Healing the wandering mind : Treatment of the default mode network in major depressive disorder

Abstract: Rumination, or extensive mind wandering defines one of the key cognitive symptoms of major depressive disorder (MDD). Several symptoms included in the psychiatric disorder have been associated with altered connectivity within the large-scaled system default mode network (DMN). Although it’s well-known that antidepressant treatment, such as selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) tend to positively affect symptoms and alterations of MDD, results are inconsistent regarding DMN connectivity pre-and-post treatment. This systematic review aims to compile findings from studies investigating DMN connectivity in MDD patients’ pre-and post SSRI and SNRItreatment, and to find possible correlations with symptomatic improvements. Five articles were included for further analysis after the literature search in MEDLINE ESBSCO and Scopus. Main findings are in alignment with previous research and suggest both hypo-and hyper DMN connectivity at baseline in MDD patients, and connectivity patterns significantly similar to healthy controls following antidepressant treatment. Future research might consider placebo controlled trials for more diverse, and quantified results, and also consider further investigation on both first-line treatments and other promising antidepressants.