Functional MRI Scans Used to Determine Patients’ Response to Antidepressants

Functional MRI Scans Used to Determine Patients’ Response to Antidepressants

The effectiveness of antidepressants can vary considerably from individual to individual. Drugs also need to be taken for a number of weeks before their effectiveness is known. If a particular treatment is ineffective, the process must start again, extending the period that patients have to suffer often debilitating symptoms.

However, if there was a way for physicians to determine in advance whether a particular treatment would be effective, patients could then be prescribed medication that would start to alleviate their symptoms sooner. If drugs would likely prove to be ineffective, patients could be prescribed alternate treatments.

Now researchers from the University of Illinois at Chicago believe they have uncovered a method of determining whether antidepressants will be effective. What is required is for patients to undergo a functional MRI (fMRI) scan prior to treatment commencing.

The researchers conducted a study on 36 adults suffering from major depressive disorder that had yet to be prescribed any treatment to alleviate symptoms. Each patient had an fMRI scan performed and completed a questionnaire to assess their symptoms.

The group was then split into two and each group was treated with a different drug. One group – comprising 22 individuals – was treated with Effexor – a selective serotonin re-uptake inhibitor. The other group of 14 individuals received treatment with Cymbalta – a serotonin-norepinephrine reuptake inhibitor.

Prior to taking the medication, each patient had a fMRI scan performed during which they were asked to complete a simple cognitive test. They watched a screen which displayed the letters X, Y, and Z flash across a screen. They were required to press a button when they saw a letter, although not if they saw the letter repeated.

The tests and fMRI scans were then repeated after 10 weeks of treatment with their respective medications. The team found that patients who made more mistakes during the first test were much more likely to respond well to their medication than those who had stronger activity in the interference processing network or error detection network.

Based on the results of the study, the researchers were able to predict which patients would respond well to antidepressant treatment and which would not. By performing the test while having the fMRI scan, the researchers were able to determine with a high degree of accuracy (90%) which patients would respond well to treatment.

While MRI scans used to be prohibitively expensive, the cost of scans has fallen considerably over the course of the past decade. Performing this test now is likely to be cost effective. If it is possible to determine which patients will respond to antidepressants, time and money would be saved and patients would be able to alleviate their symptoms much more rapidly.

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