Data-driven clustering reveals a link between symptoms and functional brain connectivity in depression

Background: Depression is a complex disorder with large inter-individual variability in symptom profiles that often occur alongside symptoms of other psychiatric domains such as anxiety. A dimensional and symptom-based approach may help refine the characterization and classification of depressive and anxiety disorders and thus aid in establishing robust biomarkers. We assess the brain functional connectivity correlates of a symptom-based clustering of individuals using functional brain imaging data. Methods: We assessed symptoms of depression and anxiety using Becks Depression and Becks Anxiety inventories in individuals with or without a history of depression, and high dimensional data clustering to form subgroups based on symptom profiles. To assess the biological relevance of this subtyping, we compared functional magnetic resonance imaging-based dynamic and static functional connectivity between subgroups in a subset of the total sample. Results: We identified five subgroups with distinct symptom profiles, cutting across diagnostic boundaries and differing in terms of total severity, symptom patterns and centrality. For instance, inability to relax, fear of the worst, and feelings of guilt were among the most severe symptoms in subgroup 1, 2 and 3, respectively. These subgroups showed evidence of differential static brain connectivity patterns, in particular comprising a fronto-temporal network. In contrast, we found no significant associations with clinical sum scores, dynamic functional connectivity or global connectivity measures. Conclusion: Adding to the ongoing pursuit of individual-based treatment, the results show subtyping based on a dimensional conceptualization and unique constellations of anxiety and depression symptoms is supported by distinct brain static functional connectivity patterns.

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