EEG vigilance and response to oral prolonged-release ketamine in treatment-resistant depression - A double-blind randomized validation study.
Psychiatry research. Neuroimaging July 1, 2025 Anna Monn, Corinne Eicher, Annia Rüesch et al. 2 citations
A higher percentage of EEG vigilance stage A1, a measure of brain activity, is associated with response to intravenous ketamine in major depression. In a phase-2 randomized controlled trial of oral prolonged-release ketamine for treatment-resistant depression, no significant interaction between response and treatment was found for this EEG marker. However, a small-scale meta-analysis showed a significant pooled mean difference between ketamine responders and non-responders. Applying a previously proposed A1 cutoff of 43% yielded chance-level prediction accuracy in the combined ketamine group but 75% accuracy in the 240 mg subgroup. Responders to 240 mg ketamine also showed more stable vigilance over time. These findings support EEG vigilance as a predictive biomarker for treatment outcomes in depression, though further validation is needed.