Using neuroimaging to predict treatment response in mood and anxiety disorders.

BACKGROUND: Functional neuroimaging has begun to show promise as a clinical tool in the prediction of treatment response in mood and anxiety disorders. Given the variance in patient responses to psychiatric treatments, the use of such predictive tools could be tremendously valuable, especially in situations where treatments carry substantial risks or costs.
METHODS: A literature search was conducted in December 2004 to identify published neuroimaging treatment prediction papers. "Neuroimaging," "treatment," and "depression or anxiety" were used as keywords. Studies of treatment prediction were complemented by studies of treatment effects to provide context.
RESULTS: Fifteen original published papers were identified as investigations of treatment prediction in mood and anxiety disorders. These studies have predominantly been conducted in patients with major depression (MDD) and obsessive-compulsive disorder (OCD). We review this literature and provide a discussion of design considerations in psychiatric neuroimaging studies of treatment response prediction.
CONCLUSIONS: The neuroimaging literature pertaining to treatment response prediction is largely limited to studies of MDD and OCD. While these initial reports are preliminary, the findings reviewed suggest that treatment outcome may be predicted by patterns of pre-treatment brain activity in psychiatric patients. However, the actual clinical utility of such tests remains to be shown.