Journal of affective disorders · 2026
Longitudinal structural connectome changes linked to recovery and persistence in women with postpartum depression.
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Li Yang, Wang Man, Han Wei, Zhang Tingting, Zhu Yuanyuan, Zhu Ying, Xu Yuhao
Аннотация
BACKGROUND: Clinical outcomes in postpartum depression (PPD) are highly heterogeneous, yet the neurobiological mechanisms underlying recovery remain unclear. Identifying network-based biomarkers that reflect the brain's capacity for adaptive reorganization may improve prognostic accuracy and support individualized treatment.
METHODS: We conducted a longitudinal diffusion tensor imaging (DTI) study of 115 PPD patients and 40 healthy postpartum controls. All participants underwent DTI scans and clinical assessments at baseline (Time 1), 3 months (Time 2), and 6 months (Time 3). Based on 6-month outcomes, patients were classified into a recovery group (PPD-R, N = 72) and a non-recovery group (PPD-NR, N = 43). Graph-theoretical analyses assessed network topology across timepoints, focusing on rich-club connections, feeder connections, and local connections, as well as small-world properties. Psychosocial variables including perceived social support were also evaluated.
RESULTS: At baseline, both PPD-R and PPD-NR groups showed reduced local connections (F = 13.034, P < 0.001) and small-world properties (F = 17.219, P < 0.001). During follow-up, only the PPD-R group exhibited significant recovery of rich-club connections (ttime1-time2 = -3.900, P < 0.001; ttime1-time3 = -4.325, P < 0.001), which correlated with initial small-world properties (βrich-club connections = 0.456, P < 0.001; β∆rich-club connections = 0.405, P < 0.001) and predicted final depression severity (OR = 0.713 [95%CI: 0.568-0.832], AUC = 0.819, P < 0.001). Perceived social support significantly moderated the relationship between small-world properties and rich-club recovery (βperceived social support-small-world properties = 0.223, P = 0.002).
CONCLUSION: Recovery from PPD was associated with selective reorganization of rich-club connections. Efficient small-world topology was related to greater rich-club reorganization, and perceived social support moderated this relationship. These findings suggest that rich-club connections may serve as a potential prognostic marker of recovery in PPD.
METHODS: We conducted a longitudinal diffusion tensor imaging (DTI) study of 115 PPD patients and 40 healthy postpartum controls. All participants underwent DTI scans and clinical assessments at baseline (Time 1), 3 months (Time 2), and 6 months (Time 3). Based on 6-month outcomes, patients were classified into a recovery group (PPD-R, N = 72) and a non-recovery group (PPD-NR, N = 43). Graph-theoretical analyses assessed network topology across timepoints, focusing on rich-club connections, feeder connections, and local connections, as well as small-world properties. Psychosocial variables including perceived social support were also evaluated.
RESULTS: At baseline, both PPD-R and PPD-NR groups showed reduced local connections (F = 13.034, P < 0.001) and small-world properties (F = 17.219, P < 0.001). During follow-up, only the PPD-R group exhibited significant recovery of rich-club connections (ttime1-time2 = -3.900, P < 0.001; ttime1-time3 = -4.325, P < 0.001), which correlated with initial small-world properties (βrich-club connections = 0.456, P < 0.001; β∆rich-club connections = 0.405, P < 0.001) and predicted final depression severity (OR = 0.713 [95%CI: 0.568-0.832], AUC = 0.819, P < 0.001). Perceived social support significantly moderated the relationship between small-world properties and rich-club recovery (βperceived social support-small-world properties = 0.223, P = 0.002).
CONCLUSION: Recovery from PPD was associated with selective reorganization of rich-club connections. Efficient small-world topology was related to greater rich-club reorganization, and perceived social support moderated this relationship. These findings suggest that rich-club connections may serve as a potential prognostic marker of recovery in PPD.