Treatment outcome is associated with pre-treatment connectome measures across psychiatric disorders - evidence for connectomic reserve?
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
Predicting treatment efficacy in psychiatric disorders remains challenging, despite the availability of effective interventions. Previous studies suggest a link between brain network topology and treatment efficacy in individual disorders, but cross-disorder investigations are lacking.
Methods
We analyzed pre-treatment MRI data from 177 individuals (113 females) with either obsessive-compulsive disorder (OCD) or post-traumatic stress disorder with comorbid personality disorders (PTSD) that received different non-pharmacological treatments. Using diffusion and resting-state MRI, we constructed structural, functional, and multilayer connectomes and calculated network measures at the global and mesoscale for network integration (global efficiency, eccentricity), segregation (modularity) and their balance (small-worldness). We assessed the relationship between these pre-treatment network measures and treatment improvement using mixed-model and Bayesian analyses and compared them to healthy controls. We also investigated associations between response and treatment-induced changes in network measures.
Results
Across disorders and treatments, psychiatric cases showed a 41.6±29.6% symptom improvement (62% response rate) after treatment and pre-treatment differences in functional and multilayer network topology compared to healthy controls. Symptom improvement was associated with pre-treatment functional (P=0.04) and structural small-worldness (P=0.01), and multilayer eccentricity (P=0.01), while responders had higher functional modularity (P=0.02). Results were robust across trials and treatments, when adjusting for medication status and showed high credibility in Bayesian analyses. Network change associations with treatment response were only modest.
Conclusions
Pre-treatment connectome characteristics are related to treatment response, regardless of treatment and psychiatric disorder, and suggest that individual differences in intrinsic features of the human connectome underlie amenability to treatment.
