Functional stability is a newly developed dynamic functional connectivity approach. The objective of this study was to adopt functional stability to investigate diagnosis-associated abnormalities (patients vs. controls) and status-related changes (acute vs. remitted status) in brain function in major depressive disorder (MDD). 132 MDD patients and 102 healthy controls underwent resting-state functional MRI as well as clinical and cognitive assessment at baseline, with 48 patients completing follow-up examinations at an average of 7 months. Results showed no group differences in baseline functional stability and no longitudinal functional stability changes from acute to remitted status in patients. However, we found that baseline functional stability in the dorsal and ventral anterior cingulate cortex, calcarine sulcus, and middle occipital gyrus could predict improvement in depressive symptoms from acute to remitted status in MDD patients, with longitudinal functional stability changes in these regions related to the degree of symptom improvement. In addition, lower baseline functional stability in the inferior temporal gyrus could predict a greater improvement in sustained attention, which was associated with a greater functional stability increase in this region. Our findings highlight functional stability as a potential prognostic biomarker to predict and track disease progression or stratify MDD patients for optimizing disease management and treatment strategies.

功能稳定性是一种新开发的动态功能连接方法。本研究的目的是采用功能稳定性来研究重度抑郁症 (MDD) 脑功能的诊断相关异常（患者与对照组）和状态相关变化（急性与缓解状态）。132 名 MDD 患者和 102 名健康对照者在基线时接受了静息状态功能 MRI 以及临床和认知评估，其中 48 名患者在平均 7 个月内完成了随访检查。结果显示基线功能稳定性没有组间差异，并且患者从急性到缓解状态的纵向功能稳定性没有变化。然而，我们发现背侧和腹侧前扣带皮层、距状沟的基线功能稳定性，枕中回和枕中回可以预测 MDD 患者抑郁症状从急性到缓解状态的改善，这些区域的纵向功能稳定性变化与症状改善的程度有关。此外，颞下回较低的基线功能稳定性可以预测持续注意力的更大改善，这与该区域更大的功能稳定性增加有关。我们的研究结果强调功能稳定性是一种潜在的预后生物标志物，可预测和跟踪疾病进展或对 MDD 患者进行分层以优化疾病管理和治疗策略。这些区域的纵向功能稳定性变化与症状改善程度有关。此外，颞下回较低的基线功能稳定性可以预测持续注意力的更大改善，这与该区域更大的功能稳定性增加有关。我们的研究结果强调功能稳定性是一种潜在的预后生物标志物，可预测和跟踪疾病进展或对 MDD 患者进行分层以优化疾病管理和治疗策略。这些区域的纵向功能稳定性变化与症状改善程度有关。此外，颞下回较低的基线功能稳定性可以预测持续注意力的更大改善，这与该区域更大的功能稳定性增加有关。我们的研究结果强调功能稳定性是一种潜在的预后生物标志物，可预测和跟踪疾病进展或对 MDD 患者进行分层以优化疾病管理和治疗策略。