Esketamine combined with sertraline for brain altered regional homogeneity in patients with major depressive disorder: A preliminary study
Bibliographic record
Abstract
INTRODUCTION: This study aims to explore the relationship between the antidepressant effects of drugs (esketamine combined with sertraline) and brain function changes in patients with major depressive disorder. METHODS: A total of 27 patients with major depressive disorder (MDD) and 27 healthy individuals were included in the study. All MDD patients received a 2-week course of intravenous esketamine infusion (0.25 mg/kg) combined with sertraline. We assessed patients' post-treatment emotional and cognitive recovery using the Hamilton Anxiety Scale, Hamilton Depression Scale, Beck Suicide Ideation Scale, and Montreal Cognitive Assessment Scale. Additionally, all participants underwent magnetic resonance imaging (MRI) scans, with local consistency techniques employed to evaluate changes in brain spontaneous activity before and after treatment. Finally, correlation analysis was used to assess the relationship between the characteristics of spontaneous brain activity in MDD patients and clinical scales. RESULTS: We found that the Reho values of certain brain regions in MDD patients differed from those in the healthy group, primarily manifested as increased regional homogeneity (Reho) values in the right superior frontal gyrus, right precentral gyrus, right middle occipital gyrus, and left middle temporal gyrus; and decreased Reho values in the right middle temporal gyrus, bilateral temporal lobes, and right posterior cerebellar lobe. After two weeks of drug treatment, we observed a reversal in the local consistency of the left middle temporal gyrus (L-MTG), which tended toward normal levels. Additionally, we observed significant improvements in anxiety, depression symptoms, suicidal ideation, and MoCA scores in MDD patients post-treatment. Furthermore, changes in Reho values in the left middle temporal gyrus (L-MTG) were significantly correlated with scores on clinical assessment scales (HAMA). CONCLUSION: Patients with MDD exhibit imbalances in spontaneous brain activity. The L-MTG, as a key hub of the default mode network and salience network, is associated with the severity of depression and recovery after treatment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".