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. A method of predicting an outcome of a first treatment based on neurophysiologic information obtained from a patient, comprising:
a) scaling said patient neurophysiologic information to enable comparison with stored neurophysiologic information obtained from a response database, wherein said stored neurophysiologic information comprises pre-treatment neurophysiologic information and responses to said first treatment in the form of active-treatment neurophysiologic information from a plurality of subjects,
b) computing at least one patient indicative variable from said patient neurophysiologic information comprising the steps of;
i) screening said scaled patient neurophysiologic information with said response database, wherein said response database comprises clusters of said pre-treatment neurophysiologic information associated with said plurality of subjects, wherein said plurality of subjects responses to said first treatment are similar;
ii) identifying said clusters as a region in a multidimensional space defined by a range of values of unitary variables such that a threshold number of subjects having said similar response to said first treatment are included in said region; and
iii) identifying said range of values of unitary variables describing said region wherein a set of unitary variables having values shared by said threshold number of subjects within said cluster forms at least one multivariable wherein said at least one multivariable is said at least one patient indicative variable; and
c) evaluating said at least one patient indicative variable with the aid of at least one rule implemented on a computing machine in order to predict said outcome of said first treatment prior to actually administering said first treatment to said patient and wherein said method is conducted on said patient independent of a behavioral mental disease diagnosis of, or behavioral data from said patient.
2. The method of claim 1 , wherein said patient neurophysiologic information and said plurality of subjects neurophysiologic information comprises electroencephalogram recordings recorded by electrodes placed in accordance with the International 10/20 system.
3. The method of claim 1 , wherein said threshold number of patients is 80%.
4. The method of claim 1 , wherein each of said similar responses includes a clinical global improvement score selected from a set consisting of an integer in the range [−1 to 3] such that ‘−1’ indicates adverse therapeutic entity effect, ‘0’ indicates no improvement, ‘1’ indicates minimal improvement, ‘2’ indicates moderate improvement and ‘3’ indicates complete absence of symptoms.
5. The method of claim 1 , wherein each of said similar responses is a measure of a difference between said active-treatment neurophysiologic information and a distribution of neurophysiologic information of age-matched reference subjects.
6. The method of claim 1 , further including the step of including said outcome of said first treatment in a report.
7. The method of claim 6 , further including the steps of: i) applying a plurality of rules associated with a plurality of indicative variables to said pre-treatment neurological information from said response database; ii) evaluating whether said plurality of rules indicate substantial agreement with one of a plurality of outcomes following said first treatment; and iii) including, in response to such an indication, said one of a plurality of outcomes following said first treatment in said report.
8. The method of claim 1 , wherein said first treatment is specified in response to a traditional diagnosis of mental disease, wherein said traditional diagnosis is based upon standards selected from the group consisting of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), and the International Classification of Diseases, 10 th revision (ICD-10).
9. The method of claim 8 , wherein said first treatment is in a list of treatments specified in response to said traditional diagnosis of mental disease whereby effective treatments in said list are rapidly identified.
10. The method of claim 9 , further including the steps of: i) comparing a result of applying at least one rule to said neurological information from said patient to at least one expected result associated with a second treatment, said second treatment not in said list of treatments based on said patient neurological information; and ii) identifying, in response to detecting a similarity between said at least one expected result and said result, said second treatment as a possible treatment in said list.
11. The method of claim 10 , wherein said traditional diagnosis is major depressive disorder and said second treatment is selected from the group consisting of glutamine, phenylalanine, and tyrosine.
12. The method of claim 10 , wherein said traditional diagnosis is psychological factors affecting medical condition, atypical asthma and the second treatment is selected from the group consisting of glutamine, phenylalanine, tyrosine, bupropion, parnate, moclobemide, phenelzine, selegiline, venlafaxine, carbamazapine, gabapentin, lamotrigine, ginko biloba , dexedrine, methamphetamine, methylphenidate, and pemoline.
13. The method of claim 10 , wherein said traditional diagnosis is one of anxiety disorders and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, bupropion, citalopram, fluvoxamine, citalopramine, clomipramine, moclobemide, parnate, phenelzine, selegitine, carbamazapine, divalproex, gabapentin, lamotrigine, guanfacine hcl, clonidine, atenolol, metoprolol, propranolol, lithium, ginko biloba , kava kava, st. john's wort, amantadine, phototherapy at 10000 lux, adderall, dexedrine, methamphetamine, methylphenidate, modafinil, and pemoline.
14. The method of claim 10 , wherein said traditional diagnosis is one of psychological factors affecting medical condition, disorders usually first diagnosed in infancy, childhood, or adolescence and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, bupropion, citalopram, clomiprimine, doxepin, fluoxetine, fluvoxamine, moclobemide, parnate, phenelzine, selegiline, trazodone, venlafaxine, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, guanfacine hcl, clorazepate, diazapam, oxazepam, quazepam, atenolol, metoprolol, propranolol, lithium, ginko biloba , kava kava, st, john's wort, silbtrimin, amantadine, phototherapy at 10000 lux, addcrall, dexedrine, methamphetamine, methylphenidate, modafinil, and phentermine.
