Objective: Tai chi (TC), a contemplative practice combining slow movements and deep breathing, has been shown to be clinically effective in alleviating depressive symptoms. Feelings of fatigue or low vitality often accompany major depressive disorder (MDD) though they are commonly overlooked and not well understood neurologically. By using resting state functional connectivity (rs-FC) using the insula as the seed, this study examines the relationship between mood and vitality symptoms in MDD and how they are impacted by TC training.

Methods: Patients (N = 16) with MDD participated in a 10-week TC intervention. Self-report scores of vitality (using the SF-36 scale) and depressed mood (using the Beck Depression Inventory) as well as rs-fMRI were collected pre- and post-intervention. A seed-to-voxel approach was used to test whether changes in insular rs-FC were related to therapeutic improvement in MDD-related symptoms resulting from TC practice.

Results: We found decreased self-reported depressed mood and increased vitality following the TC intervention. Furthermore, decreases in depressed mood were associated with increased rs-FC between the right anterior insula (AIC) and superior temporal gyrus and caudate (cluster-corrected p < 0.05). Increased vitality was associated with increased rs-FC between the right posterior insula (PIC) and regions associated with sensorimotor processes (cluster-corrected p < 0.05).

Conclusion: These results provide support for differential changes in insula connectivity as neural correlates of symptom improvement in MDD.

目的：太极拳（TC）是一种结合缓慢动作和深呼吸的沉思练习，已被证明可有效缓解抑郁症状。疲劳或低活力的感觉通常伴随着重度抑郁症（MDD），尽管它们通常被忽视并且在神经学上还没有被很好地理解。通过使用以绝缘体为种子的静止状态功能连接性（rs-FC），本研究检查了MDD中情绪和活力症状之间的关系，以及它们如何受到TC训练的影响。

方法： 耐心 （ñ= 16）与MDD一起参加了为期10周的TC干预。在干预之前和之后，收集自我报告的活力（使用SF-36量表）和沮丧的情绪（使用贝克抑郁量表）以及rs-fMRI评分。种子到体素的方法用于测试岛上rs-FC的变化是否与TC实践导致的MDD相关症状的治疗改善有关。

结果：我们发现，在进行TC干预后，自我报告的抑郁情绪降低，活力增强。此外，情绪低落与右前岛（AIC）与颞上回和尾状肌之间的rs-FC增加有关p<0.05）。活力增加与右后岛（PIC）和感觉运动过程相关区域之间的rs-FC增加有关p <0.05）。

结论：这些结果为绝缘性连接变化的差异提供了支持，因为MDD中症状改善的神经相关。