TY - JOUR
T1 - Pretreatment Rostral Anterior Cingulate Cortex Connectivity With Salience Network Predicts Depression Recovery
T2 - Findings From the EMBARC Randomized Clinical Trial
AU - Whitton, Alexis E.
AU - Webb, Christian A.
AU - Dillon, Daniel G.
AU - Kayser, Jürgen
AU - Rutherford, Ashleigh
AU - Goer, Franziska
AU - Fava, Maurizio
AU - McGrath, Patrick
AU - Weissman, Myrna
AU - Parsey, Ramin
AU - Adams, Phil
AU - Trombello, Joseph M.
AU - Cooper, Crystal
AU - Deldin, Patricia
AU - Oquendo, Maria A.
AU - McInnis, Melvin G.
AU - Carmody, Thomas
AU - Bruder, Gerard
AU - Trivedi, Madhukar H.
AU - Pizzagalli, Diego A.
N1 - Publisher Copyright:
© 2018 Society of Biological Psychiatry
PY - 2019/5/15
Y1 - 2019/5/15
N2 - Background: Baseline rostral anterior cingulate cortex (rACC) activity is a well-replicated nonspecific predictor of depression improvement. The rACC is a key hub of the default mode network, which prior studies indicate is hyperactive in major depressive disorder. Because default mode network downregulation is reliant on input from the salience network and frontoparietal network, an important question is whether rACC connectivity with these systems contributes to depression improvement. Methods: Our study evaluated this hypothesis in outpatients (N = 238; 151 female) enrolled in the Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) 8-week randomized clinical trial of sertraline versus placebo for major depressive disorder. Depression severity was measured using the Hamilton Rating Scale for Depression, and electroencephalography was recorded at baseline and week 1. Exact low-resolution electromagnetic tomography was used to compute activity from the rACC, and key regions within the default mode network (posterior cingulate cortex), frontoparietal network (left dorsolateral prefrontal cortex), and salience network (right anterior insula [rAI]). Connectivity in the theta band (4.5–7 Hz) and beta band (12.5–21 Hz) was computed using lagged phase synchronization. Results: Stronger baseline theta-band rACC–rAI (salience network hub) connectivity predicted greater depression improvement across 8 weeks of treatment for both treatment arms (B = −0.57, 95% confidence interval = −1.07, −0.08, p =.03). Early increases in theta-band rACC–rAI connectivity predicted greater likelihood of achieving remission at week 8 (odds ratio = 2.90, p =.03). Conclusions: Among patients undergoing treatment, theta-band rACC–rAI connectivity is a prognostic, albeit treatment-nonspecific, indicator of depression improvement, and early connectivity changes may predict clinically meaningful outcomes.
AB - Background: Baseline rostral anterior cingulate cortex (rACC) activity is a well-replicated nonspecific predictor of depression improvement. The rACC is a key hub of the default mode network, which prior studies indicate is hyperactive in major depressive disorder. Because default mode network downregulation is reliant on input from the salience network and frontoparietal network, an important question is whether rACC connectivity with these systems contributes to depression improvement. Methods: Our study evaluated this hypothesis in outpatients (N = 238; 151 female) enrolled in the Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) 8-week randomized clinical trial of sertraline versus placebo for major depressive disorder. Depression severity was measured using the Hamilton Rating Scale for Depression, and electroencephalography was recorded at baseline and week 1. Exact low-resolution electromagnetic tomography was used to compute activity from the rACC, and key regions within the default mode network (posterior cingulate cortex), frontoparietal network (left dorsolateral prefrontal cortex), and salience network (right anterior insula [rAI]). Connectivity in the theta band (4.5–7 Hz) and beta band (12.5–21 Hz) was computed using lagged phase synchronization. Results: Stronger baseline theta-band rACC–rAI (salience network hub) connectivity predicted greater depression improvement across 8 weeks of treatment for both treatment arms (B = −0.57, 95% confidence interval = −1.07, −0.08, p =.03). Early increases in theta-band rACC–rAI connectivity predicted greater likelihood of achieving remission at week 8 (odds ratio = 2.90, p =.03). Conclusions: Among patients undergoing treatment, theta-band rACC–rAI connectivity is a prognostic, albeit treatment-nonspecific, indicator of depression improvement, and early connectivity changes may predict clinically meaningful outcomes.
KW - Depression
KW - EEG
KW - Functional connectivity
KW - Rostral ACC
KW - Salience network
KW - Sertraline
UR - http://www.scopus.com/inward/record.url?scp=85060883837&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060883837&partnerID=8YFLogxK
U2 - 10.1016/j.biopsych.2018.12.007
DO - 10.1016/j.biopsych.2018.12.007
M3 - Article
C2 - 30718038
AN - SCOPUS:85060883837
SN - 0006-3223
VL - 85
SP - 872
EP - 880
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 10
ER -