Personalized brain circuit scores identify clinically distinct biotypes in depression and anxiety.

Autor: Tozzi L; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Zhang X; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Pines A; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Olmsted AM; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.; Sierra-Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA., Zhai ES; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Anene ET; Department of Counseling and Clinical Psychology, Teacher's College, Columbia University, New York, NY, USA., Chesnut M; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Holt-Gosselin B; Interdepartmental Neuroscience Graduate Program, Yale University School of Medicine, New Haven, CT, USA., Chang S; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA., Stetz PC; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.; Sierra-Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA., Ramirez CA; Center for Intelligent Imaging, University of California San Francisco, San Francisco, CA, USA., Hack LM; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.; Sierra-Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA., Korgaonkar MS; Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia.; Department of Radiology, Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia., Wintermark M; Department of Neuroradiology, the University of Texas MD Anderson Center, Houston, TX, USA., Gotlib IH; Department of Psychology, Stanford University, Stanford, CA, USA., Ma J; Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL, USA., Williams LM; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. leawilliams@stanford.edu.; Sierra-Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. leawilliams@stanford.edu.
Jazyk: angličtina
Zdroj: Nature medicine [Nat Med] 2024 Jul; Vol. 30 (7), pp. 2076-2087. Date of Electronic Publication: 2024 Jun 17.
DOI: 10.1038/s41591-024-03057-9
Abstrakt: There is an urgent need to derive quantitative measures based on coherent neurobiological dysfunctions or 'biotypes' to enable stratification of patients with depression and anxiety. We used task-free and task-evoked data from a standardized functional magnetic resonance imaging protocol conducted across multiple studies in patients with depression and anxiety when treatment free (n = 801) and after randomization to pharmacotherapy or behavioral therapy (n = 250). From these patients, we derived personalized and interpretable scores of brain circuit dysfunction grounded in a theoretical taxonomy. Participants were subdivided into six biotypes defined by distinct profiles of intrinsic task-free functional connectivity within the default mode, salience and frontoparietal attention circuits, and of activation and connectivity within frontal and subcortical regions elicited by emotional and cognitive tasks. The six biotypes showed consistency with our theoretical taxonomy and were distinguished by symptoms, behavioral performance on general and emotional cognitive computerized tests, and response to pharmacotherapy as well as behavioral therapy. Our results provide a new, theory-driven, clinically validated and interpretable quantitative method to parse the biological heterogeneity of depression and anxiety. Thus, they represent a promising approach to advance precision clinical care in psychiatry.
(© 2024. The Author(s).)
Databáze: MEDLINE
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