Evidence map›Paper›PMID 38886626›Full record

ArticleNature medicine2024

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

Leonardo Tozzi, Xue Zhang, Adam Pines, Alisa M Olmsted, Emily S Zhai, Esther T Anene, Megan Chesnut, Bailey Holt-Gosselin, Sarah Chang, Patrick C Stetz and 7 more

Abstract read
In one paragraph

Article in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
119citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

119 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. The relation between stress-related neural activity assessed by brainEuropean journal of nuclear medicine and molecular imaging · 2025
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59 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Leonardo TozziDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0002-9429-6476
Xue ZhangDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0003-4279-899X
Adam PinesDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Alisa M OlmstedDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Emily S ZhaiDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0001-5341-1178
Esther T AneneDepartment of Counseling and Clinical Psychology, Teacher's College, Columbia University, New York, NY, USA.
Megan ChesnutDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Bailey Holt-GosselinInterdepartmental Neuroscience Graduate Program, Yale University School of Medicine, New Haven, CT, USA.
Sarah ChangSemel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
Patrick C StetzDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Carolina A RamirezCenter for Intelligent Imaging, University of California San Francisco, San Francisco, CA, USA.
Laura M HackDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Mayuresh S KorgaonkarBrain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia.ORCID 0000-0002-1339-2221
Max WintermarkDepartment of Neuroradiology, the University of Texas MD Anderson Center, Houston, TX, USA.
Ian H GotlibDepartment of Psychology, Stanford University, Stanford, CA, USA.
Jun MaDepartment of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL, USA.
Leanne M WilliamsDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. leawilliams@stanford.edu.ORCID 0000-0001-9987-7360

Funding

ACE-D: Accelerating Cognition-guided signatures to Enhance translation in DepressionU01MH136062 · NIMH · STANFORD UNIVERSITY · PI AJILORE, OLUSOLA A., MA, JUN · 2024 to 2025
$7.6M
Mapping connectomes for disordered emotional statesU01MH109985 · NIMH · STANFORD UNIVERSITY · PI WILLIAMS, LEANNE · 2017 to 2020
$3.1M
Engaging self-regulation targets to understand the mechanisms of behavior change and improve mood and weight outcomesUH2HL132368 · NHLBI · UNIVERSITY OF ILLINOIS AT CHICAGO · PI MA, JUN, WILLIAMS, LEANNE · 2015 to 2017
$2.6M
Neural Dimensions of Threat Reactivity and Regulation for Understanding AnxietyR01MH101496 · NIMH · STANFORD UNIVERSITY · PI WILLIAMS, LEANNE · 2013 to 2016
$2.3M
Doctoral Training in Brain and Behavioral Development During Adolescence (UCLA BBDA)T32HD091059 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Mirella Dapretto, ANDREW J FULIGNI · 2018 to 2026
$1.7M
NHLBI NIH HHS UH2 HL132368NICHD NIH HHS T32 HD091059NIMH NIH HHS R01 MH101496NIMH NIH HHS U01 MH109985NIMH NIH HHS U01 MH136062U.S. Department of Health & Human Services | National Institutes of Health (NIH) U01MH109985U.S. Department of Health & Human Services | National Institutes of Health (NIH) UH2HL132368U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) R01MH101496U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) U01MH109985U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) U01MH136062U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) UH2HL132368
6 · The paper itself

Abstract

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.

Indexed as

AnxietyBrainDepressionMagnetic Resonance ImagingAdultCognitionFemaleHumansMaleMiddle AgedPrecision MedicineYoung Adult

Identifiers

PMID38886626
PMCPMC11271415

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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.