BACKGROUND:Brain lateralization, the hemispheric specialization of functional networks, is essential for motor and cognitive functions. However, how intensive athletic training shapes hemispheric organization remains poorly understood. This study investigated the formation of functional lateralization in elite athletes through long-term intensive training and its potential alteration by external factors, specifically sport-related concussions. METHODS:Resting-state functional magnetic resonance imaging data were collected from 13 world class gymnasts (WCGs) and 14 nonathletic controls. Longitudinal data were collected from 18 soccer players and eight golfers before and after one season, with concussions monitored in the soccer players. Laterality indices of hemispheric integration and segregation (LI int and LI seg ) were calculated to quantify hemispheric differences in information processing for each brain region, and the standard laterality index (LI) was employed to measure hemispheric asymmetry. Associations between laterality indices and neurotransmitter receptor/transporter densities were examined. Postseason changes in these indices were assessed to evaluate the effects of concussion on brain lateralization. RESULTS:The WCGs showed significantly increased LI int in several left-hemispheric regions, including the precentral gyrus, cingulate gyrus, thalamus, superior parietal lobule, and lateral occipital cortex compared with the healthy controls, although no significant differences were found in LI seg . Furthermore, the LI analysis revealed that the WCGs showed higher hemispheric asymmetry in the left precentral gyrus, cingulate gyrus, and thalamus. These laterality indices also were positively correlated with certain neurotransmitters. Similar patterns of enhanced lateralization and neurotransmitter associations were observed in soccer players and golfers. However, no significant changes in laterality indices were observed as a result of concussions sustained during the season. CONCLUSIONS:Long-term intensive training enhances functional integration in the left hemisphere, leading to stable brain lateralization patterns resilient to sport-related concussions.

Introduction : Occupational complexity is a major source of long-term cognitive stimulation across adulthood, yet its multidimensional effects on cognitive aging and their neural mechanisms remain unclear. This study examined how three dimensions of occupational complexity—data, people, and things—shape late-life cognitive performance, and whether brain reserve(BR) and cognitive reserve(CR) mediate these associations. Methods : A total of 3,754 retirees meeting sex-specific age eligibility criteria were recruited from the Beijing Aging Brain Rejuvenation Initiative completed a battery of multidomain neuropsychological assessments and standardized occupational history assessments coded using O*NET-based ratings.. A subsample of 851 participants also underwent structural MRI. Linear models, structural equation modeling, and voxel-/surface-based morphometry were used to test (1) dimension-specific associations with cognitive domains, (2) links to global and regional brain structure, and (3) dual-reserve mediation pathways. Results : Data complexity emerged as the primary protective dimension, independently predicting higher reasoning (β = 0.058), attention (β = 0.041), and reduced mild cognitive impairment(MCI) risk (− 5.7% after adjustment for education, p < 0.05; −14.3% unadjusted, p < 0.001). After accounting for data complexity, higher people complexity was associated with poorer working memory and language performance.. Things complexity, referring to demands related to tools and physical objects, showed no direct associations but demonstrated compensation via late-life leisure activities. Neuroimaging showed that data complexity was uniquely associated with larger gray matter volume in frontotemporal–limbic regions and higher CR. Mediation models revealed that data complexity protected cognition via both BR and CR, with mediation effects observed across multiple cognitive domains.. Conclusions : Occupational complexity, particularly data complexity, is associated with enhanced cognitive aging outcomes, including improved reasoning, attention, and reduced mild cognitive impairment (MCI) risk. Neuroimaging revealed that data complexity predicts greater frontotemporal–limbic gray matter volume and higher cognitive reserve. Mediation analyses suggested dual reserve pathways, with cognitive reserve mediating multiple cognitive domains, while brain reserve influenced hippocampal and temporal regions. These findings underscore the role of occupational environments in promoting cognitive health and mitigating late-life MCI risk.

