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2 results

  • Modulation of resting-state functional connectivity in default mode network is associated with the long-term treatment outcome in major depressive disorder

  • Yumeng Ju, Mi Wang, Jin Liu, Bangshan Liu, Danfeng Yan, Xiaowen Lu, Jinrong Sun, Qiangli Dong, Liang Zhang, Hua Guo, Futao Zhao, Mei Liao, Li Zhang, Yan Zhang, Lingjiang Li
  • Journal:
    Psychological Medicine / Volume 53 / Issue 13 / October 2023
    Published online by Cambridge University Press:
    27 September 2022, pp. 5963-5975
    • Article
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  • Background

    Treatment non-response and recurrence are the main sources of disease burden in major depressive disorder (MDD). However, little is known about its neurobiological mechanism concerning the brain network changes accompanying pharmacotherapy. The present study investigated the changes in the intrinsic brain networks during 6-month antidepressant treatment phase associated with the treatment response and recurrence in MDD.

    Methods

    Resting-state functional magnetic resonance imaging was acquired from untreated patients with MDD and healthy controls at baseline. The patients' depressive symptoms were monitored by using the Hamilton Rating Scale for Depression (HAMD). After 6 months of antidepressant treatment, patients were re-scanned and followed up every 6 months over 2 years. Traditional statistical analysis as well as machine learning approaches were conducted to investigate the longitudinal changes in macro-scale resting-state functional network connectivity (rsFNC) strength and micro-scale resting-state functional connectivity (rsFC) associated with long-term treatment outcome in MDD.

    Results

    Repeated measures of the general linear model demonstrated a significant difference in the default mode network (DMN) rsFNC change before and after the 6-month antidepressant treatment between remitters and non-remitters. The difference in the rsFNC change over the 6-month antidepressant treatment between recurring and stable MDD was also specific to DMN. Machine learning analysis results revealed that only the DMN rsFC change successfully distinguished non-remitters from the remitters at 6 months and recurring from stable MDD during the 2-year follow-up.

    Conclusion

    Our findings demonstrated that the intrinsic DMN connectivity could be a unique and important target for treatment and recurrence prevention in MDD.

  • 21 - The economic impact of treatment non-response in major depressive disorders

  • from Part V - Economic and ethical issues
  • Edited by Jay D. Amsterdam, University of Pennsylvania, Mady Hornig, University of California, Irvine, Andrew A. Nierenberg
  • Book:
    Treatment-Resistant Mood Disorders
    Published online:
    25 March 2010
    Print publication:
    28 June 2001, pp 491-503

  • Summary

    This chapter focuses on the economic impact of treatment non-response in major depressive disorders (MDD). Patient responses to initial therapy for MDD fall into four basic outcome categories. The frequency and health-care costs are associated with all four treatment outcome categories. The cost of treatment non-response is best measured relative to the costs experienced by patients who succeed on their initial course of therapy. The costs of non-response are measured relative to the costs patterns achieved by patients with an adequate course of therapy in terms of dose and duration. Multivariate ordinary least-squares (OLS) regression analyses were used to investigate the impact of the patient's drug use profile on health-care costs. The antidepressant drug therapy outcomes achieved by newly treated California Medicaid (Medi-Cal) patients are presented in the chapter. An adequate course of therapy on the initial antidepressant therapy prescribed was achieved by 17.1% of all treated patients.