at the Neuropsychiatric Institute.

The brains were mapped with a quantitative
electroencephalography machine (QEEG), which measures cordance.
According to Cook, this method of measuring brain wave activity
“gives us much more information about brain waves than other
methods of measuring brain activity.”

The procedure itself takes between 15 minutes to a half
hour. Patients wears caps fitted with electrodes that connect
to the QEEG machine. They then relax on a bed while the machine
records their brain waves.

This method has not yet become a part of treating patients
suffering from depression, but Cook believes it will be accepted
within the next few years.

“I wish it didn’t have to take that long,”
Cook said. He believes other psychiatric institutions will follow
UCLA’s lead within the next few years. He also wishes to
extend the study to include other types of treatments.

“We hope to repeat this with other medications to see if
what we found was specific for those medications or if it holds for
other medications as well.”

The Neuropsychiatric Institute will be conducting another study
using QEEG in the fall.

For more information, or to participate in a study about
depression, visit: http://depression.ucla.edu/currentresearch or
call 310-825-3351.

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Jennifer Lauren Lee
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