Comparison of Different Methods for the Evaluation of Treatment Effects from the Sleep EEG of Patients with Major Depression

  • Helland V
  • Postnova S
  • Schwarz U
 et al. 
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In healthy subjects, sleep has a typical structure of three to five
cyclic transitions between different sleep states. In major depression,
this regular pattern is often destroyed but can be reestablished during
successful treatment. The differences between healthy and abnormal sleep
are generally assessed in a time-consuming process, which consists of
determining the nightly variations of the sleep states (the hypnogram)
based on visual inspection of the electroencephalogram (EEG),
electrooculogram, and electromyogram. In this study, three different
methods of sleep EEG analysis (spectrum, outlier, and recurrence
analysis) have been examined with regard to their ability to extract
information about treatment effects in patients with major depression.
Our data suggest that improved sleep patterns during treatment with
antidepressant medication can be identified with an appropriate analysis
of the EEG. By comparing different methods, we have found that many
treatment effects identified by spectrum analysis can be reproduced by
the much simpler technique of outlier analysis. Finally, the cyclic
structure of sleep and its modification by antidepressant treatment is
best illustrated by a non-linear approach, the so-called recurrence

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  • V Carolina Figueroa Helland

  • Svetlana Postnova

  • Udo Schwarz

  • Juergen Kurths

  • Bernd Kundermann

  • Ulrich Hemmeter

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