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Major depressive disorder (MDD) is associated with dysfunctional corticolimbicnetworks, making functional connectivity studies integral for understanding themechanisms underlying MDD pathophysiology and treatment. Resting-statefunctional connectivity (RSFC) studies analyze patterns of temporally coherentintrinsic brain activity in “resting-state networks” (RSNs). The default-modenetwork (DMN) has been of particular interest to depression research; however, asingle RSN is unlikely to capture MDD pathophysiology in its entirety, and theDMN itself can be characterized by multiple RSNs. This, coupled with conflictingprevious results, underscores the need for further research. Here, we measuredRSFC in MDD by targeting RSNs overlapping with corticolimbic regions and furtherdetermined whether altered patterns of RSFC were restored with electroconvulsivetherapy (ECT). MDD patients exhibited hyperconnectivity between ventral striatum(VS) and the ventral default-mode network (vDMN), while simultaneouslydemonstrating hypoconnectivity with the anterior DMN (aDMN). ECT influenced thispattern: VS-vDMN hyperconnectivity was significantly reduced while VS-aDMNhypoconnectivity only modestly improved. RSFC between the salience RSN anddorsomedial prefrontal cortex was also reduced in MDD, but was not affected byECT. Taken together, our results support a model of ventral/dorsal imbalance inMDD and further suggest that the VS is a key structure contributing to thisdesynchronization.

Desynchronization and Plasticity of Striato-frontal Connectivity in Major Depressive Disorder