Our previous study had confirmed that lifetime intellectual cognitive reserve (LICR) is associated with better late-life cognition. However, whether LICR can delay cognitive decline remains unknown. We systematically examined the influence of LICR on cognitive trajectories, as well as mild cognitive impairment (MCI) risk, and whether such associations differ by sex. A total of 1308 cognitively intact individuals (mean age 65.54 years) were included. Information on early educational attainment, midlife occupational complexity and mental leisure activities after retirement collected at baseline was used to construct LICR, while cognitive domain scores were derived from several neuropsychological tests assessed at baseline and twice follow-up, using confirmatory factor analysis. Data were analyzed using linear mixed-effects models and Cox regression models. Compared to participants with lower LICR, those with higher LICR exhibited significantly slower language ability decline (β = 0.071, 95

Major depressive disorder (MDD) is characterized by persistent low mood and anhedonia, indicative of fundamental disruptions in emotion regulation and reward processing. With advancements in high-temporal resolution electrophysiological techniques, electroencephalography/event-related potentials have become crucial for identifying the dynamic neural signatures associated with these dysfunctions. This review synthesizes recent evidence regarding the electrophysiological underpinnings, abnormal patterns, neural circuitry, and molecular mechanisms that contribute to emotional and reward processing deficits in MDD. It further explores the potential of these deficits to serve as endophenotypes and transdiagnostic features, and it outlines mechanism-based interventions and translational findings. Current research reveals extensive electrophysiological abnormalities across various stages of emotional and reward processing, implicating dysfunction within specific cortical-limbic pathways and molecular systems. These insights hold significant implications for enhancing the diagnosis, treatment, and mechanistic understanding of MDD.

Physical exercise improves working memory (WM) across the lifespan, yet the neural mechanisms underlying this benefit remain incompletely understood, and it is unclear whether intervention-induced neuroplastic changes and long-term exercise-related differences converge on common neural circuits. We systematically searched PubMed, Web of Science, PsycINFO, and CNKI through June 2026 and included 11 task-based fMRI studies (6 longitudinal interventions and 5 cross-sectional comparisons; 403 par-ticipants) reporting whole-brain activation coordinates. Activation likelihood estima-tion (ALE) meta-analyses were performed separately for activation increases and de-creases within each design. Longitudinal studies revealed exercise-induced activation increases in the bilateral cerebellum (posterior lobe, cerebellar tonsil) and decreases in the right thalamus. Cross-sectional studies revealed greater activation in the left middle temporal gyrus (BA 21) and reduced activation in the right cingulate gyrus (BA 24) and left caudate body among long-term exercisers relative to controls. Critically, the two designs yielded spatially non-overlapping patterns. These findings support a du-al-mechanism model in which exercise strengthens task-positive network engagement while optimizing the suppression of task-irrelevant processing, and they suggest that exercise shapes working memory circuitry across distinct, timescale-dependent neural circuits.

Both type 2 diabetes mellitus (T2DM) and Apolipoprotein E (APOE) ɛ4 allele are recognized risk factors for Alzheimer’s disease (AD). However, the impact of the APOE ɛ4 allele on the accumulation of AD-related neuropathology in patients with T2DM remains unclear. We analyzed amyloid beta (Aβ) and tau deposition patterns via positron emission tomography (PET) imaging in 163 T2DM patients (64 ɛ4 carriers) and 1654 normal glucose metabolism subjects (687 ɛ4 carriers). Findings reveal that Aβ deposition has a broader range of influence in diabetics carrying the ɛ4 allele, especially in the deep cortical areas. In terms of tau accumulation, diabetic carriers exhibit progression to the posterior and frontal cortices. Specifically, a greater Aβ PET burden is associated with higher levels of plasma Aβ42 and lower levels of cerebrospinal fluid (CSF) Aβ42, Aβ42/40, and Aβ42/38. A significant positive correlation was observed between tau PET burden and CSF tau and phosphorylated tau (pTau), and plasma pTau181. Importantly, higher Aβ and tau standardized uptake value ratio were associated with poorer memory performance and lower scores on the Montreal Cognitive Assessment. These findings highlight the allele’s region-specific synergism with T2DM in driving AD-related pathology, potentially informing the development of a neuroimaging-based grading system to evaluate diabetic neuropathology severity and progression dynamics.

