Cited by 748Functional Brain Connectivity StudiesTreatment of Major DepressionMental Health Research Topics

Identifying major depression using whole-brain functional connectivity: a multivariate pattern analysis

Zeng, Ling-Li, Shen, Hui, Liu, Li, Wang, Lubin, Li, Baojuan, Fang, Peng, Zhou, Zongtan, Li, Yaming +1 more·2012·Brain

Abstract

Recent resting-state functional connectivity magnetic resonance imaging studies have shown significant group differences in several regions and networks between patients with major depressive disorder and healthy controls. The objective of the present study was to investigate the whole-brain resting-state functional connectivity patterns of depressed patients, which can be used to test the feasibility of identifying major depressive individuals from healthy controls. Multivariate pattern analysis was employed to classify 24 depressed patients from 29 demographically matched healthy volunteers. Permutation tests were used to assess classifier performance. The experimental results demonstrate that 94.3% (P < 0.0001) of subjects were correctly classified by leave-one-out cross-validation, including 100% identification of all patients. The majority of the most discriminating functional connections were located within or across the default mode network, affective network, visual cortical areas and cerebellum, thereby indicating that the disease-related resting-state network alterations may give rise to a portion of the complex of emotional and cognitive disturbances in major depression. Moreover, the amygdala, anterior cingulate cortex, parahippocampal gyrus and hippocampus, which exhibit high discriminative power in classification, may play important roles in the pathophysiology of this disorder. The current study may shed new light on the pathological mechanism of major depression and suggests that whole-brain resting-state functional connectivity magnetic resonance imaging may provide potential effective biomarkers for its clinical diagnosis.

Integrity signals

Registry

Crossref · 10.1093/brain/aws059

Cites

94 of 94 references verified0 citation errors · 0 not checkable

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Claims the paper makes

0 of 61 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The amygdala exhibited the highest discriminative power among brain regions.

    “Amygdala exhibited the highest discriminative power, and the functional connections between this region and the prefrontal lobe, visual cortex, other limbic regions and the cerebellum were altered in major depression.”
    Quote in the paperSubstantial claim
  • Findingown data

    In this study, the bilateral hippocampus/parahippocampal gyrus, anterior cingulate cortex, thalamus, and inferior temporal gyrus exhibited large region weights.

    “In this study, the bilateral hippocampus/parahippocampal gyrus, anterior cingulate cortex, thalamus and inferior temporal gyrus exhibited large region weights.”
    Quote in the paperSubstantial claim
  • Findingown data

    The majority of the most discriminating functional connections were located within or across the default mode network, affective network, visual cortical areas, and cerebellum.

    “The majority of the most discriminating functional connections were located within or across the default mode network, affective network, visual cortical areas and cerebellum, thereby indicating that the disease-related resting-state network alterations may give rise to a portion of the complex of emotional and cognitive disturbances in major depression.”
    Quote in the paperSubstantial claim
  • Findingown data

    The study found abnormal connectivity between the amygdala and the hippocampus/parahippocampal gyrus and orbitofrontal cortex.

    “Abnormal connectivity between the amygdala and the hippocampus/parahippocampal gyrus and orbitofrontal cortex were found.”
    Quote in the paperSubstantial claim
  • Findingown data

    Abnormal functional connectivity was observed between the anterior cingulate cortex and other prefrontal lobe, parahippocampal gyrus, and cerebellum.

    “Abnormal functional connectivity was also observed between the anterior cingulate cortex and other prefrontal lobe, parahippocampal gyrus and cerebellum.”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim. 3
  • Classified as probably not a substantial claim. 25
  • May combine two claims. 15
  • The quote only partly states this claim.

    Findingown data

    The top 100 consensus functional connections were mostly located within or across the default mode network, affective network, visual cortical areas, and cerebellum.

    “The top 100 consensus functional connections are shown in Fig. 3, most of which were also located within or across these resting-state networks.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Increased connections of the anterior cingulate cortex with other prefrontal cortex and within the default mode network observed here were in keeping with recent studies.

