Brain mapping is one of the most quickly evolving fields in addiction treatment, proving to be able to alter cognitive structures in the brain, gearing them less towards dependency. While brain mapping in addiction has been traditionally used in conjunction with neurofeedback exercises, new research shows that it can predict which patients with clinical depression are most likely to benefit from a certain kind of talk therapy. The University of North Carolina (UNC) School of Medicine researchers believe that the brain scans could eventually be used as a diagnostic tool for optimizing mental health treatment.
The study, published in the journal Neuropsychopharmacology, is the first to use a technique known as resting-state functional brain connectivity MRI, a technology that allows neuroscientists to identify differences in brain wiring that can predict therapeutic responses to talk therapy. The therapy, behavioral activation talk therapy, is a technique based off of applied behavioral analysis, one of the most predominant forms of behavior therapy. The results of this study have large ramifications for the optimization of treatment in the future, with the potential to shave off months of trial and error associated with finding the proper depression treatment.
“In the future, we will be able to use non-invasive brain imaging technology to match patients with the treatment option that has the best chance of lifting their depression. In my mind, that’s as important as developing new treatments. We already have a lot of excellent treatments but no way to know which one is best for a particular patient,” said senior author Gabriel S. Dichter, Aassociate Professor of Psychiatry and Psychology at the University of North Carolina.
The researchers recruited 23 patients with major depressive disorder who were not undergoing any treatment. Following a specific type of brain scan known as resting-state functional connectivity MRI (which maps the activity of various brain regions within neural networks while the brain is not engaged in any particular tasks), the participants met with counselors for roughly 12 weekly behavioral activation talk therapy sessions; the researchers then identified brain regions linked to certain behaviors or responses to therapy, finding two connectivity patterns that stood out amongst those whom benefited the most from talk therapy.
The participants showed enhanced connectivity in certain brain regions like the anterior insular cortex, an area involved in assigning importance to events, as well as the middle temporal gyrus, a section linked to the subjective experience of emotion. They also experienced stronger connections between the intraparietal sulcus, a region involved in maintaining focus and the orbital frontal cortex, a crescent-shaped area behind the eyes involved in assigning positive or negative values to things. The authors hope that the results will aid in their development of a road map for predicting which patients will respond the best to which treatments.
Brain mapping and depression markers
While the UNC study took a step forward in matching patients with the optimal treatment option for alleviating their depression, other new studies have found brain markers for it in the amygdala, a brain region responsible for detecting and responding to danger. Using fMRi, the researchers found that in the depressed participants, those who had the more reactive amygdalas at the onset of the study also had more severe symptoms of anxiety or depression in response to stressful events after that initial assessment (for at least four years after the initial assessment).
By using a brain marker in conjunction with the UNC study’s findings, people at a high risk of depression could be guided towards a treatment that is right for them early on, before the disorders develop and become more disruptive.
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