Australian medical researchers have developed a new way of using Magnetic Resonance Imaging (MRI) technology to improve the notoriously hit-and-miss prescription of antidepressant drugs.<\/p>\n
A team at the Westmead Millennium Institute for Medical Research (WMI) in Sydney has\u00a0developed a test that uses a type of MRI scanning to predict whether one of three commonly\u00a0prescribed anti-depressant medications (ADM) is likely to be effective in treating a particular\u00a0patient.<\/p>\n
The findings of WMI\u2019s Brain Dynamics Centre, published in the British Journal of Psychiatry,\u00a0could result in the first useful guide to clinicians when deciding on a drug treatment for a\u00a0patient suffering from Major Depressive Disorder (MDD) \u2013 a decision process which the\u00a0study says is currently \u201cno better than a coin toss\u201d.<\/p>\n
\u201cThe remission (success) rate for all ADMs is less than 50 per cent and, if initial medication\u00a0fails, the likelihood that an alternative anti-depressant will be effective lowers further to only\u00a020 to 30 per cent,\u201d said Brain Dynamics Centre director and study first author, Dr Mayuresh\u00a0Korgaonkar.<\/p>\n
\u201cThis is the first predictive imaging treatment test in depression and probably in psychiatry. It\u00a0has the potential to significantly improve clinical service delivery and healthcare outcomes,\u00a0saving the health system substantial amounts of money.\u201d<\/p><\/blockquote>\n
The WMI research is part of an international study by Sydney bio-tech company Brain\u00a0Resource Limited to Predict Optimised Treatment in Depression (iSPOT-D).\u00a0The $20 million iSPOT-D study is seeking to identify biomarkers that can predict outcomes\u00a0from treatment with common ADMs. There is currently no clinically useful pre-treatment
\nmeasure which can guide choice of therapy in depression.<\/p>\nStarting in 2007, data was taken from 2016 study participants across 20 sites in five\u00a0countries. Almost 250 of those had their brains imaged at Westmead, with a further 40 such\u00a0tests conducted at Stanford University as a control.<\/p>\n
Senior author of the imaging study and head of imaging research at WMI\u2019s Brain Dynamics\u00a0Centre, Professor Stuart Grieve, said the iSPOT-D imaging revealed that MDD brains are\u00a0\u201cwired\u201d differently.<\/p>\n
\u201cUsing functional and structural MRI we characterized and mapped key brain abnormalities\u00a0that distinguish a depressed state,\u201d he said.<\/p>\n
\u201cWe showed that patients suffering from MDD had excessive focal grey matter loss,\u00a0equivalent to someone up to 50 years older, and processed emotional tasks and cognitive\u00a0tasks in an abnormal way.\u201d<\/p>\n
Professor Grieve, who is the Parker-Hughes Professor of Radiology at Sydney University\u00a0Medical School, said MRI brain scanning can identify patients who are unlikely to respond to\u00a0a particular ADM with a high degree of accuracy.<\/p>\n
\u201cWe demonstrated that altered connectivity in pathways connecting the key emotional areas\u00a0of the brain predicted with 74 per cent accuracy whether an ADM would be effective.\u201d
\nHaving proven the concept in principle, Professor Grieve said the team is now hoping to\u00a0develop a more affordable version of the testing protocol.<\/p>\nThe team is working with Brain Resource Limited \u2013 an ASX listed company originally spun\u00a0out of the Brain Dynamics Centre at WMI – and also multinational giant GE Healthcare, to\u00a0translate these measures into clinical practice.<\/p>\n
Professor Grieve said the aim is to provide patients with an abbreviated MRI test for about\u00a0$200, which compared with an estimated annual cost of depression of $8000 per person, per\u00a0year, would \u201crepresent an effective allocation of health care spending\u201d.<\/p>\n
\u201cIt\u2019s probably not realistic that we give everyone with depression an MRI test but we think we\u00a0can design a test and deliver it to market at a price which is reasonable in the context of how\u00a0much depression costs,\u201d he said.<\/p>\n
MDD is a leading cause of morbidity, mortality, disability and lost productivity for individuals\u00a0aged between 15 and 44 years, costing Australia an estimated $12.6 billion per year.\u00a0Across all OECD countries the use of ADMs almost doubled between 2000 and 2011.\u00a0Australia now has the second-highest rate of ADM use in the OECD, trailing only Iceland.\u00a0Dr Korgaonkar said the team at WMI now hoped commercialisation of the depression\u00a0treatment test could commence within five years.<\/p>\n
\u201cThese findings are the culmination of 20 years of research at the Brain Dynamics Centre\u00a0and represent the start of personalised medicine for the treatment of depression,\u201d he said.\u00a0\u201cWe are using cutting-edge techniques to define circuits in the brain that are affected by\u00a0depression. This has never been done before and I think this is going to change things for\u00a0the better for patients.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
Australian medical researchers have developed a new way of using Magnetic Resonance Imaging (MRI) technology to improve the notoriously hit-and-miss prescription of antidepressant drugs. A team at the Westmead Millennium Institute for Medical Research (WMI) in Sydney has\u00a0developed a test that uses a type of MRI scanning to predict whether one of three commonly\u00a0prescribed anti-depressant […]<\/p>\n","protected":false},"featured_media":2446,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}}},"categories":[19],"class_list":["post-2500","news","type-news","status-publish","has-post-thumbnail","hentry","category-cat-news"],"acf":[],"_links":{"self":[{"href":"https:\/\/wimr.org.au\/wp-json\/wp\/v2\/news\/2500","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wimr.org.au\/wp-json\/wp\/v2\/news"}],"about":[{"href":"https:\/\/wimr.org.au\/wp-json\/wp\/v2\/types\/news"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wimr.org.au\/wp-json\/wp\/v2\/media\/2446"}],"wp:attachment":[{"href":"https:\/\/wimr.org.au\/wp-json\/wp\/v2\/media?parent=2500"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wimr.org.au\/wp-json\/wp\/v2\/categories?post=2500"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}