Dysfunction of the cingulo-opercular network in first-episode medication-naive patients with major depressive disorder
Abstract
Background Major depressive disorder (MDD) is a common psychiatric disorder that may be associated with abnormal cognitive control and emotion regulation. Previous studies have found that network disconnection within the cingulo-opercular network (CON) plays an important role in psychiatric disorders and that the CON may be relevant to the psychopathology of MDD. We thus used the resting-state functional connectivity method in patients with MDD and healthy controls to examine CON neural circuit abnormalities in MDD.Methods Using resting-state functional magnetic resonance imaging (fMRI), we investigated the resting state functional connectivity of the CON using the dorsal anterior cingulate cortex (dACC) as the seed region of interest. The resulting functional connectivity (FC) correlation maps were employed to investigate between-group differences. Additionally, we examined the association between depression symptom severity and functional connectivity results. The participants were patients with MDD (n=19) and healthy controls (n=19).Results Patients with MDD showed abnormalities in the connectivity of the CON. We found abnormal connectivity in MDD patients between the dACC and the bilateral middle frontal gyrus (MFG) and left angular gyrus (LAG) and precentral gyrus. Moreover, regression analysis showed that depression symptom severity (measured with the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and Automatic Thoughts Questionnaire scores (ATQ)) was significantly correlated with the FC values of the CON.Limitations First, our study consisted of a relatively small sample size that may have limited statistical power. Second, the current study design cannot conclusively specify the role of the CON in the neuropathology of depression.Conclusions Our findings suggest that MDD is associated with disrupted FC of the CON, which plays an important role in the pathophysiological mechanisms of MDD.
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Cortical thinning in these regions has also been observed in MDD relative to controls, and thus seems regionally similar but more severe in anxious depression.
“Cortical thinning in these regions have also been observed in MDD relative to controls [75], and thus seem regionally similar but more severe in anxious depression.”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [75]
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“It has been found that there is abnormal functional connectivity between left angular gyrus and precentral gyrus in depression patients (Wu et al., 2016).”
BackgroundBrain responses to social feedback in internalizing disorders: A comprehensive review
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“In the parcellation by Power et al. (2011), the MRN consists of parts of the posterior cingulate, posterior medial and lateral parietal cortex, regions with strong activation in memory retrieval, and frequently included in the DMN in other parcellations (Allen et al., 2011; Yeo et al., 2011).”
InfluentialWang, J., Ji, Y., Li, X., He, Z., Wei, Q., Bai, T., Tian, Y., & Wang, K. (2020) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2020.109888 · Cited by 42 · see citing works
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The superior longitudinal fasciculus and its functional triple-network mechanisms in brooding
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“It is also a critical hub in the cingulo-opercular network, which is related to the psychopathology of depressive disorders (Wu et al., 2016).”
BackgroundAltered brain regional homogeneity is associated with depressive symptoms in COVID-19
Cattarinussi, G., Miola, A., Trevisan, N., Valeggia, S., Tramarin, E., Mucignat‐Caretta, C., Morra, F., Minerva, M., Librizzi, G., Bordin, A., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.06.061 · Cited by 32 · see citing works
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“Some recent studies have characterized distinct resting-state MRI based-functional connectivity in patients with MDD (10), apathetic depression (11), and remitted MDD (12).”
BackgroundChen, X., Lü, B., Wang, Y., Li, X.-Y., Wang, Z., Li, H.-X., Liao, Y., Blumberger, D. M., Castellanos, F. X., Garza‐Villarreal, E. A., et al. (2025) · 中国科学通报:英文版 · doi:10.1016/j.scib.2025.05.042 · Cited by 32 · see citing works
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“Several previous studies have indicated decreased negative resting-state functional connectivity between the DMN and SN in patients with MDD, not only at a single-node level 63 but also at a network level.”
Temporal and Spatial Dynamics of EEG Features in Female College Students with Subclinical Depression
Zhao, S., Ng, S., Khoo, S., & Chi, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031778 · Cited by 26 · see citing works
“Several studies have suggested abnormalities in large-scale brain networks of patients with depression, including inadequate connectivity in the frontoparietal network [4], reward circuits centered in the ventral striatum [28], and reduced functional connectivity between the frontoparietal and cingulo-opercular networ…”
Background7T ultra-high-field neuroimaging for mental health: an emerging tool for precision psychiatry?
