Prediction of rTMS treatment response in major depressive disorder using machine learning techniques and nonlinear...

Prediction of therapeutic outcome of repetitive transcranial magnetic stimulation (rTMS) treatment is an important purpose that eliminates financial and psychological consequences of applying inefficient therapy. To achieve this goal we proposed a method based on machine learning to classify responders (R) and non- responders (NR) to rTMS treatment for major depression disorder (MDD) patients.

19 electrodes resting state EEG was recorded from 46 MDD patients before treatment. Then patients underwent 7 weeks of rTMS, and 23 of them responded to treatment. Features extracted from EEG include Lempel-Ziv complexity (LZC), Katz fractal dimension (KFD), correlation dimension (CD), the power spectral density, features based on bispectrum, frontal and prefrontal cordance and combination of them. The most relevant features were selected by the minimal-redundancy-maximal-relevance (mRMR) feature selection algorithm. For classifying two groups of R and NR, k-nearest neighbors (KNN) were applied. The performance of the proposed method was evaluated by leave-1-out cross-validation. For further study, the capability of features in differentiating R and NR was investigated by a statistical test.

Effective EEG features for prediction of rTMS treatment response were found. EEG beta power, the sum of bispectrum diagonal elements in delta and beta bands and CD were the most discriminative features. Power of beta classified R and NR with the high performance of 91.3% accuracy, 91.3% specificity, and 91.3% sensitivity.

Lack of large sample size restricted our method for using in clinical applications.

This considerable high accuracy indicates that our proposed method with power and some of the nonlinear and bispectral features can lead to promising results in predicting treatment outcome of rTMS for MDD patients only by one session pretreatment EEG recording.