Default mode network connectivity and treatment response in geriatric depression
Lisa A Kilpatrick1, Beatrix Krause-Sorio2, Prabha Siddarth2
1G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Brain and Behavior
|March 2, 2022
Summary
This study found that increased default mode network (DMN) connectivity correlated with improved depression symptoms in older adults. The combination of escitalopram/memantine showed a stronger link between DMN changes and symptom relief compared to escitalopram/placebo.
Area of Science:
- Neuroscience
- Psychiatry
- Gerontology
Background:
- Depression in older adults is associated with altered default mode network (DMN) connectivity.
- Subjective memory complaints are common in this demographic.
- Understanding treatment effects on brain networks is crucial for effective interventions.
Purpose of the Study:
- To investigate the relationship between changes in within-network DMN connectivity and depression symptom improvement.
- To compare these changes between escitalopram/memantine (ESC/MEM) and escitalopram/placebo (ESC/PBO) treatment groups.
- To explore the role of DMN engagement in treatment response in older adults with depression and memory complaints.
Main Methods:
- Resting-state fMRI scans were acquired at baseline and 3-month follow-up in 26 older adults with major depression.
- Participants were randomized to receive either ESC/MEM or ESC/PBO.
- Multi-block partial least squares correlation analysis assessed DMN connectivity changes and their correlation with symptom improvement, controlling for age and sex.
Main Results:
- A significant correlation was found between within-network DMN connectivity changes and symptom improvement (p = .01).
- Increased connectivity in posterior/lateral DMN regions (precuneus, angular gyrus, temporal cortex) was more strongly associated with symptom improvement in the ESC/MEM group (r = 0.97) than in the ESC/PBO group (r = 0.36).
- No significant overall group differences in DMN connectivity changes were observed.
Conclusions:
- Increased within-network connectivity of core DMN nodes correlates more strongly with depressive symptom improvement with ESC/MEM compared to ESC/PBO.
- This suggests enhanced engagement of brain circuitry involved in depression amelioration with combined ESC/MEM treatment.
- The findings support the efficacy of ESC/MEM in improving brain network function related to depression in older adults with memory complaints.
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