Table 1 Summary of Neuroimaging studies predicting treatment response in anxiety disorders
From: Neuroimaging predictors of treatment response in anxiety disorders
Article | Disorder | Imaging | Treatment type | Sample sizes | Outcome measure | Findings |
|---|---|---|---|---|---|---|
Swedo et al. [32] | OCD | PET-FDG: resting state | Clomipramine (dose and duration not specified) | OCD: 18 Healthy: 18 | OCR Responders: ≥ 40% reduction in OCR (11 R, 6 NR) | Pre-treatment rCMRglu in the right ACC and right OFC was lower in clomipramine R vs. NR. |
Saxena et al. [33] | OCD | PET-FDG: resting state | Paroxetine (8-12 weeks; 40 mg/d max) | OCD: 20 | YBOCS and CGI Responders: ≥ 25% reduction in YBOCS and CGI of much improved or very much improved (11 R, 9 NR) | Lower pre-treatment rCMRglu in bilateral OFC predicted better response to paroxetine. |
Saxena et al. [34] | OCD, MDD, OCD + MDD | PET-FDG: resting state | Paroxetine (8-12Â weeks; 30-60Â mg/d) | OCD: 27 MDD: 27 OCD + MDD: 17 | YBOCS, HAM-D | Greater pre-treatment rCMRglu in the caudate predicted greater improvement in OCD symptoms in the OCD groups. Lower rCMRglu in the amygdala predicted more improvement in MDD symptoms in MDD group and in all Ss combined. Greater pre-treatment rCMRglu in the medial frontal gyrus predicted improvement in MDD symptoms in all Ss. |
Hendler et al. [35] | OCD | SPECT: symptom provocation vs. relax | Sertraline (6 months; 200 mg/d max) | OCD: 26 | YBOCS Responders: ≥ 30% reduction in YBOCS (13 R, 13 NR) | R had lower pre-treatment perfusion during symptom provocation in dorsal/caudal ACC and higher perfusion in right caudate vs. NR. |
Rauch et al. [36] | OCD | PET-015: symptom provocation vs. neutral | Fluvoxamine (12Â weeks; 300Â mg/d max) | OCD: 9 | YBOCS | Lower rCBF in OFC and higher rCBF in PCC predicted better response. |
Sanematsu et al. [37] | OCD | fMRI: symptom provocation vs. neutral | Fluvoxamine (12Â weeks; 200Â mg/d max) | OCD: 17 | YBOCS | Pretreatment activation of right cerebellum and left superior temporal gyrus was positively correlated with YBOCS improvement. |
Ho Pian et al. [38] | OCD | SPECT: resting state | Fluvoxamine (12 weeks; 300 mg/d max) | OCD: 15 | YBOCS Responders: ≥25% reduction in YBOCS (7 R, 8 NR) | Pre-treatment cerebellar and whole brain rCBF was significantly higher in R vs. NR. |
Buchsbaum et al. [39] | OCD | PET-FDG: resting state | Risperidone or placebo augmentation (8 weeks; 3 mg/d max) | OCD: 15 Risperidone: 9 Placebo: 6 | YBOCS Responders: ≥ 25% reduction in YBOCS and/or CGI Improvement rating of very much improved or much improved (4 R, 5 NR) | Pre-treatment rCMRglu was lower in the striatum and higher in the ventral ACC in R vs. NR. |
Brody et al. [40] | OCD | PET-FDG: resting state | Fluoxetine (10Â weeks; 60Â mg/d) or group BT (10Â weeks) | OCD: 27 Fluoxetine: 9 CBT: 18 | YBOCS | Greater pre-treatment rCMRglu in the left OFC was associated with a better response to BT. In this same region, lower rCMRglu was associated with better response to fluoxetine. |
Hoexter et al. [41] | OCD | mMRI | Fluoxetine (12Â weeks; 80Â mg/d max) or group CBT (12 weekly sessions) | OCD: 29 Fluoxetine: 14 CBT: 15 | YBOCS | Lower pre-treatment gray matter density in ventrolateral prefrontal cortex predicted better response to fluoxetine. Greater gray matter density in subgenual ACC predicted better response to CBT. |
Rauch et al. [44] | OCD | PET-FDG: resting state | Anterior cingulotomy | OCD: 11 | YBOCS | Greater pre-operative rCMRglu in posterior cingulate predicted greater improvement. |
Van Laere et al. [45] | OCD | PET-FDG: resting state | Stimulation of anterior capsule | OCD: 6 Controls: 20 | YBOCS | Greater pre-operative rCMRglu in the subgenual ACC predicted greater improvement. |
Bryant et al. [68] | PTSD | mMRI | CBT (8 weekly sessions) | PTSD: 13 TENP: 13 Healthy: 13 | CAPS Responders: no longer met diagnostic criteria (7 R, 6 NR) | Greater pre-treatment gray matter density in the rACC predicted greater improvement. |
Bryant et al. [19] | PTSD | fMRI: masked fearful vs. neutral faces | CBT (8 weekly sessions) | PTSD: 14 Healthy: 14 | CAPS Responders: ≥ 50% reduction in CAPS (7 R, 7 NR) | Lower pre-treatment amygdala and rACC activation predicted greater improvement. |
Nardo et al. [69] | PTSD | mMRI | EMDR (5 sessions) | PTSD: 21 TENP: 22 | Responders: no longer met diagnostic criteria (10 R, 5 NR) | R had greater gray matter density in the insula, amygdala/parahippocampal gyrus, posterior cingulate, and middle, precentral, and dorsal medial frontal gyri. |
Whalen et al. [75] | GAD | fMRI: fearful vs. neutral/happy faces | Venlafaxine (8Â weeks; 225Â mg/d max) | GAD: 15 Healthy: 15 | HAM-A | Lower pre-treatment amygdala activation and greater rACC activation predicted greater improvement in anxiety. |
Nitschke et al. [73] | GAD | fMRI: anticipation of aversive vs. neutral images | Venlafaxine (8Â weeks; 225Â mg/d max) | GAD: 14 Healthy: 12 | HAM-A and Penn State Worry Questionnaire | Greater pre-treatment rACC activation predicted greater improvement in anxiety. |
McClure et al. [76] | GAD | fMRI: fearful vs. happy faces | Fluoxetine (8Â weeks; 40Â mg/d max) or CBT (8 weekly sessions) | GAD: 12 Fluoxetine: 5 CBT: 7 | CGI | Greater pre-treatment amygdala activation predicted greater improvement. |
Evans et al. [87] | SAD | PET-FDG: resting state | Tiagabine (6 weeks; 16 mg/d max) | SAD: 12 Healthy: 10 | LSAS Responders: ≥ 50% reduction in LSAS scores (7 R, 5 NR) | Voxelwise correlations were not significant. Pre-treatment rCMRglu was lower in subcallosal ACC in R compared to healthy controls. |
Doehrmann et al. [13] | SAD | fMRI: 1-back task, angry vs. neutral faces | CBT (12 weekly sessions) | SAD: 39 | LSAS | Greater pre-treatment activation in dorsal and ventral occipitotemporal cortex predicted greater improvement. |