Brain Markers May One Day Predict Psychotherapy Response
In the future, brain imaging scans could help predict a patient’s response to psychotherapy for depression or anxiety disorders, a new systematic review suggests.
However, despite promising initial evidence of potential neuroimaging markers, “we are still far from being able to use these markers clinically,” researchers concluded. Their findings appear in the November/December issue of the Harvard Review of Psychiatry.
"While some brain areas have emerged as potential candidate markers, there are still many barriers that preclude their clinical use," said lead author Trisha Chakrabarty, MD, of the University of British Columbia, Vancouver.
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Dr. Chakrabarty and colleagues reviewed 40 studies which evaluated brain imaging scans to predict psychotherapy outcomes in patients with major depressive or anxiety disorders. While no single brain area was consistently linked with psychotherapy response, the review did identify potential markers: the amygdala, the anterior insula, and the anterior cingulate cortex.
Higher activity in the amygdala was associated with increased likelihood of psychotherapy response in studies of patients with major depressive disorder, according to the review. Lower amygdala activity was linked with better psychotherapy outcomes in studies of patients with anxiety disorders.
Meanwhile, studies that looked at anterior insula activity found that higher pretreatment activity was linked with better psychotherapy response for patients with anxiety disorders. In major depressive disorder, lower pretreatment activity was associated with better response.
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In other studies, lower activity in some parts of the anterior cingulate cortex was linked with better psychotherapy outcomes in patients with major depressive disorder.
“Future studies of psychotherapy response may focus further on these individual regions as predictive markers,” said Dr. Chakrabarty. “Additionally, future biomarker studies may focus on pretreatment functional connectivity between these regions, as affective experience is modulated via reciprocal connections between brain areas such as the anterior cingulate cortex and amygdala.”
—Jolynn Tumolo
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