Electroencephalography based systems and methods for selecting therapies and predicting outcomes
A method and system for utilizing neurophysiologic information obtained by techniques such as quantitative electroencephalography (QEEG), electrode recordings, MRI in appropriately matching patients with therapeutic entities is disclosed. The present invention enables utilization of neurophysiologic information, notwithstanding its weak correlation with extant diagnostic schemes for mental disorders, for safer and expeditious treatment for mental disorders, discovering new applications for therapeutic entities, improved testing of candidate therapeutic entities, inferring the presence or absence of a desirable response to a treatment, and deducing the mode of action of one or more therapeutic entities. In particular, methods for effectively comparing neurophysiologic information relative to a reference set are disclosed along with database-based tools for deducing therapeutic entity actions on particular patients such that these tools are readily accessible to remote users.
1 - 62 . (canceled)
63 . A neurometric database, comprising:
a) aggregate neurophysiologic information related to a symptomatic reference population, said population comprising a plurality of subjects; and
b) at least one score related to clinical manifestations from at least one of said plurality of subjects having been diagnosed with at least one psychiatric imbalance.
64 . The database of claim 63 , wherein said information comprises a plurality of quantitative univariate measures.
65 . The database of claim 63 , wherein said reference population comprises at least one of said plurality of subjects having undergone a therapy regimen.
66 . The database of claim 63 , wherein said reference population comprises at least one of said plurality of subjects having not undergone a therapy regimen.
67 . The database of claim 65 , wherein said therapy regimen is selected from the group consisting of drug therapy, electroconvulsive therapy, electromagnetic therapy, neuromodulation therapy, and verbal therapy.
68 . The database of claim 66 , wherein said therapy regimen is selected from the group consisting of drug therapy, electroconvulsive therapy, electromagnetic therapy, neuromodulation therapy, and verbal therapy.
69 . The database of claim 63 , wherein said at least one psychiatric imbalance is selected from the group consisting of agitation, attention deficit hyperactivity disorder, abuse, Alzheimer's disease/dementia, anxiety, panic, and phobic disorders, bipolar disorders, borderline personality disorder, behavior control problems, body dysmorphic disorder, cognitive problems, depression, dissociative disorders, eating, appetite, and weight problems, edema, fatigue, hiccups, impulse-control problems, irritability, mood problems, movement problems, obsessive-compulsive disorder, pain, personality disorders, posttraumatic stress disorder, schizophrenia and other psychotic disorders, seasonal affective disorder, sexual disorders, sleep disorders, stuttering, substance abuse, tic disorders/Tourette's Syndrome, traumatic brain injury, Trichotillomania, and violent/self-destructive behaviors.
70 . The database of claim 68 , wherein said database further comprises a medication response profile for said therapy regimen.
71 . The database of claim 70 , wherein said profile comprises at least one multivariate Z score.
72 . The database of claim 71 , wherein said at least one multivariate Z score comprises at least one multivariate outcomes measure.
73 . The database of claim 68 , wherein said drug therapy is selected from the group consisting of alprazolam, amantadine, amitriptyline, atenolol, bethanechol, bupropion, buspirone, carbamazepine, chlorpromazine, chlordiazepoxide, citalopram, clomipramine, clonidine, clonazepam, clozapine, cyproheptadine, divalproex, deprenyl, desipramine, dextroamphetamine, diazepam, disulfiram, divalproex, doxepin, ethchlorvynol, fluoxetine, fluvoxamine, felbamate, fluphenazine, gabapentin, haloperidol, imipramine, isocarboxazid, lamotrigine, levothyroxine, liothyronine, lithium carbonate, lithium citrate, lorazepam, loxapine, maprotiline, meprobamate, mesoridazine, methamphetamine, midazolam, meprobamate, mirtazapine, molindone, moclobemide, naltrexone, phenelzine, nefazodone, nortriptyline, olanzapine, oxazepam, paroxetine, pemoline, perphenazine, phenelzine, pimozide, pindolol, prazepam, propranolol, protriptyline, quetiapine, reboxetine, risperidone, selegiline, sertraline, sertindole, trifluoperazine, trimipramine, temazepam, thioridazine, topiramate, tranylcypromine, trazodone, triazolam, trihexyphenidyl, trimipramine, valproic acid or venlafaxine.
74 . The database of claim 63 , wherein said score comprises a Clinical Global Improvement score.
