Table 1.
Summary of Neuroimaging studies predicting treatment response in anxiety disorders
| Article | Disorder | Imaging | Treatment type | Sample sizes | Outcome measure | Findings |
|---|---|---|---|---|---|---|
| Swedo et al. [32] |
OCD |
PET-FDG: resting state |
Clomipramine (dose and duration not specified) |
OCD: 18 Healthy: 18 |
OCR Responders: ≥ 40% reduction in OCR (11 R, 6 NR) |
Pre-treatment rCMRglu in the right ACC and right OFC was lower in clomipramine R vs. NR. |
| Saxena et al. [33] |
OCD |
PET-FDG: resting state |
Paroxetine (8-12 weeks; 40 mg/d max) |
OCD: 20 |
YBOCS and CGI Responders: ≥ 25% reduction in YBOCS and CGI of much improved or very much improved (11 R, 9 NR) |
Lower pre-treatment rCMRglu in bilateral OFC predicted better response to paroxetine. |
| Saxena et al. [34] |
OCD, MDD, OCD + MDD |
PET-FDG: resting state |
Paroxetine (8-12 weeks; 30-60 mg/d) |
OCD: 27 MDD: 27 OCD + MDD: 17 |
YBOCS, HAM-D |
Greater pre-treatment rCMRglu in the caudate predicted greater improvement in OCD symptoms in the OCD groups. Lower rCMRglu in the amygdala predicted more improvement in MDD symptoms in MDD group and in all Ss combined. Greater pre-treatment rCMRglu in the medial frontal gyrus predicted improvement in MDD symptoms in all Ss. |
| Hendler et al. [35] |
OCD |
SPECT: symptom provocation vs. relax |
Sertraline (6 months; 200 mg/d max) |
OCD: 26 |
YBOCS Responders: ≥ 30% reduction in YBOCS (13 R, 13 NR) |
R had lower pre-treatment perfusion during symptom provocation in dorsal/caudal ACC and higher perfusion in right caudate vs. NR. |
| Rauch et al. [36] |
OCD |
PET-015: symptom provocation vs. neutral |
Fluvoxamine (12 weeks; 300 mg/d max) |
OCD: 9 |
YBOCS |
Lower rCBF in OFC and higher rCBF in PCC predicted better response. |
| Sanematsu et al. [37] |
OCD |
fMRI: symptom provocation vs. neutral |
Fluvoxamine (12 weeks; 200 mg/d max) |
OCD: 17 |
YBOCS |
Pretreatment activation of right cerebellum and left superior temporal gyrus was positively correlated with YBOCS improvement. |
| Ho Pian et al. [38] |
OCD |
SPECT: resting state |
Fluvoxamine (12 weeks; 300 mg/d max) |
OCD: 15 |
YBOCS Responders: ≥25% reduction in YBOCS (7 R, 8 NR) |
Pre-treatment cerebellar and whole brain rCBF was significantly higher in R vs. NR. |
| Buchsbaum et al. [39] |
OCD |
PET-FDG: resting state |
Risperidone or placebo augmentation (8 weeks; 3 mg/d max) |
OCD: 15 Risperidone: 9 Placebo: 6 |
YBOCS Responders: ≥ 25% reduction in YBOCS and/or CGI Improvement rating of very much improved or much improved (4 R, 5 NR) |
Pre-treatment rCMRglu was lower in the striatum and higher in the ventral ACC in R vs. NR. |
| Brody et al. [40] |
OCD |
PET-FDG: resting state |
Fluoxetine (10 weeks; 60 mg/d) or group BT (10 weeks) |
OCD: 27 Fluoxetine: 9 CBT: 18 |
YBOCS |
Greater pre-treatment rCMRglu in the left OFC was associated with a better response to BT. In this same region, lower rCMRglu was associated with better response to fluoxetine. |
| Hoexter et al. [41] |
OCD |
mMRI |
Fluoxetine (12 weeks; 80 mg/d max) or group CBT (12 weekly sessions) |
OCD: 29 Fluoxetine: 14 CBT: 15 |
YBOCS |
Lower pre-treatment gray matter density in ventrolateral prefrontal cortex predicted better response to fluoxetine. Greater gray matter density in subgenual ACC predicted better response to CBT. |
| Rauch et al. [44] |
OCD |
PET-FDG: resting state |
Anterior cingulotomy |
OCD: 11 |
YBOCS |
