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Abstract
AbstarctAlthough we have some basic understanding of the neurochemical mechanisms of the antidepressants, the network-level effect of antidepressant treatment is still not fully understood. This study was conducted to investigate the effects of antidepressant on functional brain networks of patients with major depressive disorder (MDD). We performed resting-state fMRI scans on 20 first-episode drug-naive MDD patients at baseline and after escitalopram medication for 8 weeks. Twenty healthy controls also received MRI scans with an 8-week interval. The graph theory indices, long- and short-range functional connectivity strength (FCS), were computed to characterize the brain connectivity. The analysis of covariance was conducted on FCS maps of patients and controls to obtain the interaction effect of group and time, which indicate treatment-related effect. Following treatment, increased long-range FCS in the bilateral posterior cingulate cortex/precuneus and right thalamus in MDD patients at baseline were reduced. Meanwhile, increased short-range FCS in the bilateral ventromedial prefrontal cortex and left amygdala in patients were reduced, while reduced short-range FCS in the right parahippocampal gyrus was increased. Results suggest that the brain regions associated with negative emotional processing and regulation, and self-referential function could be modulated by escitalopram treatment; long- and short-range FCS are differentially affected by antidepressant.
Highlights
Major depressive disorder (MDD) is a globally prevalent disorder with multi-dimensional clinical features involving emotion, cognition, and somatic domains
Abnormal long-range FCS (lFCS) and short-range FCS (sFCS) in the cotical (PCC/precuneus, ventromedial PFC (vmPFC)) and limbic regions in patients were normalized after treatment
We found a significant effect of escitalopram treatment on the Functional connectivity strength (FCS) in cortical midline structures, including the bilateral posterior cingulate cortex (PCC)/precuneus and bilateral vmPFC
Summary
Major depressive disorder (MDD) is a globally prevalent disorder with multi-dimensional clinical features involving emotion, cognition, and somatic domains. Functional brain hubs with higher long-range FCS (lFCS) are mainly located in the posterior cingulate cortex (PCC)/precuneus, medial and lateral PFC, insula, and lateral temporal and parietal cortices. A few of studies have suggested that the brain regions showing FCS alterations in MDD patients varied with the anatomical distance of brain connectivity. Reduced sFCS in the right orbitofrontal cortex, bilateral superior temporal gyrus, bilateral precuneus, insula, right inferior parietal lobule, and occipital regions were observed in MDD patients[26, 27]. In this context, it may be important to consider the potential effect of connectivity distance in the investigation of neural mechanism of MDD
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