Scan predicts whether therapy or meds will best lift depression

Biomarker could point the way past trial-and-error inefficiencies -- NIH-funded study

2013-06-13

(Press-News.org) Pre-treatment scans of brain activity predicted whether depressed patients would best achieve remission with an antidepressant medication or psychotherapy, in a study funded by the National Institutes of Health.

"Our goal is to develop reliable biomarkers that match an individual patient to the treatment option most likely to be successful, while also avoiding those that will be ineffective," explained Helen Mayberg, M.D., of Emory University, Atlanta, a grantee of the NIH's National Institute of Mental Health.

Mayberg and colleagues report on their findings in JAMA Psychiatry, June 12, 2013.

"For the treatment of mental disorders, brain imaging remains primarily a research tool, yet these results demonstrate how it may be on the cusp of aiding in clinical decision-making," said NIMH Director Thomas R. Insel, M.D.

Currently, determining whether a particular patient with depression would best respond to psychotherapy or medication is based on trial and error. In the absence of any objective guidance that could predict improvement, clinicians typically try a treatment that they, or the patient, prefer for a month or two to see if it works. Consequently, only about 40 percent of patients achieve remission following initial treatment. This is costly in terms of human suffering as well as health care spending.

Mayberg's team hoped to identify a biomarker that could predict which type of treatment a patient would benefit from based on the state of his or her brain. Using a positron emission tomography (PET) scanner, they imaged pre-treatment resting brain activity in 63 depressed patients. PET pinpoints what parts of the brain are active at any given moment by tracing the destinations of a radioactively-tagged form of glucose, the sugar that fuels its metabolism.

They compared brain circuit activity of patients who achieved remission following treatment with those who did not improve.

Activity in one specific brain area emerged as a pivotal predictor of outcomes from two standard forms of depression treatment: cognitive behavior therapy (CBT) or escitalopram, a serotonin specific reuptake inhibitor (SSRI) antidepressant. If a patient's pre-treatment resting brain activity was low in the front part of an area called the insula, on the right side of the brain, it signaled a significantly higher likelihood of remission with CBT and a poor response to escitalopram. Conversely, hyperactivity in the insula predicted remission with escitalopram and a poor response to CBT.

Among several sites of brain activity related to outcome, activity in the anterior insula best predicted response and non-response to both treatments. The anterior insula is known to be important in regulating emotional states, self-awareness, decision-making and other thinking tasks. Changes in insula activity have been observed in studies of various depression treatments, including medication, mindfulness training, vagal nerve stimulation and deep brain stimulation.

"If these findings are confirmed in follow-up replication studies, scans of anterior insula activity could become clinically useful to guide more effective initial treatment decisions, offering a first step towards personalized medicine measures in the treatment of major depression" said Mayberg.

INFORMATION:

ELSE PRESS RELEASES FROM THIS DATE:

Genetic maps of ocean algae show bacteria-like flexibility

2013-06-13

Smaller than a speck of dust, Emiliania huxleyi plays an outsized role in the world's seas. Ranging from the polar oceans to the tropics, these free-floating photosynthetic algae remove carbon dioxide from the air, help supply the oxygen that we breathe, and form the base of marine food chains. When they proliferate, their massive turquoise blooms are visible from space. Now scientists have discovered one of the keys to E. huxleyi's success. A seven-year effort by 75 researchers from 12 countries to map its genome has revealed a set of core genes that mix and match with ...

Alzheimer's brain change measured in humans

2013-06-13

Scientists at Washington University School of Medicine in St. Louis have measured a significant and potentially pivotal difference between the brains of patients with an inherited form of Alzheimer's disease and healthy family members who do not carry a mutation for the disease. Researchers have known that amyloid beta, a protein fragment, builds up into plaques in the brains of Alzheimer's patients. They believe the plaques cause the memory loss and other cognitive problems that characterize the disease. Normal brain metabolism produces different forms of amyloid beta. The ...

Water is no lubricant

2013-06-13

Water in the Earth's crust and upper mantle may not play such an important role as a lubricant of plate tectonics as previously assumed. This is a result geoscientists present in the current issue of the scientific journal Nature (13/06/2013) after the examination of water in the mineral olivine. Laboratory experiments over the past three decades have suggested the presence of water greatly weakens the mechanical strength of the mineral olivine, a key component of the Earth's upper mantle. In a recent study led by the Bayerisches Geoinstitut in Bayreuth, the Secondary ...

