Treatment response biomarkers in anxiety disorders: From neuroimaging to neuronally-derived extracellular vesicles and beyond
Open accessAbstract
Multiple and diverse psychotherapeutic or psychopharmacologic treatments effectively reduce symptoms for many patients with anxiety disorders, but the trajectory and magnitude of response vary considerably. This heterogeneity of treatment response has invigorated the search for biomarkers of treatment response in anxiety disorders, across the lifespan. In this review, we summarize evidence for biomarkers of treatment response in children, adolescents and adults with generalized, separation and social anxiety disorders as well as panic disorder. We then discuss the relationship between these biomarkers of treatment response and the pathophysiology of anxiety disorders. Finally, we provide context for treatment response biomarkers of the future, including neuronally-derived extracellular vesicles in anxiety disorders and discuss challenges that must be overcome prior to the debut of treatment response biomarkers in the clinic. A number of promising treatment response biomarkers have been identified, although there is an urgent need to replicate findings and to identify which biomarkers might guide clinicians in selecting from available treatments rather than just simply identifying patients who may be less likely to respond to a given intervention.
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No biomarker of anxiety and related disorders has to date proven sufficiently sensitive and specific for widespread adoption in clinical practice.
“Despite the extent and rigor of research on the neurobiology of anxiety and related disorders, no biomarker of these conditions has to date proven sufficiently sensitive and specific for widespread adoption in clinical practice 11,12 .”
From The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management (2021) · cites this paper as [12]
The Introduction (page not provided) describes anxiety treatment as trial-and-error and says reliable treatment-response biomarkers are still being sought. The Discussion (page not provided) says combining biomarkers could improve sensitivity and specificity. These passages support the lack of established clinical treatment-response biomarkers, but do not establish the claim for every biomarker of anxiety and related disorders. (LLM, conf=0.82)
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References 129 · Cited by 30
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- Authors
- Strawn, J. R., & Levine, A.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- New York State Psychiatric Institute (US)
- Corresponding author
- Strawn, Jeffrey R.
- Levine, Amir
- Venue
- Biomarkers in Neuropsychiatry
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 3
- Pages
- 100024
- ISSN
- 2666-1446 (ISSN-L)
- PMC
- PMC7508464
- OpenAlex
- W3042888962
- Cited by
- 30
- References
- 129
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 6 · 2022: 6 · 2021: 2 · 2020: 1
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Biomarkers in Neuropsychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Development (R01HD098757)
- Yung Family Foundation
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- anxiety disorders, treatment response biomarkers, generalized anxiety disorder, separation anxiety disorder, social anxiety disorder, panic disorder, neuroimaging, extracellular vesicles, treatment response heterogeneity, children and adolescents, treatment selection
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