75 . The database of claim 63 , wherein said Clinical Global Improvement (CGI) score is selected from the group consisting of a CGI score of negative one (−1) indicating an adverse medication effect; a CGI score of zero (0) indicating no improvement; a CGI score of one (1) indicating minimal or mild improvement; a CGI score of two 2 indicating moderate improvement; and a CGI score of three (3) indicating marked improvement, including complete absence of symptoms.
76 . A method of creating a neurometric database, comprising:
a) providing:
i) aggregate neurophysiologic information related to a symptomatic reference population, said population comprising a plurality of subjects; and
ii) at least one score related to clinical manifestations from at least one of said plurality of subjects having been diagnosed with at least one psychiatric imbalance;
iii) a storage medium, wherein said information and said manifestation scores are capable of linked retrieval and observation;
b) storing said information and said manifestations on said medium under conditions such that said linked information and manifestations may be compared to a patient neurophysiological information set.
77 . The method of claim 76 , wherein said information comprises a plurality of quantitative univariate measures.
78 . The method of claim 76 , wherein said reference population comprises at least one of said plurality of subjects having undergone a therapy regimen.
79 . The method of claim 78 , wherein said reference population comprises at least one of said plurality of subjects having not undergone a therapy regimen.
80 . The method of claim 79 , wherein said therapy regimen is selected from the group consisting of drug therapy, electroconvulsive therapy, electromagnetic therapy, neuromodulation therapy, and verbal therapy.
81 . The method of claim 79 , wherein said therapy regimen is selected from the group consisting of drug therapy, electroconvulsive therapy, electromagnetic therapy, neuromodulation therapy, and verbal therapy.
82 . The method of claim 76 , wherein said at least one psychiatric imbalance is selected from the group consisting of agitation, attention deficit hyperactivity disorder, abuse, Alzheimer's disease/dementia, anxiety, panic, and phobic disorders, bipolar disorders, borderline personality disorder, behavior control problems, body dysmorphic disorder, cognitive problems, depression, dissociative disorders, eating, appetite, and weight problems, edema, fatigue, hiccups, impulse-control problems, irritability, mood problems, movement problems, obsessive-compulsive disorder, pain, personality disorders, posttraumatic stress disorder, schizophrenia and other psychotic disorders, seasonal affective disorder, sexual disorders, sleep disorders, stuttering, substance abuse, tic disorders/Tourette's Syndrome, traumatic brain injury, Trichotillomania, and violent/self-destructive behaviors.
83 . The method of claim 76 , wherein said database further comprises a medication response profile for said therapy regimen.
84 . The method of claim 83 , wherein said profile comprises at least one multivariate Z score.
85 . The method of claim 84 , wherein said at least one multivariate Z score comprises at least one multivariate outcomes measure.
86 . The method of claim 81 , wherein said drug therapy is selected from the group consisting of alprazolam, amantadine, amitriptyline, atenolol, bethanechol, bupropion, buspirone, carbamazepine, chlorpromazine, chlordiazepoxide, citalopram, clomipramine, clonidine, clonazepam, clozapine, cyproheptadine, divalproex, deprenyl, desipramine, dextroamphetamine, diazepam, disulfiram, divalproex, doxepin, ethchlorvynol, fluoxetine, fluvoxamine, felbamate, fluphenazine, gabapentin, haloperidol, imipramine, isocarboxazid, lamotrigine, levothyroxine, liothyronine, lithium carbonate, lithium citrate, lorazepam, loxapine, maprotiline, meprobamate, mesoridazine, methamphetamine, midazolam, meprobamate, mirtazapine, molindone, moclobemide, naltrexone, phenelzine, nefazodone, nortriptyline, olanzapine, oxazepam, paroxetine, pemoline, perphenazine, phenelzine, pimozide, pindolol, prazepam, propranolol, protriptyline, quetiapine, reboxetine, risperidone, selegiline, sertraline, sertindole, trifluoperazine, trimipramine, temazepam, thioridazine, topiramate, tranylcypromine, trazodone, triazolam, trihexyphenidyl, trimipramine, valproic acid or venlafaxine.
87 . The method of claim 76 , wherein said score comprises a Clinical Global Improvement score.
88 . The method of claim 76 , wherein said Clinical Global Improvement (CGI) score is selected from the group consisting of a CGI score of negative one (−1) indicating an adverse medication effect; a CGI score of zero (0) indicating no improvement; a CGI score of one (1) indicating minimal or mild improvement; a CGI score of two 2 indicating moderate improvement; and a CGI score of three (3) indicating marked improvement, including complete absence of symptoms.