Jammed molecular motors may play a role in the development of ALS

2013-06-13

Slowdowns in the transport and delivery of nutrients, proteins and signaling molecules within nerve cells may contribute to the development of the neurodegenerative disorder ALS, according to researchers at the University of Illinois at Chicago College of Medicine. The researchers showed how a genetic mutation often associated with inherited ALS caused delays in the transport of these important molecules along the long axons of neurons. Their findings were published in the online journal PLOS ONE on June 12. Motor neurons are among the longest cells in the human body—some ...

Researchers develop easy and effective therapy to restore sight

2013-06-13

Researchers at the University of California, Berkeley, have developed an easier and more effective method for inserting genes into eye cells that could greatly expand gene therapy to help restore sight to patients with blinding diseases ranging from inherited defects like retinitis pigmentosa to degenerative illnesses of old age, such as macular degeneration. Unlike current treatments, the new procedure – which takes a little as 15-minutes – is surgically non-invasive, and it delivers normal genes to difficult-to-reach cells throughout the entire retina. Over the last ...

Fingernails reveal clues to limb regeneration

2013-06-13

Mammals possess the remarkable ability to regenerate a lost fingertip, including the nail, nerves and even bone. In humans, an amputated fingertip can sprout back in as little as two months, a phenomenon that has remained poorly understood until now. In a paper published today in the journal Nature, researchers at NYU Langone Medical Center shed light on this rare regenerative power in mammals, using genetically engineered mice to document for the first time the biochemical chain of events that unfolds in the wake of a fingertip amputation. The findings hold promise for ...

Low birth weight could be a risk factor for age-related vision loss: UAlberta medical research

2013-06-13

Medical researchers at the University of Alberta recently published their findings that rats with restricted growth in the womb, causing low birth weights when born, were most susceptible to developing age-related vision loss, compared to their normal weight counterparts. The research team members say additional work needs to be done to see if this same link exists in people, and if it does, doctors will need to better monitor vision concerns in adults who were born with a low birth weight. "The consequence of our findings is that we are providing evidence for the need ...

Livermore develops the world's deepest ert imaging system for CO2 sequestration

2013-06-13

LIVERMORE, Calif.-- Lawrence Livermore National Laboratory researchers have broken the record for tracking the movement and concentration of carbon dioxide in a geologic formation using the world's deepest Electrical Resistance Tomography (ERT) system. The research provides insight into the effects of geological sequestration to address the impact of greenhouse gases. The team led by LLNL's Charles Carrigan obtained time lapse electrical resistivity images during the injection of more than 1 million tons of carbon dioxide (CO2) more than 10,000 feet deep in an oil ...

Research shows male guppies reproduce even after death

2013-06-13

RIVERSIDE, Calif. — Performing experiments in a river in Trinidad, a team of evolutionary biologists has found that male guppies continue to reproduce for at least ten months after they die, living on as stored sperm in females, who have much longer lifespans (two years) than males (three-four months). "Populations that are too small can go extinct because close relatives end up breeding with each other and offspring suffer from inbreeding," said David Reznick, a professor of biology at the University of California, Riverside and the principal investigator of the research ...

Commonly-prescribed drugs may influence the onset and progression of Alzheimer's disease

2013-06-13

Multiple drug classes commonly prescribed for common medical conditions are capable of influencing the onset and progression of Alzheimer's disease, according to researchers at The Mount Sinai Medical Center. The findings are published online in the journal PLoS One. Led by Giulio Maria Pasinetti, MD, PhD, the Saunders Family Chair and Professor in Neurology at Mount Sinai, a research team used a computer algorithm to screen 1,600 commercially-available medications to assess their impact on the brain accumulation of beta-amyloid, a protein abnormally accumulated in the ...

The Lancet Obstetrics, Gynecology, & Women’s Health: Taking paracetamol during pregnancy does not increase risk of autism, ADHD or intellectual disabilities, confirms new gold-standard evidence review

Scan predicts whether therapy or meds will best lift depression

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: