ArticleBiological psychiatry2021
Establishing Evidence for Clinical Utility of a Neuroimaging Biomarker in Major Depressive Disorder: Prospective Testing and Implementation Challenges.
Article in Biological psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Effects of electroconvulsive therapy on cortical thickness in depression: a systematic review.Acta neuropsychiatrica · 2024Pooled it
- Generalizability of Treatment Outcome Prediction Across Antidepressant Treatment Trials in Depression.JAMA network open · 2025Trial
- Developing Clinically Interpretable Neuroimaging Biotypes in Psychiatry.Biological psychiatry · 2026Review
- A precision medicine trial of bupropion and sertraline for major depressive disorder using a biomarker-guided sequential multiple-assignment design.Nature. Mental health · 2026Article
- Magnetic resonance imaging of regional gray matter volume in persons who died by suicide.Molecular psychiatry · 2025Article
- Emerging Medications for Treatment-Resistant Depression: A Review with Perspective on Mechanisms and Challenges.Brain sciences · 2025Review
- Prediction of individual patient outcomes to psychotherapy vs medication for major depression.Npj mental health research · 2025Article
- Breakthroughs and challenges for generating brain network-based biomarkers of treatment response in depression.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Review
- Assessing in-session rumination during CBT for depression: Replication and further evaluation of an observational measure.Journal of mood and anxiety disorders · 2024Article
- Brain-based graph-theoretical predictive modeling to map the trajectory of anhedonia, impulsivity, and hypomania from the human functional connectome.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Article
- Effects of electroconvulsive therapy on inflammatory markers and depressive symptoms in adolescents with major depressive disorder.Frontiers in psychiatry · 2024Article
- Brain-based graph-theoretical predictive modeling to map the trajectory of transdiagnostic symptoms of anhedonia, impulsivity, and hypomania from the human functional connectome.Research square · 2023Article
- Balancing the beautiful and the good in pursuit of biomarkers for depression.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2023Article
- [Effect of Sertraline on Serum Cytokine Levels in Adolescents With First-Episode Major Depressive Disorder].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2023Article
- Application of positron emission tomography in psychiatry-methodological developments and future directions.Translational psychiatry · 2022Review
- Blood metabolic signatures of hikikomori, pathological social withdrawal.Dialogues in clinical neuroscience · 2021Article
- The United States index of socioeconomic deprivation for individuals (USiDep).Personalized medicine in psychiatryArticle
Corrections and comments
- Commented on by
- Erratum issuedErratum.2021
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAlthough a number of neuroimaging biomarkers for response have been proposed, none have been tested prospectively for direct effects on treatment outcomes. To the best of our knowledge, this is the first prospective test of the clinical utility of the use of an imaging biomarker to select treatment for patients with major depressive disorder.
methodsEligible participants (n = 60) had a primary diagnosis of major depressive disorder and were assigned to either escitalopram or cognitive behavioral therapy based on fluorodeoxyglucose positron emission tomography activity in the right anterior insula. The overall study remission rate after 12 weeks of treatment, based on the end point Hamilton Depression Rating Scale score, was then examined for futility and benefit of the strategy.
resultsRemission rates demonstrated lack of futility at the end of stage 1 (37%, 10/27), and the study proceeded to stage 2. After adjustment for the change in stage 2 sample size, the complete remission rate did not demonstrate evidence of benefit (37.7%, 95% confidence interval, 26.3%-51.4%, p = .38). However, total remission rates (complete and partial remission) did reach significance in post hoc analysis (49.1%, 95% confidence interval, 37.6%-60.7%, p = .020).
conclusionsThe study shows some evidence for a role of the right anterior insula in the clinical choice of major depressive disorder monotherapy. The effect size, however, is insufficient for the use of insula activity as a sole predictive biomarker of remission. The study also demonstrates the logistical difficulties in establishing clinical utility of biomarkers.
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