Predicting ECT Response via Brain Functional Connectivity
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Solution Overview
Problem
Current methods for predicting the response to electroconvulsive therapy (ECT) are inaccurate, missing approximately 15% of true responders and discouraging over 20% of individuals from receiving ECT, despite its effectiveness in severe psychiatric disorders, due to lack of reliable biomarkers and personalized approaches.
Innovation Solution
A system and method using functional and anatomical connectivity patterns from MRI, specifically focusing on the subgenual Anterior Cingulate Cortex and dorsolateral prefrontal cortex networks, to predict ECT response, enabling precise identification of likely responders and optimizing treatment benefits versus risks.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If standard functional brain imaging approaches are used to predict ECT response, then some prediction capability is achieved with approximately 85% sensitivity, but approximately 15% of true responders are missed and over 20% of individuals are incorrectly discouraged from receiving ECT
Solution Approach 1:
The patent segments the brain into specific functional networks (subgenual Anterior Cingulate Cortex network, visual network, dorsolateral prefrontal cortex network) and analyzes connectivity patterns within and between these networks. This segmentation allows for more precise identification of biomarkers related to ECT response by focusing on specific circuitry rather than whole-brain analysis.
Solution Approach 2:
The patent applies local quality by examining functional connectivity in specific brain regions (subgenual ACC, visual cortex, DLPFC) rather than treating the brain as a homogeneous unit. The method identifies localized connectivity patterns that serve as biomarkers for ECT response, enabling more accurate predictions by focusing on quality-specific neural circuitry.
2Productivity
If ECT is prescribed based on current diagnostic and clinical indicators, then treatment can be provided to patients with severe psychiatric disorders, but approximately 50% of patients do not respond to treatment
Solution Approach 1:
The patent implements preliminary action by performing functional MRI scans and analyzing connectivity patterns before ECT treatment begins. This pre-treatment biomarker assessment identifies patients who are likely to respond to ECT, allowing clinicians to make informed decisions about treatment candidacy before committing patients to the full treatment course.
Solution Approach 2:
The patent establishes a feedback mechanism where pre-treatment connectivity patterns are measured and used to predict response, then treatment outcomes are monitored to validate and refine the predictive model. This feedback loop continuously improves the accuracy of response prediction by comparing predicted versus actual outcomes.
3Adaptability or versatility
If ECT is provided to all patients who might benefit, then comprehensive treatment coverage is achieved, but approximately 50% of treatment courses are wasted on non-responders and healthcare costs increase by $60-300 million annually
Solution Approach 1:
The patent performs preliminary functional connectivity assessment using fMRI before ECT treatment to identify likely responders. This preliminary screening prevents unnecessary treatment courses for patients who would not benefit, reducing waste of healthcare resources while maintaining accessibility for those who are predicted to respond well.
Solution Approach 2:
The patent introduces functional connectivity biomarkers as an intermediary between clinical diagnosis and treatment decision-making. This intermediary layer provides objective, biologically-based prediction that bridges the gap between traditional diagnostic indicators and treatment outcomes, enabling more efficient resource allocation.
4Ease of operation
If no biologically-based predictors are used, then ECT prescription follows standard clinical guidelines, but there are no reliable biomarkers to identify likely responders
Solution Approach 1:
The patent replaces traditional mechanical/diagnostic assessment methods with biologically-based functional imaging measurements. By substituting clinical judgment and diagnostic criteria with objective fMRI connectivity measurements, the system achieves more precise prediction of ECT response while providing a quantifiable biomarker foundation for treatment decisions.
Data Source
AI summary
An exemplary system, method, and computer-accessible medium for determining a position or a characteristic of a target(s) for a transcranial magnetic stimulation (TMS) treatment of a patient(s) can be provided, which can include, for example, receiving imaging information of a portion(s) of a head of the patient(s), and determining the position or the characteristic of the target(s) for the TMS treatment of the patient(s) based on the imaging information. The imaging information can be magnetic resonance imaging information. The imaging information can include information regarding a brain and a skull of the patient(s). The position or the characteristic of the target(s) can be determined by identifying (i) the skull, and (ii) a parcel in a section(s) of a brain of the patient(s). The parcel can a dorsolateral prefrontal cortex (DLPFC) parcel. The DLPFC parcel can be identified using a parcellation procedure, which can be a human connectome pipeline procedure.