Targeted neurostimulation reverses a spatiotemporal biomarker of treatment-resistant depression

Major depressive disorder (MDD) is one of the most significant causes of morbidity in the world. However, despite decades of functional neuroimaging research, the biological signatures of MDD remain poorly understood. Here, we characterize the propagation of spontaneous brain activity using fMRI to investigate whether the flow of neural activity differs between patients with MDD and typical controls. We find a group of patients with MDD whose symptoms are linked to aberrant propagation of brain activity within the salience network. Additionally, TMS can restore typical propagation patterns in the salience network and relieve symptoms. In sum, our results offer a pathway for identifying and treating mechanisms of neuropsychiatric diseases.