Introduction: Major depressive disorder (MDD) is a common, relapse-prone psychiatric disorder with unknown pathogenesis. Previous studies on resting-state functional magnetic resonance imaging of MDD have mostly focused on the spontaneous activity of blood oxygen level-dependent (BOLD) signals; however, a few studies have investigated BOLD signal stability. Methods: We conducted a resting-state functional study in 42 patients with MDD and 42 healthy controls (HC) matched for age and sex. This included the BOLD signal stability, resting-state functional connectivity (RSFC) analysis, correlation analysis, and support vector machine (SVM) analysis. Results: The BOLD signal stability of the left fusiform gyrus, right inferior temporal gyrus, right temporal pole superior temporal gyrus, and left thalamus was significantly lower in the MDD group compared to the HC group. Further RSFC analysis revealed that the connectivity between right inferior temporal gyrus and both left inferior temporal gyrus and left supramarginal gyrus was significantly reduced in the MDD group. Additionally, the RSFC levels of left thalamus and right thalamus were decreased. Combining BOLD signal stability and RSFC, the SVM-based classification model achieved an accuracy of 80.95% (sensitivity: 78.57%; specificity: 83.33%; receiver-operating characteristic area under the curve: 0.8793). Conclusion: The integration of the BOLD signal stability index and RSFC index demonstrates a robust capability to differentiate between individuals with MDD and HC subjects. We tentatively believe that a combination of the BOLD signal stability index and RSFC can be used to diagnose MDD.
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