    “Increased connections of the anterior cingulate cortex with other prefrontal cortex and within the default mode network observed here were in keeping with recent studies (Greicius et al., 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Greicius et al., 2007 source

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    Findingown data

    The linear support vector machine classifier using the 550 most discriminating functional connections achieved 94.3% correct classification of 24 depressed patients and 29 healthy controls under leave-one-out cross-validation.

    “The experimental results demonstrate that 94.3% (P 5 0.0001) of subjects were correctly classified by leave-one-out cross-validation, including 100% identification of all patients.”
    • Also stated in: § Classification results · plain
      “Using leave-one-out cross-validation, the linear support vector machine classifier achieved an accuracy of 94.3% (100% for patients, 89.7% for healthy controls, P 5 0.0001).”
    Quote in the paperSubstantial claim
  • May combine two claims. The quote only partly states this claim.

    Findingown data

    The amygdala, anterior cingulate cortex, parahippocampal gyrus, and hippocampus exhibited greater region weights and high discriminative power in classification than other regions.

    “Several brain regions exhibited greater weights than others, i.e. amygdala, anterior cingulate cortex, parahippocampal gyrus and hippocampus.”
    • Also stated in: § Discussion · plain
      “In particular, the amygdala, anterior cingulate cortex, parahippocampal gyrus and hippocampus exhibited high discriminative power in classification.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S1 (asserted), S4 (based).

    Findingown data

    The permutation test indicated that the classifier learned the relationship between the data and the labels with a probability of being wrong of no more than 0.0001.

    “With the generalization rate as the statistic, the permutation distribution of the estimate is shown in Fig. 1, indicating that the classifier learned the relationship between the data and the labels with a probability of being wrong of 50.0001.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The classifier correctly identified all 24 depressed patients (sensitivity 100%) and 89.7% of healthy controls (specificity 89.7%).

    “Using leave-one-out cross-validation, the linear support vector machine classifier achieved an accuracy of 94.3% (100% for patients, 89.7% for healthy controls, P 5 0.0001).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    In this study, the linear support vector machine classifier correctly classified 100% of 24 depressed patients and 89.7% of 29 healthy controls, giving an accuracy of 94.3%.

    “In this study, 100% of 24 depressed patients and 89.7% of 29 healthy control subjects were correctly classified by the linear support vector machine classifier, corresponding to an accuracy of 94.3%.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    The linear support vector machine classifier learned the relationship between the data and the labels with a probability of being wrong of 50.0001.

    “The results demonstrate that the linear support vector machine classifier learned the relationship between the data and the labels with a probability of being wrong of 50.0001.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In this study, besides aberrant connectivity within the cerebellum itself, altered connections were observed between the cerebellum and regions of the default mode network and affective network.

    “In the current study, in addition to the aberrant connectivity within itself, altered connections were observed between the cerebellum and the regions in the default mode network and affective network.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Altered functional connections of the hippocampus/parahippocampal gyrus may be related to deficits in emotion-mediated memory formation observed in depression.

    “and altered functional connections of the hippocampus/parahippocampal gyrus may be related to deficits in emotion-mediated memory formation observed in depression (LaBar and Cabeza, 2006;Savitz and Drevets, 2009).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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    • cites Savitz and Drevets, 2009 source

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  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Three patients and two controls were removed due to excessive head motion, and five additional patients and two additional controls were removed due to head motion with acute fluctuations causing spurious correlation.

    “Three patients and two controls were removed from the sample due to excessive head motion during scan acquisition (42.5 mm translation and/or 42 rotation).Five additional patients and two additional control subjects were removed due to head motions with acute fluctuations that caused strong spurious correlation.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The anterior cingulate cortex is a critical brain region in emotion processing and has been implicated as a focus of dysfunction in depression.

    “Anterior cingulate cortex, as a critical brain region in emotion processing, has been implicated as a focus of dysfunction in depression (Greicius et al., 2007;Sheline et al., 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Greicius et al., 2007 source

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    • cites Sheline et al., 2010 source

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    Interpretationcitation

    Altered connectivity between the thalamus and the prefrontal lobe and limbic areas could explain the autonomic regulation disturbances linked to depression.

