MRI could be key to diagnosing and treating depression

A new imaging study has identified unique brain connectivity patterns in people with depression and/or anxiety. Experts are hopeful that their findings could pave the way for more effective treatments for anyone struggling with mental health disorders. 

Using functional MRI and machine learning cluster analyses, experts at Stanford were able to identify six distinct biological subtypes of depression. Each subtype displayed unique activity in specific regions of the brain both while at rest and while completing various tasks that assessed participants’ cognitive and emotional function. 

Based on when and where in the brain the activity was observed, experts were able to get a better idea of how participants’ depression and anxiety might respond to specific treatments—something that is currently a lengthy process of trial and error, with no objective means of measuring treatment effectiveness. 

Senior study author Leanne Williams, PhD, a professor of psychiatry and behavioral sciences and the director of Stanford Medicine’s Center for Precision Mental Health and Wellness, hopes the findings will someday help patients get the relief they need sooner. 

“The goal of our work is figuring out how we can get it right the first time,” Williams said in a release. “It’s very frustrating to be in the field of depression and not have a better alternative to this one-size-fits-all approach.” 

The study included more than 800 individuals who had been diagnosed with depression or anxiety but were not undergoing treatment. The team randomly assigned 250 of the participants to be treated with either one of three common antidepressants or participate in talk therapy prior to their imaging. 

The group focused on connections between certain regions of the brain known to be associated with depression. Through this, several patterns emerged. 

For example, some of the participants showed patterns of overactivity in certain areas of the brain that were effectively stabilized using the antidepressant medication Effexor. Another group showed increased activity in certain regions related to cognitive and executive function while at rest; that group benefited the most from behavioral talk therapy. And another group showed decreased activity in areas associated with focus and attention during resting state, whom researchers noted were less likely to show improvements with talk therapy alone. 

“To our knowledge, this is the first time we’ve been able to demonstrate that depression can be explained by different disruptions to the functioning of the brain,” Williams said. “In essence, it’s a demonstration of a personalized medicine approach for mental health based on objective measures of brain function.” 

The group is continuing to enroll participants in the study and has plans to expand the range of treatments included in the research. 

The study abstract is available in Nature Medicine

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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