title: Neurobiological markers predicting treatment response in anxiety disorders: A systematic review and implications for clinical application.
abstract: Anxiety disorders constitute the largest group of mental disorders with a high individual and societal burden. Neurobiological markers of treatment response bear potential to improve response rates by informing stratified medicine approaches. A systematic review was performed on the current evidence of the predictive value of genetic, neuroimaging and other physiological markers for treatment response (pharmacological and/or psychotherapeutic treatment) in anxiety disorders. Studies published until March 2015 were selected through search in PubMed, Web of Science, PsycINFO, Embase, and CENTRAL. Sixty studies were included, among them 27 on genetic, 17 on neuroimaging and 16 on other markers. Preliminary evidence was found for the functional 5-HTTLPR/rs25531 genotypes, anterior cingulate cortex function and cardiovascular flexibility to modulate treatment outcome. Studies varied considerably in methodological quality. Application of more stringent study methodology, predictions on the individual patient level and cross-validation in independent samples are recommended to set the next stage of biomarker research and to avoid flawed conclusions in the emerging field of "Mental Health Predictomics".
authors.affiliation: Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany. Electronic address: Lueken_U@ukw.de.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lueken
authors.affiliation: Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany. Electronic address: Kathrin.zierhut@uni-wuerzburg.de.
authors.forename: Kathrin C
authors.initials: KC
authors.lastname: Zierhut
authors.affiliation: Department of Cognitive Psychology II, Goethe-Universität Frankfurt, Frankfurt a. M., Germany. Electronic address: hahn@psych.uni-frankfurt.de.
authors.forename: Tim
authors.initials: T
authors.lastname: Hahn
authors.affiliation: Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany. Electronic address: straubeb@med.uni-marburg.de.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Straube
authors.affiliation: Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany. Electronic address: kircher@med.uni-marburg.de.
authors.forename: Tilo
authors.initials: T
authors.lastname: Kircher
authors.affiliation: Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe-Universität Frankfurt, Frankfurt a. M., Germany. Electronic address: Andreas.Reif@kgu.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Reif
authors.affiliation: Department of Physiological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany. Electronic address: Jan.Richter@uni-greifswald.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Richter
authors.affiliation: Department of Physiological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany. Electronic address: hamm@uni-greifswald.de.
authors.forename: Alfons
authors.initials: A
authors.lastname: Hamm
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Department of Psychology, Technische Universität Dresden, Dresden, Germany. Electronic address: hans-ulrich.wittchen@tu-dresden.de.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany. Electronic address: Domschke_K@ukw.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Domschke
mesh_terms: D001008:Anxiety Disorders; D015415:Biomarkers; D006801:Humans; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Anxiety disorders; Autonomic; Biomarker; Genetic; Machine learning; Neuroimaging; Pharmacotherapy; Prediction; Psychotherapy; SSRI; Stratified medicine; Treatment outcome