Specific patterns of activity on brain scans may help clinicians identify whether psychotherapy or antidepressant medication is more likely to help a patient recover from depression.
For a new study, researchers randomly assigned patients to 12 weeks of treatment with one of two antidepressant medications or with cognitive behavioral therapy (CBT). At the start of the study, patients underwent a functional MRI brain scan, which was then analyzed to see whether the outcome to CBT or medication depended on the state of the brain prior to starting treatment.
“All depressions are not equal and, like different types of cancer, different types of depression will require specific treatments.”
The MRI scans identified that the degree of functional connectivity between an important emotion processing center (the subcallosal cingulate cortex) and three other areas of the brain was associated with the treatment outcomes.
Specifically, patients with positive connectivity between the brain regions were significantly more likely to achieve remission with CBT, whereas patients with negative or absent connectivity were more likely to remit with antidepressant medication.
“All depressions are not equal and, like different types of cancer, different types of depression will require specific treatments,” says Helen Mayberg, professor of psychiatry, neurology and radiology at Emory University School of Medicine. “Using these scans, we may be able to match a patient to the treatment that is most likely to help them, while avoiding treatments unlikely to provide benefit.”This app uses a game to fight depression
Current treatment guidelines for major depression recommend that a patient’s preference for psychotherapy or medication be considered in selecting the initial treatment approach. However, in the new study, patients’ preferences were only weakly associated with outcomes; preferences predicted treatment drop-out but not improvement.
These results are consistent with prior studies, suggesting that achieving personalized treatment for depressed patients will depend more on identifying specific biological characteristics in patients rather than relying on their symptoms or treatment preferences. The findings suggest brain scans may offer the best approach for personalizing treatment going forward.
For the study, published in the American Journal of Psychiatry, researchers recruited 344 patients made up of a for more diverse group of patients than other previous studies—roughly half self-identified as African-American or Hispanic.
“Our diverse sample demonstrated that the evidence-based psychotherapy and medication treatments recommended as first line treatments for depression can be extended with confidence beyond a white, non-Hispanic population,” says Boadie Dunlop, director of the Emory Mood and Anxiety Disorders Program.
“Ultimately our studies show that clinical characteristics, such as age, gender, etc., and even patients’ preferences regarding treatment, are not as good at identifying likely treatment outcomes as the brain measurement,” adds Mayberg.
W. Edward Craighead, professor of psychiatry and behavioral sciences is a coauthor of the study. Grants from the National Institutes of Health funded the work.
Source: Emory University
Bloomberg was first to report that Apple is exploring digital glasses that would connect wirelessly to iPhones and "show images and other information in the wearer's field of vision." The report said the digital glasses, which may use augmented reality, would not launch until 2018 at the earliest.
One person who expects a sooner launch is tech evangelist Robert Scoble, who insists that Apple is working on a pair of "mixed reality" glasses that will debut alongside the 2017 iPhone lineup, according to his sources. He also said Apple and German company Carl Zeiss are working together on augmented reality optics.
Scoble's information has yet to be corroborated by other sources, so 2018 or later remains a more likely timeline at this point.
While a standalone product appears to remain far off, most analysts agree that Apple will start incorporating AR-related features into its existing products in the near future. A future iPhone camera, for example, could be able to detect faces and apply Snapchat-like filters using augmented reality.
Apple CEO Tim Cook has shown significant interest in augmented reality over the past few years, calling the technology everything from "profound" to a "big idea like the smartphone" in recent interviews. He also believes that augmented reality is essentially more important than virtual reality.
Last year, Cook said that Apple continues to "invest a lot" in augmented reality, and the company has filed several patents related to the technology over the past decade, confirming its interest in the field. However, Apple routinely tests new products and technologies that are never publicly released.
Apple's augmented reality efforts have been preceded by the Microsoft HoloLens, a cordless, self-contained Windows 10 holographic headset that mixes virtual reality with augmented reality. Microsoft began shipping the HoloLens Development Edition in March 2016 for $3,000 in the United States and Canada.
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