Magnetic Resonance Imaging Measures of Brain Structure to Predict Antidepressant Treatment Outcome in XXXX .

@entity1 @entity308 @entity3756 @entity837 @entity906
BACKGROUND: Less than 50% of @entity1 with @entity308 ( @entity308 ) reach symptomatic remission with their initial antidepressant medication (ADM). There are currently no objective measures with which to reliably predict which individuals will achieve remission to ADMs. METHODS: 157 @entity1 with @entity308 from the International Study to Predict Optimized Treatment in @entity308 (iSPOT-D) underwent baseline MRIs and completed eight weeks of treatment with @entity837 , @entity3756 or @entity906 -ER. A score at week 8 of 7 or less on the 17 item Hamilton Rating Scale for @entity308 defined remission. Receiver Operator Characteristics (ROC) analysis using the first 50% @entity1 was performed to define decision trees of baseline MRI volumetric and connectivity (fractional anisotropy) measures that differentiated non-remitters from remitters with maximal sensitivity and specificity. These decision trees were tested for replication in the remaining @entity1 . FINDINGS: Overall, 35% of all @entity1 achieved remission. ROC analyses identified two decision trees that predicted a high probability of non-remission and that were replicated: 1. Left middle frontal volume  <  14      8  mL _ right angular gyrus volume  >  6      3  mL identified 55% of non-remitters with 85% accuracy; and 2. Fractional anisotropy values in the left cingulum bundle  <  0      63, right superior fronto-occipital fasciculus  <  0      54 and right superior longitudinal fasciculus  <  0      50 identified 15% of the non-remitters with 84% accuracy. All @entity1 who met criteria for both decision trees were correctly identified as non-remitters. INTERPRETATION: Pretreatment MRI measures seem to reliably identify a subset of @entity1 who do not remit with a first step medication that includes one of these commonly used medications. Findings are consistent with a neuroanatomical basis for non-remission in @entity308 @entity1 . FUNDING: Brain Resource Ltd is the sponsor for the iSPOT-D study (NCT00693849).
