Resting-state brain entropy in schizophrenia

Abnormal brain entropy dynamics in ADHD

BACKGROUND

Brain entropy (BEN) is a novel measure for irregularity and complexity of brain activities, which has been used to characterize abnormal brain activities in many brain disorders including attention-deficit/hyperactivity disorder (ADHD). While most research assumes BEN is stationary during scan sessions, the brain in resting state is also a highly dynamic system. The BEN dynamics in ADHD has not been explored.

METHODS

We used a sliding window approach to derive the dynamical brain entropy (dBEN) from resting-state functional magnetic resonance imaging (rfMRI) dataset that includes 98 ADHD patients and 111 healthy controls (HCs). We identified 3 reoccurring BEN states. We tested whether the BEN dynamics differ between ADHD and HC, and whether they are associated with ADHD symptom severity.

RESULTS

One BEN states, characterized by low overall BEN and low within-state BEN located in SMN (sensorimotor network) and VN (visual network), its FW (fractional window) and MDT (mean dwell time) were increased in ADHD and positively correlated with ADHD severity; another state characterized by high overall BEN and low within-state BEN located in DMN (default mode network) and ECN (executive control network), its FW and MDT were decreased in ADHD and negatively correlated with ADHD severity.

LIMITATIONS

The window length of dBEN analysis can be further optimized to suit more datasets. The co-variation between dBEN and other dynamical brain metrics was not explored.

CONCLUSION

Our findings revealed abnormal BEN dynamics in ADHD, providing new insights into clinical diagnosis and neuropathology of ADHD.

Altered brain complexity in first-episode antipsychotic-naïve patients with schizophrenia: A whole-brain voxel-wise study

BACKGROUND

Measures of cortical topology are believed to characterize large-scale cortical networks. Previous studies used region of interest (ROI)-based approaches with predefined templates that limit analyses to linear pair-wise interactions between regions. As cortical topology is inherently complex, a non-linear dynamic model that measures the brain complexity at the voxel level is suggested to characterize topological complexities of brain regions and cortical folding.

METHODS

T1-weighted brain images of 150 first-episode antipsychotic-naïve schizophrenia (FES) patients and 161 healthy comparison participants (HC) were examined. The Chaos analysis approach was applied to detect alterations in brain structural complexity using the largest Lyapunov exponent (Lambda) as the key measure. Then, the Lambda spatial series was mapped in the frequency domain using the correlation of the Morlet wavelet to reflect cortical folding complexity.

RESULTS

A widespread voxel-wise decrease in Lambda values in space and frequency domains was observed in FES, especially in frontal, parietal, temporal, limbic, basal ganglia, thalamic, and cerebellar regions. The widespread decrease indicates a general loss of brain topological complexity and cortical folding. An additional pattern of increased Lambda values in certain regions highlights the redistribution of complexity measures in schizophrenia at an early stage with potential progression as the illness advances. Strong correlations were found between the duration of untreated psychosis and Lambda values related to the cerebellum, temporal, and occipital gyri.

CONCLUSIONS

Our findings support the notion that defining brain complexity by non-linear dynamic analyses offers a novel approach for identifying structural brain alterations related to the early stages of schizophrenia.

Neuroimaging markers of aberrant brain activity and treatment response in schizophrenia patients based on brain complexity

The complexity of brain activity reflects its ability to process information, adapt to environmental changes, and transition between states. However, it remains unclear how schizophrenia (SZ) affects brain activity complexity, particularly its dynamic changes. This study aimed to investigate the abnormal patterns of brain activity complexity in SZ, their relationship with cognitive deficits, and the impact of antipsychotic medication. Forty-four drug-naive first-episode (DNFE) SZ patients and thirty demographically matched healthy controls (HC) were included. Functional MRI-based sliding window analysis was utilized for the first time to calculate weighted permutation entropy to characterize complex patterns of brain activity in SZ patients before and after 12 weeks of risperidone treatment. Results revealed reduced complexity in the caudate, putamen, and pallidum at baseline in SZ patients compared to HC, with reduced complexity in the left caudate positively correlated with Continuous Performance Test (CPT) and Category Fluency Test scores. After treatment, the complexity of the left caudate increased. Regions with abnormal complexity showed decreased functional connectivity, with complexity positively correlated with connectivity strength. We observed that the dynamic complexity of the brain exhibited the characteristic of spontaneous, recurring "complexity drop", potentially reflecting transient state transitions in the resting brain. Compared to HC, patients exhibited reduced scope, intensity, and duration of complexity drop, all of which improved after treatment. Reduced duration was negatively correlated with CPT scores and positively with clinical symptoms. The results suggest that abnormalities in brain activity complexity and its dynamic changes may underlie cognitive deficits and clinical symptoms in SZ patients. Antipsychotic treatment partially restores these abnormalities, highlighting their potential as indicators of treatment efficacy and biomarkers for personalized therapy.

Disrupted cognitive network revealed by task-induced brain entropy in schizophrenia

Brain entropy (BEN), which measures the amount of information in brain activity, provides a novel perspective for evaluating brain function. Recent studies using resting-state functional magnetic resonance imaging (fMRI) have shown that BEN during rest can help characterize brain function alterations in schizophrenia (SCZ). However, there is a lack of research on BEN using task-evoked fMRI to explore task-dependent cognitive deficits in SCZ. In this study, we evaluate whether the reduced working memory (WM) capacity in SCZ is possibly associated with dynamic changes in task BEN during tasks with high cognitive demands. We analyzed data from 15 patients with SCZ and 15 healthy controls (HC), calculating task BEN from their N-back task fMRI scans. We then examined correlations between task BEN values, clinical symptoms, 2-back task performance, and neuropsychological test scores. Patients with SCZ exhibited significantly reduced task BEN in the cerebellum, hippocampus, parahippocampal gyrus, thalamus, and the middle and superior frontal gyrus (MFG and SFG) compared to HC. In HC, significant positive correlations were observed between task BEN and 2-back accuracy in several brain regions, including the MFG and SFG; such correlations were absent in patients with SCZ. Additionally, task BEN was negatively associated with scores for both positive and negative symptoms in areas including the parahippocampal gyrus among patients with SCZ. In conclusion, our findings indicate that a reduction in BEN within prefrontal and hippocampal regions during cognitively demanding tasks may serve as a neuroimaging marker for SCZ.

