There are 6 types of depression that can be identified using brain scans

Treating depression has always taken a “one-size-fits-all” approach, but that could be about to change as new research has discovered six types of depression that can be identified using brain scans. The different types, or “biotypes,” respond better to some treatments than others and could help us provide better and faster care to people living with depression.

The study examined functional MRI scans (fMRI) of 801 participants who had previously been diagnosed with anxiety or depression. They examined their brain activity at rest and during a series of tests of cognitive and emotional functions, paying particular attention to which brain regions were active and looking for connections between them. Using machine learning, they were able to group the analysis results based on similarities and identify six distinct patterns of brain activity.

The team then randomly assigned one of three common antidepressants or behavioral talk therapy to 250 of the participants and assessed their response to the treatment. It revealed trends in different subtypes of depression, called biotypes, and the most effective treatment approach.

The goal of our work is to figure out how to get it right the first time.

Dr Leanne Williams

For example, Venlafaxine, sometimes known as Effexor, has been shown to be the most effective drug for a biotype characterized by hyperactivity in certain regions of the brain. Another biotype characterized by high levels of activity in three brain regions associated with problem solving and depression was found to respond best to behavioral talk therapy.

“To our knowledge, this is the first time that we have managed to demonstrate that depression can be explained by different disturbances in brain function,” said Dr. Leanne Williams, lead author of the study, in a statement. “Essentially, this is a demonstration of a personalized medicine approach to mental health based on objective measures of brain function.”

Williams, inaugural Vincent VC Woo Professor of Psychiatry and Behavioral Sciences, is professor of psychiatry and behavioral sciences and director of the Center for Precision Mental Health and Wellness at Stanford Medicine. She lost her partner to depression in 2015 and focused her work on pioneering the field of precision psychiatry, centered on individualizing diagnosis and using a personal approach to tailor treatment.

About a third of people with depression have treatment-resistant depression, meaning that despite several rounds of medication and talk therapy, their symptoms do not improve. It is hoped that by taking a more precise and personalized approach to depression management, doctors can better help patients fully return their symptoms to healthy levels.

“The goal of our job is to figure out how to get it right the first time,” Williams said. “It’s very frustrating to be in the depression field and not have a better alternative to this one-size-fits-all approach.”

The study is published in the journal Nature Medicine.