Study: Scans May Predict Best Depression Treatment Per Patient
According to a new study that sought to figure out if pre-treatment scans of brain activity could help predict how depressed patients could best be treated, scientists believe they have hit the motherload. The study was funded by the National Institutes of Health and published in JAMA Psychiatry, June 12, 2013.
"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 Helen Mayberg, M.D., of Emory University, Atlanta, a grantee of the NIH's National Institute of Mental Health (NIMH) program.
"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," adds NIMH Director Thomas R. Insel, M.D.
The study looked at whether a brain scan could help predict if antidepressant drugs like Paxil or traditional psychotherapy would be the most effective treatment in ridding patients of depression. Mayberg's team wanted to take the guesswork out of treatments by scanning their brains beforehand. Using a positron emission tomography (PET) scanner, the researchers took images of the participating patients’ brain activity during restful periods as well as when the activity in the brain increased. They then compared brain circuit activity of patients that had achieved a remission of symptoms after treatments to those patients whose conditions didn’t improve.
What they found was that the activity in one area of the brain (the anterior insula) was a viable predictor of therapeutic outcomes from cognitive behavior therapy (CBT) or an SSRI antidepressant drug.
"If these findings are confirmed in follow-up replication studies, scans of anterior insula 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," Mayberg notes.
SSRIs are commonly used to treat depression but they are linked to serious adverse effects. In fact, Paxil has been known to cause patients to suffer from violent and suicidal thoughts and behavior as well as lead to birth defects in babies born to mothers who take the pills while pregnant. The birth defects linked to Paxil use include PPHN, spina bifida, neural tube defects, oral clefts and heart, lung and brain defects. Confirmation of this study’s finding could help reduce the number of patients who suffer from these serious side effects.