Age-dependent functional development pattern in neonatal brain: An fMRI-based brain entropy study

The relationship between brain entropy (BEN) and early brain development has been established through animal studies. However, it remains unclear whether the BEN can be used to identify age-dependent functional changes in human neonatal brains and the genetic underpinning of the new neuroimaging marker remains to be elucidated. In this study, we analyzed resting-state fMRI data from the Developing Human Connectome Project, including 280 infants who were scanned at 37.5-43.5 weeks postmenstrual age. The BEN maps were calculated for each subject, and a voxel-wise analysis was conducted using a general linear model to examine the effects of age, sex, and preterm birth on BEN. Additionally, we evaluated the correlation between regional BEN and gene expression levels. Our results demonstrated that the BEN in the sensorimotor-auditory and association cortices, along the 'S-A' axis, was significantly positively correlated with postnatal age (PNA), and negatively correlated with gestational age (GA), respectively. Meanwhile, the BEN in the right rolandic operculum correlated significantly with both GA and PNA. Preterm-born infants exhibited increased BEN values in widespread cortical areas, particularly in the visual-motor cortex, when compared to term-born infants. Moreover, we identified five BEN-related genes (DNAJC12, FIG4, STX12, CETN2, and IRF2BP2), which were involved in protein folding, synaptic vesicle transportation and cell division. These findings suggest that the fMRI-based BEN can serve as an indicator of age-dependent brain functional development in human neonates, which may be influenced by specific genes.

The heritability and structural correlates of resting-state fMRI complexity

The complexity of fMRI signals quantifies temporal dynamics of spontaneous neural activity, which has been increasingly recognized as providing important insights into cognitive functions and psychiatric disorders. However, its heritability and structural underpinnings are not well understood. Here, we utilize multi-scale sample entropy to extract resting-state fMRI complexity in a large healthy adult sample from the Human Connectome Project. We show that fMRI complexity at multiple time scales is heritable in broad brain regions. Heritability estimates are modest and regionally variable. We relate fMRI complexity to brain structure including surface area, cortical myelination, cortical thickness, subcortical volumes, and total brain volume. We find that surface area is negatively correlated with fine-scale complexity and positively correlated with coarse-scale complexity in most cortical regions, especially the association cortex. Most of these correlations are related to common genetic and environmental effects. We also find positive correlations between cortical myelination and fMRI complexity at fine scales and negative correlations at coarse scales in the prefrontal cortex, lateral temporal lobe, precuneus, lateral parietal cortex, and cingulate cortex, with these correlations mainly attributed to common environmental effects. We detect few significant associations between fMRI complexity and cortical thickness. Despite the non-significant association with total brain volume, fMRI complexity exhibits significant correlations with subcortical volumes in the hippocampus, cerebellum, putamen, and pallidum at certain scales. Collectively, our work establishes the genetic basis and structural correlates of resting-state fMRI complexity across multiple scales, supporting its potential application as an endophenotype for psychiatric disorders.

Task-related brain activation associated with violence in patients with schizophrenia: A meta-analysis

This study investigates specific changes in brain function during cognitive and emotional tasks in patients with schizophrenia and a history of violence (VSCZ) compared with non-violent patients with schizophrenia and healthy controls. A comprehensive literature search was conducted at the Web of Science, Medline, and PubMed. Ten studies met the inclusion criteria. In which, eight studies compared brain activation between patients with VSCZ and non-violent patients with schizophrenia, and the former exhibited increased activation at the middle occipital gyrus and rectus compared with the latter. Seven studies compared brain activation between patients with VSCZ and controls, and the former exhibited increased activation at the anterior cingulate cortex, cerebellum VI region, lingual gyrus and fusiform. Subgroup analysis in five studies performing emotional tasks revealed that patients with VSCZ showed increased activation at the middle occipital gyrus compared with non-violent patients with schizophrenia. Our findings suggest that abnormal emotion perception and regulation significantly contribute to the increased risk of violence in patients with schizophrenia. Notably, the middle occipital gyrus and rectus emerge as key neurophysiological correlates associated with this phenomenon.

Divergent association between pain intensity and resting-state fMRI-based brain entropy in different age groups

Pain is a multidimensional subjective experience sustained by multiple brain regions involved in different aspects of pain experience. We used brain entropy (BEN) estimated from resting-state fMRI (rsfMRI) data to investigate the neural correlates of pain experience. BEN was estimated from rs-fMRI data provided by two datasets with different age range: the Human Connectome Project-Young Adult (HCP-YA) and the Human Connectome project-Aging (HCP-A) datasets. Retrospective assessment of experienced pain intensity was retrieved from both datasets. No main effect of pain intensity was observed. The interaction between pain and age, however, was related to increased BEN in several pain-related brain regions, reflecting greater variability of spontaneous brain activity. Dividing the sample into a young adult group (YG) and a middle age-aging group (MAG) resulted in two divergent patterns of pain-BEN association: In the YG, pain intensity was related to reduced BEN in brain regions involved in the sensory processing of pain; in the MAG, pain was associated with increased BEN in areas related to both sensory and cognitive aspects of pain experience.

The brain entropy dynamics in resting state

As a novel measure for irregularity and complexity of the spontaneous fluctuations of brain activities, brain entropy (BEN) has attracted much attention in resting-state functional magnetic resonance imaging (rs-fMRI) studies during the last decade. Previous studies have shown its associations with cognitive and mental functions. While most previous research assumes BEN is approximately stationary during scan sessions, the brain, even at its resting state, is a highly dynamic system. Such dynamics could be characterized by a series of reoccurring whole-brain patterns related to cognitive and mental processes. The present study aims to explore the time-varying feature of BEN and its potential links with general cognitive ability. We adopted a sliding window approach to derive the dynamical brain entropy (dBEN) of the whole-brain functional networks from the HCP (Human Connectome Project) rs-fMRI dataset that includes 812 young healthy adults. The dBEN was further clustered into 4 reoccurring BEN states by the k-means clustering method. The fraction window (FW) and mean dwell time (MDT) of one BEN state, characterized by the extremely low overall BEN, were found to be negatively correlated with general cognitive abilities (i.e., cognitive flexibility, inhibitory control, and processing speed). Another BEN state, characterized by intermediate overall BEN and low within-state BEN located in DMN, ECN, and part of SAN, its FW, and MDT were positively correlated with the above cognitive abilities. The results of our study advance our understanding of the underlying mechanism of BEN dynamics and provide a potential framework for future investigations in clinical populations.

