Rostral Anterior Cingulate Cortex Morphology Predicts Treatment Response to Internet-Based Cognitive Behavioral Therapy for Depression
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Background Rostral and subgenual anterior cingulate cortex (rACC and sgACC) activity and, to a lesser extent, volume have been shown to predict depressive symptom improvement across different antidepressant treatments. This study extends prior work by examining whether rACC and/or sgACC morphology predicts treatment response to internet-based cognitive behavioral therapy (iCBT) for major depressive disorder (MDD). This is the first study to examine neural predictors of response to iCBT. Methods Hierarchical linear modeling tested whether pre-treatment rACC and sgACC volumes predicted depressive symptom improvement during a 6-session (10-week) randomized clinical trial of iCBT (n = 35) vs. a monitored attention control (MAC; n = 38). Analyses also tested whether pre-treatment rACC and sgACC volumes differed between patients who achieved depression remission versus those who did not remit. Results Larger pre-treatment right rACC volume was a significant predictor of greater depressive symptom improvement in iCBT, even when controlling for demographic (age, gender, race) and clinical (baseline depression, anhedonia and anxiety) variables previously linked to treatment response. In addition, pre-treatment right rACC volume was larger among iCBT patients whose depression eventually remitted relative to those who did not remit. Corresponding analyses in the MAC group and for the sgACC were not significant. Conclusions rACC volume prior to iCBT demonstrated incremental predictive validity beyond clinical and demographic variables previously found to predict symptom improvement. Such findings may help inform our understanding of the mediating anatomy of iCBT and, if replicated, may suggest neural targets to augment treatment response (e.g., via modulation of rACC function). ClinicalTrials.gov Identifier NCT01598922
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Larger pretreatment right rostral anterior cingulate cortex volume was a significant predictor of greater depressive symptom improvement on ICBT, even after controlling for demographic and clinical variables.
“Another study 87 found that larger pretreatment right rostral anterior cingulate cortex volume was a significant predictor of greater depressive symptom improvement on ICBT, even after control ling for demographic and clinical variables previously linked to treatment response.”
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- Authors
- Webb, C. A., Olson, E. A., Killgore, W. D. S., Pizzagalli, D. A., Rauch, S. L., & Rosso, I. M.
- Affiliations
- Harvard University (US)
- University of Arizona (US)
- Corresponding author
- Rosso, Isabelle M.
- ORCID
- Venue
- Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 3
- Issue
- 3
- Pages
- 255-262
- ISSN
- 2451-9022 (ISSN-L)
- PMC
- PMC6005352
- OpenAlex
- W2770975402
- Semantic Scholar
- 4498090e31cb9dce07187da0606b978a07e06ca1
- Cited by
- 34
- References
- 69
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 4 · 2018: 4
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Biological Psychiatry Cognitive Neuroscience and Neuroimaging (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23 MH108752, R01 MH096987)
- U.S. Army (W81XWH-12-1-0109)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- rostral anterior cingulate cortex, subgenual anterior cingulate cortex, brain structure, treatment response prediction, internet-based cognitive behavioral therapy, major depressive disorder, depression remission, antidepressant response
- MeSH terms
- Adolescent, Adult, Depressive Disorder, Female, Gyrus Cinguli, Humans, Male, Middle Aged, Organ Size, Predictive Value of Tests, Cognitive Behavioral Therapy, Treatment Outcome, Remote Consultation, Internet, Young Adult
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