New Treatment Strategy for Depression Uses AI and Brain Scans

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Highlights:

• Artificial Intelligence (AI) and brain scanning can predict which treatment is best for depression
• The AI technology will help to choose the right antidepressant that will benefit the patient most
• This technology has the potential to bring about a revolution in the Psychiatry field

Artificial Intelligence (AI) could soon play a crucial role in deciding which antidepressant would be best for treating patients with depression, reveals a new multicenter, international study led by physician-scientists at UT Southwestern Medical Center, Dallas, Texas, USA.

This is the latest in a series of studies, based on a previous large multicenter US study known as the EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care) Trial.

‘Artificial Intelligence (AI) and brain scanning help predict which antidepressants will benefit patients with depression. This technology could revolutionize the field of Psychiatry in the near future.’

The research team is confident that modern tools, such as AI, coupled with electroencephalography (EEG) and blood tests, could revolutionize the field of Psychiatry in the near future.

The study, published in Nature Biotechnology, was led by Dr. Madhukar Trivedi, MD, who is a Professor in the Department of Psychiatry at UT Southwestern Medical Center, Dallas, Texas, USA. He is also Chief of the Division of Mood Disorders and the Founding Director of the Center for Depression Research and Clinical Care, where he holds the Betty Jo Hay Distinguished Chair in Mental Health and the Julie K. Hersh Chair for Depression Research and Clinical Care.

Dr. Amit Etkin, MD, PhD, who is a Professor of Psychiatry and Behavioral Sciences at Stanford University, was a study collaborator who helped in developing the algorithm.

EEG Studies: Key Features

• Over 300 patients with depression were included in the study
• The patients were randomly assigned to the following two groups:
• Group 1: Patients received a class of antidepressant called SSRI (Selective Serotonin Reuptake Inhibitors)
• Group 2: Patients received a placebo (a substance having no therapeutic effect and used as a control)
• EEG was used to measure brain electrical activity before beginning treatment
• A machine-learning algorithm was developed to analyze the EEG data and make predictions
• AI technology predicted the following:
• Treatment Outcome: Identification of patients who would benefit from the medication over a span of 8 weeks
• Alternative Therapies: Suggest alternative therapies (psychotherapy or brain stimulation) if the patients were unlikely to benefit from the medication
• Three additional patient groups were used to validate the results

"This study takes previous research, showing that we can predict who benefits from an antidepressant, and actually brings it to the point of practical utility," says Etkin.

EMBARC Trial: Key Features

• The EMBARC Trial was a multicenter trial which was coordinated by Dr. Madhukar Trivedi
• The key features of the EMBARC Trial are as follows:
• The trial was designed to identify bio-signatures of depression
• The trial was conducted at four US sites over a period of 16 weeks
• The aim of the trial was to establish biology-based, objective strategies to treat depression
• Elucidate why 66 percent of patients don't respond to their first antidepressant
• Brain imaging by Magnetic Resonance Imaging (MRI), blood tests and DNA (deoxyribonucleic acid) tests were used to evaluate patients with major depressive disorder

With reference to the diagnostic tools, the research team indicated that EEG would be most preferable as it is comparatively inexpensive and equally or more effective that other investigative tools. However, they were of the opinion that blood tests and MRI may also be required in some patients if the depression manifested in a different way.

"There are many signatures of depression in the body," says Trivedi. "Having all these tests available will improve the chances of choosing the right treatment the first time."

Antidepressant Use: A Mounting Problem in USA

The use of antidepressants in the US has grown at an alarming rate over the last couple of decades. Based on data published by the National Health and Nutrition Examination Survey (NHANES), antidepressant use has increased by almost 65 percent - from 7.7 percent in 1999-2002 to 12.7 percent in 2011-2014.

Trivedi explains: "The expanded use of medications makes it more critical to further understand the underpinnings of depression and ensure patients are prescribed an effective therapy."

(https:www.nature.com/articles/s41587-019-0397-3)

Source: Medindia

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