Impact of exposure to natural versus urban soundscapes on brain functional connectivity, BOLD entropy and behavior

BACKGROUND

Humans have been moving from rural to urban environments for decades. This process may have important consequences for our health and well-being. Most previous studies have focused on visual input, and the auditory domain has been understudied so far. Therefore, we set out to investigate the influence of exposure to natural vs urban soundscapes on brain activity and behavior.

METHODS

Resting-state fMRI data was acquired while participants (N = 35) listened to natural and urban soundscapes. Two affective questionnaires (the Positive and Negative Affect Schedule (PANAS) and the Perceived Stress Scale) and two cognitive tasks (dual n-back (DNB) and the backward digit-span (BDS)) were assessed before and after each soundscape condition. To quantify brain function we used complexity and network measures, namely brain entropy (BEN) and whole brain functional connectivity (FC). To study the link between brain and behavior, changes in BEN and whole brain FC were correlated to changes in cognitive performance and self-reported affect.

RESULTS

We found higher BEN when listening to urban sounds in posterior cingulate gyrus, cuneus and precuneus, occipital lobe/calcarine as compared to nature sounds, which was negatively correlated to (post-pre) differences in positive affect (PANAS) in the urban soundscape condition. In addition, we found higher FC between areas in the auditory, cinguloopercular, somatomotor hand and mouth networks when listening to nature as compared to urban sounds which was positively correlated to (post-pre) differences of the of the composite score of Digit span and N-back for nature soundscape.

CONCLUSIONS

This study provides a framework for the neural underpinnings of how natural versus urban soundscapes affect both whole brain FC and BEN and bear implications for the understanding of how the physical auditory environment affects brain function and subsequently observed behavior. Moreover, correlations with cognition and affect reveal the meaning that exposure to soundscapes may have on the human brain. To the best of our knowledge this is the first study to analyze BEN and whole brain FC at rest during exposure to nature and urban soundscapes and to explore their relationship to behavior.

Molecular basis underlying changes of brain entropy and functional connectivity in major depressive disorders after electroconvulsive therapy

INTRODUCTION

Electroconvulsive therapy (ECT) is widely used for treatment-resistant depression. However, it is unclear whether/how ECT can be targeted to affect brain regions and circuits in the brain to dynamically regulate mood and cognition.

METHODS

This study used brain entropy (BEN) to measure the irregular levels of brain systems in 46 major depressive disorder (MDD) patients before and after ECT treatment. Functional connectivity (FC) was further adopted to reveal changes of functional couplings. Moreover, transcriptomic and neurotransmitter receptor data were used to reveal genetic and molecular basis of the changes of BEN and functional connectivities.

RESULTS

Compared to pretreatment, the BEN in the posterior cerebellar lobe (PCL) significantly decreased and FC between the PCL and the right temporal pole (TP) significantly increased in MDD patients after treatment. Moreover, we found that these changes of BEN and FC were closely associated with genes' expression profiles involved in MAPK signaling pathway, GABAergic synapse, and dopaminergic synapse and were significantly correlated with the receptor/transporter density of 5-HT, norepinephrine, glutamate, etc. CONCLUSION: These findings suggest that loops in the cerebellum and TP are crucial for ECT regulation of mood and cognition, which provides new evidence for the antidepressant effects of ECT and the potential molecular mechanism leading to cognitive impairment.

Task-induced changes in brain entropy

Entropy indicates irregularity of a dynamic system, with higher entropy indicating higher irregularity and more transit states. In the human brain, regional brain entropy (BEN) has been increasingly assessed using resting state fMRI (rs-fMRI), while changes of regional BEN during task-based fMRI have been scarcely studied. The purpose of this study is to characterize task-induced regional BEN alterations using the large Human Connectome Project (HCP) data. To control the potential modulation by the block design, BEN of task-fMRI was calculated from the fMRI images acquired during the task conditions only (task BEN) and then compared to BEN of rs-fMRI (resting BEN). Moreover, BEN was separately calculated from the control blocks of the task-fMRI runs (control BEN) and compared to task BEN. Finally, control BEN was compared to resting BEN to test for residual task effects in the control condition. With respect to resting state, task performance unanimously induced BEN reduction in the peripheral cortical area and BEN increase in the centric part of the sensorimotor and perception networks. Control compared to resting BEN showed similar entropy alterations, suggesting large residual task effects. Task compared to control BEN was characterized by reduced entropy in occipital, orbitofrontal, and parietal regions.

Common hyper-entropy patterns identified in nicotine smoking, marijuana use, and alcohol use based on uni-drug dependence cohorts

Substance use disorders present similar behaviors and psychopathologies related to impaired decision making/inhibition control and information processing, suggesting common alterations in frontal and limbic brain areas. To test this hypothesis, we identified three uni-substance use cohorts with dependence to only one type of substance from the Human Connectome Project: marijuana dependence, nicotine dependence, and alcohol dependence. Fifty-nine marijuana uses, 34 nicotine smokers, 35 alcohol drinkers, and their age and sex-matched non-substance use controls were identified. We used brain entropy mapping to probe brain alterations in substance use disorders. Compared to non-substance use individuals, all three substance use disorder cohorts had increased brain entropy. Marijuana dependence and nicotine dependence showed overlapped hyper-brain entropy in bilateral dorso-lateral prefrontal cortex, anterior cingulate cortex, and right insula. Hyper-brain entropy in marijuana dependence and alcohol dependence overlap in left insula, left doso-lateral prefrontal cortex, and posterior cingulate. Hyper-brain entropy in nicotine dependence and alcohol dependence overlap only in left dorso-lateral prefrontal cortex. Hyper-brain entropy in those areas was correlated with increased impulsivity or reduced inhibition control in substance use disorder but not in controls. Drug dependence is associated with hyper-brain entropy in the prefrontal cortex and the meso-limbic system, independent of a specific addictive drug. Brain entropy in this circuit provides a sensitive marker to detect brain and behavioral alterations in substance user disorders.

