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fMRI predictors of treatment outcome in pediatric anxiety disorders

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Abstract

Introduction

A growing number of studies have found evidence that anxiety and depressive disorders are associated with atypical amygdala hyperactivation, which decreases with effective treatment. Interest has emerged in this phenomenon as a possible biological marker for individuals who are likely to benefit from tailored treatment approaches.

Objective

The present study was designed to examine relationships between pretreatment amygdala activity and treatment response in a sample of anxious children and adolescents.

Materials and methods

Participants, who were diagnosed predominantly with generalized anxiety disorder (GAD), underwent functional magnetic resonance imaging (fMRI) scanning before treatment with fluoxetine or cognitive behavioral therapy (CBT).

Results

Results indicated significant negative associations between degree of left amygdala activation and measures of posttreatment symptom improvement in the group, as a whole.

Discussion

Taken together with research on associations between adult amygdala activation and treatment response, these findings suggest that patients whose pretreatment amygdala activity is the strongest may be particularly likely to respond well to such widely used treatments as selective serotonin reuptake inhibitor (SSRI) medications and CBT.

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Authors and Affiliations

  1. Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA

    Erin B. McClure

  2. Emotional Development and Affective Neuroscience Branch, Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA

    Abby Adler, Eric E. Nelson, Monique Ernst & Daniel S. Pine

  3. Department of Psychology and the Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA

    Christopher S. Monk

  4. Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA

    Jennifer Cameron & Samantha Smith

  5. Unit of Affective Disorders, Pediatrics and Developmental Neuropsychiatry Branch, Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA

    Ellen Leibenluft

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  1. Erin B. McClure
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  2. Abby Adler
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  4. Jennifer Cameron
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  9. Daniel S. Pine
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Correspondence to Erin B. McClure.

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McClure, E.B., Adler, A., Monk, C.S. et al. fMRI predictors of treatment outcome in pediatric anxiety disorders. Psychopharmacology 191, 97–105 (2007). https://doi.org/10.1007/s00213-006-0542-9

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  • DOI: https://doi.org/10.1007/s00213-006-0542-9

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