Functional Magnetic Resonance Imaging (fMRI)

fMRI may reveal depression ‘subtypes’ and treatments that could work.

About Functional Magnetic Resonance Imaging (fMRI)

  • Measuring Brain Activity: Functional magnetic resonance imaging (fMRI) is a technique that reveals brain activity by measuring blood oxygen levels.
  • Non invasive: It is a noninvasive technique to observe the brain’s activity.
  • Distinction from Traditional MRI: Unlike traditional MRI, which focuses on brain structure, fMRI captures brain activity during specific functions or tasks. 
  • Creating a Functional Map: It essentially creates a functional map of brain activity, allowing researchers and physicians to better understand, diagnose, monitor, and treat various conditions.

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Understanding Brain Activity in Mental Illness

  • Electrical Activity in the Brain: The brain, like the heart, exhibits electrical activity, which can be captured and analysed using functional magnetic resonance imaging (fMRI) to observe changes over time.
  • Abnormal Brain Circuit Activation: In individuals with mental illness, brain circuits connecting different regions may not activate properly. 
    • This can result in abnormal intensity of electrical activity in certain brain areas compared to healthy individuals.
  • Identification of Brain Activity Patterns: People exhibit unique brain activity patterns, both normal and abnormal. 
    • When similar patterns are observed among individuals with a specific mental illness, these are classified as subtypes.
  • Theory-Driven Approach to Subtyping: While many studies have identified subtypes of depression based on brain activity, the new study utilised a “theory-driven” approach to develop subtypes that are clinically relevant and potentially useful for targeted treatments.

Breakthrough Study in Depression Subtypes

  • Identification of Depression Subtypes: Recent research has categorised depression into six distinct subtypes based on faulty brain patterns observed in fMRI scans.
  • Brain Biomarkers and Precision Psychiatry: The study aims to apply principles similar to cardiology, using brain activity data to refine psychiatric treatment, akin to how electrocardiograms evaluate heart conditions.
  • Treatment Predictions: The research found that three of the six subtypes responded positively to specific antidepressants and therapies. 
    • Example: A subtype with hyperactive cognitive circuits showed better response to venlafaxine XR. However, treatment options for three subtypes remained unclear. Further research is needed to understand these subtypes and their treatment needs.

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Depressive Disorder (Depression)

  • Definition and Symptoms: Depressive disorder (depression) is a prevalent mental health condition characterised by a persistently depressed mood or loss of interest in activities over extended periods.
  • Difference from Normal Mood Changes: Depression differs from typical mood fluctuations and everyday feelings; it profoundly impacts various aspects of life.
  • Risk Factors: Depression results from a complex interaction of social, psychological, and biological factors.
    • Anyone can develop depression, but individuals with a history of abuse, severe losses, or stressful experiences are at higher risk.
  • WHO’s Response: WHO’s Mental health action plan 2013–2030 highlights the steps required to provide appropriate interventions for people with mental disorders including depression. 
  • World Mental Health Day is observed on 10th October every year, with the overall objective of raising awareness of mental health issues around the world.
  • The Mental Health Atlas was launched by WHO in 2017 and is released triennially.
  • Suicide prevention is a global priority and included in the Sustainable Development Goals (SDG’s).

 

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