Motor imagery electroencephalogram (MI-EEG) decoding plays a crucial role in developing motor imagery brain-computer interfaces (MI-BCIs). However, decoding intentions from MI remains challenging due to the inherent complexity of EEG signals relative to the small-sample size. To address this issue, we propose a spatial- spectral and temporal dual prototype network (SST-DPN). First, we design a lightweight attention mechanism to uniformly model the spatial-spectral relationships across multiple EEG electrodes, enabling the extraction of powerful spatial-spectral features. Then, we develop a multi-scale variance pooling module tailored for EEG signals to capture long-term temporal features. This module is parameter-free and computationally efficient, offering clear advantages over the widely used transformer models. Furthermore, we introduce dual prototype learning to optimize the feature space distribution and training process, thereby improving the model's generalization ability on small-sample MI datasets. Our experimental results show that the SSTDPN outperforms state-of-the-art models with superior classification accuracy (84.11% for dataset BCI4-2A, 86.65% for dataset BCI4-2B). Additionally, we use the BCI3-4A dataset with fewer training data to further validate the generalization ability of the proposed SST-DPN, achieving superior performance with 82.03% classification accuracy. Benefiting from the lightweight parameters and superior decoding performance, our SST-DPN shows great potential for practical MI-BCI applications. The code is publicly available at https: //github.com/hancan16/SST-DPN.

In an evolving global knowledge economy, many countries are actively implementing policies to recruit and retain foreign students as potential global talents and valuable human resources. This article provides a comprehensive review of the evolution of foreign student employment policy in China. The study finds that foreign student employment policy covers three distinct phases: (1) preparation phase (1949–1978) in which few internships, no employment or startups were allowed; (2) construction phase (1979–2009) in which internships and work-study were allowed with complicated procedures; (3) deepening reform phase (2010 to the present) in which qualified foreign students can take part-time jobs, startup business and even immigrate after graduation. The rationales, guidelines and objectives in each policy phase are identified by inductive document analysis using NVivo qualitative software. Moreover, the result of inductive document analysis is converted into the Multiple Streams Framework (MSF) for further analysis. The MSF analysis shows that domestic demands and overseas competition for global talents in the problem stream, together with advocates in policy community inspired by the Party’s ideology of talent development eventually opens a decision window from the political stream. Lastly, this article proposes a modified MSF to better explain agenda setting and policymaking processes in non-Western contexts like China, and calls for more contributions in the MSF-related research.

The predictors and clinical outcomes of Percutaneous Coronary Intervention in patients with suspected coronary heart disease with COmorbid major DEpressive disorder (PCI CODE) study employs a prospective, multidisciplinary, observational design to evaluate clinical outcomes post-percutaneous coronary intervention (PCI) between coronary heart disease (CHD) patients with or without major depressive disorder (MDD). This study is registered with ClinicalTrials.gov (NCT03852082). During enrollment, all consecutive individuals aged ≥18 years who are clinically suspected of CHD and scheduled for coronary angiography at Nanjing First Hospital are our observational cohort. After completing the self-rated Patient Health Questionnaire, undergoing a clinical MDD diagnosis by a psychiatrist when indicated, and having CHD confirmed by interventional cardiologists, participants in the PCI arm are stratified into 2 groups: CHD patients with MDD and CHD patients without MDD. The primary composite endpoint is the 1-year and 5-year incidence of major adverse cardiac events including all-cause death, non-fatal myocardial infarction, and any coronary revascularization. The secondary endpoints comprise individual events, including all-cause death, cardiovascular death, non-fatal myocardial infarction, any coronary revascularization, stent thrombosis, in-stent restenosis, cardiac-related rehospitalization, non-cardiac-related rehospitalization, or stroke. The PCI CODE study, which hypothesizes that certain biomarker combinations may correlate with a higher incidence of major adverse cardiac events at 1 and 5 years post-PCI, seeks to identify the key determinants that lead to poorer prognoses following PCI in patients with CHD and comorbid MDD compared to those without MDD.

Social skills are essential for fostering healthy relationships and promoting positive social interactions. Supporting students’ development of these skills has become increasingly important in educational contexts and is emphasized within many countries’ national core curricula. However, teachers often lack pedagogical methods for nurturing such skills. This study addresses this gap by investigating how the “Curious About Others” play based on solution-focused and playful pedagogical approaches can support students’ learning of social skills. In the study, we used a qualitative research method involving the qualitative data collected from students’ written documents, learning reflections, discussion recordings, observations, and interviews with students and teachers. The material was analyzed using content analysis. Results indicate that the intervention improved students’ social skills and their abilities in communication, cooperation, empathy, and self-control. These findings highlight the benefits of integrating solution-focused and playful approaches into educational practices. The study underscores the importance of incorporating such interventions into curricula to foster social skills. Practical implications for educators include promoting playful learning activities and strength-based solution-focused approaches to support social–emotional development and create a positive learning environment.

