Weakened effective connectivity between salience network and default mode network during resting state in adolescent depression

• DOI: 10.3389/fpsyt.2024.1386984
• Publication Date: 2024-04-04T09:20:01Z
• Authors: David Willinger; Isabelle Häberling; Iva Ilioska; Gregor Berger; Susanne Walitza; Silvia Brem
• Keywords: Psychiatry; affective disorders; 11558 Neuroscience Center Zurich; brain connectivity; RC435-571; 220 Statistical Imaging Neuroscience; Cognitive Neuroscience - Radboud University Medical Center - DCMN; 610 Medicine & health; 2738 Psychiatry and Mental Health; adolescence; affective disorders; brain connectivity; resting-state fMRI; SSRI; 03 medical and health sciences; 0302 clinical medicine; 10058 Child and Adolescent Psychiatry; SSRI; resting; adolescence; state fMRI.; resting-state fMRI

Adolescent major depressive disorder (MDD) is associated with altered resting-state connectivity between the default mode network (DMN) and the salience network (SN), which are involved in self-referential processing and detecting and filtering salient stimuli, respectively. Using spectral dynamical causal modelling, we investigated the effective connectivity and input sensitivity between key nodes of these networks in 30 adolescents with MDD and 32 healthy controls while undergoing resting-state fMRI. We found that the DMN received weaker inhibition from the SN and that the medial prefrontal cortex and the anterior cingulate cortex showed reduced self-inhibition in MDD, making them more prone to external influences. Moreover, we found that selective serotonin reuptake inhibitor (SSRI) intake was associated with decreased and increased self-inhibition of the SN and DMN, respectively, in patients. Our findings suggest that adolescent MDD is characterized by a hierarchical imbalance between the DMN and the SN, which could affect the integration of emotional and self-related information. We propose that SSRIs may help restore network function by modulating excitatory/inhibitory balance in the DMN and the SN. Our study highlights the potential of prefrontal-amygdala interactions as a biomarker and a therapeutic target for adolescent depression.