Predictive neuroimaging markers of treatment response are increasingly sought in order to inform the treatment of major depressive and anxiety disorders. We review the existing literature regarding candidate predictive neuroimaging markers of psychotherapy response and assess their potential clinical utility.
We searched Embase, PsycINFO, and PubMed up to October 2014 for studies correlating pretreatment neuroimaging parameters with psychotherapy response in major depressive and anxiety disorders. Our search yielded 40 eligible studies.
The anterior cingulate cortex, amygdala, and anterior insula emerged as potential markers in major depressive disorder and some anxiety disorders. Results across studies displayed a large degree of variability, however, and to date the findings have not been systematically validated in independent clinical cohorts and have not been shown capable of distinguishing between medication and psychotherapy responders. Also limited is the examination of how neuroimaging compares or might add to other prognostic clinical variables.
While the extant data suggest avenues of further investigation, we are still far from being able to use these markers clinically. Future studies need to focus on longitudinal testing of potential markers, determining their prescriptive value and examining how they might be integrated with clinical factors.
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From the Department of Psychiatry, University of British Columbia.
Original manuscript received 19 May 2015; revised manuscript received 12 December 2015, accepted for publication subject to revision 11 January 2016; revised manuscripts received 8 February, 12 April, 10 June, and 15 August 2016.
Correspondence: Trisha Chakrabarty, MD, Department of Psychiatry, Faculty of Medicine, Gordon and Leslie Diamond Health Care Center, 11th Floor, 2775 Laurel St., Vancouver BC V5Z 1M9, Canada
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