Predicting which depression patients will benefit from certain therapies is as much an art as a science, with most psychiatrists engaging in a trial-and-error method of identifying the right antidepressants and psychotherapy. But new research suggests brain scans can identify which patients will benefit most from certain treatments.
The study, conducted by Emory University researchers with a grant from the National Institute of Mental Health, found pre-treatment scans of brain activity accurately predicted whether depressed patients would benefit most from antidepressant medication or psychotherapy.
The study, published in the journal JAMA Psychiatry, may help mental health treatment decision-making move beyond trial-and-error by identifying a biomarker that could predict which type of treatment a patient would benefit from based on the state of his or her brain.
"Our goal is to develop reliable biomarkers that match an individual patient to the treatment option most likely to be successful, while also avoiding those that will be ineffective," explained researcher Helen Mayberg, M.D.
"For the treatment of mental disorders, brain imaging remains primarily a research tool, yet these results demonstrate how it may be on the cusp of aiding in clinical decision-making," said NIMH Director Thomas R. Insel, M.D.
Currently, only about 40 percent of patients benefit from initial treatment for depression. But Dr. Mayberg's team found the use of positron emission tomography (PET) scanners pinpointed activity in regions of the brains of 63 patients that can predict whether cognitive behavior therapy (CBT) or antidepressants known as SSRIs (serotonin specific reuptake inhibitors) would be likely to be more effective.
"If these findings are confirmed in follow-up replication studies, scans of [brain] activity could become clinically useful to guide more effective initial treatment decisions, offering a first step towards personalized medicine measures in the treatment of major depression" said Dr. Mayberg.
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