Adolescents with major depression featured by sensory-association subtyping show divergent information dynamics and streams

Adolescent major depressive disorder (MDD) exhibits complex and heterogeneous alterations of brain functional organization. To understand the neurobiological basis of adolescent MDD, we adopted resting-state functional MRI data and used various matrix decomposition approaches to obtain the organization gradients, temporal dynamics, and information streams. With clustering sensory-association gradient features in our exploratory sample (NMDD = 250 and NControls = 203), we identified two MDD subtypes. Subtype 1 was characterized by sensory contraction and subtype 2 was associated with association expansion. In addition, two subtypes showed divergent bottom-up and top-down information flows in sensory and association areas using temporal dynamics analysis. These subtypes exhibit distinct age-related changes and reorganization trajectories along sensory-association and auditory-visual axes, highlighting that cortical information flow patterns systematically vary and relate differently to sensory integration, cognitive complexity, and aging. These network distinctions are linked to clinical severity and molecular mechanisms. Subtype 1 is predominantly associated with early neurodevelopmental abnormalities and emotional regulation deficits, while Subtype 2 is more related to synaptic dysfunction and reduced neuronal excitability. These results could be largely replicated in another independent sample (NMDD = 73 and NControls = 28). We therefore construct a sensory-association dual functional framework to characterize MDD heterogeneity in adolescent MDD. Itl integrates cortical hierarchy, developmental trajectories, and genetic influences, offering novel insights into MDD pathophysiology and providing a theoretical foundation for precision psychiatry, facilitating personalized diagnosis and intervention strategies.