***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: IMPORTANCE The default mode network ( DMN ) is a collection of brain regions that reliably deactivate during goal -directed behaviors and is more active during a baseline , or so-called resting , condition . Coherence of neural activity , or functional connectivity , within the brain 's DMN is increased in major depressive disorder relative to healthy control ( HC ) subjects ; however , whether similar abnormalities are present in persons with dysthymic disorder ( DD ) is unknown . Moreover , the effect of antidepressant medications on DMN connectivity in patients with DD is also unknown . OBJECTIVE To use resting-state functional-connectivity magnetic resonance imaging ( MRI ) to study ( 1 ) the functional connectivity of the DMN in subjects with DD vs HC participants and ( 2 ) the effects of antidepressant therapy on DMN connectivity . DESIGN After collecting baseline MRI scans from subjects with DD and HC participants , we enrolled the participants with DD into a 10-week prospect i ve , double-blind , placebo-controlled trial of duloxetine and collected MRI scans again at the conclusion of the study . Enrollment occurred between 2007 and 2011 . SETTING University research institute . PARTICIPANTS Volunteer sample of 41 subjects with DD and 25 HC participants aged 18 to 53 years . Control subjects were group matched to patients with DD by age and sex . MAIN OUTCOME MEASURES We used resting-state functional-connectivity MRI to measure the functional connectivity of the brain 's DMN in persons with DD compared with HC subjects , and we examined the effects of treatment with duloxetine vs placebo on DMN connectivity . RESULTS Of the 41 subjects with DD , 32 completed the clinical trial and MRI scans , along with the 25 HC participants . At baseline , we found that the coherence of neural activity within the brain 's DMN was greater in persons with DD compared with HC subjects . Following a 10-week clinical trial , we found that treatment with duloxetine , but not placebo , normalized DMN connectivity . CONCLUSIONS AND RELEVANCE The baseline imaging findings are consistent with those found in patients with major depressive disorder and suggest that increased connectivity within the DMN may be important in the pathophysiology of both acute and chronic manifestations of depressive illness . The normalization of DMN connectivity following antidepressant treatment suggests an important causal pathway through which antidepressants may reduce depression Sertraline , one of the oldest antidepressants , remains to be the most efficacious treatment for depression . However , major depression disorder ( MDD ) is characterized by altered emotion processing and deficits in cognitive control . In cognitive interference tasks , patients with MDD have shown excessive hypothalamus activity . The purpose of this study was to examine the effects of antidepressant treatment ( sertraline ) on hypothalamus-anchored resting brain circuitry . Functional magnetic resonance imaging was conducted on depressed patients ( n=12 ) both before and after antidepressant treatment .  After eight weeks of antidepressant treatment , patients with depression showed significantly increased connectivity between the hypothalamus and dorsolateral prefrontal cortex , orbitofrontal cortex , anterior cingulate cortex , insula , putamen , cau date , and claustrum . By contrast , decreased connectivity of the hypothalamus-related areas was primarily located in the inferior frontal gyrus , medial frontal gyrus , cingulated gyrus , precuneus , thalamus , and cerebellum . After eight weeks of antidepressant therapy , 8 out of the 12 depressed subjects achieved 70 % reduction or better in depressive symptoms , as measured on the Hamilton depression rating scale . Our findings may infer that antidepressant treatment can alter the functional connectivity of the hypothalamus resting brain to achieve its therapeutic effect Kendall 's coefficient concordance ( KCC ) can measure the similarity of a number of time series . It has been used for purifying a given cluster in functional MRI ( fMRI ) . In the present study , a new method was developed based on the regional homogeneity ( ReHo ) , in which KCC was used to measure the similarity of the time series of a given voxel to those of its nearest neighbors in a voxel-wise way . Six healthy subjects performed left and right finger movement tasks  in event-related design ; five of them were additionally scanned in a rest condition .  