Greater pre-operative rCMRglu in posterior cingulate predicted greater improvement. |
| Van Laere et al. [45] |
OCD |
PET-FDG: resting state |
Stimulation of anterior capsule |
OCD: 6 Controls: 20 |
YBOCS |
Greater pre-operative rCMRglu in the subgenual ACC predicted greater improvement. |
| Bryant et al. [68] |
PTSD |
mMRI |
CBT (8 weekly sessions) |
PTSD: 13 TENP: 13 Healthy: 13 |
CAPS Responders: no longer met diagnostic criteria (7 R, 6 NR) |
Greater pre-treatment gray matter density in the rACC predicted greater improvement. |
| Bryant et al. [19] |
PTSD |
fMRI: masked fearful vs. neutral faces |
CBT (8 weekly sessions) |
PTSD: 14 Healthy: 14 |
CAPS Responders: ≥ 50% reduction in CAPS (7 R, 7 NR) |
Lower pre-treatment amygdala and rACC activation predicted greater improvement. |
| Nardo et al. [69] |
PTSD |
mMRI |
EMDR (5 sessions) |
PTSD: 21 TENP: 22 |
Responders: no longer met diagnostic criteria (10 R, 5 NR) |
R had greater gray matter density in the insula, amygdala/parahippocampal gyrus, posterior cingulate, and middle, precentral, and dorsal medial frontal gyri. |
| Whalen et al. [75] |
GAD |
fMRI: fearful vs. neutral/happy faces |
Venlafaxine (8 weeks; 225 mg/d max) |
GAD: 15 Healthy: 15 |
HAM-A |
Lower pre-treatment amygdala activation and greater rACC activation predicted greater improvement in anxiety. |
| Nitschke et al. [73] |
GAD |
fMRI: anticipation of aversive vs. neutral images |
Venlafaxine (8 weeks; 225 mg/d max) |
GAD: 14 Healthy: 12 |
HAM-A and Penn State Worry Questionnaire |
Greater pre-treatment rACC activation predicted greater improvement in anxiety. |
| McClure et al. [76] |
GAD |
fMRI: fearful vs. happy faces |
Fluoxetine (8 weeks; 40 mg/d max) or CBT (8 weekly sessions) |
GAD: 12 Fluoxetine: 5 CBT: 7 |
CGI |
Greater pre-treatment amygdala activation predicted greater improvement. |
| Evans et al. [87] |
SAD |
PET-FDG: resting state |
Tiagabine (6 weeks; 16 mg/d max) |
SAD: 12 Healthy: 10 |
LSAS Responders: ≥ 50% reduction in LSAS scores (7 R, 5 NR) |
Voxelwise correlations were not significant. Pre-treatment rCMRglu was lower in subcallosal ACC in R compared to healthy controls. |
| Doehrmann et al. [13] | SAD | fMRI: 1-back task, angry vs. neutral faces | CBT (12 weekly sessions) | SAD: 39 | LSAS | Greater pre-treatment activation in dorsal and ventral occipitotemporal cortex predicted greater improvement. |
ACC anterior cingulate cortex, BT behavioral therapy, CAPS Clinician Administered PTSD Scale, CBT cognitive-behavioral therapy, CGI Clinical Global Impression scale, EMDR eye movement desensitization and reprocessing, fMRI functional magnetic resonance imaging, GAD generalized anxiety disorder, HAM-A Hamilton Rating Scale for Anxiety, HAM-D Hamilton Rating Scale for Depression, LSAS Liebowitz Social Anxiety Scale, MDD major depressive disorder, mg/d milligrams per day, mMRI morphometric magnetic resonance imaging, NR non-responders, OCD obsessive-compulsive disorder, OCR Obsessive Compulsive Rating scale, OFC orbitofrontal cortex, PET-FDG positron emission tomography with fluorodeoxyglucose, PET-015 positron emission tomography with oxygen-15, PTSD posttraumatic stress disorder, R responders, rACC rostral anterior cingulate cortex, rCBF regional cerebral blood flow, rCMRglu regional cerebral metabolic rate for glucose, SAD social anxiety disorder, SPECT single photon emission computed tomography, Ss subjects, TENP trauma-exposed non-PTSD, YBOCS Yale-Brown Obsessive-Compulsive Scale.