Neuner, I., Veselinović, T., Ramkiran, S., Rajkumar, R., Schnellbächer, G. J., & Shah, N. J. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-01787-3 · Cited by 26 · see citing works
“Disturbed connectivity has been reported in the cingulo-opercular network in first-episode medication-naive patients with major depressive disorder [46].”
BackgroundStern, E. R., Eng, G. K., Nadai, A. S. D., Iosifescu, D. V., Tobe, R. H., & Collins, K. A. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-01780-w · Cited by 23 · see citing works
Major depressive disorder on a neuromorphic continuum
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“Previousstudies havereported that theCON wasa key area involved in the pathology of MDD, which was found using functional MRI, metabolic studies, and perfusion approaches to be altered in MDD patients 63 .”
Krug, S., Müller, T., Kayali, Ö., Leichter, E., Peschel, S. K. V., Jahn, N., Winter, L., Krüger, T. H. C., Kahl, K. G., Sinke, C., et al. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.07.040 · Cited by 20 · see citing works
Neural functional connectivity during rumination in individuals with adverse childhood experiences
Sokołowski, A., Kowalski, J., & Dragan, M. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008198.2022.2057700 · Cited by 19 · see citing works
“CONTACT Małgorzata Dragan malgorzata.dragan@psych.uw.edu.pl Faculty of Psychology, University of Warsaw, Stawki 5/7, Warszawa, 00-183, Poland 有不良童年经历的个体在反刍过程中的神经功能连接 背景:童年逆境与发展精神病理学、情绪刺激处理改变和神经功能变化的风险增加有关。 尽管之前已经描述了反刍的神经相关性,对于童年的不良经历与反刍期间的大脑功能之间 的关系知之甚少。 目的:本研究探讨了有无童年逆境史的参与者之间神经功能连接的差异,控制了反刍倾 向、静息状态和反刍诱导。 方法:共有 86 名成年…”
BackgroundInfluentialGuo, Z., Liao, D., Chen, L., Wang, C., Qu, M., Lv, X., Fang, J., & Liu, C. (2024) · Brain Sciences · doi:10.3390/brainsci14090945 · Cited by 19 · see citing works
“These findings demonstrate that taVNS treatment may improve depressive symptoms by modulating the disrupted network topological organization in patients with MDD, which may provide new insights into the underlying brain mechanism for patients with MDD.”
BackgroundZhu, H., Zuo, L., Zhu, W., Jing, J., Zhang, Z., Ding, L., Wang, F., Cheng, J., Wu, Z., Wang, Y., et al. (2022) · Brain Imaging and Behavior · doi:10.1007/s11682-022-00689-8 · Cited by 20 · see citing works
“, 2018), major depressive disorder (Wu et al., 2016), Alzheimer’s disease (Tumati et al.”
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Focal application of accelerated iTBS results in global changes in graph measures
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“(Wu et al., 2016) showed that depression symptom severity was significantly correlated with the connectivity values of this network.”
BackgroundChi, S., Song, M., Lee, J., Ko, M., Suh, S., & Lee, M. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.08.026 · Cited by 15 · see citing works
Using dynamic graph convolutional network to identify individuals with major depression disorder
Zhou, N., Yuan, Z., Zhou, H., Lyu, D., Wang, F., Wang, M., Lu, Z., Huang, Q., Chen, Y., Huang, H., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.11.035 · Cited by 15 · see citing works
Wu, X., Liang, C., Bustillo, J., Kochunov, P., Wen, X., Jing Sui (Beijing Normal University), my correct affiliation is beijing normal university, N. Q. U. O. S. A. T., Jiang, R., Yang, X., Fu, Z., Zhang, D., et al. (2025) · Human Brain Mapping · doi:10.1002/hbm.70206 · Cited by 16 · see citing works
“…as replicable AN-VIN across 4 functional atlases were identified in MDD. Previous studies showed that HDRS was significantly correlated with the FC values of the cingulo-opercular network (AN-related) (Wu et al. 2016) and FC between medial PFC and left angular gyrus (PL-related) (Wang et al. 2019).”
