Dynamic and static changes of amplitude of low-frequency fluctuations associated with childhood trauma in youth major depression disorder patients with atypical features.

BACKGROUND

Major depressive disorder (MDD) with atypical features often characterized with increased misdiagnosis and poor response to standard treatment. This research explores the neurobiological mechanisms underlying atypical depression (AD) by examining spontaneous brain activity and childhood trauma contrasting these findings with non-atypical depression (NAD).

METHODS

A total 93 youth patients with MDD (31 with AD and 62 NAD) and 52 healthy controls (HCs) were studied using resting-state functional magnetic resonance imaging (fMRI). We employed the amplitude of low-frequency fluctuation (ALFF) method alongside a sliding-window dynamic analysis to investigate temporal variations in local brain activity. Childhood trauma was evaluated using the Childhood Trauma Questionnaire (CTQ).

RESULTS

Both the youth AD and NAD exhibited increased dynamic ALFF (dALFF) in the midbrain, and decreased static ALFF (sALFF) in the left lingual gyrus (LG) and the bilateral anterior cingulate cortex (ACC) when compared to HCs. Both MDD groups exhibited increased sALFF in the left cerebellum relative to HCs, whereas AD demonstrated decreased sALFF in the left inferior temporal gyrus (ITG) when compared to NAD. The elevated sALFF in the left cerebellum was inversely correlated with CTQ emotional and physical neglect scores in AD.

CONCLUSIONS

Abnormal spontaneous brain activity in the midbrain, LG, ACC, and cerebellum may represent inherent characteristics of MDD, regardless of atypical features. Childhood trauma may be an early risk factor for MDD, which is not sufficient to distinguish between atypical and non-atypical phenotypes.