Abstract
BackgroundPrevious studies have demonstrated that patients with treatment-resistant depression (TRD) and treatment-sensitive depression (TSD) differed at neural level. However, it remains unclear if these two subtypes of depression differ in the interhemispheric coordination. This study was undertaken for two purposes: (1) to explore the differences in interhemispheric coordination between these two subtypes by using the voxel-mirrored homotopic connectivity (VMHC) method; and (2) to determine if the difference of interhemispheric coordination can be used as a biomarker(s) to differentiate TRD from both TSD and healthy subjects (HS).MethodsTwenty-three patients with TRD, 22 with TSD, and 19 HS participated in the study. Data of these participants were analyzed with the VMHC and seed-based functional connectivity (FC) approaches.ResultsCompared to the TSD group, the TRD group showed significantly lower VMHC values in the calcarine cortex, fusiform gyrus, hippocampus, superior temporal gyrus, middle cingulum, and precentral gyrus. Lower VMHC values were also observed in the TRD group in the calcarine cortex relative to the HS group. However, the TSD group had no significant change in VMHC value in any brain region compared to the HS group. Receiver operating characteristic curves (ROC) analysis revealed that the VMHC values in the calcarine cortex had discriminatory function distinguishing patients with TRD from patients with TSD as well as those participants in the HS group.ConclusionsLower VMHC values of patients with TRD relative to those with TSD and those in the HS group in the calcarine cortex appeared to be a unique feature for patients with TRD and it may be used as an imaging biomarker to separate patients with TRD from those with TSD or HS.
Highlights
Despite the rapid progress that has been made in the development of antidepressants over the years, approximately one-third of depressed patients still fail to respond to standard antidepressant treatments [1]
A bulk of positron emission tomography (PET) and functional magnetic resonance imaging studies have accumulated enough evidence to suggest that major depressive disorder (MDD) is related to widespread local changes in many brain areas within the cortico-limbic circuit (See L et al [6] for a review)
In order to be eligible for this present study, all patients had to meet the following inclusion criteria: (1) In a current major depressive episode diagnosed with a Structured Clinical Interview for DSM-IV (SCID) [25]; (2) Within 18–50 years of age; (3) Righthanded Han Chinese; and (4) Hamilton Rating Scale for Depression (HRSD) score of $18
Summary
Despite the rapid progress that has been made in the development of antidepressants over the years, approximately one-third of depressed patients still fail to respond to standard antidepressant treatments [1]. Treating TRD remains a common therapeutic challenge for psychiatrists [3,4]. To overcome this challenge is to develop more effective treatment for major depressive disorder (MDD), especially TRD. This effort requires better understanding of the pathogenesis of MDD [5]. Previous studies have demonstrated that patients with treatment-resistant depression (TRD) and treatmentsensitive depression (TSD) differed at neural level. It remains unclear if these two subtypes of depression differ in the interhemispheric coordination. This study was undertaken for two purposes: (1) to explore the differences in interhemispheric coordination between these two subtypes by using the voxel-mirrored homotopic connectivity (VMHC) method; and (2) to determine if the difference of interhemispheric coordination can be used as a biomarker(s) to differentiate TRD from both TSD and healthy subjects (HS)
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