Brain activity can predict success of depression treatment

April 11, 2018, McLean Hospital
Credit: CC0 Public Domain

McLean Hospital and Harvard Medical School researchers believe they have uncovered a method that could be useful in predicting a depressed patient's treatment prognosis, prior to starting treatment.

In the paper "Pretreatment Rostral Anterior Cingulate Cortex Activity in Relation to Symptom Improvement in Depression: A Randomized Clinical Trial," currently available online and scheduled to appear in the June 2018 edition of JAMA Psychiatry, the investigative team details its work in identifying whether certain markers in the brain could allow clinicians to identify patients with a high or low likelihood of responding to certain treatments for depression.

The study was jointly first-authored by Diego A. Pizzagalli, PhD, and Christian A. Webb, PhD. "Our work shows that we could predict a patient's to an antidepressant by looking at the activation level of the rostral (ACC) region of the brain by using a non-invasive monitoring system to test brain activity called an electroencephalogram—also known as an EEG," said Diego A. Pizzagalli, director of the McLean Imaging Center as well as the hospital's Center For Depression, Anxiety and Stress Research and Laboratory for Translational and Affective Neuroscience. Webb, assistant professor at Harvard Medical School and director of the Treatment and Etiology of Depression in Youth Laboratory, noted that this is the first study to "demonstrate the 'incremental predictive validity' of this neural marker, that is, the fact that activity in this brain region predicts the likelihood of above and beyond the contribution of a range of low-cost and easily administered clinical and demographic characteristics previously shown to predict treatment outcome."

For this study, the team built upon Pizzagalli's previous work showing that EEG recordings of rostral ACC activity could predict the eventual response. "In that prior study, we saw that the higher the activity before the start of the treatment, the better the clinical response months later," noted Pizzagalli, who is also a professor of psychiatry at Harvard Medical School.

For the new study, more than 300 patients were tested at four sites in the United States—using sertraline for the treatment group. "We showed that the rostral ACC marker predicted clinical response eight weeks later, even when statistically controlling for demographics and clinical variables previously linked to treatment response," said Pizzagalli. "For those with the marker of good response, a clinician could tell patients that they have a high chance of benefitting from the intervention, and they should stay engaged in treatment," he explained. Conversely, he said, for patients with the marker of low response, "clinicians could decide to start with more aggressive treatment at the outset, such as a combination of pharmacology and psychotherapy, and importantly, monitor these patients more closely."

Soon, Webb, Pizzagalli, and their colleagues plan to deploy these approaches on patients at McLean Hospital to determine whether they can lead to -specific predictions. "Our vision is to determine if an optimal combination of markers—including brain-based but also clinical and demographic characteristics—might allow us to predict response to drug A but not drug B or psychotherapy, for example," Webb explained.

Also, if an ACC marker predicts better response, researchers might develop cognitive training that specifically targets this region, which could increase brain activation to accelerate or boost response to more traditional intervention. Pizzagalli and his team hope to engage in further research into this concept by testing with major depressive disorder.

Explore further: IL-6 levels predict response to ECT in depressive disorder

Related Stories

IL-6 levels predict response to ECT in depressive disorder

March 14, 2018
(HealthDay)—For patients with major depressive disorder, interleukin-6 (IL-6) may predict benefit from electroconvulsive therapy (ECT), according to a study published recently in the Journal of Clinical Psychiatry.

Brain scans could help predict response to psychotherapy for anxiety and depression

November 10, 2016
Brain imaging scans may one day provide useful information on the response to psychotherapy in patients with depression or anxiety, according to a review of current research in the November/December issue of the Harvard Review ...

PET tracer could help predict treatment effectiveness for depression

April 6, 2018
A positron emission tomography (PET) imaging agent could show, ahead of time, whether a specific treatment is likely to be effective for major depressive disorder (MDD)—a debilitating condition that affects more than 14 ...

Getting the right treatment: Predicting treatment response in depression

December 28, 2017
New evidence from mice suggests why an antidepressant treatment can alleviate depression in one person but not another. The study, publishing December 28 in the open access journal PLOS Biology, was led by Marianne Müller ...

Brain scans may help clinicians choose talk therapy or medication treatment for depression

March 24, 2017
Researchers from Emory University have found that specific patterns of activity on brain scans may help clinicians identify whether psychotherapy or antidepressant medication is more likely to help individual patients recover ...

Recommended for you

Beauty is simpler, and less special, than we realize

August 20, 2018
Beauty, long studied by philosophers, and more recently by scientists, is simpler than we might think, New York University psychology researchers have concluded in a new analysis. Their work, which appears in the journal ...

Bilingual children who speak native language at home have higher intelligence

August 20, 2018
Children who regularly use their native language at home while growing up in a different country have higher IQs, a new study has shown.

People are more honest when using a foreign tongue, research finds

August 17, 2018
New UChicago-led research suggests that someone who speaks in a foreign language is probably more credible than the average native speaker.

FDA approves brain stimulation device for OCD

August 17, 2018
(HealthDay)—A brain stimulation device to treat obsessive-compulsive disorder (OCD) has received approval for marketing Friday by the U.S. Food and Drug Administration.

Research eyes role of stress in mental illnesses

August 17, 2018
We all face stress in our lives. Even researchers seeking to understand why some people shrug it off while others face battles against disorders like depression or PTSD.

16 going on 66: Will you be the same person 50 years from now?

August 17, 2018
How much do you change between high school and retirement? The answer depends on whether you're comparing yourself to others or to your younger self.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.