Trial reportJAMA psychiatry2013
Toward a neuroimaging treatment selection biomarker for major depressive disorder.
Trial report in JAMA psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00367341 (Imaging Predictors of Treatment Response in Depression), which is not on this map. Cited by 212 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Imaging Predictors of Treatment Response in Depression
Who cites it
212 citing papers in PubMed, 7 syntheses or guidelines pooled it, 561 citations in OpenAlex.
- Co-alteration Network Architecture of Major Depressive Disorder: A Multi-modal Neuroimaging Assessment of Large-scale Disease Effects.Neuroinformatics · 2023Pooled it
- Common and distinct patterns of intrinsic brain activity alterations in major depression and bipolar disorder: voxel-based meta-analysis.Translational psychiatry · 2020Pooled it
- Psychotherapy or medication for depression? Using individual symptom meta-analyses to derive a Symptom-Oriented Therapy (SOrT) metric for a personalised psychiatry.BMC medicine · 2020Pooled it
- Personalized (N-of-1) Trials for Depression: A Systematic Review.Journal of clinical psychopharmacology · 2018Pooled it
- Common and distinct patterns of grey-matter volume alteration in major depression and bipolar disorder: evidence from voxel-based meta-analysis.Molecular psychiatry · 2017Pooled it
- Computational meta-analysis of statistical parametric maps in major depression.Human brain mapping · 2016Pooled it
- Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2015Pooled it
- Network effects of Stanford Neuromodulation Therapy (SNT) in treatment-resistant major depressive disorder: a randomized, controlled trial.Translational psychiatry · 2023Trial
- Neural substrates of emotional conflict with anxiety in major depressive disorder: Findings from the Establishing Moderators and biosignatures of Antidepressant Response in Clinical Care (EMBARC) randomized controlled trial.Journal of psychiatric research · 2022Trial
- Change in posttraumatic stress disorder-related thoughts during treatment: Do thoughts drive change when pills are involved?Journal of traumatic stress · 2022Trial
- Multiple Pre-Treatment miRNAs Levels in Untreated Major Depressive Disorder Patients Predict Early Response to Antidepressants and Interact with Key Pathways.International journal of molecular sciences · 2022Trial
- Trial
- Reward related ventral striatal activity and differential response to sertraline versus placebo in depressed individuals.Molecular psychiatry · 2020Trial
- Magnetoencephalographic Correlates of Suicidal Ideation in Major Depression.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2020Trial
- Benefits of Sequentially Adding Cognitive-Behavioral Therapy or Antidepressant Medication for Adults With Nonremitting Depression.The American journal of psychiatry · 2019Trial
- Prefrontal networks dynamically related to recovery from major depressive disorder: a longitudinal pharmacological fMRI study.Translational psychiatry · 2019Trial
- Pretreatment and early-treatment cortical thickness is associated with SSRI treatment response in major depressive disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2018Trial
- Pretreatment Rostral Anterior Cingulate Cortex Theta Activity in Relation to Symptom Improvement in Depression: A Randomized Clinical Trial.JAMA psychiatry · 2018Trial
- Gamma-Hydroxybutyrate Increases Resting-State Limbic Perfusion and Body and Emotion Awareness in Humans.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2017Trial
- Functional Connectivity of the Subcallosal Cingulate Cortex And Differential Outcomes to Treatment With Cognitive-Behavioral Therapy or Antidepressant Medication for Major Depressive Disorder.The American journal of psychiatry · 2017Trial
152 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
importanceCurrently, fewer than 40% of patients treated for major depressive disorder achieve remission with initial treatment. Identification of a biological marker that might improve these odds could have significant health and economic impact.
objectiveTo identify a candidate neuroimaging "treatment-specific biomarker" that predicts differential outcome to either medication or psychotherapy.
designBrain glucose metabolism was measured with positron emission tomography prior to treatment randomization to either escitalopram oxalate or cognitive behavior therapy for 12 weeks. Patients who did not remit on completion of their phase 1 treatment were offered enrollment in phase 2 comprising an additional 12 weeks of treatment with combination escitalopram and cognitive behavior therapy.
settingMood and anxiety disorders research program at an academic medical center.
participantsMen and women aged 18 to 60 years with currently untreated major depressive disorder.
interventionRandomized assignment to 12 weeks of treatment with either escitalopram oxalate (10-20 mg/d) or 16 sessions of manual-based cognitive behavior therapy. MAIN OUTCOME AND MEASURE: Remission, defined as a 17-item Hamilton depression rating scale score of 7 or less at both weeks 10 and 12, as assessed by raters blinded to treatment.
resultsPositive and negative predictors of remission were identified with a 2-way analysis of variance treatment (escitalopram or cognitive behavior therapy) × outcome (remission or nonresponse) interaction. Of 65 protocol completers, 38 patients with clear outcomes and usable positron emission tomography scans were included in the primary analysis: 12 remitters to cognitive behavior therapy, 11 remitters to escitalopram, 9 nonresponders to cognitive behavior therapy, and 6 nonresponders to escitalopram. Six limbic and cortical regions were identified, with the right anterior insula showing the most robust discriminant properties across groups (effect size = 1.43). Insula hypometabolism (relative to whole-brain mean) was associated with remission to cognitive behavior therapy and poor response to escitalopram, while insula hypermetabolism was associated with remission to escitalopram and poor response to cognitive behavior therapy. CONCLUSIONS AND RELEVANCE: If verified with prospective testing, the insula metabolism-based treatment-specific biomarker defined in this study provides the first objective marker, to our knowledge, to guide initial treatment selection for depression.
trial registrationRegistered at clinicaltrials.gov (NCT00367341).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.