The Comparative Effectiveness of EEG Biomarkers in Antidepressant Response and Illness Prediction in Major Depressive Disorder

Background: There is growing evidence that individual EEG differences may aid in classifying patients with major depressive disorder (MDD) and also help predict clinical response to antidepressant treatment. This study aims to compare the effectiveness of EEG frequency band power, alpha asymmetry and prefrontal theta cordance towards escitalopram response prediction and MDD diagnosis, in a multi-site initiative. Methods: Resting EEG (eyes open and closed) was recorded from 64 electrodes in 44 depressed patients and 20 healthy controls at baseline, 2 weeks post-treatment and 8 weeks post-treatment. Clinical response was measured as change from baseline MADRS of 50% or more. EEG measures were analyzed (1) at baseline (2) at 2 weeks post-treatment and (3) as an ‘‘early change” variable defined as change in EEG from baseline to 2 weeks post-treatment. Results: At baseline, responders exhibited greater absolute alpha power in the left hemisphere versus the right while non-responders showed the opposite. Responders further exhibited a cortical asymmetry of greater right relative to left activity in parietal areas. Groups also differed in baseline relative delta power with responders showing greater power in the right hemisphere versus the left while non-responders showed the opposite. At 2 weeks post-treatment, responders exhibited greater absolute beta power in the left hemisphere relative to right and the opposite was noted for non-responders. The opposite pattern was noted for absolute and relative delta power at 2 weeks post-treatment. Responders exhibited early reduction in relative alpha power and early increments in relative theta power. Non-responders showed a significant early increase in prefrontal theta cordance. Absolute delta power helped distinguish MDD patients from healthy controls. Conclusions: Hemispheric asymmetries in the alpha and delta bands at pre-treatment baseline and at 2 weeks post-treatment have moderate to moderately strong predictive utility towards antidepressant treatment response. These findings have significant potential for improving clinical practice in psychiatry by eventually guiding clinical choice of treatments. This would greatly benefit patients awaiting relief from depressive symptoms as treatment optimization would help overcome problems associated with delayed recovery. Our results also indicate that resting EEG activity may have clinical utility in predicting MDD diagnosis.

The Open Data Smart City: A Case Study of Smart City Progress through Open Data Initiatives

Smart cities, cities that are supported by an extensive digital infrastructure of sensors, databases and intelligent applications, have become a major area of academic, governmental and public interest. Simultaneously, there has been a growing interest in open data, the unrestricted use of organizational data for public viewing and use. Drawing on Science and Technology Studies (STS), Urban Studies and Political Economy, this thesis examines how digital processes, open data and the physical world can be combined in smart city development, through the qualitative interview-based case study of a Southern Ontario Municipality, Anytown. The thesis asks what are the challenges associated with smart city development and open data proliferation, is open data complimentary to smart urban development; and how is expertise constructed in these fields? The thesis concludes that smart city development in Anytown is a complex process, involving a variety of visions, programs and components. Although smart city and open data initiatives exist in Anytown, and some are even overlapping and complementary, smart city development is in its infancy. However, expert informants remained optimistic, faithful to a technologically sublime vision of what a smart city would bring. The thesis also questions the notion of expertise within the context of smart city and open data projects, concluding that assertions of expertise need to be treated with caution and scepticism when considering how knowledge is received, generated, interpreted and circulates, within organizations.