KCC was compared among the three conditions ( left finger movement , right finger movement , and the rest ) . Results show that bilateral primary motor cortex ( M1 ) had higher KCC in either left or right finger movement condition than in rest condition . Contrary to prediction and to activation pattern , KCC of ipsilateral M1 is significantly higher than contralateral M1 in unilateral finger movement conditions . These results support the previous electrophysiologic findings of increasing ipsilateral M1 excitation during unilateral movement . ReHo can consider as a complementary method to model-driven method , and it could help reveal the complexity of the human brain function . More work is needed to underst and the neural mechanism underlying ReHo In this study , we applied coherence to voxel-wise measurement of regional homogeneity of resting-state functional magnetic resonance imaging ( RS-fMRI ) signal . We compared the current method , regional homogeneity based on coherence ( Cohe-ReHo ) , with previously proposed method , ReHo based on Kendall 's coefficient of concordance ( KCC-ReHo ) , in terms of correlation and paired t-test in a large sample of healthy participants . We found the two measurements differed mainly in some brain regions where physiological noise is dominant . We also compared the sensitivity of these methods in detecting difference between resting-state conditions [ eyes open ( EO ) vs. eyes closed ( EC ) ] and in detecting abnormal local synchronization between two groups [ attention deficit hyperactivity disorder ( ADHD ) patients vs. normal controls ] . Our results indicated that Cohe-ReHo is more sensitive than KCC-ReHo to the difference between two conditions ( EO vs. EC ) as well as that between ADHD and normal controls . These preliminary results suggest that Cohe-ReHo is superior to KCC-ReHo . A possible reason is that coherence is not susceptible to r and om noise induced by phase delay among the time courses to be measured . However , further investigation is still needed to eluci date the sensitivity and specificity of these methods It has been hypothesized that one of the effects of antidepressants is to increase functional connectivity between the cortical mood-regulating and the limbic mood-generating regions . One consequence of this antidepressant effect is thought to be decreased limbic activation in response to negative emotional stimuli . Twelve unmedicated unipolar depressed patients and 11 closely matched healthy comparison subjects completed two magnetic resonance imaging ( MRI ) scanning sessions at baseline and after 6 weeks . Depressed patients received treatment with sertraline between the two sessions . During each MRI session , subjects completed a resting state functional connectivity scan and a conventional block- design negative vs. neutral pictures regional brain activation scan . After 6 weeks of sertraline treatment resting state , functional connectivity between the ACC and limbic regions increased while limbic activation in response to negative versus neutral pictures decreased . The results of this study are consistent with the hypothesis that antidepressant treatment has reciprocal effects on corticolimbic functional connectivity and limbic activation in response to emotional stimuli This study explored the relative contribution of the therapist 's technical skills and the qualities inherent in any good human relationship to outcome in time-limited individual psychotherapy . Highly experienced psychotherapists treated 15 patients drawn from a relatively homogeneous patient population ( male college students , selected primarily on the basis of elevations on the depression , anxiety , and social introversion scales of the Minnesota Multiphasic Personality Inventory ) . By traditional diagnostic categories , they would be classified as neurotic depression or anxiety reactions . Obsessional trends and borderline personalities were common . A comparable patient group was treated by  college  professors chosen for their ability to form underst and ing relationships . Patients treated by professors showed , on the average , as much improvement as patients treated by professional therapists . Treated groups slightly exceeded the controls . Group means , however , obscured considerable individual variability The relationship between therapeutic alliance and treatment outcome was examined for depressed out patients who received interpersonal psychotherapy , cognitive-behavior therapy , imipramine with clinical management , or placebo with clinical management .  Clinical raters scored videotapes of early , middle , and late therapy sessions for 225 cases ( 619 sessions ) . Outcome was assessed from patients ' and clinical evaluators ' perspectives and from depressive symptomatology . Therapeutic alliance was found to have a significant effect on clinical outcome for both psychotherapies and for active and placebo pharmacotherapy .  Ratings of patient contribution to the alliance were significantly related to treatment outcome ; ratings of therapist contribution to the alliance and outcome were not significantly linked . These results indicate that the therapeutic alliance is a common factor with significant influence on outcome 
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These included ( 1 ) associations between response to antidepressant medications and increased functional connectivity between frontal and limbic brain regions , possibly result ing in greater inhibitory control over neural circuits that process emotions ; ( 2 ) connectivity of visual recognition circuits in studies that compared treatment resistant and treatment sensitive patients ; ( 3 ) response to TMS was consistently predicted by subcallosal cortex connectivity ; and ( 4 ) hyperconnectivity of the default mode network and hypoconnectivity of the cognitive control network differentiated treatment-resistant from treatment-sensitive MDD patients .