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

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.

In this study, task-free and task-evoked data was used 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).

Personalized and interpretable scores of brain circuit dysfunction, grounded in a theoretical taxonomy, were derived from these patients.

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 the 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.

The 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.

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Read the full publication here.

Tozzi, L., Zhang, X., Pines, A., Olmsted, A. M., Zhai, E. S., Anene, E. T., Chesnut, M., Holt-Gosselin, B., Chang, S., Stetz, P. C., Ramirez, C. A., Hack, L. M., Korgaonkar, M. S., Wintermark, M., Gotlib, I. H., Ma, J., & Williams, L. M. (2024). Personalized brain circuit scores identify clinically distinct biotypes in depression and anxiety. Nature medicine, 10.1038/s41591-024-03057-9.

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