Non-linear variations in glutamate dynamics during a cognitive task engagement in schizophrenia

To investigate the role of glutamate in psychosis, we employ functional magnetic resonance spectroscopy at an ultra-high magnetic field (7T) and employ fuzzy-approximate entropy (F-ApEn) and Hurst Exponent (HE) to capture time-varying nature of glutamate signaling during a cognitive task. We recruited thirty first-episode psychosis patients (FEP) with age- and gender-matched healthy controls (HC) and administered the Color-Word Stroop paradigm, providing 128 raw MRS time-points per subject over a period of 16 min. We then performed metabolite quantification of glutamate in the dorsal anterior cingulate cortex, a region reliably activated during the Stroop task. Symptoms/cognitive functioning was measured using Positive and Negative Syndrome Scale-8 score, Social and Occupational Functioning (SOFAS) score, digit symbol) coding score, and Stroop accuracy. These scores were related to the Entropy/HE data from the overall glutamate time-series. Patients with FEP had significantly higher HE compared to HC, with individuals displaying significantly higher HE having lower functional performance (SOFAS) in both HC and FEP groups. Among healthy individuals, higher HE also indicated significantly lower cognitive function through Stroop accuracy and DSST scores. F-ApEn had an inverse Pearson correlation with HE, and tracked diagnosis, cognition and function as expected, but with lower effect sizes not reaching statistical significance. We demonstrate notable diagnostic differences in the temporal course of glutamate signaling during a cognitive task in psychosis.

Aberrant brain entropy in posttraumatic stress disorder comorbid with major depressive disorder during the coronavirus disease 2019 pandemic

Aim

Previously, neuroimaging studies on comorbid Posttraumatic-Major depression disorder (PTSD-MDD) comorbidity found abnormalities in multiple brain regions among patients. Recent neuroimaging studies have revealed dynamic nature on human brain activity during resting state, and entropy as an indicator of dynamic regularity may provide a new perspective for studying abnormalities of brain function among PTSD-MDD patients. During the COVID-19 pandemic, there has been a significant increase in the number of patients with PTSD-MDD. We have decided to conduct research on resting-state brain functional activity of patients who developed PTSD-MDD during this period using entropy.

Methods

Thirty three patients with PTSD-MDD and 36 matched TCs were recruited. PTSD and depression symptoms were assessed using multiple clinical scales. All subjects underwent functional magnetic resonance imaging (fMRI) scans. And the brain entropy (BEN) maps were calculated using the BEN mapping toolbox. A two-sample t-test was used to compare the differences in the brain entropy between the PTSD-MDD comorbidity group and TC group. Furthermore, correlation analysis was conducted between the BEN changes in patients with PTSD-MDD and clinical scales.

Results

Compared to the TCs, PTSD-MDD patients had a reduced BEN in the right middle frontal orbital gyrus (R_MFOG), left putamen, and right inferior frontal gyrus, opercular part (R_IFOG). Furthermore, a higher BEN in the R_MFOG was related to higher CAPS and HAMD-24 scores in the patients with PTSD-MDD.

Conclusion

The results showed that the R_MFOG is a potential marker for showing the symptom severity of PTSD-MDD comorbidity. Consequently, PTSD-MDD may have reduced BEN in frontal and basal ganglia regions which are related to emotional dysregulation and cognitive deficits.

Task-induced changes in brain entropy

Entropy indicates irregularity of a dynamic system with higher entropy indicating higher irregularity and more transit states. In the human brain, regional entropy has been increasingly assessed using resting state fMRI. Response of regional entropy to task has been scarcely studied. The purpose of this study is to characterize task-induced regional brain entropy (BEN) alterations using the large Human Connectome Project (HCP) data. To control the potential modulation by the block-design, BEN of task-fMRI was calculated from the fMRI images acquired during the task conditions only and then compared to BEN of rsfMRI. Compared to resting state, task-performance unanimously induced BEN reduction in the peripheral cortical area including both the task activated regions and task non-specific regions such as the task negative area and BEN increase in the centric part of the sensorimotor and perception networks. Task control condition showed large residual task effects. After controlling the task non-specific effects using the control BEN vs task BEN comparison, regional BEN showed task specific effects in target regions.

From local properties to brain-wide organization: A review of intraregional temporal features in functional magnetic resonance imaging data

Based on the fluctuations ensembled over neighbouring neurons, blood oxygen level-dependent (BOLD) signal is a mesoscale measurement of brain signals. Intraregional temporal features (IRTFs) of BOLD signal, extracted from regional neural activities, are utilized to investigate how the brain functions in local brain areas. This literature highlights four types of IRTFs and their representative calculations including variability in the temporal domain, variability in the frequency domain, entropy, and intrinsic neural timescales, which are tightly related to cognitions. In the brain-wide spatial organization, these brain features generally organized into two spatial hierarchies, reflecting structural constraints of regional dynamics and hierarchical functional processing workflow in brain. Meanwhile, the spatial organization gives rise to the link between neuronal properties and cognitive performance. Disrupted or unbalanced spatial conditions of IRTFs emerge with suboptimal cognitive states, which improved our understanding of the aging process and/or neuropathology of brain disease. This review concludes that IRTFs are important properties of the brain functional system and IRTFs should be considered in a brain-wide manner.

Intrinsic neural timescales in autism spectrum disorder and schizophrenia. A replication and direct comparison study

Intrinsic neural timescales (INT) reflect the duration for which brain areas store information. A posterior-anterior hierarchy of increasingly longer INT has been revealed in both typically developed individuals (TD), as well as persons diagnosed with autism spectrum disorder (ASD) and schizophrenia (SZ), though INT are, overall, shorter in both patient groups. In the present study, we aimed to replicate previously reported group differences by comparing INT of TD to ASD and SZ. We partially replicated the previously reported result, showing reduced INT in the left lateral occipital gyrus and the right post-central gyrus in SZ compared to TD. We also directly compared the INT of the two patient groups and found that these same two areas show significantly reduced INT in SZ compared to ASD. Previously reported correlations between INT and symptom severity were not replicated in the current project. Our findings serve to circumscribe the brain areas that can potentially play a determinant role in observed sensory peculiarities in ASD and SZ.

Altered brain entropy and functional connectivity patterns in generalized anxiety disorder patients

BACKGROUND

Generalized anxiety disorder (GAD) is a highly prevalent disease characterized by chronic, pervasive, and intrusive worry. Previous resting-state functional MRI (fMRI) studies on GAD have mainly focused on conventional static linear features. Entropy analysis of resting-state functional magnetic resonance imaging (rs-fMRI) has recently been adopted to characterize brain temporal dynamics in some neuropsychological or psychiatric diseases. However, the nonlinear dynamic complexity of brain signals has been rarely explored in GAD.

