Association of Depressive Symptom Scores with Multimodal Brain Imaging and Behavioral Phenotypes: A Resting-State, Task-FMRI, and Clinical Comorbidity Study Based on the Human Connectome Project

Objective: Depressive symptoms exist on a continuum in the general population, yet the underlying neurobiological mechanisms, particularly the interplay between resting-state networks and task-evoked social cognitive responses, remain elusive. Methods: Leveraging the Human Connectome Project (HCP) dataset, we included 867 participants. With depression scores as the independent variable and age/sex as covariates, we systematically examined associations with sleep quality, negative emotions, sensory scores, gray matter volume (GMV), fractional amplitude of low-frequency fluctuations (fALFF), multi-seed resting-state functional connectivity (rsFC), as well as brain activation and behavioral performance during working memory, emotion recognition, social cognition, relational reasoning, language comprehension, and gambling tasks. The statistical threshold was set at voxel-level p < 0.001 (uncorrected) combined with cluster-level FWE correction at p < 0.05. Results: (1) Depression scores were positively correlated with sleep disturbances, negative emotions (anger/fear), and pain. (2) In resting-state, depression scores negatively correlated with ventral striatum (VS)–cerebellum/parahippocampal gyrus/fusiform rsFC, yet positively correlated with pregenual anterior cingulate cortex (preACC)–supplementary motor area (SMA) rsFC. (3) In task-fMRI, only the social task showed a positive association with task accuracy and regional activation in bilateral pre/postcentral gyri, superior temporal gyri, left middle frontal gyrus, and SMA/paracentral lobule. Conclusions: Elevated depression scores are linked to a pattern that may reflect relative decoupling between reward and perceptual systems, along with enhanced connectivity in cognitive control circuits. Socially, high scorers exhibit a pattern suggestive of compensatory hypervigilance, accompanied by enhanced behavioral performance. This study provides multidimensional evidence for the dimensional neural representation of depressive symptoms.