In the future, seeking assistance for depression could include a brief brain scan to determine the best treatment approach for you.
A study examining brain activity in individuals with depression and anxiety both at rest and when performing particular tasks revealed six distinctive patterns of neural activity, associated symptoms, and reactions to therapeutic interventions.
The researchers from both the US and Australia who carried out the study also identified treatments that are more probable to be effective for certain categories. Consequently, this might enable physicians to better pair patients with optimal therapies according to their brain activity patterns.
"The prevailing 'one-size-fits-all' method of diagnosis in psychiatry often results in patients going through various treatments via a process of trial and error," says Leonardo Tozzi from Stanford University along with his team. write In their published paper, they describe it as protracted, costly, and exasperating, noting that 30-40 percent of patients fail to achieve remission after attempting one therapy.
The researchers examined 801 primarily untreated participants who were diagnosed with either major depressive disorder , generalized anxiety disorder , panic disorder , social anxiety disorder , obsessive-compulsive disorder , or post-traumatic stress disorder , or a mix of these. Additionally, they incorporated 137 individuals without the conditions as control subjects.
Functional MRI ( fMRI Brain scans were utilized to obtain 41 measurements of activation and connectivity for each participant, concentrating on six neural networks associated with depression. The imaging was conducted both during periods of rest and while participants engaged in cognitive and emotional tasks.
Machine learning was utilized to group individuals suffering from depression and anxiety into six categories according to particular brain circuits that show either heightened activity or reduced function compared to one another and the healthy control subjects.
As far as we know, this is the first instance where we have shown that depression may stem from various impairments in how the brain operates, says lead author Leanne Williams, a psychiatrist and behavioral scientist at Stanford University.
The team subsequently randomly allocated 250 participants to be prescribed one of three antidepressants or to undergo talk therapy. The antidepressant venlafaxine performed most effectively for one specific group: individuals with overly active cognitive areas of the brain.
Counseling was more effective for individuals who exhibited greater activity in areas of the brain associated with depression and problem-solving. Conversely, those showing lower activity in the brain’s attention circuits derived lesser benefit from counseling, which might imply they could see more advantage from initially addressing their attention-related issues through other means. the reduced activity when taking medication.
"To genuinely advance the discipline towards precision psychiatry "we need to pinpoint the treatments that are most likely to succeed for patients and initiate those treatments as quickly as possible," said public health scientist Jun Ma from the University of Illinois. says .
Having data about their brain activity could assist in tailoring more accurate treatments and medications for individuals.
In 2023, some members of the same team recognized a novel cognitive biotype Of depression, which impacts 27 percent of individuals diagnosed with major depressive disorder. The cognitive impairments – related to attention, memory, and self-regulation – typically remain unchanged when treated with antidepressants that target serotonin.
And earlier this year Williams and a fellow researcher employed fMRI technology to pinpoint individuals possessing the cognitive biotype, achieving a prediction success rate of 63%, as opposed to just 36% without using fMRI. Investigations into new therapies specifically targeting this biotype are currently underway.
Depression is complex , as are the factors contributing for it. This process might require considerable time. those who have access to treatment to find one that helps , should they ever decide to. So every step Moving towards a more efficient, tailored approach proves beneficial.
Feeling extremely frustrated within the realm of depression treatment due to the lack of alternatives for this one-size-fits-all method. says Williams. "Our aim is to determine how we can achieve success on the initial attempt."
The study has been released in Nature Medicine .