METHODS

We measured the approximate entropy (ApEn) and sample entropy (SampEn) of the resting-state fMRI data from 38 GAD patients and 37 matched healthy controls (HCs). The brain regions with significantly different ApEn and SampEn values between the two groups were extracted. Using these brain regions as seed points, we also investigated whether there are differences in whole brain resting-state function connectivity (RSFC) pattern between GADs and HCs. Correlation analysis was subsequently conducted to investigate the association between brain entropy, RSFC and the severity of anxiety symptoms. A linear support vector machine (SVM) was used to assess the discriminative power of BEN and RSFC features among GAD patients and HCs.

RESULTS

Compared to the HCs, patients with GAD showed increased levels of ApEn in the right angular cortex (AG) and increased levels of SampEn in the right middle occipital gyrus (MOG) as well as the right inferior occipital gyrus (IOG). Contrarily, compared to the HCs, patients with GAD showed decreased RSFC between the right AG and the right inferior parietal gyrus (IPG). The SVM-based classification model achieved 85.33 % accuracy (sensitivity: 89.19 %; specificity: 81.58 %; and area under the receiver operating characteristic curve: 0.9018). The ApEn of the right AG and the SVM-based decision value was positively correlated with the Hamilton Anxiety Scale (HAMA).

LIMITATIONS

This study used cross-sectional data and sample size was small.

CONCLUSION

Patients with GAD showed increased level of nonlinear dynamical complexity of ApEn in the right AG and decreased linear features of RSFC in the right IPG. Combining the linear and nonlinear features of brain signals may be used to effectively diagnose psychiatric disorders.

Progressive brain abnormalities in schizophrenia across different illness periods: a structural and functional MRI study

Schizophrenia is a chronic brain disorder, and neuroimaging abnormalities have been reported in different stages of the illness for decades. However, when and how these brain abnormalities occur and evolve remains undetermined. We hypothesized structural and functional brain abnormalities progress throughout the illness course at different rates in schizophrenia. A total of 115 patients with schizophrenia were recruited and stratified into three groups of different illness periods: 5-year group (illness duration: ≤5 years), 15-year group (illness duration: 12-18 years), and 25-year group (illness duration: ≥25 years); 230 healthy controls were matched by age and sex to the three groups, respectively. All participants underwent resting-state MRI scanning. Each group of patients with schizophrenia was compared with the corresponding controls in terms of voxel-based morphometry (VBM), fractional anisotropy (FA), global functional connectivity density (gFCD), and sample entropy (SampEn) abnormalities. In the 5-year group we observed only SampEn abnormalities in the putamen. In the 15-year group, we observed VBM abnormalities in the insula and cingulate gyrus and gFCD abnormalities in the temporal cortex. In the 25-year group, we observed FA abnormalities in nearly all white matter tracts, and additional VBM and gFCD abnormalities in the frontal cortex and cerebellum. By using two structural and two functional MRI analysis methods, we demonstrated that individual functional abnormalities occur in limited brain areas initially, functional connectivity and gray matter density abnormalities ensue later in wider brain areas, and structural connectivity abnormalities involving almost all white matter tracts emerge in the third decade of the course in schizophrenia.

Neuroimaging biomarkers for detecting schizophrenia: A resting-state functional MRI-based radiomics analysis

Schizophrenia (SZ) is a common psychiatric disorder that is difficult to accurately diagnose in clinical practice. Quantifiable biomarkers are urgently required to explore the potential physiological mechanism of SZ and improve its diagnostic accuracy. Thus, this study aimed to identify biomarkers that classify SZ patients and healthy control subjects and investigate the potential neural mechanisms of SZ using degree centrality (DC)- and voxel-mirrored homotopic connectivity (VMHC)-based radiomics. Radiomics features were extracted from DC and VMHC metrics generated via resting-state functional magnetic resonance imaging, and significant features were selected and dimensionality was reduced using t-tests and least absolute shrinkage and selection operator. Subsequently, we built our model using a support vector machine classifier. We observed that our method obtained great classification performance (area under the curve, 0.808; accuracy, 74.02%), and it could be generalized to different brain atlases. The regions that we identified as discriminative features mainly included bilateral dorsal caudate and front-parietal, somatomotor, limbic, and default mode networks. Our findings showed that the radiomics-based machine learning method could facilitate us to understand the potential pathological mechanism of SZ more comprehensively and contribute to the accurate diagnosis of patients with SZ.

Lower resting brain entropy is associated with stronger task activation and deactivation

Brain entropy (BEN) calculated from resting state fMRI has been the subject of increasing research interest in recent years. Previous studies have shown the correlations between rest BEN and neurocognition and task performance, but how this relates to task-evoked brain activations and deactivations remains unknown. The purpose of this study is to address this open question using large data (n = 862). Voxel wise correlations were calculated between rest BEN and task activations/deactivations of five different tasks. For most of the assessed tasks, lower rest BEN was found to be associated with stronger activations (negative correlations) and stronger deactivations (positive correlations) only in brain regions activated or deactivated by the tasks. Higher workload evoked spatially more extended negative correlations between rest BEN and task activations. These results not only confirm that resting brain activity can predict brain activity during task performance but also for the first time show that resting brain activity may facilitate both task activations and deactivations. In addition, the results provide a clue to understanding the individual differences of task performance and brain activations.

Flights and Perchings of the BrainMind: A Temporospatial Approach to Psychotherapy

This article introduces a process-oriented approach for improving present moment conceptualization in psychotherapy that is in alignment with neuroscience: the Temporospatial movements of mind (TSMM) model. We elaborate on seven temporal movements that describe the moment-to-moment morphogenesis of emotional feelings and thoughts from inception to maturity. Temporal refers to the passage of time through which feelings and thoughts develop, and electromagnetic activity, that among other responsibilities, bind information across time. Spatial dynamics extend from an undifferentiated to three dimensional experiences of emotional and cognitive processes. Neurophysiologically, spatial refers to structures within the brain and their varying interactions with one another. This article culminates in the development of an atheoretical temporospatial grid that may help clinicians conceptualize where patients are in their cognitive and emotional development to further guide technique.

