MRI findings may signal patients' receptiveness to different mental health treatment methods
Experts may be able to use certain imaging findings from MRI brain scans to help guide treatment decisions in patients with anxiety disorders.
A new paper published in JAMA Network details how functional MR imaging can be used to determine the effectiveness of cognitive behavioral therapy in anxious individuals. In it, researchers reveal that differences in connectivity patterns could determine which patients are most likely to respond positively to self-guided therapy via phone app, thus giving providers valuable insight into how to best manage patients’ symptoms.
“Anxiety disorders are prevalent among young adults. Cognitive-behavioral therapy (CBT) is an effective treatment, but many individuals have difficulty accessing CBT due to cost and limited availability,” Faith M. Gunning, PhD, Department of Psychiatry, Weill Cornell Medicine, and colleagues noted. “Digital applications may increase accessibility. Identifying brain mechanisms associated with differential treatment response could advance understanding of what makes patients likely to respond to CBT. We examined whether baseline resting state functional connectivity (rsFC) was associated with improvement in anxiety after use of the app.”
The study focused on individuals diagnosed with anxiety disorder. Participants underwent pre- and post-intervention MRI. The intervention included use of an app containing interactive modules focused on identifying emotions, exposure, reframing negative thoughts and relaxation.
Participants completed two 20-minute sessions per week for six weeks, in addition to meeting with researchers weekly for mental health assessments. The study authors compared participants’ Hamilton Anxiety Rating Scale (HAM-A) scores alongside imaging to determine the physiological effects of engaging in CBT.
On imaging, lower baseline connectivity between the left anterior insula and left dorsolateral prefrontal cortex was found to be correlated with greater improvements in HAM-A scores. The group noted that these areas are known to be linked to emotional and interoceptive processing, and these findings may suggest that lower connectivity between these areas could signal greater receptiveness to CBT.
“These exploratory results suggests that lower insula-dorsolateral prefrontal cortex connectivity, possibly reflecting more adaptive emotional processing, is associated with greater improvement of anxiety symptoms with app-delivered CBT skills,” the authors explained. “This extends prior work that suggests an association between functional connectivity of the salience network and response to face-to-face CBT in adolescents.”
Though the study was small and the findings will need to be replicated in larger sample sizes, the researchers maintain that their findings add to the mounting evidence that supports the use of imaging to guide mental health treatment.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.