A Treatment-Response Comparison Study of Resting-State Functional Magnetic Resonance Imaging Between Standard Treatment of SSRI and Standard Treatment of SSRI Plus Non-dominant Hand-Writing Task in Patients With Major Depressive Disorder.

Rabia Kevser Boyraz,Ayse Aralasmak,Tezer Kiliçarslan,Onur Özyurt,Ismet Kirpinar,Onur Yilmaz

doi:10.3389/fpsyt.2021.698954

Rabia Kevser Boyraz, Ayse Aralasmak + Show 4 more

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https://doi.org/10.3389/fpsyt.2021.698954

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Abstract

Background: Researches have recently shifted from functional/structural imaging studies to functional connectivity (FC) studies in major depressive disorder (MDD). We aimed to compare treatment response of two treatment groups before and after treatment, in terms of both with psychiatric evaluation scales and resting-state functional connectivity (RSFC) changes in order to objectively demonstrate the possible contribution of the non-dominant hand-writing exercise (NHE) effect on depression treatment.Methods: A total of 26 patients who were right-handed women with similar sociodemographic characteristics were enrolled. Their pre-treatment resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychiatric tests were recorded, and then, patients were divided into two groups randomly. A standard treatment (ST) (fix sertraline 50 mg/day) was given to both groups. One randomly selected group was given the NHE in addition to the ST. After 8 weeks of treatment, all patients were reevaluated with rs-fMRI and neuropsychiatric tests. Pre- and post-treatment FC changes within the groups and post-treatment connectivity changes between groups were evaluated.Results: Post-treatment neuropsychiatric tests were significantly different in both groups. Post-treatment, two brain regions' connectivity changed in the ST group, whereas 10 brain regions' connectivity changed significantly in the ST + NHE group. When treatment groups were compared with each other after the treatment, the FC of 13 regions changed in the ST + NHE group compared to the ST group (p-unc/p-PFD <0.05). The density of connectivity changes in the frontal and limbic regions, especially connectivities shown to change in depression treatment, in the ST + NHE group indicates a positive contribution to depression treatment, which is also supported by neuropsychiatric scale changes.Conclusion: NHE, which we developed with inspiration from the Eye Movement Desensitization and Reprocessing (EMDR) method, showed significantly more connecitivity changes related with MDD treatment. Beyond offering a new additional treatment method, our study will also contribute to the current literature with our efforts to evaluate all brain regions and networks that may be related to MDD and its treatment together, without being limited to a few regions.Trial Registration: The rs-fMRI and treatment registers were recorded in the BizMed system, which is the patient registration system of Bezmialem Vakif University Medicine Faculty, under the BAP support project approval code and the registration number 3.2018/8.

Highlights

With increasing neuroimaging studies in major depressive disorder (MDD), it is seen that resting-state functional connectivity (RSFC) changes are among the reasons mentioned more in etiology rather than a localized brain region [1]
To unify word selection for all ethnic groups, a volunteer research assistant from Marmara University Turkish Language and Literature Department prepared 120 paragraphs (38 of them are Turkish words, 37 of them are from Persian and Arabic, and 37 of them are from the European language family) to apply daily for 8 weeks. 20-Item Toronto Alexithymia Scale (TAS-20) It was developed by Bagby et al to determine the severity of alexithymic symptoms
Despite all pharmacological treatment approaches, incomplete remission and high relapse rates remain for many patients with MDD

Summary

Introduction

With increasing neuroimaging studies in major depressive disorder (MDD), it is seen that resting-state functional connectivity (RSFC) changes are among the reasons mentioned more in etiology rather than a localized brain region [1]. An open-label sertraline treatment-response study found increased connectivity between the frontal and limbic regions and it contributed to a more effective inhibitory response in emotion regulation [6]. In another RSFC study, it was shown that the connectivity from the posterior cingulate cortex (PCC) to the right lateral parietal cortex and right inferior temporal gyrus (ITG) returned to normal after duloxetine treatment [7]. We aimed to compare treatment response of two treatment groups before and after treatment, in terms of both with psychiatric evaluation scales and resting-state functional connectivity (RSFC) changes in order to objectively demonstrate the possible contribution of the non-dominant hand-writing exercise (NHE) effect on depression treatment

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