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Neuroimaging studies review suggests areas of agreement in psychiatric diagnoses

The JAMA Network Journals

A review of neuroimaging studies suggests there are areas of agreement across psychiatric diagnoses in terms of the integrity of the brain's anterior insula/dorsal anterior cingulate network, which may relate to executive function deficits seen across the various diagnoses, according to a study published online by JAMA Psychiatry.

Psychiatry has focused on establishing diagnostic categories based on clinical symptoms. There is a disconnection between current psychiatric disease classifications and rapidly emerging biological findings, which emphasizes the need to look for neurobiological characteristics shared across diagnoses, according to background information in the study.

Madeleine Goodkind, Ph.D., of the Veterans Affairs Palo Alto Healthcare System and the Sierra Pacific Mental Illness, Research, Education and Clinical Center, in Palo Alto, Calif., and coauthors reviewed medical literature of structural neuroimaging studies across multiple psychiatric diagnoses and three large data sets of healthy participants. The authors' final sample included 193 peer-reviewed articles, representing a total of 7,381 patients and 8,511 matched healthy control patients. The diagnostic groups included were schizophrenia, bipolar disorder, depression, addiction, obsessive-compulsive disorder and anxiety.

The authors found that brain gray matter loss converged across diagnoses in three regions: the dorsal anterior cingulate (dACC), right insula and left insula. In analyses of the three healthy participant data sets, the authors found the common gray matter loss regions were an interconnected network during tasks and at rest and that lower gray matter in this network was associated with poor executive functioning.

"These results do not imply that phenotypic differences between diagnoses are negligible. ... Nonetheless, the fact that common structural changes are seen despite potentially differing etiologies raises the possibility that some interventions that target the anterior insula and dACC may prove of broad use across psychopathology," the study concludes.

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JAMA Psychiatry. Published online February 4, 2015. doi:10.1001/jamapsychiatry.2014.2206. Available pre-embargo to the media at http://media.jamanetwork.com.

Authors made funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

To contact corresponding author Amit Etkin, M.D., Ph.D., call Bruce Goldman at 650-725-2106 or email goldmanb@stanford.edu.

To place an electronic embedded link to this study in your story Links will be live at the embargo time: http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2014.2206

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