Anxiety is the most common mental disorder during adolescence. The first-line therapeutics are SSRIs; however, only 50% of the pediatric patients respond to these agents.

The purpose of a study was to identify the neurofunctional targets of SSRIs and investigate the pretreatment or early-treatment neurofunctional markers of the response to this treatment modality among adolescents. 

This study used functional magnetic resonance imaging (MRI) reports of patients with generalized anxiety disorder (GAD) who were randomized to eight weeks of either escitalopram or placebo. The imaging was performed during a continuous processing task while the patients endured emotional and neutral distractors. 

The findings revealed that escitalopram enhanced emotional processing speed, negative right amygdala-bilateral ventromedial prefrontal cortex (vmPFC), as well as positive left amygdala-right angular gyrus connectivity during emotion processing. Meanwhile, the baseline amygdala-vmPFC connectivity and escitalopram-induced accentuated amygdala-angular gyrus connectivity during the second week predicted the extent of improvement in anxiety symptoms. 

It was concluded that amygdala connectivity to the default-mode network hubs could be a potential target of short-term SSRI treatment. Additionally, pretreatment and early-treatment amygdala connectivity could act as biomarkers of SSRI treatment response among adolescents with GAD.