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Cognitive therapy or medication? Brain scans may help personalize treatments

Pre­dict­ing How Patients Respond to Ther­apy (press release):

A new study led by MIT neu­ro­sci­en­tists has found that brain scans of patients with social anx­i­ety dis­or­der can help pre­dict whether they will ben­e­fit from cog­ni­tive behav­ioral therapy…Social anx­i­ety is usu­ally treated with either cog­ni­tive behav­ioral ther­apy or med­ica­tions. How­ever, it is cur­rently impos­si­ble to pre­dict which treat­ment will work best for a par­tic­u­lar patient. The team of researchers from MIT, Boston Uni­ver­sity (BU) and Mass­a­chu­setts Gen­eral Hos­pi­tal (MGH) found that the effec­tive­ness of ther­apy could be pre­dicted by mea­sur­ing patients’ brain activ­ity as they looked at pho­tos of faces, before the ther­apy ses­sions began.. “Our vision is that some of these mea­sures might direct indi­vid­u­als to treat­ments that are more likely to work for them”…  “It moves the field for­ward, and brings psy­chol­ogy into more of a rig­or­ous sci­ence, using neu­ro­science to dis­tin­guish between clin­i­cal cases that at first appear homogeneous.”

Study: Pre­dict­ing Treat­ment Response in Social Anx­i­ety Dis­or­der From Func­tional Mag­netic Res­o­nance Imag­ing (Archives of Gen­eral Psy­chi­a­try). From the abstract:

  • Results: Pre­treat­ment responses sig­nif­i­cantly pre­dicted sub­se­quent treat­ment out­come of patients selec­tively for social stim­uli and par­tic­u­larly in regions of higher-order visual cor­tex. Com­bin­ing the brain mea­sures with infor­ma­tion on clin­i­cal sever­ity accounted for more than 40% of the vari­ance in treat­ment response and sub­stan­tially exceeded pre­dic­tions based on clin­i­cal mea­sures at base­line. Pre­dic­tion suc­cess was unaf­fected by test­ing for poten­tial con­found­ing fac­tors such as depres­sion sever­ity at baseline.
  • Con­clu­sions: The results sug­gest that brain imag­ing can pro­vide bio­mark­ers that sub­stan­tially improve pre­dic­tions for the suc­cess of cog­ni­tive behav­ioral inter­ven­tions and more gen­er­ally sug­gest that such bio­mark­ers may offer evidence-based, per­son­al­ized med­i­cine approaches for opti­mally select­ing among treat­ment options for a patient.

To Learn More about the Future of Per­son­al­ized Med­i­cine & the Brain:

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Categories: Cognitive Neuroscience, Health & Wellness

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