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Randomized Controlled Trial
. 2024 Nov 18:2024:9294268.
doi: 10.1155/2024/9294268. eCollection 2024.

A Longitudinal Correlational Study of Psychological Resilience, Depression Disorder, and Brain Functional-Structural Hybrid Connectome in Breast Cancer

Mu Zi Liang  1 , Jin Zhou  2 , Peng Chen  3 , Ya Lan Song  4 , Shu Han Li  5 , Yu Yan Liang  6 , Guang Yun Hu  7 , Qu Hu  8 , Zhe Sun  9 , Yuan Liang Yu  10 , Alex Molassiotis  11 , M Tish Knobf  12 , Zeng Jie Ye  13
Affiliations
Randomized Controlled Trial

A Longitudinal Correlational Study of Psychological Resilience, Depression Disorder, and Brain Functional-Structural Hybrid Connectome in Breast Cancer

Mu Zi Liang et al. Depress Anxiety. .

Abstract

Purposes: To evaluate the association between psychological resilience, depression disorder (DD), and brain functional-structural hybrid connectome in patients with breast cancer before treatment (T0) and at 1 year. Methods: Between February 2017 and October 2019, 172 patients were longitudinally enrolled from a multicenter trial named as Be Resilient to Breast Cancer (BRBC) and completed resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) before the T0. Data-driven multivoxel pattern analysis (MVPA) and correlational tractography (CT) were performed to identify distinct functional-structural hybrid connectome. DD was diagnosed by psychiatry physicians according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Psychological resilience was collected by Resilience Scale Specific to Cancer (RS-SC) and tested as the mediation variable between hybrid connectome and DD. Results: Of the total sample of 172, 14.5% (N = 25) were diagnosed with DD. High psychological resilience was associated with a lower risk of DD (hazard ratio (HR) = 0.37, 95% confidence interval (CI), 0.17-0.82, p=0.0368). Frontal pole right (88.0%) in rs-fMRI and arcuate fasciculus_L (75.2%) in DTI were identified as main significant brain areas. Psychological resilience accounted for 10.01%-12.14% of direct effect between brain functional-structural hybrid connectome and 1-year DD. Conclusion: Psychological resilience predicts DD at 1 year and mediates the association between brain functional-structural hybrid connectome and DD at 1 year in patients diagnosed with breast cancer. Trial Registration: ClinicalTrials.gov identifier: NCT03026374.

Keywords: Be Resilient to Breast Cancer; brain functional–structural hybrid connectome; breast cancer; depression disorder; psychological resilience.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Timeline for the enrollment in the BRBC. (B) rs-fMRI and DTI scanning parameters in different centers. (C) Baseline demographic and clinical characteristics for patients. BRBC, Be Resilient to Breast Cancer; DTI, diffusion tensor imaging; rs-fMRI, resting-state functional magnetic resonance imaging.
Figure 2
Figure 2
(A) PCA for RI. (B) The Kaplan–Meier analysis between psychological resilience group membership (high versus low) and 1-year DD. DD, depression disorder; PCA, principal component analysis; RI, resilience index.
Figure 3
Figure 3
(A) Significant brain regions and voxels in MVPA. (B) Seed-to-voxel associations in the high/low resilience groups. (C) ROI to ROI associations in the high/low resilience groups. MVPA, multivoxel pattern analysis; ROI, region of interest.
Figure 4
Figure 4
(A) Reconstruction for the fibers across the whole brain. (B) Super-resolution white matter imaging for all patients. (C) Significant neural pathways in CT. (D) ROI to ROI associations in the high/low resilience groups. CT, correlational tractography; ROI, region of interest.
Figure 5
Figure 5
(A) The mediation analysis between brain functional–structural hybrid connectome and 1-year. (B) AUC, NRI, and IDI for Model 1 (CM) versus Model 2 (CM + connectomics). (C) Calibration curves for Model 1 (CM) versus Model 2 (CM + connectomics). (D) Decision curve analysis for Model 1 (CM) versus Model 2 (CM + connectomics). (E) Clinical impact curve for Model 2 (CM + connectomics). AUC, area under curve; CM, conventional model; DD, depression disorder; IDI, integrated discrimination improvement; NRI, net reclassification improvement.
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