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Using PET to scan for depression

Watching TV for a few hours may convince you of two things. First, that Americans are suffering from numerous diseases, and second, that a pill could cure those diseases. Do you have restless leg syndrome? Perhaps you have to visit the bathroom too many times a day? Or maybe you are feeling depressed. There seems to be a medical answer for all of these ailments.

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Of course, certain diseases may best be controlled or eliminated by medication. Where would Magic Johnson, or many residents of the African continent, be without their HIV medication? There is concern, however, about the proliferation of pharmaceutical answers to many ailments -- especially when we hear the side effects of some of these pills.

What did our ancestors do before all of these wonder drugs appeared? How did they combat restless leg syndrome? What would happen if they had a problem becoming aroused? And how did any of them ever find a way to combat depression without taking a pill? Is there a way that some of us can wean ourselves from a dependence on so much medication?

For people who suffer from debilitating depression, the answer might be yes. Researchers may have found a way to figure out whether talk therapy or antidepressants could be most effective for certain individuals.

An alternative to antidepressants?

Individuals with depression are often put on medication, but only 40 percent see their symptoms go away, according a study out of Emory University published in JAMA Psychiatry. A Forbes article notes that depressed individuals who do not experience relief may be taken off of one medication and placed on another, which might help, or might lead to a trial and error period where the depression continues without remission.

Looking for another way to tackle depression, researchers from Emory University conducted a study using positron emission tomography (PET) scans. With PET scans, nuclear medicine technologists can provide information such as three-dimensional images of body parts such as the brain. Since PET scanning allows doctors to measure the amount of glucose used by the brain, it can show different levels of activity in certain areas.

Helen Mayberg, professor of psychiatry, neurology and radiology at Emory University School of Medicine, was the principal investigator for the study. Mayberg notes: "To be ill with depression any longer than necessary can be perilous. This is a serious illness and the prolonged suffering resulting from an ineffective treatment can have serious medical, personal and social consequences."

PET scans for brain imaging

The researchers gathered 63 test subjects diagnosed with depression. The subjects varied in age, from 18 up to 60 years old. PET scans were taken, and then the subjects were split up into two different groups to receive treatment. The first group was given a drug called escitalopram oxalate, and the second received cognitive behavior therapy or CBT. (CBT is a form of psychotherapy that explores the links between thoughts, feelings and behaviors, according to the National Alliance on Mental Health.)

The participants had measurable activity in areas of the brain already associated with depression, but the most interesting results were in the right anterior insula. Alice G. Walton explains in Forbes that the insula shapes our visceral responses so that they become subjective perceptions. During the study this part of the brain was found to respond to different types of treatment, depending on the amount of activity it displayed. If the anterior insula showed little activity, then remission from symptoms was experienced with CBT rather than medication. Participants who showed higher activity in the insula experienced remission with the use of medication but had little response to CBT.

To be fair, this study took place over the course of 12 weeks, and the results are from 38 participants. The other 25 members of the study didn't show distinctive enough results to provide conclusive findings. The researchers acknowledge the small sample size of their study, but, according to Wired magazine, they suggest that if the results are verified with prospective testing, this method may help "guide initial treatment selection for depression." New testing is already underway, as the Emory researchers are re-examining the subjects who didn't display a significant response to either treatment.

How can a PET scan help?

As seen above, many patients with depression do not find relief with the initial treatment prescribed -- individuals who do not respond to antidepressants may be given different medications, which also may not alleviate their symptoms. With this brain imaging procedure, physicians could gain more information on which to base their choice of treatment. Healthcare providers could prescribe medication if drugs would likely be more effective than psychotherapy such as CBT. And patients could be referred to mental health professionals such as psychologists if that appeared to be the correct treatment.

Further testing is needed, but the Emory University study could perhaps lead to more success treating people with symptoms of depression. There is nothing wrong with taking a pill if it is necessary. There is something wrong with not being able to effectively treat patients. Thanks to clinical researchers and health educators thinking outside the box, innovative approaches like this could potentially offer some relief soon.

About the Author:

Jamar Ramos has been writing poetry and fiction for many years, and earned his bachelor’s degree in Creative Writing from San Francisco State University. For the last three years, Mr. Ramos switched to producing blog posts for CBSSports.com and writing professionally as an independent contributor for a number of Internet sites. His creative works have been featured in The Bohemian and The San Matean. He now contributes articles for OnlineDegrees.com, OnlineColleges.com, and AlliedHealthWorld.com.