Decreased functional connectivity of the insula within the salience network as an indicator for prospective insufficient response to antidepressants

Abstract

HighlightsConnectivity analyses complemented with a metric exploring switching in brain activity.Lower insula-salience connectivity predicts insufficient antidepressant response.This same insula region is activated less when switching from task to a rest.This could be a potential biomarkers for predicting future antidepressant response.

Differential Alterations in Resting State Functional Connectivity Associated with Depressive Symptoms and Early Life Adversity

“…Differential FC patterns may not only be related to different clinical symptom profiles but may also have implications for treatment. In a recent study, it has been proposed that lower insula FC within the SN serves as an indicator for an insufficient response to antidepressant treatment [ 64 ]. Given the negative association between severity of depressive symptoms and FC within the SN that we observed in participants with higher levels of childhood abuse, this may be an explanation for the fact that individuals with a history of ELA respond more poorly to antidepressant treatment compared to individuals without such a history [ 22 ].…”

Neural changes in youth at high risk for bipolar disorder undergoing family‐focused therapy or psychoeducation

“…This interpretation is supported by previous studies showing changes in insula connectivity during antidepressant treatment 35 and abnormalities in insula connectivity as a predictor of response to antidepressants. 36,37 Pre-minus post-treatment decreases in amygdala and hippocampus activation were seen in both groups. The amygdala has been a focus of research on pediatric bipolar disorder for decades 38 with growing evidence of abnormal connectivity with VLPFC.…”

Fifteen years of NESDA Neuroimaging: An overview of results related to clinical profile and bio-social risk factors of major depressive disorder and common anxiety disorders

“…Future models of depression need to take into account morphological features, baseline activity and connectivity characteristics, to fully understand the off-set from where stimulus-related activation and connectivity changes emerge. Finally, recent explorations of the timevarying nature of network organization, as also explored NESDA by Geugies et al (2019), make it evident that also the dynamic nature of the network reconfiguration is an important aspect of understanding both the depressive state related abnormalities involved in perpetuation of the current disorder, as well as the time-varying dynamics on the clinical level including recovery, relapse in newer episodes, and development of comorbid disorders.…”

“…Because we did not specifically investigate effects of SSRI use, by comparing SSRI-using patients with non-using patients, we could not report on regional brain activation or morphometry that is related to antidepressant medication use. Nevertheless, in an exploratory analysis, it was investigated whether functional connectivity patterns during resting state were predictive of antidepressant non-response as a proxy for treatment-resistance (Geugies et al, 2019). MDD patients from the NESDA Neuroimaging sample that were prescribed at least two types of antidepressant medication (n = 17) were compared to MDD patients that kept the same type of medication (n = 32) and carefully matched healthy controls (n = 19).…”