Title: Brain circuit response to pharmacological and psychological treatments for depression and anxiety across British and Chinese cohorts
Funder: The Academy of Medical Sciences

Abstract: Very little is known about the impact of treatments for depression and anxiety on brain circuit function. One theory, inspired by animal models and proposed by the UK host is that pharmacological and psychological treatments ‘tune-down’ circuits which amplify salient information and drive the prominent and debilitating symptom of negative cognitive bias. However, this theory has yet to be tested. Dr. Hongru Zhu and his Chinese colleagues have already collected multilevel biological data of Chinese subjects with mood and anxiety disorders (N=278) (and healthy controls N=182), including functional MRI, structural MRI, cognitive tasks and psychological assessment. Among these patients, 82 have been assessed before and after 8 weeks of pharmacological or psychological treatment. Dr Robinson has an ongoing project which has already collected the same type of data from over 100 participants (of which N=25 are patients with mood and anxiety disorders) before and after psychological treatment. Thus, in this project, Dr. Zhu and Dr. Robinson aim to 1) conduct neuroimaging data analysis on Chinese sample using advanced computational technologies, 2) conduct an out-of-sample trans-cultural validation analysis for measures already in place across the two datasets, and then 3) align the study protocols across countries for data collection going forward so we can compare neural substrates of treatment outcomes. Specifically, we predict 1) elevated prefrontal-amgydala positive coupling in patient vs controls (and as a function of continuous symptom measures) at baseline; 2) normalization of this pattern following both types of treatment; and 3) that these baseline and treatment effects will be trans-culturally consistent across both countries. Further exploratory analyses will examine any unforeseen trans-cultural differences as well potential differences between psychological and pharmacological interventions. Overall this work will enable us to better understand the neurobiological impact of treatments for mood and anxiety disorders as well as uniquely replicating analyses across two distinct cultures to ensure greater generalisability of results. Ultimately this work may lead to better targeting of treatments to responders for these costly and debilitating disorders.

Lay abstract: Anxiety and depression are debilitating psychiatric disorders which lead to negative mood states, but also a host of changes to how we think and process information. These changes are also associated with changes in brain function. Patients often receive either medication or psychotherapy, but different individuals may be more likely to get better using one or the other. However, for each patient, we cannot predict who will respond to which treatment in advance. Recent work from animal models suggests that brain circuitry measured by brain scanning might predict response to treatment. Therefore, understanding brain responses to treatment may eventually enable us to target treatments to those who will respond. A particularly unique aspect of this project is that we have independently collected uniquely similar data from psychiatric patients in both the UK and China so we can confirm our findings across two distinct cultural environments (which is usually overlooked as global research is heavily Western-centric). We will first look at how brain responses differ across healthy individuals and those with mood and anxiety disorders. We will then look at how these change following medication or psychological therapy. We can look at this in both cultural environments separately. Ultimately this will help pave the way to targeting treatments to the right patients, and hence improve quality of life for patients across the UK and China.

Research activity codes: 5.1 PHARMACEUTICALS;5.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH;NEUROLOGICAL