Shared increased entropy of brain signals across patients with different mental illnesses: A coordinate-based activation likelihood estimation meta-analysis

Entropy is a measurement of brain signal complexity. Studies have found increased/decreased entropy of brain signals in psychiatric patients. There is no consistent conclusion regarding the relationship between the entropy of brain signals and mental illness. Therefore, this meta-analysis aimed to identify consistent abnormalities in the brain signal entropy in patients with different mental illnesses. We conducted a systematic search to collect resting-state functional magnetic resonance imaging (rs-fMRI) studies in patients with psychiatric disorders. This work identified 9 eligible rs-fMRI studies, which included a total of 14 experiments, 67 activation foci, and 1383 subjects. We tested the convergence across their findings by using the activation likelihood estimation method. P-value maps were corrected by using cluster-level family-wise error p < 0.05 and permuting 2000 times. Results showed that patients with different psychiatric disorders shared commonly increased entropy of brain signals in the left inferior and middle frontal gyri, and the right fusiform gyrus, cuneus, precuneus. No shared alterations were found in the subcortical regions and cerebellum in the patient group. Our findings suggested that the increased entropy of brain signals in the cortex, not subcortical regions and cerebellum, might have associations with the pathophysiology across mental illnesses. This meta-analysis study provided the first comprehensive understanding of the abnormality in brain signal complexity across patients with different psychiatric disorders.

Decreased Resting-State Functional Complexity in Elderly with Subjective Cognitive Decline

Individuals with subjective cognitive decline (SCD) are at high risk of developing preclinical or clinical state of Alzheimer’s disease (AD). Resting state functional magnetic resonance imaging, which can indirectly reflect neuron activities by measuring the blood-oxygen-level-dependent (BOLD) signals, is promising in the early detection of SCD. This study aimed to explore whether the nonlinear complexity of BOLD signals can describe the subtle differences between SCD and normal aging, and uncover the underlying neuropsychological implications of these differences. In particular, we introduce amplitude-aware permutation entropy (AAPE) as the novel measure of brain entropy to characterize the complexity in BOLD signals in each brain region of the Brainnetome atlas. Our results demonstrate that AAPE can reflect the subtle differences between both groups, and the SCD group presented significantly decreased complexities in subregions of the superior temporal gyrus, the inferior parietal lobule, the postcentral gyrus, and the insular gyrus. Moreover, the results further reveal that lower complexity in SCD may correspond to poorer cognitive performance or even subtle cognitive impairment. Our findings demonstrated the effectiveness and sensitiveness of the novel brain entropy measured by AAPE, which may serve as the potential neuroimaging marker for exploring the subtle changes in SCD.

Increased resting-state brain entropy of parahippocampal gyrus and dorsolateral prefrontal cortex in manic and euthymic adolescent bipolar disorder

BACKGROUND

Alterations of brain signal complexity may reflect brain functional abnormalities. In adolescent bipolar disorder (ABD) distribution of brain regions showing abnormal complexity in different mood states remains unclear. We aimed to analyze brain entropy (BEN) alteration of functional magnetic resonance imaging (fMRI) signal to observe spatial distribution of complexity in ABD patients, as well as the relationship between this variation and clinical variables.

METHODS

Resting-state fMRI data were acquired from adolescents with bipolar disorder (BD) who were in manic (n = 19) and euthymic (n = 20) states, and from healthy controls (HCs, n = 17). The differences in BEN among the three groups, and their associations with clinical variables, were examined.

RESULTS

Compared to HCs, manic and euthymic ABD patients showed increased BEN in right parahippocampal gyrus (PHG) and left dorsolateral prefrontal cortex (DLPFC). There was no significant difference of BEN between the manic and the euthymic ABD groups. In manic ABD patients, right PHG BEN exhibited significantly positive relationship with episode times.

CONCLUSIONS

Increased BEN in right PHG and left DLPFC in ABD patients may cause dysfunction of corticolimbic circuitry which is important to emotional processing and cognitive control. The positive correlation between PHG BEN and episode times of manic ABD patients further expressed a close association between brain complexity and clinical symptoms. From the perspective of brain temporal dynamics, the present study complements previous findings that have reported corticolimbic dysfunction as an important contributor to the pathophysiology of BD. BEN may provide valuable evidences for understanding the underlying mechanism of ABD.

The Application of Complexity Analysis in Brain Blood-Oxygen Signal

One of the daunting features of the brain is its physiology complexity, which arises from the interaction of numerous neuronal circuits that operate over a wide range of temporal and spatial scales, enabling the brain to adapt to the constantly changing environment and to perform various cognitive functions. As a reflection of the complexity of brain physiology, the complexity of brain blood-oxygen signal has been frequently studied in recent years. This paper reviews previous literature regarding the following three aspects: (1) whether the complexity of the brain blood-oxygen signal can serve as a reliable biomarker for distinguishing different patient populations; (2) which is the best algorithm for complexity measure? And (3) how to select the optimal parameters for complexity measures. We then discuss future directions for blood-oxygen signal complexity analysis, including improving complexity measurement based on the characteristics of both spatial patterns of brain blood-oxygen signal and latency of complexity itself. In conclusion, the current review helps to better understand complexity analysis in brain blood-oxygen signal analysis and provide useful information for future studies.

Brain Entropy is Associated with Divergent Thinking

Creativity is the ability to generate original and useful products, and it is considered central to the progression of human civilization. As a noninherited emerging process, creativity may stem from temporally dynamic brain activity, which, however, has not been well studied. The purpose of this study was to measure brain dynamics using entropy and to examine the associations between brain entropy (BEN) and divergent thinking in a large healthy sample. The results showed that divergent thinking was consistently positively correlated with regional BEN in the left dorsal anterior cingulate cortex/pre-supplementary motor area and left dorsolateral prefrontal cortex, suggesting that creativity is closely related to the functional dynamics of the control networks involved in cognitive flexibility and inhibitory control. Importantly, our main results were cross-validated in two independent cohorts from two different cultures. Additionally, three dimensions of divergent thinking (fluency, flexibility, and originality) were positively correlated with regional BEN in the left inferior frontal gyrus and left middle temporal gyrus, suggesting that more highly creative individuals possess more flexible semantic associative networks. Taken together, our findings provide the first evidence of the associations of regional BEN with individual variations in divergent thinking and show that BEN is sensitive to detecting variations in important cognitive abilities in healthy subjects.

