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MRI May Predict Which Depression Patients Respond Best to Therapy

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A simple x-ray may help predict the effectiveness of a common therapy for depression, new research shows.

Currently, only 45 percent of people with depression respond positively to cognitive-behavioral therapy, according to a study published Wednesday in Science Advances. Now, researchers say functional magnetic resonance imaging, or fMRI, can help to identify which patients should receive the therapy.

"So far most fMRI studies that have looked for a brain signature of treatment response in depression have reported on average differences between responders and non-responders and then assumed that these differences generalize to each individual but this may not be the case," Filippo Queirazza, a researcher at the University of Glasgow and study lead author, said in a news release.

For the study, researchers analyzed 37 patients who used internet-based cognitive behavioral therapy to treat depression. The patients had their brain activity recorded with the fMRI after performing reinforcement learning tasks requiring them to choose which of two given options was most rewarding.

Then, the researchers applied a fitted mathematical model based on those responses. They used that data to determine which patients responded well to cognitive behavioral therapy.

In all, the fMRI was about 80 percent accurate in predicting whether the therapy would be successful.

Knowing early on if a therapy method could work is important because it allows health professionals to steer patients to more fitting treatments with a better chance of success. It also reduces the chance a patient would get discouraged from the lack of success of the first therapy option.

And while cognitive-behavioral therapy doesn't work for everyone, another study shows its the best first option for young people with depression.

The National Institutes of Health estimate more than 17 million adults in the United States has suffered at least one major depressive event.

"We explicitly model the mechanisms of treatment response to uncover brain activity that predicts CBT response," said Marios Philiastides, a researcher at the University of Glasgow and study senior author. "While this approach has the potential to enhance the predictive power of imaging biomarkers, it can also provide important insights into novel targets for drug development."

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Schedule22 Sep 2023