ArticleNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology2026
Resting-state functional connectivity of the default mode network as a predictor for escitalopram response in adolescents with depression.
Article in Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Adolescent depression differs from adult depression in neurobiology and treatment response. Although resting-state functional connectivity (rsFC) of the default mode network (DMN) has been linked to treatment response in adults, its value as a biomarker in adolescents remains unclear. This study investigated whether baseline DMN rsFC predicts response to selective serotonin reuptake inhibitor (SSRI) treatment in adolescents with major depressive disorder (MDD). Seventy medication-naïve adolescents with MDD (ages 12-17 years) underwent baseline resting-state functional magnetic resonance imaging and an 8-week open-label escitalopram trial. Depressive symptoms were measured using the Children's Depression Rating Scale-Revised (CDRS-R). Seed-based DMN rsFC analyses used the ventromedial prefrontal cortex (vMPFC), dorsomedial prefrontal cortex (dMPFC), and posterior cingulate cortex (PCC) as seeds. Voxel-wise regressions assessed associations between baseline rsFC and treatment response, defined as the change in CDRS-R score from baseline to week 8. Our results showed that greater baseline DMN rsFC consistently predicted SSRI treatment response in adolescents with MDD. Stronger vMPFC-postcentral gyrus, vMPFC-insula, dMPFC-supramarginal, and PCC-supramarginal gyrus rsFCs at baseline were significantly associated with greater treatment response, as reflected by greater reductions in CDRS-R score following escitalopram treatment (r = -0.498 to -0.603, all p
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