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

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.