Depression is stubbornly hard to treat, and at the moment, there’s little to guide a doctor’s treatment recommendation beyond a patient’s own preferences. But new research published online in the American Journal of Psychiatry suggests an improvement that’s both simple and radically advanced: recommending medication or therapy based on a patient’s brain scans.

Researchers led by Helen Mayberg, MD, a professor of psychiatry, neurology and radiology at Emory University School of Medicine, found that connectivity between specific brain regions predicted how well (or not) depression patients would respond to either antidepressants or cognitive behavioral therapy, or CBT — the two leading methods to treat depression today. Patients with high connectivity between a region of the brain that processes emotions and three other areas fared better with CBT while patients with low connectivity in the same areas were more likely to improve on medication.

Interestingly, there was only a small association between the treatments patients said they’d prefer and the treatment that, according to the findings, would benefit them most.

The findings (published in two parts online) echo a larger trend towards personalized and precision treatments in the medical world. “All depressions are not equal and like different types of cancer, different types of depression will require specific treatments,” Mayberg said in a press release about the findings. “Using these scans, we may be able to match a patient to the treatment that is most likely to help them, while avoiding treatments unlikely to provide benefit.”

Another high point of this study? The subjects were unusually diverse for depression research, with roughly half of the 344 people studied identifying as Hispanic or African-American. That suggests the findings would apply to people outside the predominantly white subjects you usually see in depression research.

The potential implications are huge. According to the National Institutes of Mental Health, roughly 16.1 million Americans 18 years and older had at least one episode of major depression in 2015. Research-backed ways to figure out who should get what treatment could go a long way towards making depression feel less like an unfixable problem and more like a problem to be solved.

Read more about the findings in two parts, here and here.

Originally published at