BACKGROUND:Affective flexibility deficits in Major Depressive Disorder (MDD) are hypothesized to reflect valence-specific impairments in shifting between emotional and non-emotional processing. However, the underlying neurophysiological mechanisms remain poorly understood. METHODS:Twenty-nine individuals with MDD and twenty-nine healthy controls (HCs) completed a modified Affective Switching Task (AST) requiring rapid alternation between judging emotional valence (positive/negative) and counting human figures, while undergoing 64-channel EEG recording. Behavioral switch costs and event-related potentials (ERPs), particularly the Late Positive Potential (LPP), were analyzed across positive and negative contexts using mixed-design ANOVAs and correlation analyses. RESULTS:MDD participants showed significantly elevated positive engagement switch costs (PE-SC) compared to HCs (F(1,56) = 5.072, p = 0.028, η2ₚ = 0.083), which positively correlated with depression severity (r = 0.48, p = 0.009). At the neural level, MDD participants exhibited significantly reduced LPP modulation during negative engagement (NE-LPPD; F(1,56) = 5.490, p = 0.023, η2ₚ = 0.089), indicating impaired emotional resource allocation. Moreover, enhanced negative disengagement predicted greater LPP responses to positive engagement, suggesting a compensatory resource reallocation mechanism. Notably, behavioral and neural indices were dissociated in positive trials, suggesting a potential imbalance between compensatory and depleted neural processes. CONCLUSIONS:These findings provide novel ERP-based evidence of valence-specific affective flexibility deficits in MDD, characterized by behavioral difficulty engaging with positive stimuli and attenuated neural responsiveness during negative processing. This valence asymmetry may underlie emotional rigidity in depression and highlight neurocognitive targets for intervention.

Long-term intensive training has enabled world class gymnasts to attain exceptional skill levels, inducing notable neuroplastic changes in their brains. Previous studies have identified optimized brain modularity related to long-term intensive training based on resting-state functional MRI, which is associated with higher efficiency in motor and cognitive functions. However, most studies assumed that functional topological networks remain static during the scans, neglecting the inherent dynamic changes over time. This study applied a multilayer network model to identify the effect of long-term intensive training on dynamic functional network properties in gymnasts. The imaging data were collected from 13 gymnasts and 14 age- and gender-matched non-athlete controls. We first construct dynamic functional connectivity matrices for each subject to capture the temporal information underlying these brain signals. Then, we applied a multilayer community detection approach to analyse how brain regions form modules and how this modularity changes over time. Graph theoretical parameters, including flexibility, promiscuity, cohesion and disjointedness, were estimated to characterize the dynamic properties of functional networks across global, network, and nodal levels in the gymnasts. The gymnasts showed significantly lower flexibility, cohesion and disjointedness at the global level than the controls. Then, we observed lower flexibility and cohesion in the auditory, dorsal attention, sensorimotor, subcortical, cingulo-opercular and default mode networks in the gymnasts than in the controls. Furthermore, these gymnasts showed decreased flexibility and cohesion in several regions associated with motor function. Together, we found brain functional neuroplasticity related to long-term intensive training, primarily characterized by decreased flexibility of brain dynamics in the gymnasts, which provided new insights into brain reorganization in motor skill learning.

