Response Inhibition and Predicting Response to Pharmacological and Cognitive Behavioral Therapy Treatments for Major Depressive Disorder: A Canadian Biomarker Integration Network for Depression Study

Prabhjot Dhami; Lena C Quilty; Benjamin Schwartzmann; Rudolf Uher; Timothy A Allen; Stefan Kloiber; Raymond W Lam; Glenda MacQueen; Benicio N Frey; Roumen Milev; Daniel J Müller; Stephen C Strother; Pierre Blier; Claudio N Soares; Sagar V Parikh; Gustavo Turecki; Jane A Foster; Susan Rotzinger; Sidney H Kennedy; Faranak Farzan

doi:10.1016/j.bpsc.2021.12.012

Response Inhibition and Predicting Response to Pharmacological and Cognitive Behavioral Therapy Treatments for Major Depressive Disorder: A Canadian Biomarker Integration Network for Depression Study

Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Feb;8(2):162-170. doi: 10.1016/j.bpsc.2021.12.012. Epub 2022 Jan 13.

Authors

Prabhjot Dhami¹, Lena C Quilty², Benjamin Schwartzmann³, Rudolf Uher⁴, Timothy A Allen⁵, Stefan Kloiber⁵, Raymond W Lam⁶, Glenda MacQueen⁷, Benicio N Frey⁸, Roumen Milev⁹, Daniel J Müller¹⁰, Stephen C Strother¹¹, Pierre Blier¹², Claudio N Soares⁹, Sagar V Parikh¹³, Gustavo Turecki¹⁴, Jane A Foster¹⁵, Susan Rotzinger¹⁶, Sidney H Kennedy¹⁶, Faranak Farzan¹⁷

Affiliations

¹ eBrain Lab, Simon Fraser University, Surrey, British Columbia, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
² Department of Psychology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
³ eBrain Lab, Simon Fraser University, Surrey, British Columbia, Canada.
⁴ Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
⁵ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
⁶ Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
⁸ Mood Disorders Program and Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, Ontario, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
⁹ Departments of Psychiatry and Psychology, Queen's University, Providence Care, Kingston, Ontario, Canada.
¹⁰ Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
¹¹ Rotman Research Institute, Baycrest, Toronto, Ontario, Canada.
¹² Mood Disorders Research Unit, University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada.
¹³ University of Michigan Depression Center, Ann Arbor, Michigan.
¹⁴ Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
¹⁵ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
¹⁶ Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Ontario, Canada.
¹⁷ eBrain Lab, Simon Fraser University, Surrey, British Columbia, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Electronic address: ffarzan@sfu.ca.

PMID: 35032682
DOI: 10.1016/j.bpsc.2021.12.012

Abstract

Background: Major depressive disorder (MDD) is associated with various cognitive impairments, including response inhibition. Deficits in response inhibition may also underlie poor antidepressant treatment response. Recent studies revealed that the neurobiological correlates of response inhibition can predict response to pharmacological treatments. However, the generalizability of this finding to first-line nonpharmacological treatments, particularly cognitive behavioral therapy, remains to be investigated.

Methods: Data from two independent treatment protocols were combined, one in which 65 patients with MDD underwent treatment with escitalopram, and the other in which 41 patients with MDD underwent a course of cognitive behavioral therapy. A total of 25 healthy control subjects were also recruited. Neural correlates of response inhibition were captured by participants completing a Go/NoGo task during electroencephalography recording. Response inhibition-related measures of interest included the amplitudes of the N2 and P3 event-related potentials.

Results: Pretreatment P3 amplitude, which has been linked to both the motor and cognitive aspects of response inhibition, was a significant predictor of change in depressive symptoms following escitalopram and cognitive behavioral therapy treatment. A greater pretreatment P3 amplitude was associated with a greater reduction in depressive severity. In addition, the pretreatment P3 amplitude was found to be significantly greater at baseline in remitters than in nonremitters and healthy control subjects.

Conclusions: The integrity of response inhibition may be critical for a successful course of pharmacological or psychological treatment for MDD. Electrophysiological correlates of response inhibition may have utility as a general prognostic marker of treatment response in MDD. Future studies may investigate the benefit of preceding first-line treatments with interventions that improve response inhibition in MDD.

Trial registration: ClinicalTrials.gov NCT04851392.

Keywords: Antidepressants; Event-related potentials (ERPs); Go/NoGo; Major depressive disorder (MDD); Response inhibition.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Canada
Depression
Depressive Disorder, Major* / diagnosis
Depressive Disorder, Major* / drug therapy
Escitalopram
Humans

Response Inhibition and Predicting Response to Pharmacological and Cognitive Behavioral Therapy Treatments for Major Depressive Disorder: A Canadian Biomarker Integration Network for Depression Study

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