Neuroimaging-based biomarkers for treatment selection in major depressive disorder.
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.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA.
Boadie W
BW
Dunlop
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA.
Helen S
HS
Mayberg
D000928:Antidepressive Agents / Q000494:pharmacology; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D059906:Neuroimaging / Q000379:methods*; D057285:Precision Medicine / Q000379:methods*
D000928:Antidepressive Agents; D015415:Biomarkers
antidepressive agent; biological marker; depression; effect modifier; individualized medicine; magnetic resonance imaging; patient outcome assessment; positron-emission tomography; psychotherapy