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Recent research suggests that we may be able to predict how people with depression will respond to various treatments.
In this study, individuals with high activity in a specific brain region called the anterior insula responded better to medication treatment for depression, whereas lower activity in the anterior insula corresponded with better response to psychotherapy treatment for depression.
In the future, brain scans of this region may help to identify which depression treatment, medication or psychotherapy, will be most effective for a specific individual. This idea is part of a growing movement toward “personalized medicine,” an approach that seeks to identify effective treatments based on an individual’s specific makeup.
Excerpts from article:
A team led by Callie L. McGrath and Dr. Helen S. Mayberg at Emory University looked for a biological marker or “biomarker” that could predict whether patients with depression would respond best to medication or psychotherapy. The study was funded by NIH’s National Institute of Mental Health (NIMH) and National Institute of General Medical Sciences (NIGMS). Results appeared online on June 12, 2013, in JAMA Psychiatry.
Activity in a number of brain regions corresponded to treatment outcomes. The strongest correlation was in an area known as the anterior insula. Increased glucose metabolism in this area corresponded to successful treatment with medication but poor response to behavior therapy. Conversely, decreased glucose metabolism in the area was associated with success using behavior therapy but not escitalopram. One limitation of this potential imaging biomarker, the researchers note, is that it may not predict when neither of these therapies would work.
“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,” says Mayberg. “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.”
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