fMRI predictors of treatment outcome in pediatric anxiety disorders.
BACKGROUND
A growing number of studies have found evidence that anxiety and depressive disorders are associated with atypical amygdala hyperactivation, which decreases with effective treatment. Interest has emerged in this phenomenon as a possible biological marker for individuals who are likely to benefit from tailored treatment approaches.


OBJECTIVE
The present study was designed to examine relationships between pretreatment amygdala activity and treatment response in a sample of anxious children and adolescents.


METHODS
Participants, who were diagnosed predominantly with generalized anxiety disorder (GAD), underwent functional magnetic resonance imaging (fMRI) scanning before treatment with fluoxetine or cognitive behavioral therapy (CBT).


RESULTS
Results indicated significant negative associations between degree of left amygdala activation and measures of posttreatment symptom improvement in the group, as a whole.


CONCLUSIONS
Taken together with research on associations between adult amygdala activation and treatment response, these findings suggest that patients whose pretreatment amygdala activity is the strongest may be particularly likely to respond well to such widely used treatments as selective serotonin reuptake inhibitor (SSRI) medications and CBT.
McClure
Erin B
EB
Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA 30302-5010, USA. emcclure@gsu.edu
Adler
Abby
A
Monk
Christopher S
CS
Cameron
Jennifer
J
Smith
Samantha
S
Nelson
Eric E
EE
Leibenluft
Ellen
E
Ernst
Monique
M
Pine
Daniel S
DS
D000293:Adolescent; D000679:Amygdala / Q000473:pathology* / Q000503:physiopathology; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D002648:Child; D015928:Cognitive Behavioral Therapy; D004644:Emotions; D005149:Facial Expression; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D000297:Psychology, Adolescent; D002666:Psychology, Child; D017367:Selective Serotonin Reuptake Inhibitors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors