{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:07:13Z","timestamp":1786975633356,"version":"build-2736575974"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230791-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Selective serotonin reuptake inhibitors (SSRIs) are considered a first-line pharmacological treatment for adolescent depression with moderate or higher levels of symptom severity. Thus, it is important to understand neurobiological changes related to SSRIs during the course of treatment for adolescents with depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi230791-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine neurobiological changes associated with SSRI treatment in adolescents with major depressive disorder (MDD) by measuring longitudinal changes in volume and resting-state functional connectivity (rsFC) in the dorsolateral prefrontal cortex (DLPFC), a core region of cognitive control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi230791-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cohort study was conducted with an open-label design. Adolescents with MDD and healthy controls were recruited at the Seoul National University Hospital (Seoul, South Korea). Adolescents with MDD were treated with escitalopram for 8 weeks. Data analysis was conducted between April 2021 and February 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi230791-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Depressive symptoms were assessed using the Children\u2019s Depression Rating Scale\u2013Revised. The outcome measure was defined as the change in Children\u2019s Depression Rating Scale\u2013Revised scores from week 0 (before treatment) to week 8 (after treatment) or upon termination. Participants completed structural and resting-state functional magnetic resonance imaging (rsfMRI) assessments before (week 0) and after (week 8) SSRI treatment. Repeated measures analysis of variance and liner mixed model analyses were used to examine the longitudinal associations of SSRI treatment with DLPFC volume and rsFC between responders who showed at least a 40% decrease in depressive symptoms and nonresponders who did not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi230791-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-five adolescents with MDD and 57 healthy controls were initially recruited. The final analyses of volume included 36 responders (mean [SD] age, 15.0 [1.6] years; 25 girls [69.4%]) and 26 nonresponders (mean [SD] age, 15.3 [1.5] years; 19 girls [73.1%]). Analyses of rsFC included 33 responders (mean [SD] age, 15.2 [1.5] years; 21 girls [63.6%]) and 26 nonresponders (mean [SD] age, 15.3 [1.5] years; 19 girls [73.1%]). The longitudinal associations of SSRI treatment were more evident in responders than in nonresponders. Responders showed significantly increased right DLPFC volume, decreased bilateral DLPFC rsFC with the superior frontal gyri, and decreased left DLPFC rsFC with the ventromedial PFC after treatment compared with before treatment. Furthermore, increased right DLPFC volume was correlated with decreased rsFC between the right DLPFC and superior frontal gyri after SSRI treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi230791-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The preliminary results of this cohort study suggest that the DLPFC volumetric and rsFC changes may serve as potential neurobiological treatment markers that are associated with symptom improvement in adolescents with MDD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.27331","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T11:31:26Z","timestamp":1691148686000},"page":"e2327331","source":"Crossref","is-referenced-by-count":31,"title":["Measures of Connectivity and Dorsolateral Prefrontal Cortex Volumes and Depressive Symptoms Following Treatment With Selective Serotonin Reuptake Inhibitors in Adolescents"],"prefix":"10.1001","volume":"6","author":[{"given":"Kyung Hwa","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyoon","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung","family":"Lee","sequence":"additional","affiliation":[{"name":"Integrative Care Hub, Seoul National University Children\u2019s Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyun","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Catholic University of Korea, Seoul St Mary\u2019s Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Brent","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, 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