Prefrontal resting-state connectivity and antidepressant response: no associations in the ELECT-TDCS trial
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ORIGINAL PAPER
Prefrontal resting‑state connectivity and antidepressant response: no associations in the ELECT‑TDCS trial Lucia Bulubas1,2 · Frank Padberg1 · Eva Mezger1 · Paulo Suen3 · Priscila V. Bueno3 · Fabio Duran4 · Geraldo Busatto4 · Edson Amaro Jr5 · Isabela M. Benseñor6 · Paulo A. Lotufo6 · Stephan Goerigk1,7,8 · Wagner Gattaz3 · Daniel Keeser1,9,10 · Andre R. Brunoni1,3,6 Received: 30 April 2020 / Accepted: 20 August 2020 © Springer-Verlag thivGmbH Germany, part of Springer Nature 2020
Abstract Functional and structural MRI of prefrontal cortex (PFC) may provide putative biomarkers for predicting the treatment response to transcranial direct current stimulation (tDCS) in depression. A recent MRI study from ELECT-TDCS (Escitalopram versus Electrical Direct-Current Theror Depression Study) showed that depression improvement after tDCS was associated with gray matter volumes of PFC subregions. Based thereon, we investigated whether antidepressant effects of tDCS are similarly associated with baseline resting-state functional connectivity (rsFC). A subgroup of 51 patients underwent baseline rsFC-MRI. All patients of ELECT-TDCS were randomized to three treatment arms for 10 weeks (anodal-left, cathodal-right PFC tDCS plus placebo medication; escitalopram 10 mg/day for 3 weeks and 20 mg/day thereafter plus sham tDCS; and placebo medication plus sham tDCS). RsFC was calculated for various PFC regions and analyzed in relation to the individual antidepressant response. There was no significant association between baseline PFC connectivity of essential structural regions, nor any other PFC regions (after correction for multiple comparisons) and patients’ individual antidepressant response. This study did not reveal an association between antidepressants effects of tDCS and baseline rsFC, unlike the gray matter volume findings. Thus, the antidepressant effects of tDCS may be differentially related to structural and functional MRI measurements. Keywords Antidepressant response · Resting state functional connectivity (rsFC-MRI) · Major depressive disorder (MDD) · Non-invasive transcranial brain stimulation (NTBS) · Prefrontal cortex · Transcranial direct current stimulation (tDCS) Abbreviations ACC Anterior cingulate cortex BA Brodmann area DMN Default mode network MPFC Medial prefrontal cortex DLPFC Dorsal lateral prefrontal cortex ELECT-TDCS Escitalopram versus Electrical directcurrent therapy for depression HDRS-17 Hamilton depression rating scale
NA Negative affect PANAS Positive and negative affect scale PA Positive affect PCC Posterior cingulate cortex PFC Prefrontal cortex ROI Region of interest rsFC Resting state functional connectivity TMS Repetitive transcranial magnetic stimulation tDCS Transcranial direct current stimulation
Daniel Keeser and Andre R. Brunoni contributed equally. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00406-020-01187-y) contains supplementary material, which is available to authorized users. * Andre R. Brunon
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