A NIH funded study is looking at how to develop biomarkers from brain scans to determine if depressed patients would be best treated with antidepressant medication or psychotherapy.

“Our goal is to develop reliable biomarkers that match an individual patient to the treatment option most likely to be successful, while also avoiding those that will be ineffective,” explained Helen Mayberg, M.D., of Emory University, Atlanta, a grantee of the NIH’s National Institute of Mental Health.

Mayberg and colleagues report on their findings in JAMA Psychiatry, June 12, 2013.

“For the treatment of mental disorders, brain imaging remains primarily a research tool, yet these results demonstrate how it may be on the cusp of aiding in clinical decision-making,” said NIMH Director Thomas R. Insel, M.D.

The study is focused on insula activity, whereby low insula activity pre-treatment indicates a higher likelihood of recovery with CBT and poor outcome with medication. Conversely, medication like escitalopram is likely to have a better outcome with a hyperactivity in the insula area.

“If these findings are confirmed in follow-up replication studies, scans of anterior insula activity could become clinically useful to guide more effective initial treatment decisions, offering a first step towards personalized medicine measures in the treatment of major depression” said Mayberg.

For more information see: Toward a neuroimaging treatment selection biomarker for major depressive disorder. JAMA Psychiatry. McGrath CL, Kelley MD, Holzheimer III PE, Dunlop BW, Craighead WE, Franco AR, Craddock RC, Mayberg HS. June 12, 2013, JAMA Psychiatry

Source: NIH http://www.nimh.nih.gov/news/science-news/2013/scan-predicts-whether-therapy-or-meds-will-best-lift-depression.shtml

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