Brain regulation of emotional conflict predicts antidepressant treatment response for depression.

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ID: 52413
2019
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Abstract
The efficacy of antidepressant treatment for depression is controversial due to the only modest superiority demonstrated over placebo. However, neurobiological heterogeneity within depression may limit overall antidepressant efficacy. We sought to identify a neurobiological phenotype responsive to antidepressant treatment by testing pretreatment brain activation during response to, and regulation of, emotional conflict as a moderator of the clinical benefit of the antidepressant sertraline versus placebo. Using neuroimaging data from a large randomized controlled trial, we found widespread moderation of clinical benefits by brain activity during regulation of emotional conflict, in which greater downregulation of conflict-responsive regions predicted better sertraline outcomes. Treatment-predictive machine learning using brain metrics outperformed a model trained on clinical and demographic variables. Our findings demonstrate that antidepressant response is predicted by brain activity underlying a key self-regulatory emotional capacity. Leveraging brain-based measures in psychiatry will forge a path toward better treatment personalization, refined mechanistic insights and improved outcomes.
Reference Key
fonzo2019brainnature Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Fonzo, Gregory A;Etkin, Amit;Zhang, Yu;Wu, Wei;Cooper, Crystal;Chin-Fatt, Cherise;Jha, Manish K;Trombello, Joseph;Deckersbach, Thilo;Adams, Phil;McInnis, Melvin;McGrath, Patrick J;Weissman, Myrna M;Fava, Maurizio;Trivedi, Madhukar H;
Journal Nature human behaviour
Year 2019
DOI
10.1038/s41562-019-0732-1
URL
Keywords
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