Rumination and Default Mode Network Subsystems Connectivity in First-episode, Drug-Naive Young Patients with Major Depressive Disorder

Neuroimaging evidence implicates the association between rumination and default mode network (DMN) in major depressive disorder (MDD). However, the relationship between rumination and DMN subsystems remains incompletely understood, especially in patients with MDD. Thirty-three first-episode drug-naive patients with MDD and thirty-three healthy controls (HCs) were enrolled and underwent resting-sate fMRI scanning. Functional connectivity analysis was performed based on 11 pre-defined regions of interest (ROIs) for three DMN subsystems: the midline core, dorsal medial prefrontal cortex (dMPFC) and medial temporal lobe (MTL). Compared with HCs group, patients with MDD exhibited increased within-system connectivity in the dMPFC subsystem and inter-system connectivity between the dMPFC and MTL subsystems. Decreased inter-system connectivity was identified between the midline core and dMPFC subsystem in MDD patients. Depressive rumination was positively correlated with within-system connectivity in the dMPFC subsystem (dMPFC-TempP) and with inter-system connectivity between the dMPFC and MTL subsystems (LTC-PHC). Our results suggest MDD may be characterized by abnormal DMN subsystems connectivity, which may contribute to the pathophysiology of the maladaptive self-focus in MDD patients.