BackgroundRecovery of upper limb function after stroke secondary to ischemia or hemorrhage is crucial for patients’ independence in daily living and quality of life. Virtual reality (VR) is a promising computer-based technology designed to enhance the effects of rehabilitation; however, the results of VR-based interventions remain equivocal. ObjectiveThis study aims to review the plausible factors that may have influenced VR’s therapeutic effects on improving upper limb function in patients with stroke, with the goal of synthesizing an optimal VR intervention protocol. MethodsThe databases PubMed, EMBASE, Web of Science, and Cochrane Library were queried for English-language papers published from May 2022 onward. Two reviewers independently extracted data from the included papers, and discrepancies in their findings were resolved through consensus during joint meetings. The risk of bias was assessed using the Physiotherapy Evidence Database Scale and the Methodological Index for Non-Randomized Studies. Outcome variables included the Action Research Arm Test, Box-Block Test, Functional Independence Measure, Upper Extremity Fugl-Meyer Assessment, and Wolf Motor Function Test. The plausible factors examined were age, total dosage (hours), trial length (weeks), session duration (hours/session), frequency (sessions/week), and VR content design. The Bonferroni adjustment was applied to P values to prevent data from being incorrectly deemed statistically significant. ResultsThe final sample included 15 articles with a total of 1243 participants (age range 48.6-75.59 years). Participants in the VR therapy (VRT) group (n=455) demonstrated significantly greater improvements in upper limb function and independence in activities of daily living compared with those in the conventional therapy group (n=301). Significant factors contributing to improved outcomes in upper limb function were younger age (mean difference [MD] 5.34, 95% CI 2.18-8.5, P<.001; I2=0%), interventions lasting more than 15 hours (MD 9.67, 95% CI 4.19-15.15, P<.001; I2=0%), trial lengths exceeding 4 weeks (MD 4.02, 95% CI 1.39-6.65, P=.003; I2=15%), and more than 4 sessions per week (MD 3.48, 95% CI 0.87-6.09, P=.009; I2=0%). However, the design of the VR content, including factors such as the number of features (eg, offering exercise and functional tasks; individualized goals; activity quantification; consideration of comorbidities and baseline activity level; addressing patient needs; aligning with patient background such as education level; patient-directed goals and interests; goal setting; progressive difficulty levels; and promoting self-efficacy), did not demonstrate significant effects (MD 3.89, 95% CI –6.40 to 1.09; effect Z=1.36, P=.16). ConclusionsGreater VR effects on improving upper limb function in patients with stroke were associated with higher training doses (exceeding 15 hours) delivered over 4-6 weeks, with shorter sessions (approximately 1 hour) scheduled 4 or more times per week. Additionally, younger patients appeared to benefit more from the VR protocol compared with older patients.

Previous studies have found that loneliness affects cognitive functions in older persons. However, the influence of loneliness on different cognitive fields and the internal mechanism of the relationship are unclear. A total of 4772 older persons aged above 50 years (Mean = 65.31, SD = 6.96, 57.7% female) were included in this study. All the participants completed the characteristics scale, as well as the loneliness scale, leisure activity scale, and cognitive function tests in six domains. The results showed that 17.6% of participants had high loneliness, while 16.7% of participants had low loneliness. Associations were observed between higher levels of loneliness and lower scores in general cognitive ability, memory, and executive functions. Mediation analysis suggested that leisure activities, encompassing mental, physical, and social activities, were associated with cognitive functions in the context of loneliness. These results indicate that leisure activities may play a significant role in the relationship between loneliness and cognitive functions in older adults. The study highlights the importance of considering leisure activities in this demographic to potentially mitigate the adverse cognitive effects associated with loneliness.

BACKGROUND:This study aims to evaluate the effectiveness of computerized cognitive training (CCT) on white matter (WM) neuroplasticity and neuropsychological performance. METHODS:A total of 128 community older adults (64.36 ± 6.14 years) were recruited and randomly assigned to the intervention or control group. Participants in the intervention group received a home-based, multidomain, and adaptive CCT for 30 minutes, 2 days per week for 1 year. Neuropsychological assessments, diffusion magnetic resonance imaging (MRI), and T1-weighted structural MRI were performed at the pre- and post-intervention visits. RESULTS:Eighty-one of 128 participants (41 in the intervention group and 40 in the control group) completed the 1-year intervention, and 61 of them (27 in the intervention group and 34 in the control group) underwent MRI scans twice. After excluding attrition bias, a significant time-by-group interaction on the Stroop Color-Word Test (SCWT; F = 51.85, p < .001) was found, showing improvement in the intervention group and a decline in the control group. At the brain level, the intervention group exhibited increased axial diffusivity in the left posterior thalamic radiation, and this increase was significantly correlated with reduced SCWT reaction time (r = ‒0.42, p = .029). No significant time-by-group interactions were found for gray matter volume. CONCLUSIONS:Our findings suggest that conducting multidomain adaptive CCT is an effective and feasible method to counteract cognitive decline in older adults, with WM neuroplasticity underpinning cognitive improvements. This study contributes to the understanding of the neural basis for the beneficial effect of CCT for older adults.

