By Will Boggs, MD

NEW YORK (Reuters Health) Apr 12 - Functional MRI can be used to predict which patients with unipolar depression will respond to cognitive behavior therapy (CBT), according to a report in the April issue of the American Journal of Psychiatry.

"By examining brain function before treatment," Dr. Greg J. Siegle from the University of Pittsburgh School of Medicine told Reuters Health, "it may be possible to give cognitive therapy to just those patients for whom it is most likely to be effective, thereby improving treatment rates and decreasing patient burden."

Dr. Siegle and colleagues performed functional MRI on 14 unmedicated depressed patients and 21 comparison subjects who had never been depressed. This was done during performance of a task sensitive to sustained emotional information processing. The investigators repeated testing of the depressed patients after 16 sessions of CBT.

The team found that low sustained reactivity in the subgenual cingulate cortex to negative words was strongly associated with a reduction in depression after CBT. High sustained reactivity to negative words in a region of the right amygdala was also associated with improved treatment response.

"Depression," continued Dr. Siegle, "often involves increased automatic reactions to emotional situations and decreased regulation of emotional responses, This study suggests that cognitive therapy, which helps people to react differently to emotional situations and thoughts, may be particularly useful for depressed people who have brain correlates of these characteristics."

Dr. Siegle went on to say that he and his colleagues are conducting a larger study to investigate "whether the same mechanisms which predict response to CBT change upon recovery. In addition, we are looking forward to performing similar studies with patients who are receiving medications."

Reuters Health Information 2006. © 2006 Reuters Ltd.
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