Shared and disorder-specific large-scale intrinsic and effective functional network connectivities in postpartum depression with and without anxiety

Postpartum depression and postpartum depression with anxiety, which are highly prevalent and debilitating disorders, become a growing public concern. The high overlap on the symptomatic and neurobiological levels led to ongoing debates about their diagnostic and neurobiological uniqueness. Delineating the shared and disorder-specific intrinsic functional connectivities and their causal interactions is fundamental to precision diagnosis and treatment. In this study, we recruited 138 participants including 45 postpartum depression, 31 postpartum depression comorbid with anxiety patients, and 62 healthy postnatal women with age ranging from 23 to 40 years. We combined independent component analysis, resting-state functional connectivity, and Granger causality analysis to reveal the abnormal intrinsic functional couplings and their causal interactions in postpartum depression and postpartum depression comorbid with anxiety from a large-scale brain network perspective. We found that they exhibited widespread abnormalities in intrinsic and effective functional network connectivities. Importantly, the intrinsic and effective functional network connectivities within or between the fronto-parietal network, default model network, ventral and dorsal attention network, sensorimotor network, and visual network, especially the functional imbalances between primary and association cortices could serve as effective neural markers to differentiate postpartum depression, postpartum depression comorbid with anxiety, and healthy controls. Our findings provide the initial evidence for shared and disorder-specific intrinsic and effective functional network connectivities for postpartum depression and postpartum depression comorbid with anxiety, which provide an underlying neuropathological basis for postpartum depression or postpartum depression comorbid with anxiety to facilitate precision diagnosis and therapy in future studies.