Key result
Eight-week treatment with escitalopram or duloxetine significantly reduced intrinsic functional connectivity across extensive brain networks in first-episode drug-naïve patients with major depressive disorder.
Why the study?
It was unclear whether functional connectivity abnormalities in MDD stem from pathophysiology or antidepressant medication effects.
Does 8-week antidepressant treatment alter resting-state functional connectivity in first-episode drug-naïve patients with major depressive disorder?
Cohort (n=133)
Open-label
No
Does 8-week antidepressant treatment alter resting-state functional connectivity in first-episode drug-naïve patients with major depressive disorder?
p-value: p=<0.001
Antidepressant treatment significantly reduces functional connectivity across extensive brain networks in MDD patients, indicating that medication effects must be accounted for in neuroimaging studies of depression.
Reduced DMN connectivity in medicated MDD warrants no practice change; leaves open medication versus recurrence effects in observational cohorts.
Previous neuroimaging studies have revealed abnormal functional connectivity of brain networks in patients with major depressive disorder (MDD), but findings have been inconsistent. A recent big-data study found abnormal intrinsic functional connectivity within the default mode network in patients with recurrent MDD but not in first-episode drug-naïve patients with MDD. This study also provided evidence for reduced default mode network functional connectivity in medicated MDD patients, raising the question of whether previously observed abnormalities may be attributable to antidepressant effects. The present study (ClinicalTrials.gov identifier: NCT03294525) aimed to disentangle the effects of antidepressant treatment from the pathophysiology of MDD and test the medication normalization hypothesis. Forty-one first-episode drug-naïve MDD patients were administrated antidepressant medication (escitalopram or duloxetine) for 8 weeks, with resting-state functional connectivity compared between posttreatment and baseline. To assess the replicability of the big-data finding, we also conducted a cross-sectional comparison of resting-state functional connectivity between the MDD patients and 92 matched healthy controls. Both Network-Based Statistic analyses and large-scale network analyses revealed intrinsic functional connectivity decreases in extensive brain networks after treatment, indicating considerable antidepressant effects. Neither Network-Based Statistic analyses nor large-scale network analyses detected significant functional connectivity differences between treatment-naïve patients and healthy controls. In short, antidepressant effects are widespread across most brain networks and need to be accounted for when considering functional connectivity abnormalities in MDD.
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Li et al. (2021) conducted a cohort in Major depressive disorder (n=133). Antidepressant medication (escitalopram or duloxetine) vs. Baseline (pre-treatment) and Healthy Controls was evaluated on Resting-state functional connectivity (FC) change from baseline to posttreatment (p=<0.001). Eight-week treatment with escitalopram or duloxetine significantly reduced intrinsic functional connectivity across extensive brain networks in first-episode drug-naïve patients with major depressive disorder.
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