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Comment & Response
February 2014

Certainly Not the First Neuroimaging Treatment Selection Biomarker

Author Affiliations
  • 1The Synaptic Space, Centennial, Colorado
  • 2University of British Columbia, Vancouver, British Columbia, Canada
JAMA Psychiatry. 2014;71(2):210-211. doi:10.1001/jamapsychiatry.2013.3303

To the Editor We were rather surprised that McGrath and colleagues1 claim to have discovered the first biomarker in psychiatry, but perhaps not nearly as surprised as Brockmann et al, Saxena et al, and Cho et al, to name just a few who have published evidence of neuroimaging biomarkers previously. In their article, McGrath et al state in the Abstract and at the end of the article: “…this study would provide the first objective marker [italics added] to guide initial treatment selection for major depression…”1(p827) This simply is not true. For example, Brockmann and colleagues2 have already shown that regional cerebral blood flow in the prefrontal cortex as measured using single-photon emission computed tomography objectively predicts the response of patients with major depressive disorder to citalopram. As a second example, Saxena and colleagues3 reported the [18F]-fluorodeoxyglucose–positron emission tomography neuroimaging markers to differentiate medication-responsive from nonresponsive patients with obsessive-compulsive disorder. As a third example, Cho and colleagues4 reported a single-photon emission computed tomography biomarker for stimulant-responsive attention-deficit/hyperactivity disorder, which has been replicated clinically and in several independent studies. Despite claims by the principal author Helen S. Mayberg, MD, in the interview on the JAMA Psychiatry website and in numerous press releases, this is not the first neuroimaging biomarker.

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