Brain scans may be key to ID best treatment for patients with depression

In a new study called PReDICT, researchers found that by using MRI, clinicians will be better able to identify the best treatment for patients with depression, whether its psychotherapy or antidepressant medication.

Researchers from Emory University randomly assigned 344 patients to 12 weeks of treatment with one of two antidepressant medications or with cognitive behavioral therapy (CBT). About half of the participants self-identified as African-American or Hispanic, which allowed researchers to assess a more diverse group than those in previous studies.

In the beginning of the study published in the American Journal of Psychiatry, each participant underwent a functional MRI (fMRI) scan so that researchers would be able to compare and assess if medication or CBT depended on the state of the brain before starting treatment.

"All depressions are not equal and like different types of cancer, different types of depression will require specific treatments. Using these scans, we may be able to match a patient to the treatment that is most likely to help them, while avoiding treatments unlikely to provide benefit," said Helen Mayberg, MD, who led the study, in a statement.

The fMRI scans showed that the degree of functional connectivity between the subcallosal cingulate cortex and three other regions of the brain were linked to responses of treatment. Pateints with positive connectivity between the brain regions were much more likely to achieve remission with CBT, whereas patients with negative or no connectivity were more likely to remit with antidepressant medication.

"Ultimately our studies show that clinical characteristics, such as age, gender, etc., and even patients' preferences regarding treatment, are not as good at identifying likely treatment outcomes as the brain measurement," said Mayberg.