    “Altered connectivity of the thalamus with the prefrontal lobe and the limbic areas may account for the disturbances in autonomic regulations that are associated with depression (Drevets et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Drevets et al., 2008 source

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    Premisecitation

    The functional connectivity observed in this study between the cortex and other prefrontal cortex regions and within the default mode network agrees with recent studies.

    “cortex with other prefrontal cortex and within the default mode network observed here were in keeping with recent studies (Greicius et al., 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Greicius et al., 2007 source

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    Interpretationcitation

    Abnormal functional connectivity of the inferior temporal gyrus might contribute to working memory impairment in depressed patients.

    “Abnormal functional connectivity of the inferior temporal gyrus may contribute to working memory dysfunction in depressed patients (Axmacher et al., 2008;Parra et al., 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Axmacher et al., 2008 source

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    • cites Parra et al., 2010 source

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    Premisecitation

    If a multivariate pattern analysis-based classifier can label new samples with better-than-random accuracy, then the two populations are likely different and the classifier can capture population differences.

    “If a multivariate pattern analysisbased classifier can label new samples with better-than-random accuracy, then the two populations are indeed likely to be different, and the classifier can capture the population differences (Golland and Fischl, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Golland and Fischl, 2003

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The inferior temporal gyrus participates in processing complex emotional visual stimuli, particularly those strongly associated with visual memory.

    “The inferior temporal gyrus is involved in the processing of complex emotional visual stimuli (Geday et al., 2001), especially those deeply involved with visual memory (Masahiko and Atsuo, 2002).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Geday et al., 2001 source

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    • cites Masahiko and Atsuo, 2002

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  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Major depressive symptoms are associated with dysregulation of a distributed neuronal network encompassing cortical and limbic regions rather than with breakdown of a single discrete brain region.

    “It has been proposed that major depressive symptoms are associated with the dysregulation of a distributed neuronal network encompassing cortical and limbic regions rather than with the (functional) breakdown of a single discrete brain region (Mayberg, 1997(Mayberg, , 2003;;Davidson et al., 2002;Drevets, 2003;Phillips et al., 2003;Seminowicz et al., 2004;Drevets et al., 2008;Price and Drevets, 201”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Mayberg, 1997 source

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    • cites Davidson et al., 2002 source

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    • cites Price and Drevets, 2010 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Abnormality of the default mode network in depression is reported in several previous studies.

    “Abnormality of the default mode network in depression is reported in several previous studies (Greicius et al., 2007;Bluhm et al., 2009;Sheline et al., 2010;Zhou et al., 2010b).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Greicius et al., 2007 source

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    • cites Bluhm et al., 2009 source

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    • cites Sheline et al., 2010 source

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  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All patients were medication-naive at the time of the scan.

    “All patients were medication-naive at the time of the scan.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    Results with global signal regression are more readily or reliably interpreted.

    “so the results with global signal regression are more readily or reliably interpreted.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Seed-based resting-state fMRI methods limit obtained information to selected regions of interest and make it difficult to examine functional connectivity patterns on a whole-brain scale.

    “First, seed-based methods limit the obtained information to the selected regions of interest and make it difficult to examine functional connectivity patterns on a whole-brain scale (Van den Heuvel and Hulshoff Pol, 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Van den Heuvel and Hulshoff Pol, 2010 source

      Not checked in the free run.

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    Premisecitation

    Global signal regression creates artefactual negative correlations but is suggested to improve the specificity of positive correlations and can remove specific confounds to facilitate evaluation of neurophysiological relationships.

    “Global signal regression creates artefactual negative correlations, but this technique is suggested to improve the specificity of positive correlations and can remove specific confounds from the data to facilitate the evaluation of neurophysiological relationships (Fox et al., 2009), so the results with global signal regression are more readily or reliably interpreted.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Fox et al., 2009 source

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    Study design and conductcitation

    Depressed patients met DSM-IV criteria for a current episode of unipolar recurrent major depression, confirmed by clinical psychiatrists using the Structured Clinical Interview for DSM-IV.

