Six different “subtypes” have been identified using functional MRI

A Stanford team has just published a study in “Nature” that identified six “profiles” of depression by performing functional MRI scans on 801 patients who had received this diagnosis. These six subtypes were able to be associated with more effective therapeutic options.

Depression does not necessarily pin its victims to their bed or on their sofa. It can take on many other faces. At least six, according to an American study which “saw” them in the brains of patients using MRI scans. Details from Géraldine Zamansky, journalist at the Health Magazine on France 5.

franceinfo: The challenge is above all to be able to better adapt treatments?

Geraldine Zamansky : Exactly, that’s the whole point of this research. Not only does it very precisely identify six subtypes of depression, but it also manages to associate them with more effective solutions. This or that medication or, on the contrary, psychotherapy.

The challenge is to reduce the all too frequent failures of first prescriptions, as Dr Leonardo Tozzi, one of the medical researchers at the heart of this study at Stanford University in California, explained to me.

His team therefore succeeded in mobilizing 801 affected patients at the start of their care journey. It was first of all their brains which were examined using so-called functional MRIs, capable, in very simplified terms, of visualizing the level of activity of neurons.

And this examination therefore showed different disorders in the activity of the brain?

That’s it. And usually, in this type of research, the volunteers’ sole mission is to “think of nothing”. This time, Dr. Tozzi told me that their brains were even deciphered in full action, with tests of attention and reaction to emotions. The whole thing made it possible to distinguish several “profiles” of disturbances. With hyperactivity or slowdowns…

It is impossible to detail the rather complex characteristics of the six subtypes discovered. But their relevance has been confirmed by tests, this time carried out outside of the MRI. With, for example, a group very reduced in its capacity for concentration, which reacts very well to a certain family of antidepressants.

Could these become routine diagnostic tools?

So unfortunately, as Professor Antoine Pelissolo, head of the psychiatry department at the Henri Mondor Hospital in the Paris region, confirmed to me, there are not enough functional MRIs in France today. Identifying profiles and especially good treatments will perhaps be easier thanks to tests carried out outside the machine.

But Professor Pelissolo appreciates this advance in the exploration of disrupted processes, with the hope of more personalized, and therefore more effective, prescriptions. And he is not surprised by the good results of behavioral and cognitive therapies for several groups.

These very “practical” strategies can, for example, act on the management of emotions and, on their own, resolve certain depressions. These are courses that are starting to be offered more often, including online.

The study