Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.
Department of Radiology, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.
Asian J Psychiatr. 2024 May;95:104009. doi: 10.1016/j.ajp.2024.104009. Epub 2024 Mar 18.
Adolescent depression shows high clinical heterogeneity. Brain functional networks serve as a powerful tool for investigating neural mechanisms underlying depression profiles. A key challenge is to characterize how variation in brain functional organization links to behavioral features and psychosocial environmental influences.
We recruited 80 adolescents with major depressive disorder (MDD) and 42 healthy controls (HCs). First, we estimated the differences in functional connectivity of resting-state networks (RSN) between the two groups. Then, we used sparse canonical correlation analysis to characterize patterns of associations between RSN connectivity and symptoms, cognition, and psychosocial environmental factors in MDD adolescents. Clustering analysis was applied to stratify patients into homogenous subtypes according to these brain-behavior-environment associations.
MDD adolescents showed significantly hyperconnectivity between the ventral attention and cingulo-opercular networks compared with HCs. We identified one reliable pattern of covariation between RSN connectivity and clinical/environmental features in MDD adolescents. In this pattern, psychosocial factors, especially the interpersonal and family relationships, were major contributors to variation in connectivity of salience, cingulo-opercular, ventral attention, subcortical and somatosensory-motor networks. Based on this association, we categorized patients into two subgroups which showed different environment and symptoms characteristics, and distinct connectivity alterations. These differences were covered up when the patients were taken as a whole group.
This study identified the environmental exposures associated with specific functional networks in MDD youths. Our findings emphasize the importance of the psychosocial context in assessing brain function alterations in adolescent depression and have the potential to promote targeted treatment and precise prevention.
青少年抑郁症表现出高度的临床异质性。脑功能网络是研究抑郁特征潜在神经机制的有力工具。一个关键的挑战是描述大脑功能组织的变化如何与行为特征和心理社会环境影响相关联。
我们招募了 80 名患有重度抑郁症（MDD）的青少年和 42 名健康对照组（HCs）。首先，我们估计了两组之间静息态网络（RSN）功能连接的差异。然后，我们使用稀疏典型相关分析来描述 MDD 青少年的 RSN 连接与症状、认知和心理社会环境因素之间的关联模式。聚类分析用于根据这些脑-行为-环境关联对患者进行同质亚型分层。
与 HCs 相比，MDD 青少年的腹侧注意和扣带-顶叶网络之间存在明显的过度连接。我们在 MDD 青少年的 RSN 连接和临床/环境特征之间确定了一个可靠的关联模式。在这种模式中，心理社会因素，特别是人际关系和家庭关系，是影响显着性、扣带-顶叶、腹侧注意、皮质下和躯体感觉运动网络连接变化的主要因素。基于这种关联，我们将患者分为两个亚组，这两个亚组具有不同的环境和症状特征，以及不同的连接改变。当将患者作为一个整体考虑时，这些差异被掩盖了。
这项研究确定了与 MDD 青少年特定功能网络相关的环境暴露因素。我们的发现强调了心理社会环境在评估青少年抑郁症大脑功能改变中的重要性，并有可能促进有针对性的治疗和精确的预防。
