Pretreatment brain magnetic resonance imaging outperforms clinical ratings in predicting major depressive disorder treatment outcomes

Motivation: It is clinically needed to explore predictive potential of pretreatment features in major depressive disorder (MDD) treatment outcomes to guide personalized medicine approaches. Goal(s): To evaluate and compare overall predictive performance of clinical and brain magnetic resonance imaging (MRI) features for treatment outcomes and assess performance of distinct modalities and interventions in MRI studies. Approach: We conducted separate meta-analyses on clinical and MRI studies followed with subgroup meta-analyses and meta-regression. Results: MRI studies outperformed clinical studies in sensitivity. Within MRI group, resting-state functional MRI exhibited higher specificity than task-based functional MRI . No significant differences were found among remaining modality and intervention subgroups. Impact: Our findings highlight the potential of utilizing pretreatment brain MRI data to predict treatment outcomes for MDD. This is valuable for using MRI features to early identify patients' treatment outcomes, potentially assisting clinicians in considering alternative treatment options.