A treatment response comparison study with resti̇ng state functional magneti̇c resonance imaging between standard treatment of ssri with standard treatment of ssri plus a nondominant hand writing study in pati̇ents with major depressive disorder

Introduction: Major depressive disorder (MDD) is a mental disorder that contributes greatly to the global burden of disease by the World Health Organization (WHO) because of its prevalence in the community, the high likelihood of recurrence despite various treatment modalities and the loss of functionality it causes. In MDD, it is seen that the researches have recently shifted from functional and structural imaging studies to functional connectivity studies. Method: In our study, 26 patients with similar sociodemographic characteristics were administered pre-treatment rs-f MRI imaging and psychiatric evaluation scales and the patient group was divided into two groups to compare the treatment response. Standard antidepressant treatment was given to both groups and a randomly selected group was given nondominant hand writing (left hand in our study). After eight weeks of treatment, all patients were reevaluated with rs-f MRI imaging and psychiatric scales. Results: Post-treatment depression and frontal function scale scores were significantly different in both groups. At the end of the study, only two brain regions had a statistically significant change in the interdependence of the only-drug group, whereas a significant change was observed in the interconnectivity of the ten brain regions in the group receiving the nondominant hand study with the drug. When the intergroup changes were statistically compared, the functional connectivity of the 13 regions was significantly different. The density of the frontal and limbic regions draws attention among network connecitivity changes and seems to be compatible with the scale change. Conclusion: In our study, we investigated the changes in brain networks according to treatment response in individuals with MDD. We observed that the nondominant hand study inspired and developed by 'Eye Movement Desensitization and Reprocessing' (EMDR) method caused significant differences in response to treatment. The nondominant handwriting task, which we propose as an adjuvant method in addition to standard medical treatment, can be considered as a new treatment support for patients with various limitations in achieving professional psychotherapeutic support in MDD treatment. We think that our study will contribute to the current literature with our efforts to evaluate all brain regions and networks that may be related to depressive disorder together, without being limited to a few regions.