    “Depressed patients met the criteria for a current episode of unipolar recurrent major depression based on the DSM (Diagnostic and Statistical Manual of Mental Disorders)-IV criteria (APA, 2000).Using the Structured Clinical Interview for DSM-IV (First et al., 1995), confirmation of the diagnosis was made by clinical psychiatrists.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites APA, 2000

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    • cites First et al., 1995

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    Premisecitation

    Physiological noises such as cardiac and respiratory rates can alias into the low-frequency domain of functional MRI signals.

    “Some physiological noises, such as cardiac and respiratory rates, can alias into the low-frequency domain of functional MRI signals (Strother, 2006;Murphy et al., 2009).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Strother, 2006 source

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    • cites Murphy et al., 2009 source

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    Study design and conductnone given

    Cardiac and respiratory rates were not collected during the scans in this study.

    “However, cardiac and respiratory rates were not collected during the scans in this study, and the impact of these physiological noises on classifier performance remains to be determined.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Several earlier functional MRI studies using emotional or cognitive tasks have reported cerebellar abnormalities associated with depression.

    “Using emotional or cognitive tasks with functional MRI, several previous studies have reported abnormalities in the cerebellum in association with depression (Pillay et al., 1997;Frodl et al., 2010;Liu et al., 2010;Guo et al., 2011).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Pillay et al., 1997 source

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    • cites Frodl et al., 2010 source

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    • cites Liu et al., 2010 source

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  • May combine two claims.

    Study design and conductnone given

    The study has limitations concerning sample size, scanner variability, and the absence of a large independent data set to test the methods and confirm the findings.

    “Although the classification results of this study using resting-state functional connectivity are encouraging, there are still limitations related to sample size, scanner variability and the lack of a large independent data set with which to test our methods and confirm the findings.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    The fusiform gyrus is involved in perceiving emotions in facial stimuli.

    “The altered functional connections related to the fusiform gyrus, which is involved in the perception of emotions in facial stimuli (Kanwisher et al., 1997;Fu et al., 2008), may result in the social avoidance observed in depressed patients by participating in negative cognitive models (Yao et al., 2009;Liu et al., 2010).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Kanwisher et al., 1997 source

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    • cites Fu et al., 2008

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    Premisecitation

    Several recent brain imaging studies have tried to distinguish depressed patients from healthy controls.

    “Recently, several brain imaging studies have attempted to distinguish depressed patients from healthy controls (Fu et al., 2008;Costafreda et al., 2009;Craddock et al., 2009).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Fu et al., 2008

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    • cites Costafreda et al., 2009 source

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    • cites Craddock et al., 2009 source

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    Premisecitation

    This result is partly consistent with prior findings that the cerebellum has anatomical connections to limbic regions involved in mood regulation.

    “To some extent, this result is in accordance with the previous findings that the cerebellum has anatomical connections with the limbic regions, which are involved in mood regulation (Turner et al., 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Turner et al., 2007 source

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    Interpretationcitation

    Altered connectivity between temporal poles and the parahippocampal gyrus, and between the basal ganglia and orbitofrontal cortex, might reflect visceral monitoring dysfunctions that are compromised in depression.

    “In addition, the altered connectivity between temporal poles and the parahippocampal gyrus, as well as the basal ganglia and orbitofrontal cortex, may reflect dysfunctions of visceral monitoring, which is compromised in depression (Sheline et al., 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sheline et al., 2010 source

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    Premisecitation

    Functionally defined regions of interest have recently been proposed for whole-brain connectivity analysis.

    “Functionally defined regions of interest have recently been suggested in whole-brain connectivity analysis (Shirer et al., 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Shirer et al., 2012 source

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    Premisecitation

    The brainstem might be central to monoaminergic hypotheses of major depression.

    “The automated anatomical labelling atlas, including 116 regions, covers the entire cerebrum and the cerebellum but excludes the brainstem, which may be central to monoaminergic hypotheses in major depression (Drevets et al., 2007); clearly, the functional connectivity of the brainstem should be investigated in the future.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Drevets et al., 2007 source

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    Premisecitation

    Abnormal resting-state functional connectivity of the primary visual area, including the occipital cortex and calcarine gyrus and extending into the lingual gyrus, has been reported previously.