The neurocognitive correlates of brain entropy estimated by resting state fMRI

Resting state brain activity consumes most of brain energy, likely creating and maintaining a reserve of general brain functionality. The latent reserve if it exists may be reflected by the profound long-range fluctuations of resting brain activity. The long-range temporal coherence (LRTC) can be characterized by resting state fMRI (rsfMRI)-based brain entropy (BEN) mapping. While BEN mapping results have shown sensitivity to neuromodulations or disease conditions, the underlying neuromechanisms especially the associations of BEN or LRTC to neurocognition still remain unclear. To address this standing question and to test a novel hypothesis that resting BEN reflects a latent functional reserve through the link to general functionality, we mapped resting BEN of 862 young adults and comprehensively examined its associations to neurocognitions using data from the Human Connectome Project (HCP). Our results unanimously highlighted two brain circuits: the default mode network (DMN) and executive control network (ECN) through their negative associations of BEN to general functionality, which is independent of age and sex. While BEN in DMN/ECN increases with age, it decreases with education years. These results demonstrated the neurocognitive correlates of resting BEN in DMN/ECN and suggest resting BEN in DMN/ECN as a potential proxy of the latent functional reserve that facilitates general brain functionality and may be enhanced by education.

"Unrest while Resting"? Brain entropy in autism spectrum disorder

Biological systems typically exhibit complex behavior with nonlinear dynamic properties. Nonlinear signal processing techniques such as sample entropy is a novel approach to characterize the temporal dynamics of brain connectivity. Estimating entropy is especially important in clinical populations such as autism spectrum disorder (ASD) as differences in entropy may signal functional alterations in the brain. Considering the models of disrupted brain network connectivity in ASD, sample entropy would provide a novel direction to understand brain organization. Resting state fMRI data from 45 high-functioning children with ASD and 45 age-and-IQ-matched typically developing (TD) children were obtained from the Autism Brain Imaging Data Exchange (ABIDE-II) database. Data were preprocessed using the CONN toolbox. Sample entropy was then calculated using the complexity toolbox, in a whole-brain voxelwise manner as well as in regions of interests (ROIs) based methods. ASD participants demonstrated significantly increased entropy in left angular gyrus, superior parietal lobule, and right inferior temporal gyrus; and reduced sample entropy in superior frontal gyrus compared to TD participants. Positive correlations of average entropy in clusters of significant group differences scores across all subjects were found. Finally, ROI analysis revealed a main effect of lobes. Differences in entropy between the ASD and TD groups suggests that entropy may provide another important index of brain dysfunction in clinical populations like ASD. Further, the relationship between increased entropy and ASD symptoms in our study underscores the role of optimal brain synchronization in cognitive and behavioral functions.

The Clinical, Philosophical, Evolutionary and Mathematical Machinery of Consciousness: An Analytic Dissection of the Field Theories and a Consilience of Ideas

The Cartesian model of mind-body dualism concurs with religious traditions. However, science has supplanted this idea with an energy-matter theory of consciousness, where matter is equivalent to the body and energy replaces the mind or soul. This equivalency is analogous to the concept of the interchange of mass and energy as expressed by Einstein's famous equation [Formula: see text]. Immanuel Kant, in his Critique of Pure Reason, provided the intellectual and theoretical framework for a theory of mind or consciousness.  Any theory of consciousness must include the fact that a conscious entity, as far as is known, is a wet biological medium (the brain), of stupendously high entropy. This organ or entity generates a field that must account for the "binding problem", which we will define. This proposed field, the conscious electro-magnetic information (CEMI) field, also has physical properties, which we will outline.  We will also demonstrate the seamless transition of the Kantian philosophy of the a priori conception of space and time, the organs of perception and conception, into the CEMI field of consciousness. We will explore the concept of the CEMI field and its neurophysiological correlates, and in particular, synchronous and coherent gamma oscillations of various neuronal ensembles, as in William J Freeman's experiments in the early 1970s with olfactory perception in rabbits. The expansion of the temporo-parietal-occipital (TPO) cortex in hominid evolution epitomizes metaphorical and abstract thinking. This area of the cortex, with synchronous thalamo-cortical oscillations has the best fit for a minimal neural correlate of consciousness. Our field theory shifts consciousness from an abstract idea to a tangible energy with defined properties and a mathematical framework. Even further, it is not a coincidence that the cerebral cortex is very thin with respect to the diameter of the brain. This is in keeping with its fantastically high entropy, as we see in the event horizon of a black hole and the conformal field theory/anti-de Sitter (CFT/ADS) holographic model of the universe. We adumbrate the uniqueness of consciousness of an advanced biological system such as the human brain and draw insight from Avicenna's gendanken, floating man thought experiment. The multi-system high volume afferentation of a biological wet system honed after millions of years of evolution, its high entropy, and the CEMI field variation inducing currents in motor output pathways are proposed to spark the seeds of consciousness. We will also review Karl Friston's free energy principle, the concept of belief-update in a Bayesian inference framework, the minimization of the divergence of prior and posterior probability distributions, and the entropy of the brain. We will streamline these highly technical papers, which view consciousness as a minimization principle akin to Hilbert's action in deriving Einstein's field equation or Feynman's sum of histories in quantum mechanics. Consciousness here is interpreted as flow of probability densities on a Riemmanian manifold, where the gradient of ascent on this manifold across contour lines determines the magnitude of perception or the degree of update of the belief-system in a Bayesian inference model. Finally, the science of consciousness has transcended metaphysics and its study is now rooted in the latest advances of neurophysiology, neuro-radiology under the aegis of mathematics.

Acute Alcohol Intake Produces Widespread Decreases in Cortical Resting Signal Variability in Healthy Social Drinkers

BACKGROUND

Acute alcohol intoxication has wide-ranging neurobehavioral effects on psychomotor, attentional, inhibitory, and memory-related cognitive processes. These effects are mirrored in disruption of neural metabolism, functional activation, and functional network coherence. Metrics of intraregional neural dynamics such as regional signal variability (RSV) and brain entropy (BEN) may capture unique aspects of neural functional capacity in healthy and clinical populations; however, alcohol's influence on these metrics is unclear. The present study aimed to elucidate the influence of acute alcohol intoxication on RSV and to clarify these effects with subsequent BEN analyses.

METHODS

26 healthy adults between 25 and 45 years of age (65.4% women) participated in 2 counterbalanced sessions. In one, participants consumed a beverage containing alcohol sufficient to produce a breath alcohol concentration of 0.08 g/dl. In the other, they consumed a placebo beverage. Approximately 35 minutes after beverage consumption, participants completed a 9-minute resting-state fMRI scan. Whole-brain, voxel-wise standard deviation was used to assess RSV, which was compared between sessions. Within clusters displaying alterations in RSV, sample entropy was calculated to assess BEN.

