Deep learning using electroencephalogram (EEG) data for diagnosing and predicting SSRI response in major depressive...

Major Depression (MDD) is a potentially life-threatening condition that ranks among the diseases with the highest global burden. Despite its prevalence, current diagnostic methods remain largely subjective, and first-line treatments exhibit high rates of non-responders.

This study investigates the application of deep learning (DL) algorithms to electroencephalogram (EEG) data for the MDD-diagnosis and prediction of treatment outcomes following the administration of selective serotonin reuptake inhibitors (SSRIs), using six large, independent datasets with a total of n = 146 for healthy subjects and n = 203 for patients. DL models were trained on one portion of the datasets and tested on unseen data from different subjects. To interpret the classification features, Gradient-weighted Class Activation Mapping (Grad-CAM) was applied.

The models achieve an average accuracy of 67.5% (best fold 70%) in distinguishing MDD patients from healthy controls and mean 79% accuracy (best fold 85%) in predicting SSRI responders. Key EEG markers for both classification tasks revealed by Grad-CAM include alpha activity in the frontal and parietal regions. Simulation of a clinical decision scenario for SSRI treatment selection indicates a number needed to treat (NNT) of five when using a model with 80% predictive accuracy, corresponding to an increase in treatment response from a 50% baseline to 70% with model-guided selection.

These findings underscore the clinical potential of EEG-based DL models for stratified treatment in MDD, facilitating accurate therapy choices and reducing ineffective treatments. The results of the integration of objective neurophysiological markers into clinical psychiatry are indicating the potential for more personalized treatment allocation.