Shan, Z., Mohamed, A. Z., Schwenn, P., McLoughlin, L. T., Boyes, A., Sacks, D. D., Driver, C., Calhoun, V. D., Lagopoulos, J., & Hermens, D. F. (2022) · NeuroImage · doi:10.1016/j.neuroimage.2022.119358 · Cited by 13 · see citing works
Cognitive vulnerabilities and Depression: A Culture-Moderated Meta-Analysis
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“They discussed a putative link between MS E and the “task-positive” CON, which plays a central role in sustaining alertness/perceptual readiness (Coste and Kleinschmidt 2016; Sadaghiani and D’Esposito 2015), and whose disrupted connectivity was observed in depression (Wu et al. 2016).”
BackgroundZhang, W., Braden, B. B., Miranda, G., Shu, K., Wang, S., Liu, H., & Wang, Y. (2021) · Neuroinformatics · doi:10.1007/s12021-021-09523-w · Cited by 10 · see citing works
“Moreover, (Wu et al. 2016) found ATQ scores were correlated with functional connectivity of the cingulo-opercular network, which includes the PrG, in MDD patients.”
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Resting-state dynamics as a neuromarker of dopamine administration in healthy female adults
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“The studies involving patients with depression included a larger sample size compared to those on FM, with only four studies having a sample size of 20 or fewer participants (Peng et al., 2015, 2018; Wu et al., 2016; Luan et al., 2019).”
Jing, R., Huo, Y., Si, J., Li, H., Yu, M., Lin, X., Liu, G., & Li, P. (2022) · Brain Imaging and Behavior · doi:10.1007/s11682-022-00739-1 · Cited by 3 · see citing works
“Recently, a few studies obtained significant results about FEDN MDD (Wu et al., 2016; Yang et al., 2018; Zhang et al., 2022).”
ResultExamining the role of physical activity in older adults with epilepsy
Klaus, S. P., Akkol, S., Achuthan, S. K., He, A., Zheng, C., Faught, E., & Alexander, H. B. (2025) · Epilepsy & Behavior Reports · doi:10.1016/j.ebr.2025.100756 · Cited by 3 · see citing works
“Dysfunction of this network is associated with mood disturbance including depression [94] and anhedonia [95].”
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“…2023; Chin Fatt, Cooper, Jha, Aslan, et al., 2021; Rolle et al., 2020), and align with studies on similar datasets (Chen et al., 2018; Godlewska et al., 2018; Karim et al., 2018; Korgaonkar et al., 2020; Li et al., 2023; Lu et al., 2020; Martens et al., 2022; Strege et al., 2023; Wu et al., 2016).”
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Serum KNG and FVIII may serve as potential biomarkers for depression
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“Such disruptions may bias the inappropriate attribution of salience to external cues, contributing to heightened threat sensitivity and persistent rumination [47 – 50].”
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“Impairment in mood regulation [39,40], which is described as a vulnerability to develop a depressive state and an inability to disengage from that state [41], may negatively impact drive and is also a core feature of a major depressive episode.”
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Increased Aperiodic Exponents Track Depression Symptom SeverityPreprint
Libowitz, M. R., Sun, W., Rabinovich, R. J., Du, J., Campbell, J. M., Cowan, R. L., Shahdoust, N., Price, T. A., Davis, T. S., Buckner, R. L., et al. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2025.12.17.694966
Increased Aperiodic Exponents Track Depressive Symptom Severity in Refractory Epilepsy
Libowitz, M. R., Sun, W., Rabinovich, R. J., Du, J., Campbell, J. M., Cowan, R. L., Shahdoust, N., Price, T. A., Davis, T. S., Buckner, R. L., et al. (2026) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2026.06.017
- Authors
- Wu, X., Lin, P., Yang, J., Song, H., Yang, R., & Yang, J.
- Affiliations
- First Affiliated Hospital of Xi'an Jiaotong University (CN)
- Xi'an Jiaotong University (CN)
- Xian Central Hospital (CN)
- Corresponding author
- Lin, Pan
- Yang, Jian
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 200
- Pages
- 275-283
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2345054935
- Cited by
- 73
- References
- 72
- Citations by year
- 2026: 2 · 2025: 13 · 2024: 8 · 2023: 5 · 2022: 15 · 2021: 6 · 2020: 5 · 2019: 8 · 2018: 5 · 2017: 5 · 2016: 1
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- major depressive disorder, cingulo-opercular network, resting-state functional connectivity, dorsal anterior cingulate cortex, depression severity, middle frontal gyrus, angular gyrus, precentral gyrus, emotion regulation, cognitive control
- MeSH terms
- Adult, Cerebral Cortex, Major Depressive Disorder, Emotions, Female, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Nerve Net, Young Adult
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