The study conducted at UNC School of Medicine is the first using the resting-state functional brain connectivity MRI technique to isolate differences in how brain is wired, potentially predicting results to talk therapy.
The findings were published in journal Neuropsychopharmacology.
Researchers found that brain scans could have a role in determining the most appropriate course of treatment for millions of Americans suffering from depression.
“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,” said senior author Gabriel S. Dichter, PhD, associate professor of psychiatry and psychology. “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.”
As doctors identify immediately the best treatment, the trial and error period is significantly reduced, minimizing the painful effects of depression on patients and their families, Dr. Dichter added.
In the study, researchers asked 23 patients with major depressive disorder who were not treated at that moment to undergo a specific type of brain scan known as resting-state functional connectivity MRI. This procedure, known as rs-fcMRI, visualizes the brain activity of several brain regions in a coordinated manner, and considers several functional neural networks while the brain in free of any particular tasks. As a result, scientists can see which brain areas light up at the same time. Using this information, researchers can uncover activity networks that are potentially linked to behaviors or responses to therapy.
Following being scanned, patients met with counselors for 12 weekly talks therapy sessions, on average, who used the behavioral activation talk therapy method. Unlike other forms of talk therapy that involve analysis of childhood experiences or modifying thought processes, the behavioral activation talk therapy concentrates on those behaviors immediately associated with depression such as not being able to get to work on time or spending insufficient time with loved ones. Typically for these sessions, patients set goals that address these behaviors.
Andrew Crowther, graduate student studying neurobiology at UNC and first author of the paper, analyzed the data in an attempt to identify relationships between brain connectivity and responses to treatment. His efforts unveiled two connectivity patterns that were common to patients who had most to benefit from the talk therapy.
The first pattern discovered what that patients had greater connectivity between the anterior insular cortex and the middle temporal gyrus, a brain tissue with an active role in personalized experience of emotion. The second pattern involved connections between the intraperietal sulcus and orbital frontal cortex, a brain region involved in determining the positive of negative value of events.
“There’s a complex interplay between the regions of the brain that are involved in cognitive control and those regions involved in understanding how something is going to feel,” said Dichter, who is also a member of UNC’s Carolina Institute for Developmental Disabilities. “We’ve known for a long time that atypical connections between those regions are involved in depression, but now we know that they can also be involved in how a person responds to talk therapy.”