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Brain imaging could predict psychotherapy response in depression, anxiety

Recent findings indicated some neuroimaging markers predicted psychotherapy response among individuals with major depressive and anxiety disorders, though researchers noted this requires further investigation.

“Since psychotherapy often requires a considerable investment of time and effort, having the means to forecast from the outset whether an individual is likely to benefit could be of great clinical utility,” Trisha Chakrabarty, MD, of the University of British Columbia, and colleagues wrote. “Recent studies have examined whether biomarkers can assist in this context, and it has been suggested that neuroimaging may be able to accurately predict psychotherapy response and perhaps even differentiate psychotherapy from medication responders. These findings have been greeted as a promising advance in the treatment of MDD and anxiety.”

To assess potential clinical utility of neuroimaging biomarkers for predicting psychotherapy response, researchers conducted a systematic review of 40 studies correlating pre-treatment neuroimaging parameters with psychotherapy response in MDD and anxiety.

Analysis indicated the anterior cingulate cortex, amygdala and anterior insula as potential markers for major depressive disorder and some anxiety disorders.

Study results significantly varied and have not been systematically validated in independent clinical cohorts, according to researchers.

Further, findings did not indicate that neuroimaging biomarkers distinguish between medication and psychotherapy responders.

“The role that pretreatment neuroimaging measures play in predicting the outcome of [psychotherapy] needs to be further investigated, as does the potential prognostic role of neuroimaging changes that occur early in therapy,” the researchers wrote. “While a reliable prognostic marker could conceivably be a useful adjunct to clinical care, it would be important to guard against the possibility of becoming overly reliant on such a measure and thus overly reductionist in our approach to patient care. The growing consensus in psychiatric research is that environmental factors should be considered as ‘covariables’ to any proposed biomarker; it remains to be seen how such an integrated predictive model can be actualized.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.