EEG Microstate Alterations in Anhedonia Subtypes of Major Depressive Disorder and Their Modulation by Intermittent Theta-Burst Stimulation

IF 2.7 2区医学 Q1 PSYCHIATRY

Depression and Anxiety Pub Date : 2026-09-21 DOI:10.1155/da/1982576

Jiang Wu, Zhengzhi Deng, Xinyuan Cheng, Shaoqing Li, Nan Qiu, Lan Hu, Zhihong Chen, Dezhong Yao, Li Pu, Hongmei Yan

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Abstract

Background

Anhedonia is a core symptom of major depressive disorder (MDD) and is associated with functional impairment, treatment resistance, and relapse. Emerging evidence suggests that anhedonia severity reflects distinct neural alterations; however, current neuromodulation protocols have not yet accounted for this clinical heterogeneity. We investigated whether intermittent theta-burst stimulation (iTBS) differentially modulates electroencephalography (EEG) microstate dynamics across anhedonia subtypes and aimed to identify electrophysiological signatures for treatment stratification.

Method

Fifty MDD patients were stratified into high-anhedonia (HA, n = 25) and low-anhedonia (LA, n = 25) groups based on Snaith–Hamilton pleasure scale (SHAPS) scores, alongside 25 healthy controls (HCs). Clinical assessment and resting-state EEG data were collected at baseline and after a 2-week course of iTBS targeting the left dorsolateral prefrontal cortex (DLPFC). Microstate parameters and transition probabilities (TPs) were analyzed.

Results

At baseline, both patient groups showed reductions in microstates, MS_A and MS_D relative to HCs. The HA group additionally exhibited MS_C deficits, whereas the LA group showed MS_B reductions. TPs were decreased in both groups, with broader deficits in the HA group. Following iTBS, most microstate parameters of LA group no longer differed significantly from those of HCs, whereas the HA group exhibited only partial changes, with persistent abnormalities in MS_B duration, MS_C coverage, and MS_D parameters. Correlation analyses further revealed that, in the HA group, greater anhedonia improvement was associated with increased MS_A duration and decreased MS_B duration.

Conclusion

iTBS exerts subtype-specific modulation of large-scale network dynamics in MDD with anhedonia. The LA group demonstrates treatment-associated resolution, whereas the HA group displays enduring integration deficits involving the dorsal attention network (DAN), sensory network (SN), and default mode network (DMN). Notably, in the HA group, clinical improvement correlates with SN reorganization, suggesting that microstate changes may serve as a treatment response marker. MS_D dynamics represent a candidate signature for subtype classification, supporting stratification-guided neuromodulation.

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重度抑郁症快感缺失亚型的脑电图微状态改变及其间歇性θ - burst刺激的调节。

背景：快感缺乏是重度抑郁症（MDD）的核心症状，与功能障碍、治疗抵抗和复发相关。新出现的证据表明，快感缺乏的严重程度反映了明显的神经改变；然而，目前的神经调节方案尚未考虑到这种临床异质性。我们研究了间歇性θ -burst刺激（iTBS）是否会对快感缺乏亚型的脑电图（EEG）微状态动力学产生差异调节，旨在确定治疗分层的电生理特征。方法：50例重度抑郁症患者根据Snaith-Hamilton快乐量表（SHAPS）评分分为高快感缺乏症组（HA, n = 25）和低快感缺乏症组（LA, n = 25），并与25名健康对照（hc）。临床评估和静息状态EEG数据在基线和2周的iTBS后收集，目标是左背外侧前额叶皮层（DLPFC）。分析了微状态参数和跃迁概率。结果：在基线时，两组患者的显微状态，MS_A和MS_D相对于hc均有所降低。HA组还表现出MS_C缺陷，而LA组则表现出MS_B减少。两组TPs均下降，HA组TPs下降幅度更大。iTBS后，LA组的大多数微状态参数与hc组不再有显著差异，而HA组仅表现出部分变化，MS_B持续时间、MS_C覆盖和MS_D参数持续异常。相关分析进一步显示，在HA组中，快感缺乏症改善程度越大，MS_A持续时间越长，MS_B持续时间越短。结论：iTBS对重度抑郁症伴快感缺乏的大尺度网络动力学具有亚型特异性调节作用。LA组表现出治疗相关的消退，而HA组表现出涉及背侧注意网络（DAN）、感觉网络（SN）和默认模式网络（DMN）的持久整合缺陷。值得注意的是，在HA组中，临床改善与SN重组相关，这表明微观状态的改变可能是治疗反应的标志。MS_D动态代表了亚型分类的候选特征，支持分层引导的神经调节。

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来源期刊

Depression and Anxiety 医学-精神病学

CiteScore

15.00

自引率

1.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.