Brain Scan Predicts Response To Depression Treatment

Fewer than 40% of people being treated for depression achieve remission of their symptoms with the first treatment they try. The search for an effective treatment can be slow and costly. This study suggests that performing a brain scan before starting therapy could help identify which type of treatment – antidepressants or cognitive therapy – would be best for individual patients. In this study, researchers conducted pretreatment scans of 63 patients with depression to measure brain activity. They were randomly assigned to cognitive behavioral therapy or to take escitalopram for 12 weeks. Of these people, 38 had clear outcomes and usable scan data, including 12 people who had remission of their symptoms on cognitive behavioral therapy, 11 who had remission on escitalopram, nine people who clearly did not respond to cognitive behavioral therapy and 6 people who clearly did not respond to escitalopram. Activity in the part of the brain known as the right anterior insula predicted who responded to which treatment. This area of the brain regulates emotional states and decision-making. People with low activity in this area responded to cognitive behavioral therapy but not to escitalopram, while people with high activity in this area responded to escitalopram but not to cognitive behavioral therapy. If these findings are confirmed by other studies, scans of this brain region could help guide initial treatment for depression.

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