Summary
We have previously reported successful classification of patients with a variety of psychiatric disorders, using multiple discriminant functions based upon selected neurometric QEEG variables. In independent replications, these functions accurately separate patients with different DSM-III-R diagnoses from one another and from normals. This capability demonstrates that distinctive and replicable patterns of neurometric abnormalities are correlated with the clinical symptom clusters upon which DSM-III-R diagnostic criteria are based. However, patients with the same clinical diagnoses often respond very differently to the same treatments. Similar symptoms may arise from different pathophysiology. This study explored the ‘natural structure’ of a population of psychiatric patients in 8 diagnostic categories, using uninformed cluster analysis based upon the same set of neurometric variables found useful in separating each of these categories from normal. This preliminary numerical taxonomic approach reveals that groups of patients in each of these DSM-III-R categories contain subtypes with markedly different pathophysiology; further, patients in different DSM-III-R categories were aggregated together within each cluster, displaying similar pathophysiological profiles. Objective classification based on such physiological measurements may add information useful to improve treatment outcomes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alper, K., Chabot, R., Prichep, L., and John, E. Crack cocaine dependence: Discrimination from major depression using QEEG variables. In Maurer, K., editor, Imaging of the Brain in Psychiatry and Related Fields. Springer-Verlag, Berlin. In press, 1991.
Czobor, P. and Volavka, J. Pretreatment EEG predicts shortterm response to haloperidol treatment. Biolog. Psychiat., 1991, 30: 927–942.
de Weerd, A., Veldhuizen, R., Veering, M., and Poortvliet, D. Long-term clinical and neurophysiological effects of reconstructive vascular surgery for cerebral ischemia. Acta Neurologica Scandinavica, 1989, 79: 311–315.
Duffy, F., Bartels, P., and Burchfield, J. Significance probability mapping. Electroenceph. clin. Neurophysiol., 1981, 51: 455–462.
Fitz-Gerald, M. J. and Patrick, G. Longitudinal quantitative eeg findings after acute carbon monoxide exposure: Two case studies. Clin. Electroencephalography, 1991, 22(4): 217–224.
Harmony, T., Alvarez, A., Pascual, R., Ramos, A., Marosi, E., Leon, A. D. D., Valdes, P., and Becker, J. EEG maturation on children with different economic and psychosocial characteristics. Intl. J. Neurosci., 1987, 31:103–113.
John, E., Ahn, H., Prichep, L., Trepetin, M., Brown, D., and Kaye, H. Developmental equations for the electroencephalogram. Science, 1980, 210: 1255–1258.
John, E., Karmel, B., Corning, W., Easton, P., Brown, D., Ahn, H., John, M., Harmony, T., Prichep, L., Toro, A., Gerson, I., Bartlett, F., Thatcher, R., Kaye, H., Valdes, P., and Schwartz, E. Neurometrics: numerical taxonomy identifies different profiles of brain functions within groups of behaviorally similar people. Science, 1977, 196: 1383–1410.
John, E. and Prichep, L. Neurometric studies of aging and cognitive impairment. In Uylings, H., Eden, C. V., Bruin, J. D., Corner, M., and Feenstra, M., editors, The Prefrontal Cortex, its Structure, Function and Pathology. Progress in Brain Research, 1990, 545–555. Elsevier, Amsterdam.
John, E., Prichep, L., Fridman, J., and Easton, P. Neurometrics: Computer assisted differential diagnosis of brain dysfunctions. Science, 1988a, 293: 162–169.
John, E., Prichep, L., Friedman, J., and Easton, P. Neurometric topographic mapping of EEG and evoked potential features: Application to clinical diagnosis and cognitive evaluation. In Maurer, K., editor, Topographic Brain Mapping of EEG and Evoked Potentials, 1988b, 90–117. Springer-Verlag, Berlin.
John, E., Prichep, L., Friedman, J., and Easton, P. Neurometric topographic mapping of EEG and evoked potential features: Application to clinical diagnosis and cognitive evaluation. In Maurer, K., editor, Topographic Brain Mapping of EEG and Evoked Potentials, 1989, 90–111. Springer-Verlag.
Jonkman, E., Poortvliet, D., Veering, M., deWeerd, A., and John, E. The use of neurometrics in the study of patients with cerebral ischemia. Electroenceph. and clin. Neurophysiol., 1985, 51: 333–341.
Mas, F., Prichep, L., Cancro, R., John, E., and Alper, K. Neurometric-quantitative EEG as a diagnostic adjunct in clinical psychiatry. Eur. Psychiatry, 1991a, 6:131–139.
