Klimes-Dougan Bonnie, Başgöze Zeynep, Mueller Bryon, Wiglesworth Andrea, Carosella Kathrine A, Westlund Schreiner Melinda, Bortnova Ana, Reigstad Kristina, Cullen Kathryn R, Gunlicks-Stoessel Meredith
Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA.
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA.
J Clin Med. 2022 Mar 28;11(7):1878. doi: 10.3390/jcm11071878.
Precision medicine approaches hold tremendous promise to advance current clinical practice by providing information about which individuals will benefit from which treatments. This pilot study evaluated if baseline structure and function of the salience and emotion brain regions implicated in adolescent depression, specifically the amygdala and anterior cingulate cortex (ACC), predict response to Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). Adolescents ( = 15; mean age = 14.5 (1.6); 80.0% female) diagnosed with a depressive disorder completed brain scans before the start of a 16 week trial of IPT-A. Clinical measures assessing depressive symptoms were completed before, during, and after a trial of therapy. Results show that at baseline, greater ACC activation in the context of an emotion-matching task and greater amygdala-ACC resting-state functional connectivity was related to greater improvement in depression symptoms. There was minimal evidence that brain structure predicted changes in depressive symptoms. The present study is the first to evaluate neural predictors of IPT-A response. While the results are preliminary, these findings suggest some avenues for future research to pursue in the hopes that more will benefit from treatment.
精准医学方法有望通过提供有关哪些个体将从哪些治疗中受益的信息，推动当前的临床实践。这项初步研究评估了与青少年抑郁症相关的显著脑区和情感脑区（特别是杏仁核和前扣带回皮质（ACC））的基线结构和功能，是否能预测青少年抑郁症人际心理治疗（IPT-A）的疗效。被诊断患有抑郁症的青少年（n = 15；平均年龄 = 14.5（1.6）；80.0%为女性）在进行为期16周的IPT-A试验开始前完成了脑部扫描。在治疗试验前、期间和之后完成了评估抑郁症状的临床测量。结果表明，在基线时，在情感匹配任务中ACC激活程度更高以及杏仁核-ACC静息态功能连接性更强与抑郁症状的更大改善相关。几乎没有证据表明脑结构能预测抑郁症状的变化。本研究是首次评估IPT-A疗效的神经预测指标。虽然结果是初步的，但这些发现为未来的研究提供了一些途径，希望更多人能从治疗中受益。
