Introduction
MDD, TRD
MAJOR DEPRESSIVE DISORDER 2, REMISSION
Failure to achieve complete remission in treating Major Depressive Disorder (MDD) leads to increased morbidity, relapse rates [Indeed, relatively little is known about brain functional correlates of ATD treatment. Most studies exploring this question utilize typical ATD therapies, which are inherently confounded by nonspecific factors due to the duration of time between initiation and ATD effect. More recently, other pharmacological agents like ketamine and psilocybin have demonstrated rapid ATD effects, suggesting that they may be able to help address this issue. However, the contribution of these drugs in the study of the mechanisms of action might be limited by non-specific pharmacological action [To this end, we investigated the effects of active Stanford Neuromodulation Therapy—as compared to sham stimulation—on FC immediately after 5 days of treatment. Next, we examined the relationship between FC changes and clinical changes from baseline to the immediate-post visit. Finally, we explored whether baseline FC was different from that of a healthy control group, and if so, whether active stimulation could normalize it. We hypothesized that active stimulation would be associated with significant changes in FC from baseline to the immediate-post visit and that these FC changes would be associated with the extent of clinical change. As exploratory hypotheses, we postulated that 1/the FC at baseline would differ between TRD participants and healthy controls, and the FC changes induced by active stimulation would eliminate this difference 2/ the induced FC changes in the active group immediately post-stimulation would be sustained at one-month. In this paper, the overarching goal was to explore regional/distant functional brain response and its relationship with clinical changes.