Marieke A G Martens1,2, Nicola Filippini2,3, Catherine J Harmer1,4, Beata R Godlewska5,6. 1. Department of Psychiatry, University of Oxford, Oxford, UK. 2. Wellcome Center for Integrative Neuroimaging, University of Oxford, OX3 9DU, Oxford, UK. 3. Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK. 4. Oxford Health NHS Foundation Trust, Oxford, UK. 5. Department of Psychiatry, University of Oxford, Oxford, UK. beata.godlewska@psych.ox.ac.uk. 6. Oxford Health NHS Foundation Trust, Oxford, UK. beata.godlewska@psych.ox.ac.uk.
Abstract
RATIONAL: With no available response biomarkers, matching an appropriate antidepressant to an individual can be a lengthy process. Improving understanding of processes underlying treatment responsivity in depression is crucial for facilitating work on response biomarkers. OBJECTIVES: To identify differences in patterns of pre-treatment resting-state functional connectivity (rsFC) that may underlie response to antidepressant treatment. METHODS: After a baseline MRI scan, thirty-four drug-free patients with depression were treated with an SSRI escitalopram 10 mg daily for 6 weeks; response was defined as ≥ 50% decrease in Hamilton Depression Rating Scale (HAMD) score. Thirty-one healthy controls had a baseline clinical assessment and scan. Healthy participants did not receive treatment. RESULTS: Twenty-one (62%) of patients responded to escitalopram. Treatment responsivity was associated with enhanced rsFC of the right fronto-parietal network (FPN)-with the posterior DMN, somatomotor network (SMN) and somatosensory association cortex. The lack of treatment response was characterized by reduced rsFC: of the bilateral FPN with the contralateral SMN, of the right FPN with the posterior DMN, and of the extended sensorimotor auditory area with the inferior parietal lobule (IPL) and posterior DMN. Reduced rsFC of the posterior DMN with IPL was seen in treatment responders, although only when compared with HC. CONCLUSIONS: The study supports the role of resting-state networks in response to antidepressant treatment, and in particular the central role of the frontoparietal and default mode networks.
RATIONAL: With no available response biomarkers, matching an appropriate antidepressant to an individual can be a lengthy process. Improving understanding of processes underlying treatment responsivity in depression is crucial for facilitating work on response biomarkers. OBJECTIVES: To identify differences in patterns of pre-treatment resting-state functional connectivity (rsFC) that may underlie response to antidepressant treatment. METHODS: After a baseline MRI scan, thirty-four drug-free patients with depression were treated with an SSRI escitalopram 10 mg daily for 6 weeks; response was defined as ≥ 50% decrease in Hamilton Depression Rating Scale (HAMD) score. Thirty-one healthy controls had a baseline clinical assessment and scan. Healthy participants did not receive treatment. RESULTS: Twenty-one (62%) of patients responded to escitalopram. Treatment responsivity was associated with enhanced rsFC of the right fronto-parietal network (FPN)-with the posterior DMN, somatomotor network (SMN) and somatosensory association cortex. The lack of treatment response was characterized by reduced rsFC: of the bilateral FPN with the contralateral SMN, of the right FPN with the posterior DMN, and of the extended sensorimotor auditory area with the inferior parietal lobule (IPL) and posterior DMN. Reduced rsFC of the posterior DMN with IPL was seen in treatment responders, although only when compared with HC. CONCLUSIONS: The study supports the role of resting-state networks in response to antidepressant treatment, and in particular the central role of the frontoparietal and default mode networks.
Authors: Andrea Cipriani; Toshi A Furukawa; Georgia Salanti; Anna Chaimani; Lauren Z Atkinson; Yusuke Ogawa; Stefan Leucht; Henricus G Ruhe; Erick H Turner; Julian P T Higgins; Matthias Egger; Nozomi Takeshima; Yu Hayasaka; Hissei Imai; Kiyomi Shinohara; Aran Tajika; John P A Ioannidis; John R Geddes Journal: Focus (Am Psychiatr Publ) Date: 2018-10-18
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