Disrupted left frontal operculum connectivity in adolescent depression: Mediating the impact of childhood emotional neglect.

BACKGROUND

Major depressive disorder (MDD) in adolescence is a major public health issue, with childhood emotional neglect recognized as a key environmental risk factor. However, the neurobiological mechanisms linking early emotional neglect to brain development and depression remain unclear. Previous studies have largely focused on single-modal imaging, neglecting the potential benefits of integrating structural and functional data.

METHODS

34 adolescents with MDD and 30 healthy controls (HCs) participated in the study. The key brain area was identified by calculating and comparing the intensity of structure-function coupling (SFC) between the two groups. Mediation analysis and whole-brain functional connectivity analysis were subsequently employed to explore the relationship between this brain region, emotional neglect, and clinical depression symptoms.

RESULTS

Adolescents with MDD exhibited significantly lower SFC in the left frontal operculum (L-FOP) compared to HCs (p < 0.001). Mediation analysis across all three models consistently revealed that the SFC of L-FOP plays a crucial role in linking emotional neglect to depression (p < 0.05). Additionally, extensive disruptions in functional connectivity between the L-FOP and key brain networks were observed, with these altered connections strongly correlating with clinical depressive symptoms (p < 0.05).

CONCLUSION

Childhood emotional neglect may increase vulnerability to adolescent depression by disrupting SFC within the L-FOP, a critical hub for sensory, emotional, and cognitive integration. This decoupling is associated with widespread brain network dysfunction, contributing to emotional dysregulation and cognitive impairment. These findings highlight the L-FOP as a potential target for early detection and neuromodulation interventions in adolescent depression.