Neuroimaging, genetic, clinical, and demographic predictors of treatment response in patients with social anxiety disorder [Elektronisk resurs]
-
Frick, Andreas (författare)
-
Engman, Jonas (författare)
-
Alaie, Iman (författare)
-
Björkstrand, Johannes (författare)
-
Gingnell, Malin, 1982- (författare)
-
Larsson, Elna-Marie (författare)
-
Eriksson, Elias (författare)
-
Wahlstedt, Kurt (författare)
-
Fredrikson, Mats (författare)
-
Furmark, Tomas (författare)
-
Uppsala universitet Humanistisk-samhällsvetenskapliga vetenskapsområdet (utgivare)
-
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
-
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
-
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
- Publicerad: 2020
- Engelska.
-
Ingår i: Journal of Affective Disorders. - 0165-0327. ; 261, 230-237
-
Läs hela texten
-
Läs hela texten
-
Läs hela texten
Sammanfattning
Ämnesord
Stäng
- Background: Correct prediction of treatment response is a central goal of precision psychiatry. Here, we tested the predictive accuracy of a variety of pre-treatment patient characteristics, including clinical, demographic, molecular genetic, and neuroimaging markers, for treatment response in patients with social anxiety disorder (SAD). Methods: Forty-seven SAD patients (mean +/- SD age 33.9 +/- 9.4 years, 24 women) were randomized and commenced 9 weeks' Internet-delivered cognitive behavior therapy (CBT) combined either with the selective serotonin reuptake inhibitor (SSRI) escitalopram (20 mg daily [10 mg first week], SSRI+CBT, n= 24) or placebo (placebo+CBT, n= 23). Treatment responders were defined from the Clinical Global Impression-Improvement scale (CGI- I <= 2). Before treatment, patients underwent functional magnetic resonance imaging and the Multi-Source Interference Task taxing cognitive interference. Support vector machines (SVMs) were trained to separate responders from nonresponders based on pre-treatment neural reactivity in the dorsal anterior cingulate cortex (dACC), amygdala, and occipital cortex, as well as molecular genetic, demographic, and clinical data. SVM models were tested using leave-one-subject-out cross-validation. Results: The best model separated treatment responders (n= 24) from nonresponders based on pre-treatment dACC reactivity (83% accuracy, P= 0.001). Responders had greater pre-treatment dACC reactivity than nonresponders especially in the SSRI+CBT group. No other variable was associated with clinical response or added predictive accuracy to the dACC SVM model. Limitations: Small sample size, especially for genetic analyses. No replication or validation samples were available. Conclusions: The findings demonstrate that treatment outcome predictions based on neural cingulate activity, at the individual level, outperform genetic, demographic, and clinical variables for medication-assisted Internet-delivered CBT, supporting the use of neuroimaging in precision psychiatry.
Ämnesord
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Psychiatry (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Psykiatri (hsv)
Genre
- government publication (marcgt)
Indexterm och SAB-rubrik
- Social phobia
- SSRI
- CBT
- Personalized medicine
- SVM
- Pattern recognition
Inställningar
Hjälp
Beståndsinformation saknas