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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0905

Changes in moment-to-moment neural variability following adjunctive pramipexole treatment in anhedonic depression: a 7 Tesla MRI study

CHANGES IN MOMENT-TO-MOMENT NEURAL VARIABILITY AFTER PRAMIPEXOLE ADD-ON TREATMENT FOR ANEDHONIC DEPRESSION: A 7 TESLA MRI STUDY

Adjunctive pramipexole treatment led to increased resting-state neural variability in depression-related brain networks compared with placebo.

The aim was to characterize changes in neural variability induced by pramipexole, a dopamine receptor agonist emerging as an effective adjunctive treatment option for anhedonia. Neural variability was defined as the temporal standard deviation of the BOLD signal (SD-BOLD) for each voxel; whole-brain voxelwise partial least squares (PLS) analyses were performed before and after treatment in a subgroup of 51 patients from the 2026 Nature Medicine study by Ventorp and colleagues (k=44,674). An MDD-related brain network derived from the 2023 Molecular Psychiatry study by Wei and colleagues, which showed reduced neural variability in medication-naïve patients with major depressive disorder (MDD) compared with healthy controls, was also examined. Following resting-state fMRI assessment, patients with anhedonic MDD were randomized to adjunctive pramipexole or placebo and monitored using the SHAPS and MADRS scales. Pramipexole produced a greater reduction in anhedonia symptoms (SHAPS scores) than placebo (mean difference −4.04; 95% confidence interval −6.89 to −1.18; p=0.006; Hedges' g=0.62). The interaction effect between group (pramipexole, placebo) and time (before treatment, after treatment) showed a greater increase in resting-state neural variability in patients with MDD receiving pramipexole than in those receiving placebo (permutation p=0.026, BSR±3). Analysis of the MDD-related neural network also confirmed a group-by-time interaction (permutation p=0.036, BSR±2), showing increased neural variability following adjunctive pramipexole treatment in regions such as the lingual gyrus and right superior temporal gyrus. In conclusion, this increase observed in pramipexole-treated patients is consistent with previous evidence linking higher neural variability to healthier and more adaptive neural functioning and suggests normalization following treatment; pramipexole-induced changes in resting-state neural variability may serve as an indicator of treatment-related modulation of anhedonia.

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