Antidepressant drugs are the gold standard for treating patients with major depressive disorders (MDD). Given the critical role of the underlying neural control mechanism in the physiopathology of depression, a recent study investigated the effects of escitalopram on the changes in functional brain controllability for MDD. 

It collected resting-state functional magnetic resonance imaging data from 20 unmedicated major depressive patients at baseline, one week, and six weeks after escitalopram treatment. 

The results showed a significantly larger global average and smaller modal controllability of MDD patients compared to healthy subjects. It also showed a significantly smaller modal controllability rank of the frontoparietal network in depression patients than the healthy subjects. However, the global average and modal controllability and the controllability of the default mode network and frontoparietal network of MDD patients were consistently changed throughout the escitalopram treatment to the healthy subjects level. The results also showed that the changes in global average and modal controllability measures could predict the improvements in clinical scores of MDD patients as the escitalopram treatment advances. 

This study explains promising brain controllability-based biomarkers to mechanistically understand and predict the effects of escitalopram treatment for depression. Investigators can expand these results to predict and understand the impact of other interventions for other neurological and psychiatric diseases.

Source: Fang F, Godlewska B, Cho RY, et al., Effects of escitalopram therapy on functional brain controllability in major depressive disorder. Journal of Affective Disorders. 2022;310:68-74. https://doi.org/10.1016/j.jad.2022.04.123.