Energy inefficiency underpinning brain state dysregulation in individuals with major depressive disorder
摘要
Disruptions in brain state dynamics are a hallmark of major depressive disorder (MDD), yet their underlying mechanisms remain unclear. Here, building on network control theory, this case–control study reveals that energy inefficiency, characterized by elevated energy costs and reduced control stability, drives decreased state stability and increased state-switching frequency in MDD. Key brain regions, including the left dorsolateral prefrontal cortex and insula, exhibited impaired energy regulation capacity (a metric validated against cerebral metabolism). Moreover, these region-specific energy patterns were correlated with depressive symptom severity. Neurotransmitter and gene expression association analyses linked these energy deficits to intrinsic biological factors, notably the serotonin 5-HT2A receptor and astrocytes. These findings shed light on the energetic mechanism underlying brain state dysregulation in MDD and its associated biological underpinnings, highlighting brain energy dynamics as a potential biomarker by which to explore therapeutic targets and advance precise interventions for restoring healthy brain dynamics in depression.