Treating
depression can be challenging for clinicians, with no way of knowing how a
patient will respond. But brain scans taken before treatment may help predict
which treatment is best for an individual patient, according to a study
published in JAMA Psychiatry (Volume 70, page 821).
In the
study, researchers used a positron emission tomography (PET) scanner to obtain
images of the resting brain in 63 people, ages 18 to 60, with depression. They
then compared brain activity of patients who were successfully treated with
that of those who saw no improvement. Participants had been randomly assigned
to either 12 weeks of antidepressants or 16 weeks of psychotherapy.
Based on
the PET imaging, activity in the area of the brain known as the anterior insula - responsible for such things as decision-making, emotions and body cues (such
as hunger and cravings) - appeared to be able to predict which depression
treatment would elicit a patient's response: cognitive behavior therapy or
escitalopram (Lexapro). Low activity in the insula was associated with a better
chance of successful treatment with cognitive behavior therapy and failure with
escitalopram, while high activity in the insula correlated with successful treatment
using medication and failure with therapy.
Takeaway
- If further research supports these findings, it may mark the beginning of
more individualized medicine.
(Source: John Hopkins Health
Alert, 27 May 2014)
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