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Neuroimaging for precision medicine in psychiatry

Neuropsychopharmacology (2024)Cite this article

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Abstract

Although the lifetime burden due to mental disorders is increasing, we lack tools for more precise diagnosing and treating prevalent and disabling disorders such as major depressive disorder. We lack strategies for selecting among available treatments or expediting access to new treatment options. This critical review concentrates on functional neuroimaging as a modality of measurement for precision psychiatry, focusing on major depressive and anxiety disorders. We begin by outlining evidence for the use of functional neuroimaging to stratify the heterogeneity of these disorders, based on underlying circuit dysfunction. We then review the current landscape of how functional neuroimaging-derived circuit predictors can predict treatment outcomes and clinical trajectories in depression and anxiety. Future directions for advancing clinically appliable neuroimaging measures are considered. We conclude by considering the opportunities and challenges of translating neuroimaging measures into practice. As an illustration, we highlight one approach for quantifying brain circuit function at an individual level, which could serve as a model for clinical translation.

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Fig. 1: A conceptual overview of precision psychiatry informed by functional neuroimaging.
Fig. 2: An illustration of the analogy between precision medicine in cardiology and precision medicine in psychiatry.
Fig. 3: Availability of magnetic resonance imaging scanners.

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Funding

This work was supported by the National Institutes of Health [grant numbers R01MH101496 (LMW; NCT02220309), U01MH109985 (LMW)] and R61/R33 MH132072-01 (SWG).

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  1. These authors contributed equally: Leanne M. Williams, Susan Whitfield Gabrieli.

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA

    Leanne M. Williams

  2. Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA

    Leanne M. Williams

  3. Department of Psychology, Northeastern University, 805 Columbus Ave, Boston, MA, 02120, USA

    Susan Whitfield Gabrieli

  4. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

    Susan Whitfield Gabrieli

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LMW contributed to the conceptualization of the review and to the writing and editing. SWG contributed to the conceptualization of the review and to the writing and editing.

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LMW declares US Pants. App. 10/034,645 and 15/820,338: Systems and methods for detecting complex networks in MRI image data. SWG has nothing to declare.

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Williams, L.M., Whitfield Gabrieli, S. Neuroimaging for precision medicine in psychiatry. Neuropsychopharmacol. (2024). https://doi.org/10.1038/s41386-024-01917-z

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