Functional connectome fingerprints (CFPs) derived from functional magnetic resonance imaging (fMRI) data predicted improvement in symptoms of depression rather than response to antidepressant therapy in patients with major depressive disorder (MDD). These results from a randomized study conducted by researchers from Yale University were published in Chronic Stress.
Non-drug patients (N = 200) with MDD were randomized to receive sertraline (up to 200 mg daily) or placebo for 8 weeks. Patients were rated using the 17-point Hamilton Depression Rating Scale (HAMD) and fMRI. The A424 atlas was used to parcel out the entire gray matter brain into 424 nodes to build the patient-specific network. The complete network included information on pairwise connectivity of functional networks, node strength, and internal and external network-constrained node strength.
Symptom improvement after 8 weeks was associated with CFP regardless of the use of sertraline or placebo (r, 0.19; P = 0.03), in which patients with lower connectivity between the Executive and Sensomotor and Salience modules with increased connectivity between Modules in Standard Mode and The rest of the brain were more likely to have fewer symptoms of depression.
Stratified by CFP resolution, those with higher resolution (full connectome with 424 nodes) predicted a percentage change in MDD symptoms (r, 0.19; P = 0.02), but not in patients with lower resolution (r, 0 , 14; P = 0.08).
Similarly, the knot fingerprint (NFP) was significantly associated with symptom improvement after 8 weeks, regardless of whether he received sertraline or placebo (r, 0.18; P = 0.03). This association was determined by the internal node (r, 0.19; P = 0.02), but not by the external (r, 0.15; P = 0.08) network-restricted strength.
No CFP or NFP patterns were associated with treatment with sertraline (all P <0.05).
This study was limited because of its sample size and some group differences were likely overlooked due to a lack of statistical power.
The study’s authors concluded that patients with decreased functional connectivity in the central executive region of the brain are more likely to improve MDD symptoms. Longitudinal studies are needed to determine whether changes in connectivity correlate with changes in symptoms.
Disclosure: An author declared his affiliation with the industry. For a full list of the details, see the original article.
Fan S., Nemati S., Akiki TJ, et al. The pre-treatment brain connectome fingerprint predicts treatment response in major depression. Published online December 29, 2020. Chronic Stress (Thousand Oaks). doi: 10.1177 / 2470547020984726
This article originally appeared on Psychiatry Advisor