Moment-to-Moment Brain Signal Variability Reliably Predicts Psychiatric Treatment Outcome
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Abstract
BACKGROUND: Biomarkers of psychiatric treatment response remain elusive. Functional magnetic resonance imaging (fMRI) has shown promise, but low reliability has limited the utility of typical fMRI measures (e.g., average brain signal) as harbingers of treatment success. Notably, although historically considered a source of noise, temporal brain signal variability continues to gain momentum as a sensitive and reliable indicator of individual differences in neural efficacy, yet has not been examined in relation to psychiatric treatment outcomes. METHODS: A total of 45 patients with social anxiety disorder were scanned twice (11 weeks apart) using simple task-based and resting-state fMRI to capture moment-to-moment neural variability. After fMRI test-retest, patients underwent a 9-week cognitive behavioral therapy. Multivariate modeling and reliability-based cross-validation were used to perform brain-based prediction of treatment outcomes. RESULTS: = 0.77), outperforming self-reports, resting-state neural variability, and standard mean-based measures of neural activity. Notably, task-based brain signal variability showed excellent test-retest reliability (intraclass correlation coefficient = 0.80), even with a task length less than 3 minutes long. CONCLUSIONS: Rather than a source of undesirable noise, moment-to-moment fMRI signal variability may instead serve as a highly reliable and efficient prognostic indicator of clinical outcome.
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Self-citation
- Authors
- Månsson, K. N. T., Waschke, L., Manzouri, A., Furmark, T., Fischer, H., & Garrett, D. D.
- Affiliations
- Karolinska Institutet (SE)
- Max Planck Institute for Human Development (DE)
- Stockholm University (SE)
- Uppsala University (SE)
- Corresponding author
- Månsson, Kristoffer N.T.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2022-04
- Volume
- 91
- Issue
- 7
- Pages
- 658-666
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W3205551466
- Cited by
- 49
- References
- 53
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 14 · 2023: 11 · 2022: 6
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Biological Psychiatry (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- MPG.PuRe (Max Planck Society) (submittedVersion, other-oa)
- Funders
- Deutsche Forschungsgemeinschaft
- Vetenskapsrådet (2016-02228, 2018-06729, 2018-)
- Umeå Universitet
- Max-Planck-Institut für Bildungsforschung
- Biodiversity Institute, University of Florida
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- treatment outcome prediction, social anxiety disorder, cognitive behavioral therapy, test-retest reliability, resting-state fMRI, task-based fMRI, prognostic factors
- MeSH terms
- Brain, Brain Mapping, Humans, Magnetic Resonance Imaging, Reproducibility of Results, Treatment Outcome
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