Brain scans and depression treatment outcomes

http://archpsyc.jamanetwork.com/article.aspx?articleid=1696349

In an NIH funded clinical trial, researchers at Emory University have discovered that specific patterns of brain activity may indicate whether a depressed patient will or will not respond to treatment with medication or psychotherapy.

Professor Helen Mayberg, MD and colleagues used PET scans to measure brain glucose metabolism, an important index of brain functioning to test this hypothesis.  Participants in the trial were randomly assigned to receive a 12-week course of either the SSRI medication escitalopram or cognitive behavior therapy after first undergoing a pretreatment PET scan.  The team found that activity in one particular region of the brain, the anterior insula, could discriminate patients who recovered from those who were non-responders to the treatment assigned. Specifically, patients with low activity in the insula showed remission with CBT, but poor response to medication; patients with high activity in the insula did well with medication, and poorly with CBT.


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