Mindfulness-based cognitive therapy (MBCT) alters brain network dynamics during depressive rumination in people with recurrent depression. In a randomized trial, 27 patients received MBCT plus treatment as usual, while 21 received treatment as usual alone. Using fMRI, researchers analyzed brain substates during an induced rumination state before and after treatment. MBCT changed the probability of a specific 'Salience-somatomotor' brain substate occurring during rumination, compared to the control group. These dynamic network changes were linked to reduced depressive symptoms after treatment and at three months follow-up, suggesting a candidate brain mechanism for how mindfulness training improves clinical outcomes.
This preregistration describes an update and extension of a meta-analysis examining ketamine and esketamine for adults with treatment-resistant major depressive disorder. The project is nested within a larger network meta-analysis of next-step strategies for treatment-resistant depression. It restricts interventions to ketamine and esketamine regimens versus placebo, structures outcomes into three time windows (24–72 hours, 1–3 weeks, and 4–12 weeks), and pools results using pairwise random-effects meta-analyses rather than network meta-analysis due to expected lack of direct comparisons between treatment nodes. Short-term outcomes will be extracted from longer-term trials. Subgroup and meta-regression analyses are exploratory.