Structural alterations of the brain preceded functional alterations in major depressive disorder patients: Evidence from multimodal connectivity

Background: Recent studies showed that major depressive disorder (MDD)has been involved in abnormal functional and structural connections in specific brain regions. However, comprehensive researches on MDD-related alterations in the topological organization of brain functional and structural networks are still limited. Methods: Functional network (FN)was constructed from resting-state functional MRI temporal series correlations and structural network (SN)was established by Diffusion tensor imaging (DTI)data in 58 MDD patients and 71 healthy controls (HC). The measurements of the network properties were calculated for two networks respectively. Correlations were conducted between altered network parameters and Hamilton depression scale (HAMD)score. Additionally, network resilient analysis were conducted on FN and SN. Results: The losses of small-worldness charateristics and the decline of nodal efficiency across FN and SN were found in MDD patients. Based on network-based statistic (NBS)approach, the decreased connections in MDD patients were mainly found in the superior occipital gyrus, superior temporal gyrus for FN and SN, while the increased connections were distributed in putamen, superior frontal gyrus only for SN. Compared with the FN, the SN showed less resilient to targeted or random node failure. Besides, altered edges in NBS and regions with decreased nodal efficiency were negatively associated with HAMD score in MDD patients. Limitations: The samples size is small and most of the MDD patients take different antidepressant medications. Conclusions: Alterations of SN in the brain of MDD patients preceded that of FN to some extent, and reorganization of the brain network was a mechanism which compensated for functional and structural alterations during disease progression.