A Longitudinal Correlational Study of Psychological Resilience, Depression Disorder, and Brain Functional–Structural Hybrid Connectome in Breast Cancer

Purposes: To evaluate the association between psychological resilience, depression disorder (DD), and brain functional–structural hybrid connectome in patients with breast cancer before treatment (T0) and at 1 year. Methods: Between February 2017 and October 2019, 172 patients were longitudinally enrolled from a multicenter trial named as Be Resilient to Breast Cancer (BRBC) and completed resting‐state functional magnetic resonance imaging (rs‐fMRI) and diffusion tensor imaging (DTI) before the T0. Data‐driven multivoxel pattern analysis (MVPA) and correlational tractography (CT) were performed to identify distinct functional‐structural hybrid connectome. DD was diagnosed by psychiatry physicians according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5). Psychological resilience was collected by Resilience Scale Specific to Cancer (RS‐SC) and tested as the mediation variable between hybrid connectome and DD. Results: Of the total sample of 172, 14.5% ( N = 25) were diagnosed with DD. High psychological resilience was associated with a lower risk of DD (hazard ratio (HR) = 0.37, 95% confidence interval (CI), 0.17–0.82, p = 0.0368). Frontal pole right (88.0%) in rs‐fMRI and arcuate fasciculus_L (75.2%) in DTI were identified as main significant brain areas. Psychological resilience accounted for 10.01%–12.14% of direct effect between brain functional–structural hybrid connectome and 1‐year DD. Conclusion: Psychological resilience predicts DD at 1 year and mediates the association between brain functional–structural hybrid connectome and DD at 1 year in patients diagnosed with breast cancer. Trial Registration: ClinicalTrials.gov identifier: NCT03026374