Topline
Researchers are challenging the notion that depression has one underlying brain signature, with a new review finding that anhedonia, rumination, insomnia and suicidal behavior map to different brain circuits, a discovery that could lead to more symptom-specific treatments.
PRODUCTION – 18 February 2023, Hamburg: A man is sitting at the window with his head in his hands. Photo: Jonas Walzberg/dpa (Photo by Jonas Walzberg/picture alliance via Getty Images)
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Key Facts
A systematic review published in Translational Psychiatry is pushing back against the concept that depression is a single condition, finding that anhedonia, rumination, insomnia and suicidal behavior are each associated with different brain connectivity patterns.
Consummatory anhedonia and anticipatory anhedonia likely rely on partially different circuits, and suicidal ideation and suicide attempts show different connectivity profiles, the review identified.
The review looked at resting-state functional magnetic resonance imaging studies, which map the brain’s intrinsic functional connectivity when a person is resting, to identify connectivity signatures that are tied to specific symptoms as opposed to a broad diagnosis.
The paper says the standard guide used to diagnose depression allows so many symptom combinations to be grouped under a single label that patients who have the same formal diagnosis can have very different clinical profiles.
Having a dimensional approach could help researchers develop treatments that target specific symptoms or neural circuits, the review argues.
Using a single diagnostic category for people that present with different symptoms makes it hard to determine which treatment is likely to work best for the patient, the paper argues, and the authors hope that after more research is conducted these findings could be used to guide more targeted patient care.
KEY BACKGROUND
The traditional diagnosis for major depressive disorder groups patients together based on clusters of symptoms as opposed to demonstrated biological cause, which can result in two people receiving the same diagnosis despite experiencing different problems. This new paper looks at what happens if researchers focus on the specific neural circuits for individual symptoms, which could open up the possibility for more targeted treatments, though more testing is needed before this could be implemented into routine clinical practice.
BIG NUMBER
Up to 227. This is the number of theoretically different symptom combinations that have traditionally been able to meet the diagnostic criteria for major depressive disorder.
CRUCIAL QUOTE
“It allows us to begin considering interventions that are better tailored to each patient’s clinical and neurobiological profile,” said Dr. Narcís Cardoner, one of the article’s authors, of the findings.
FURTHER READING
A 10-Year Study Showed That This One Habit Cuts Depression Odds By 48% (Forbes)
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