RESULTS

Compared to the placebo, alcohol intake resulted in widespread reductions in RSV in the bilateral middle frontal, right inferior frontal, right superior frontal, bilateral posterior cingulate, bilateral middle temporal, right supramarginal gyri, and bilateral inferior parietal lobule. Within these clusters, significant reductions in BEN were found in the bilateral middle frontal and right superior frontal gyri. No effects were noted in subcortical or cerebellar areas.

CONCLUSIONS

Findings indicate that alcohol intake produces diffuse reductions in RSV among structures associated with attentional processes. Within these structures, signal complexity was also reduced in a subset of frontal regions. Neurobehavioral effects of acute alcohol consumption may be partially driven by disruption of intraregional neural dynamics among regions involved in higher-order cognitive and attentional processes.

Spatiotemporal Integrity and Spontaneous Nonlinear Dynamic Properties of the Salience Network Revealed by Human Intracranial Electrophysiology: A Multicohort Replication

The salience network (SN) plays a critical role in cognitive control and adaptive human behaviors, but its electrophysiological foundations and millisecond timescale dynamic temporal properties are poorly understood. Here, we use invasive intracranial EEG (iEEG) from multiple cohorts to investigate the neurophysiological underpinnings of the SN and identify dynamic temporal properties that distinguish it from the default mode network (DMN) and dorsolateral frontal-parietal network (FPN), two other large-scale brain networks that play important roles in human cognition. iEEG analysis of network interactions revealed that the anterior insula and anterior cingulate cortex, which together anchor the SN, had stronger intranetwork interactions with each other than cross-network interactions with the DMN and FPN. Analysis of directionality of information flow between the SN, DMN, and FPN revealed causal outflow hubs in the SN consistent with its role in fast temporal switching of network interactions. Analysis of regional iEEG temporal fluctuations revealed faster temporal dynamics and higher entropy of neural activity within the SN, compared to the DMN and FPN. Critically, these results were replicated across multiple cohorts. Our findings provide new insights into the neurophysiological basis of the SN, and more broadly, foundational mechanisms underlying the large-scale functional organization of the human brain.

Individual Cortical Entropy Profile: Test-Retest Reliability, Predictive Power for Cognitive Ability, and Neuroanatomical Foundation

The entropy profiles of cortical activity have become novel perspectives to investigate individual differences in behavior. However, previous studies have neglected foundational aspects of individual entropy profiles, that is, the test-retest reliability, the predictive power for cognitive ability in out-of-sample data, and the underlying neuroanatomical basis. We explored these issues in a large young healthy adult dataset (Human Connectome Project, N = 998). We showed the whole cortical entropy profile from resting-state functional magnetic resonance imaging is a robust personalized measure, while subsystem profiles exhibited heterogeneous reliabilities. The limbic network exhibited lowest reliability. We tested the out-of-sample predictive power for general and specific cognitive abilities based on reliable cortical entropy profiles. The default mode and visual networks are most crucial when predicting general cognitive ability. We investigated the anatomical features underlying cross-region and cross-individual variations in cortical entropy profiles. Cortical thickness and structural connectivity explained spatial variations in the group-averaged entropy profile. Cortical folding and myelination in the attention and frontoparietal networks determined predominantly individual cortical entropy profile. This study lays foundations for brain-entropy-based studies on individual differences to understand cognitive ability and related pathologies. These findings broaden our understanding of the associations between neural structures, functional dynamics, and cognitive ability.

Altered Brain Entropy as a predictor of antidepressant response in major depressive disorder

OBJECTIVE

To explore the alterations and value of brain entropy (BEN) in major depressive disorder (MDD).

METHODS

85 MDD patients and 45 matched normal controls were recruited. MDD was diagnosed based on Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV). Symptoms of depression were assessed using the Hamilton depression scale-24 (HAMD-24) at baseline and follow-up (after 8-week treatment). All subjects underwent functional magnetic resonance imaging (fMRI) scans at baseline, and 30 MDD patients completed scans at 8th week. Whole brain BEN maps at each session was calculated using the BEN mapping toolbox.

RESULTS

The 8-week antidepressant treatment improved symptoms for all MDD patients. As compared to normal controls, MDD showed reduced BEN in medial orbitofrontal cortex (MOFC)/subgenual cingulate cortex (sgACC), but increased BEN in motor cortex (MC). In MDD patients, higher baseline BEN in MOFC/sgACC and lower baseline BEN in temporal cortex (TC) were associated with higher baseline HAMD scores; higher baseline BEN in MOFC/sgACC and hippocampus were associated with greater reduction of HAMD scores after 8-week medication; greater reduction of HAMD scores after 8-week medication was correlated with greater BEN reduction in MOFC/sgACC but were correlated with less BEN reduction in MC, TC, fusiform gyrus (FG) and visual cortex (VC).

CONCLUSION

The results highlighted MOFC/sgACC BEN as a potential marker for the prediction of MDD diagnosis and treatment effect. MDD might have increased MOFC/sgACC BEN but reduced BEN in visual and sensory-motor circuits corresponding to the imbalanced emotional and sensory-motor information processing. Reversing this unbalanced BEN would improve disease conditions in MDD.

Disrupted Brain Entropy And Functional Connectivity Patterns Of Thalamic Subregions In Major Depressive Disorder

PURPOSE

Entropy analysis of resting-state functional magnetic resonance imaging (R-fMRI) has recently been adopted to characterize brain temporal dynamics in some neuropsychological or psychiatric diseases. Thalamus-related dysfunction might be a potential trait marker of major depressive disorder (MDD), but the abnormal changes in the thalamus based on R-fMRI are still unclear from the perspective of brain temporal dynamics. The aim of this study was to identify local entropy changes and subregional connectivity patterns of the thalamus in MDD patients.

PATIENTS AND METHODS

We measured the sample entropy of the R-fMRI data from 46 MDD patients and 32 matched healthy controls. We employed the Louvain method for the module detection algorithm to automatically identify a functional parcellation of the thalamus and then examined the whole-brain subregional connectivity patterns.

RESULTS

The results indicated that the MDD patients had decreased entropy in the bilateral thalami compared with healthy controls. Increased functional connectivity between the thalamic subregions and the medial part of the superior frontal gyrus (mSFG) was found in MDD patients.

CONCLUSION

This study showed new evidence about sample entropy changes in MDD patients. The functional connectivity alterations that were widely distributed across almost all the thalamic subregions with the mSFG in MDD suggest a general involvement independent of the location and function of the subregions.