Mas, F., Prichep, L., John, E., and Levine, R. Neurometric Q-EEG subtyping of obsessive compulsive disorder. In Maurer, K., editor, Imaging of the Brain in Psychiatry and Related Fields. Springer Verlag, Berlin, Heidelberg, 1991b.
Prichep, L. Neurometric quantitative EEG measures of depressive disorders. In Takahashi, R., Flor-Henry, P., Gruzelier, J., and Niwa, S., editors, Cerebral Dynamics, Laterality and Psychopathology, 1987, pages 55–69. Elsevier, Amsterdam, New York, Oxford.
Prichep, L. and John, E. II. Neurometric studies of methylphenidate responders and non-responders. In Pavlidis, G. T., editor, Perspectives on Dyslexia Vol. 1, chapter 7, 1990, 133–139. John Wiley & Sons.
Prichep, L. and John, E. QEEG profiles of psychiatric disorders. Brain Topography, 1992, 4 (4): 249–257.
Prichep, L., John, E., Essig-Peppard, T., and Alper, K. Neurometric subtyping of depressive disorders. In Cazzullo, C., Invernizzi, G., Sacchetti, E., and Vita, A., editors, Plasticity and Morphology of the Central Nervous System. M.T.P. Press, London 1990a.
Prichep, L., John, E., Ferris, S., Reisberg, B., Alper, K., and Cancro, R. Quantitative EEG correlates of cognitive deterioration in the elderly. In New Research Program and Abstracts: American Psychiatric Association 143rd. Annual Meeting, 1990b, page 301, New York, New York.
Prichep, L., John, E., Mas, F., and Essig-Peppard, T. Neurometric functional imaging I: Subtyping of schizophrenia. In Machinery of the Mind, 1990c, 460–470. Birkhauser, Cambridge.
Prichep, L., Lieber, A., John, E., Alper, K., Gomez-Mont, F., Essig-Peppard, T., and Flitter, M. Quantitative EEG in depressive disorders. In Shagass, C., Josiassen, R., and Roemer, R., editors, Brain Electrical Potentials and Psychopathology, 223–244. Elsevier Science Publishing.
Prichep, L., Mas, F., John, E., and Levine, R. (1991). Neurometric subtyping of obsessive compulsive disorders. In Stefanis, C., Rabavilas, A., and Soldatos, C., editors, Psychiatry: A World Perspective - Volume 1, 1986, 557–562. Elsevier.
Roemer, R., Shagass, C., Dubin, W., Joffe, R., and Katz, R. Relationship between pretreatment electroencephalographic coherence measures and subsequent response to electroconvulsive therapy: A preliminary study. Neuropsychobiol., 1991, 180.
Senf, G. Neurometric brain mapping in the diagnostic rehabilitation of cognitive brain dysfunction. Cognitive Rehabilitation, 1988, 6:20–37.
Struve, F., Straumanis, J., Patrick, G., and Price, L. Topographic mapping of quantitative EEG variables in chronic heavy marijuana users: Empirical findings with psychiatric patients. Clin. Electroenceph., 1989, 20(1):6–23.
Struve, F., Straumanis, J., Patrick, G., and Raz, Y. Quantitative EEG and cognitive evoked potentials in chronic marijuana users. Electroenceph. clin. Neurophyiol., 1990, 75(1):145.
Thatcher, R., Walker, R., Gerson, I., and Geisler, F. EEG discriminant analyses of mild head trauma. Electroenceph. clin. Neurophysiol., 1989, 73: 94–106.
Veering, N., Jonkman, E., Poortvliet, D., de Weerd, A., Tans, J., and John, E. The effect of reconstructive vascular surgery on clinical status, quantitative EEG and cerebral blood flow in patients with cerebral ischaemia. A three month follow-up study in operated and unoperated stroke patients. Electroenceph. clin. Neurophysiol., 1986, 64(5): 383–393.
Author information
Authors and Affiliations
Additional information
Acknowledgment: The technological assistance of MeeLee Tom, Henry Merkin and Bryant Howard is acknowledged. In addition, we acknowledge Heather Stein for assistance in preparation of this manuscript. This work was supported in part by Cadwell Laboratories, Kennewick, Washington.
Rights and permissions
About this article
Cite this article
John, E.R., Prichep, L.S. & Almas, M. Subtyping of psychiatric patients by cluster analysis of QEEG. Brain Topogr 4, 321–326 (1992). https://doi.org/10.1007/BF01135569
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01135569