Abstract
A high proportion of patients with remitted major depressive disorder (MDD) will experience recurring episodes, whilst some develop resilience and remain in recovery. The neural basis of resilience to recurrence is elusive. Abnormal resting-state connectivity of the subgenual cingulate cortex (sgACC) was previously found in cross-sectional studies of MDD, suggesting its potential pathophysiological importance. The current study aimed to investigate whether resting-state connectivity to a left sgACC seed region distinguishes resilient patients from those developing recurring episodes. A total of 47 medication-free remitted MDD patients and 38 healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. Over 14 months, 30 patients remained resilient whilst 17 experienced a recurring episode. Attenuated interhemispheric left-to-right sgACC connectivity distinguished the resilient from the recurring-episode and control groups and was not correlated with residual depressive symptoms. The current study revealed a neural signature of resilience to recurrence in MDD and thereby elucidates the role of compensatory adaptation in sgACC networks.
Highlights
Major depressive disorder (MDD) is recurrent in a large proportion of patients, whilst some patients develop resilience after recovering from a major depressive episode (MDE; American Psychiatric Association, 2000)
The current study revealed a neural signature of resilience to recurrence in major depressive disorder (MDD) and thereby elucidates the role of compensatory adaptation in subgenual cingulate cortex (sgACC) networks
Our analyses revealed a main effect of group for connectivity of the left anterior sgACC seed region with the right anterior sgACC and with the left posterior sgACC (Table 3; Fig. 1)
Summary
Major depressive disorder (MDD) is recurrent in a large proportion of patients, whilst some patients develop resilience after recovering from a major depressive episode (MDE; American Psychiatric Association, 2000). In a cross-sectional activation fMRI study, our group reported lower functional connectivity between an anterior temporal lobe (ATL) seed region and the sgACC during the experience of guilt (self-blame) relative to indignation (other-blame) in remitted MDD (rMDD) patients compared with a healthy control (HC) group (Green et al 2012). A high proportion of patients with remitted major depressive disorder (MDD) will experience recurring episodes, whilst some develop resilience and remain in recovery. The current study aimed to investigate whether resting-state connectivity to a left sgACC seed region distinguishes resilient patients from those developing recurring episodes
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