TO READ: This is Your Brain on Therapy
Scientists are learning more on a daily basis about how the brains of people with depression differ from those without it. But can those differences be used to predict how best to treat depressed people? According to recent research, they can.

Using functional magnetic resonance imaging (fMRI), researchers at the University of Pittsburgh School of Medicine measured activity in two key areas of the brains of depressed persons while they responded to different words. The words were chosen to have negative, positive or neutral associations, and the patients were asked to choose words that reflected their feelings when they felt depressed. Then each person participated in a 12-week program of cognitive behavioral therapy (CBT) for their depression, and their depression levels were measured again.

The results seem strong: Among the nine patients with a particular brain activity pattern (a decrease in activity in the subgenual cingulate cortex) when responding to negative words, seven recovered during CBT. Among the five people who did not show that pattern, only one responded to CBT. The positive and neutral words produced no changes related to mood improvement in CBT.

So, even given this small initial trial, fMRI seems to provide a predictor of which depressed people will respond to CBT, a structured therapy that teaches how to control emotional reactions and rumination. Learning how to identify depressed patients who are likely to benefit from CBT versus some other therapy could provide quicker, more effective treatment for all.

For more info: Am J Psychiatry. 2006; 163:735-738.