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Early-treatment cerebral blood flow change as a predictive biomarker of antidepressant treatment response: evidence from the EMBARC clinical trial

Published online by Cambridge University Press:  09 May 2024

Yi Dang ,
Bin Lu ,
Tamara Vanderwal ,
Francisco Xavier Castellanos  and
Chao-Gan Yan Open the ORCID record for Chao-Gan Yan [Opens in a new window]
Yi Dang
Affiliation:
Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
Bin Lu
Affiliation:
CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China Department of Psychology, University of Chinese Academy of Sciences, Beijing, China International Big-Data Center for Depression Research, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
Tamara Vanderwal
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada BC Children's Hospital Research Institute, Vancouver, BC, Canada
Francisco Xavier Castellanos
Affiliation:
Department of Child and Adolescent Psychiatry, NYU Robert I. Grossman School of Medicine, New York, NY, USA Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
Chao-Gan Yan*
Affiliation:
Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China Department of Psychology, University of Chinese Academy of Sciences, Beijing, China International Big-Data Center for Depression Research, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
*
Corresponding author: Chao-Gan Yan; Email: yancg@psych.ac.cn
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Abstract

Background

Major depressive disorder (MDD) is one of the most prevalent and disabling illnesses worldwide. Treatment of MDD typically relies on trial-and-error to find an effective approach. Identifying early response-related biomarkers that predict response to antidepressants would help clinicians to decide, as early as possible, whether a particular treatment might be suitable for a given patient.

Methods

Data were from the two-stage Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) trial. A whole-brain, voxel-wise, mixed-effects model was applied to identify early-treatment cerebral blood flow (CBF) changes as biomarkers of treatment response. We examined changes in CBF measured with arterial spin labeling 1-week after initiating double-masked sertraline/placebo. We tested whether these early 1-week scans could be used to predict response observed after 8-weeks of treatment.

Results

Response to 8-week placebo treatment was associated with increased cerebral perfusion in temporal cortex and reduced cerebral perfusion in postcentral region captured at 1-week of treatment. Additionally, CBF response in these brain regions was significantly correlated with improvement in Hamilton Depression Rating Scale score in the placebo group. No significant associations were found for selective serotonin reuptake inhibitor treatment.

Conclusions

We conclude that early CBF responses to placebo administration in multiple brain regions represent candidate neural biomarkers of longer-term antidepressant effects.

Keywords

antidepressantarterial spin labelingbiomarkercerebral blood flowEMBARC
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 10
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

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