    “The abnormality of the restingstate functional connectivity related to the primary visual area, including the occipital cortex and calcarine gyrus and extending into the lingual gyrus, has been reported before (Veer et al., 2010) and may be related to impaired selective attention and working memory in major depression (Borkowska and Rybakowski, 2001;Phillips et al., 2003;Desseilles et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Veer et al., 2010 source

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  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The automated anatomical labelling atlas contains 116 regions, covers the entire cerebrum and cerebellum, but excludes the brainstem.

    “The automated anatomical labelling atlas, including 116 regions, covers the entire cerebrum and the cerebellum but excludes the brainstem, which may be central to monoaminergic hypotheses in major depression (Drevets et al., 2007); clearly, the functional connectivity of the brainstem should be investigated in the future.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The cerebellum might contribute to certain non-motor functions, including emotion and cognitive processing.

    “The cerebellum may contribute to certain non-motor functions, including emotion and cognitive processing (Dolan, 1998;Schmahmann and Sherman, 1998;Schmahmann and Caplan, 2006;Hu et al., 2008;Habas et al., 2009;Krienen and Buckner, 2009;O'Reilly et al., 2010;Moulton et al., 2011).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Dolan, 1998 source

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    • cites Schmahmann and Sherman, 1998

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    • cites Schmahmann and Caplan, 2006

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37 of 37
  • The paper relies on this without support.

    No prior study had established whether multivariate pattern analysis of whole-brain resting-state functional connectivity can discriminate depressed patients from healthy controls at the individual level with high accuracy.

    “To date, it is unknown whether multivariate pattern analysis can capture whole-brain resting-state functional connectivity patterns to discriminate or identify depressed patients from healthy controls at the individual subject level with a high degree of accuracy.”
  • The paper relies on this without support.

    The findings from this sample of medication-free, non-comorbid major depressive disorder patients and matched healthy controls generalize to major depressive disorder more broadly.

    “The purpose of this study was to explore significant disorder-related patterns using whole-brain resting-state functional MRI in medication-free depressed patients without co-morbidity and in carefully matched healthy controls and to discriminate patients from healthy subjects.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Depressed patients and healthy controls could be automatically classified with multivariate pattern analysis (94% accuracy) and support vector machines (99% accuracy).

    “depressed patients and healthy controls could be automatically classified with multivariate pattern analysis (94% accuracy) 108 and support vector machines (99% accuracy).65”
  • Cognitive deficits have been seen in people with heightened inflammation.

    “Cognitive impairment has been observed in individuals with elevated inflammation.21”

    From Cognitive Impairment in Major Depressive Disorder (2019) · cites this paper as [21]

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. First, 1995, Structured clinical Interview for DSM-IV axis 1 disorder-patient edition(SCID-I/P)
  2. Guy, 1976, Clinical global impressions: in ECDEU assessment manual for psychopharmacology

Cited by

Sorted by citations

Authors
Zeng, L.-L., Shen, H., Liu, L., Wang, L., Li, B., Fang, P., Zhou, Z., Li, Y., & Hu, D.
Affiliations
  • National University of Defense Technology (CN)
  • First Hospital of China Medical University (CN)
Venue
Brain
Published
2012-03-14
Volume
135
Issue
5
Pages
1498-1507
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2168372372
Cited by
748
References
94
Citations by year
2026: 14 · 2025: 45 · 2024: 34 · 2023: 46 · 2022: 58 · 2021: 53 · 2020: 57 · 2019: 75 · 2018: 56 · 2017: 77 · 2016: 50 · 2015: 55 · 2014: 54 · 2013: 57 · 2012: 17
FWCI
29.94
Type
journal article
Language
en
Open access
closed
Locations
  • Brain (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Natural Science Foundation of China (60835005, 61003202, 90820304)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
major depressive disorder, resting-state functional connectivity, multivariate pattern classification, default mode network, affective networks, cerebellum, amygdala, anterior cingulate cortex, hippocampus, parahippocampal gyrus, depression biomarkers, depression diagnosis
MeSH terms
Adolescent, Adult, Brain, Brain Mapping, Major Depressive Disorder, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neural Pathways, Oxygen, Young Adult

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