Emotion-Processing Biases and Neural Connectivity in Remitted Major Depressive Disorder among Adolescents

Major depressive disorder (MDD) among adolescents is recurrent and characterized by persistent emotion-processing biases. Adolescents (N=161; ages 13-18-years-old; remitted MDD=90, healthy controls=71) completed baseline and 6-month clinical assessments. Additionally, at baseline, participants completed the Facial Recognition Task while EEG data were recorded. The late positive potential (LPP) and effective connectivity during negative emotion processing were examined in relation to 6-month depressive symptoms and behavioral withdrawal (homestay from passive GPS). No group differences in LPP emerged. However, remitted MDD showed stronger right precuneus-superior frontal gyrus (theta-alpha) to sad faces and weaker left precuneus-SFG (alpha-beta) to angry faces relative to controls. Greater right precuneus-SFG connectivity during sad faces predicted depressive symptom severity (b=0.221, p=.025) and increased homestay (b=242.78, p=.048). Thus, altered precuneus-SFG connectivity during sad face processing may serve as a neural marker of depression risk, which could support early identification approaches and personalized interventions.