Enhanced default mode network functional connectivity links with electroconvulsive therapy response in major...

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Electroconvulsive therapy (ECT) is a proven neuromodulatory treatment for major depressive disorder (MDD).
• ECT's precise mechanisms remain unclear, but modulation of brain connectivity is hypothesized.
• Investigating ECT's impact on functional connectivity (FC) and its predictive value for treatment response is crucial.

Purpose of the Study:

• To examine longitudinal changes in resting-state functional connectivity (FC) following ECT in MDD patients.
• To determine if baseline FC can predict therapeutic response to ECT.
• To identify specific brain networks affected by ECT.

Main Methods:

• Resting-state functional magnetic resonance imaging (rs-fMRI) data acquired at baseline and post-ECT from 33 MDD patients.
• Whole-brain multi-voxel pattern analysis (MVPA) and region of interest (ROI)-wise FC analysis were performed.
• Linear support vector regression used to predict symptom improvement from baseline FC.

Main Results:

• ECT significantly altered FC within the default mode network (DMN), central executive network (CEN), sensorimotor network (SMN), and cerebellar posterior lobe.
• Increased FC within the DMN and between the DMN and CEN observed post-ECT.
• Baseline DMN and DMN-CEN FC predicted depressive symptom improvement.

Conclusions:

• Functional connectivity within the DMN and between the DMN and CEN are critical for ECT efficacy.
• These connectivity patterns serve as potential neuromarkers for predicting treatment response in MDD.
• Targeting these networks may enhance antidepressant treatment outcomes.