A Study On The Neuroimaging Of Sleep Efficiency Mediated Clinical Symptom Improvement In Major Depressive Disorder Patients

Background and purpose:Antidepressant medications represent the most common treatment option for major depressive disorder(MDD).The objective of this study was to investigate status-related changes(acute vs.remitted status)in brain function in MDD patients.Methods:Forty-eight MDD patients were receiving regular antidepressant medications(an average of 7 months after the initial visit,remitted status).At each visit,all the patients underwent MRI and polysomnography examinations and clinical assessment.Results:We found that baseline fractional amplitude of low-frequency fluctuations(f ALFF)of right superior parietal gyrus(SPG)and right middle frontal gyrus could predict improvement in depression and anxiety symptoms acute to remitted status in MDD patients,respectively.Moreover,we found that f ALFF of the right SPG in MDD patients was significantly positively correlated with baseline sleep efficiency(SE).Further mediation analysis revealed that the f ALFF of right SPG mediated the relationship between baseline SE and depressive symptom improvement.Conclusions:Apart from highlighting the f ALFF as a potential prognostic biomarker to predict and track disease progression in MDD patients,these findings might provide a neural mechanism basis for improving sleep quality of MDD patients and thus promoting the recovery of clinical symptoms,as well as provide a practical basis for clinical interventions in MDD patients with sleep disorders.