15. The method of claim 10 , wherein said traditional diagnosis is one of eating disorders and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, bupropion, moclobemide, parnate, phenelzine, selegiline, venlafaxine, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, diazapam, Iorazepam, atenolol, metoprolol, propranolol, lithium, ginko biloba , kava kava, st. john's wort, amantadine, phototherapy at 10000 lux, zolipidem, adderall, dexedrine, methamphetamine, methylphenidate, modafinil, pemoline, and phentermine.
16. The method of claim 10 , wherein said traditional diagnosis is one of delirium, dementia and amnestic and other cognitive disorders and the second treatment is selected from the group consisting of glutamine, phenylalanine, tyrosine, donepezil, amitriptyline, bupropion, fluxotine, moclobemide, parnate, phenelzine, selegiline, venlafaxine, carbamazapine, divalproex, gabapentin, lamotrigine, atenolol, metoprolol, propranolol, lithium, ginko biloba , silbtrimin, amantadine, phototherapy at 10000 lux, zolipidem, adderall, dexedrine, methamphetamine, methylphenidate, modafinil, pemoline, and phentermine
17. The method of claim 10 , wherein said traditional diagnosis is impulse control disorders not elsewhere classified and the second treatment is selected from the group consisting of glutamine, phenylalanine, tyrosine, donepezil, bupropion, citalopram, clomiprimine, desipramine, moclobemide, nefazodone, parnate, phenelzine, selegiline, venlafaxine, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, guanfacine hcl, clonidine, atenolol, metoprolol, propranolol, ginko biloba , kava kava, silbtrimin, amantadine, phototherapy at 10000 lux, adderall, dexedrine, methamphetamine, methylphenidate, and pemoline.
18. The method of claim 10 , wherein said traditional diagnosis is one of mood disorders and the second treatment is selected from the group consisting of glutamine, phenylalanine, tyrosine, moclobemide, parnate, phenelzine, selegiline, diphenylhydantoin, lamotrigine, guanfacine hcl, clonidine, Iorazepam, oxazepam, quazepam, temazepam, trizolam, atenolol, metoprolol, propranolol, ginko biloba , kava kava, st. john's wort, phototherapy at 10000 lux, adderall, dexedrine, methamphetamine, methylphenidate, pemoline, and phentermine.
19. The method of claim 10 , wherein said traditional diagnosis is one of other codes and conditions and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, bupropion, citalopram, clomiprimine, fluvoxamine, moclobemide, notriptyline, parnate, phenelzine, selegiline, trazodone, venlafaxine, carbamazapine, divalproex, gabapentin, lamotrigine, guanfacine hcl, clonidine, atenolol, metoprolol, propranolol, ginko biloba , kava kava, st. john's wort, amantadine, phototherapy at 10000 lux, zolipidem, adderall, dexedrine, methamphetamine, methylphenidate, pemoline, and phentermine.
20. The method of claim 10 , wherein said traditional diagnosis is one of personality disorders and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, bupropion, moclobemide, parnate, phenelzine, selegiline, venlafaxine, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, diazapam, atenolol', metoprolol, propranolol, lithium, ginko biloba , kava kava, st. john's wort, phototherapy at 10000 lux, adderall, dexedrine, methamphetamine, methylphenidate, pemoline, and phentermine.
21. The method of claim 10 , wherein said traditional diagnosis is hypoactive sexual desire disorder and the second treatment is selected from the group consisting of bupropion, buspirone, moclobemide, parnate, phenelzine, and selegiline.
22. The method of claim 10 , wherein said traditional diagnosis is one of sleep disorders and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, bupropion, buspirone, citalopram, clomiprimine, desipramine, fluoxetine, fluvoxamine, moclobemide, parnate, phenelzine, selegiline, sertraline, venlafaxine, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, guanfacine hcl, clonidine, atenolol, metoprolol, propranolol, lithium, ginko biloba , kava kava, st. john's wort, silbtrimin, phototherapy at 10000 lux, adderall, dexedrine, methamphetamine, methylphenidate, pemoline, and phentermine.
23. The method of claim 10 , wherein said traditional diagnosis is one of somatoform disorders and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, bupropion, citalopram, fluvoxamine, moclobemide, parnate, phencizine, selegiline, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, atenolol, metoprolol, propranolol, ginko biloba , kava kava, st. john's wort, amantadine, phototherapy at 10000 lux, zolipidem, adderall, dexedrine, methamphetamine, methylphenidate, modafinil, pemoline, and phentermine.
24. The method of claim 10 , wherein said traditional diagnosis is one of substance related disorders and the second treatment is selected from the group consisting of gaba, glutamine, phenylalanine, tyrosine, donepezil, fluvoxamine, moclobemide, parnate, phenelzine, selegiline, venlafaxine, carbamazapine, diphenylhydantoin, divalproex, gabapentin, lamotrigine, guanfacine hcl, atenolol, metoprolol, propranolol, ginko biloba , kava kava, st. john's wort, silbtrimin, phototherapy at 10000 lux, adderall, dexedrine, methamphetamine, methylphenidate, and pemoline.