Evidentiary Significance of Routine EEG in Refractory Cases: A Paradigm Shift in Psychiatry.
| Autor: | Swatzyna RJ; Houston Neuroscience Brain Center, Houston, TX, USA., Morrow LM; Houston Brain Center, Houston, Texas, USA., Collins DM; Child, Adolescent, and Adult Psychiatry, Sugar Land, TX, USA., Barr EA; Houston Neuroscience Brain Center, Houston, TX, USA., Roark AJ; Houston Neuroscience Brain Center, Houston, TX, USA., Turner RP; Network Neurology, LLC, University of South Carolina School of Medicine, Charleston, SC, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Clinical EEG and neuroscience [Clin EEG Neurosci] 2024 Jan 18, pp. 15500594231221313. Date of Electronic Publication: 2024 Jan 18. |
| DOI: | 10.1177/15500594231221313 |
| Abstrakt: | Over the past decade, the Diagnostic and Statistical Manual 's method of prescribing medications based on presenting symptoms has been challenged. The shift toward precision medicine began with the National Institute of Mental Health and culminated with the World Psychiatric Association's posit that a paradigm shift is needed. This study supports that shift by providing evidence explaining the high rate of psychiatric medication failure and suggests a possible first step toward precision medicine. A large psychiatric practice began collecting electroencephalograms (EEGs) for this study in 2012. The EEGs were analyzed by the same neurophysiologist (board certified in electroencephalography) on 1,233 patients. This study identified 4 EEG biomarkers accounting for medication failure in refractory patients: focal slowing, spindling excessive beta, encephalopathy, and isolated epileptiform discharges. Each EEG biomarker suggests underlying brain dysregulation, which may explain why prior medication attempts have failed. The EEG biomarkers cannot be identified based on current psychiatric assessment methods, and depending upon the localization, intensity, and duration, can all present as complex behavioral or psychiatric issues. The study highlights that the EEG biomarker identification approach can be a positive step toward personalized medicine in psychiatry, furthering the clinical thinking of "testing the organ we are trying to treat." Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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