Depression is a common issue but there is no marker of response to an antidepressant treatment.The measurement of variation of the cortical excitability in responders to a selective serotonin reuptake inhibitor (SSRI) (compared to no-responders) had never been done before. In the study of Robol et al. (2004) concerning the acute effects of citalopram on markers of cortical excitability, the authors have pointed out an increase on the cortical silent period (CSP) after administration of citalopram (2.5 hours). The investigators hypothesize that this effect remains later and that the diminution of cortical excitability could be a biomarker of antidepressant response. In this case, they expect that the variation of CSP between day 1 and day 28 is higher in responders to a SSRI (citalopram) compared to non-responders. the investigators lead a pilot, prospective, multicentric study in drug-naive patients to compare the variation of the markers of cortical excitability (the CSP but to the resting motor threshold RMT, the motor evoked potential MEP, the intra-cortical inhibition ICI and the intra-cortical facilitation ICF) between day 1 and day 28 in responders to citalopram, compared to non-responders.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
22
In the arm experimental "treatment by citalopram", measurements of markers of cortical excitability by Transcranial Magnetic Stimulation will be applied. These measurements were: the cortical silent period CSP, the evoked potential MEP, the intra-cortical inhibition ICI and the intra-cortical facilitation ICF). Electromagnetic coil is placed upon the vertex, according to the International 10-20 EEG system. Gathering of the peripheral signal by a surface EMG electrode (non invasive device) placed regarding one of the first dorsal interosseous muscle.
Rouvray Hospital
Sotteville-lès-Rouen, France
RECRUITINGVariation of the CSP between day 1 and day 28
The difference in variation of the cortical silent period (CSP) between day 1 and day 28 in responders compared to non-responders. A decrease by at least 50% on Hamilton Depression rating Scale (HAMD-21) define response to citalopram.The HAMD-21 assesses the intensity of the depressive symptoms with 21 items. Its score is between 0 (no depression) and 73 (the maximum of intensity).
Time frame: 28 days
Variation of the RMT between day 1 and day 28
The difference in variation of other markers of cortical excitability like resting motor threshold (RMT) between day 1 and day 28 in responders compared to non responders.
Time frame: 28 days
Variation of the MEP between day 1 and day 28
The difference in variation of the motor evoked potential (MEP) between day 1 and day 28 in responders compared to non responders.
Time frame: 28 days
Variation of the ICI between day 1 and day 28
The difference in variation of the intra-cortical inhibition (ICI) between day 1 and day 28 in responders compared to non responders.
Time frame: 28 days
Variation of the ICF between day 1 and day 28
The difference in variation of the intra-cortical facilitation (ICF) between day 1 and day 28 in responders compared to non responders.
Time frame: 28 days
Variation of the markers of cortical excitability at other times
Differences in variations of RMT, MEP, ICI and ICF in responders compared to non-responders at other times : between day 1 and day 3, day 1 and day 7 and day 1 and day 14.
Time frame: 14 days
Variation in HAMD-21 between day 1 and day 60 for the responders at day 28
The variation in HAMD-21 between day 1 and day 60 for the responders at day 28.
Time frame: 60 days
Variations in UKU (Udvalg pour Kliniske Undersøgelser Side Effect Rating Scale) at different times
The variations in UKU scale adapted for antidepressants at day 3, day 7, day 14, day 28 (and day 60 for the responders at day 28). The UKU assesses the side effects of the antidepressants. Its score is between 0 (no side effect) and 120 (the maximum of side effects).
Time frame: 60 days
Variations in Morisky compliance scale
The variations in Morisky compliance scale at day 3, day 7, day 14, day 28 (and day 60 for the responders at day 28).The Morisky scale assesses the compliance with antidepressant treatment and its score is between 0 (no compliance) and 8 (good compliance).
Time frame: 60 days
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