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Imaging scans predict efficacy of psychotherapy for depression

Imaging diagnostics may determine whether certain patients with major depressive disorder are likely to benefit from psychotherapy, according to data published in Neuropsychopharmacology.

“In the future, we will be able to use non-invasive brain imaging technology to match patients with the treatment option that has the best chance of lifting their depression,” Gabriel S. Dichter, PhD, associate professor of psychiatry and psychology at the University of North Carolina Health Care, said in a press release. “In my mind, that’s as important as developing new treatments. We already have a lot of excellent treatments but no way to know which one is best for a particular patient.”

Gabriel S. Dichter

Dichter and colleagues examined how resting-state functional brain connectivity (rs-fcMRI) predicted response to the Behavioral Activation Treatment for Depression model among 23 nonmedicated outpatients with major depressive disorder (MDD) who underwent 12 sessions of psychotherapy. Twenty matched controls without depression also completed the scans.

Data indicate 12.04 points of mean changes to the Beck Depression Inventory-II scores after psychotherapy (P<.001), the researchers wrote. They also found that connectivity between 9 region pairs varied among the MDD and control groups.

“There’s a complex interplay between the regions of the brain that are involved in cognitive control and those regions involved in understanding how something is going to feel,” Dichter said. “We’ve known for a long time that atypical connections between those regions are involved in depression, but now we know that they can also be involved in how a person responds to talk therapy.”

Specifically, MDD group responses to psychotherapy were predicted by pretreatment connectivity of the right insula with the right middle temporal gyrus and the left intraparietal sulcus with the orbital frontal cortex, the researchers wrote.

“It's a long road to find the right treatment for each patient,” Dichter said. “Our goal is to develop a road map, to use this type of information to predict which patients will respond to which treatments.” – by Samantha Costa

Disclosure: Crowther was supported by a UNC Neuroscience Center predoctoral training grant. All other researchers report no relevant financial disclosures.