Neuroimaging-based biomarkers for treatment selection in major depressive disorder.

• Type of Material: Article
• Authors: Boadie W Dunlop, Emory University; Helen S Mayberg, Emory University
• Language: English
• Date: 2014-12
• Publisher: Les Laboratories Servier
• Publication Version: Final Published Version
• Copyright Statement: © 2014 AICH – Servier Research Group. All rights reserved
• License: Creative Commons Attribution 3.0 Unported
• Final Published Version (URL): http://www.ncbi.nlm.nih.gov/pmc/issues/249701/
• Title of Journal or Parent Work: Dialogues in Clinical Neuroscience
• ISSN: 1294-8322
• Volume: 16
• Issue: 4
• Start Page: 479
• End Page: 490
• Keywords: biological marker; positron-emission tomography; individualized medicine; antidepressive agent; effect modifier; patient outcome assessment; magnetic resonance imaging; psychotherapy; depression
• Research Categories: Psychology, General; Psychology, Cognitive

Abstract

The use of neuroimaging approaches to identify likely treatment outcomes in patients with major depressive disorder is developing rapidly. Emerging work suggests that resting state pretreatment metabolic activity in the fronto-insular cortex may distinguish between patients likely to respond to psychotherapy or medication and may function as a treatment-selection biomarker. In contrast, high metabolic activity in the subgenual anterior cingulate cortex may be predictive of poor outcomes to both medication and psychotherapy, suggesting that nonstandard treatments may be pursued earlier in the treatment course. Although these findings will require replication before clinical adoption, they provide preliminary support for the concept that brain states can be measured and applied to the selection of a specific treatment most likely to be beneficial for an individual patient.