Multiple facets of sleep neurophysiology, including electroencephalography (EEG) metrics such as non-rapid eye movement (NREM) spindles and slow oscillations, are altered in individuals with schizophrenia (SCZ). However, beyond group-level analyses, the extent to which NREM deficits vary among patients is unclear, as are their relationships to other sources of heterogeneity including clinical factors, aging, cognitive profiles, and medication regimens. Using newly collected high-density sleep EEG data on 103 individuals with SCZ and 68 controls, we first sought to replicate our previously reported group-level differences between patients and controls (original N = 130) during the N2 stage. Then in the combined sample (N = 301 including 175 patients), we characterized patient-to-patient variability. We replicated all group-level mean differences and confirmed the high accuracy of our predictive model (area under the receiver operating characteristic curve [AUC] = 0.93 for diagnosis). Compared to controls, patients showed significantly increased between-individual variability across many (26%) sleep metrics. Although multiple clinical and cognitive factors were associated with NREM metrics, collectively they did not account for much of the general increase in patient-to-patient variability. The medication regimen was a greater contributor to variability. Some sleep metrics including fast spindle density showed exaggerated age-related effects in SCZ, and patients exhibited older predicted biological ages based on the sleep EEG; further, among patients, certain medications exacerbated these effects, in particular olanzapine. Collectively, our results point to a spectrum of N2 sleep deficits among SCZ patients that can be measured objectively and at scale, with relevance to both the etiological heterogeneity of SCZ as well as potential iatrogenic effects of antipsychotic medication.

Background: The aging population and high rates of Alzheimer's disease (AD) create significant medical burdens, prompting a need for early prevention. Targeting modifiable risk factors like vascular risk factors (VRFs), closely linked to AD, may provide a promising strategy for intervention. Objective: This study investigates how VRFs influence cognitive performance and brain structures in a community-based cohort. Methods: In this cross-sectional study, 4,667 participants over 50 years old, drawn from the Beijing Ageing Brain Rejuvenation Initiative project, were meticulously examined. Cognitive function and VRFs (diabetes mellitus, hypertension, hyperlipidemia, obesity, and smoking), were comprehensively assessed through one-to-one interviews. Additionally, a subset of participants (n = 719) underwent MRI, encompassing T1-weighted and diffusion-weighted scans, to elucidate gray matter volume and white matter structural network organization. Results: The findings unveil diabetes as a potent detriment to memory, manifesting in atrophy within the right supramarginal gyrus and diminished nodal efficiency and degree centrality in the right inferior parietal lobe. Hypertension solely impaired memory without significant structural changes. Intriguingly, individuals with comorbid diabetes and hypertension exhibited the most pronounced deficits in both brain structure and cognitive performance. Remarkably, hyperlipidemia emerged as a factor associated with enhanced cognition, and preservation of brain structure. Conclusions: This study illuminates the intricate associations between VRFs and the varied patterns of cognitive and brain structural damage. Notably, the synergistic effect of diabetes and hypertension emerges as particularly deleterious. These findings underscore the imperative to tailor interventions for patients with distinct VRF comorbidities, especially when addressing cognitive decline and structural brain changes.

Using data from the China Education Panel Survey, this study examines the impact of homework time on academic performance among Chinese junior high school students. The findings show that seventh and ninth graders spend 2.28 and 2.67 hours daily on homework, respectively, exceeding the 90-minute limit stipulated by the “double reduction” policy. Homework time significantly varies by gender, grade, and region. The relationship between homework time and the academic performance of junior high school students follows an inverted U-shaped pattern. Ordinary Least Squares analysis indicates that the optimal homework time for maximizing academic performance is less than 0.96 hours per day. Beyond the threshold, the positive effect diminishes, and when homework time exceeds 4.07 hours, it negatively impacts academic performance. Mediating effect analysis shows that excessive homework time leads to negative emotions, such as boredom, unhappiness, frustration, and sadness while depriving students of necessary sleep for healthy growth. It is concluded that optimal daily homework time is about 1 hour, aligning with the “double reduction” policy guidelines.

BACKGROUND:The intricate pathophysiological mechanisms of major depressive disorder (MDD) necessitate the development of comprehensive early indicators that reflect the complex interplay of emotional, physical, and cognitive factors. Despite its potential to fulfill these criteria, interoception remains underexplored in MDD. This study aimed to evaluate the potential of interoception in transforming MDD's clinical practices by examining interoception deficits across various MDD stages and analyzing their complex associations with the spectrum of depressive symptoms. METHODS:This study included 431 healthy individuals, 206 subclinical depression individuals, and 483 MDD patients. Depressive symptoms and interoception function were assessed using the PHQ-9 and MAIA-2, respectively. RESULTS:Interoception dysfunction occurred in the preclinical phase of MDD and further impaired in the clinical stage. Antidepressant therapies showed limited efficacy in improving interoception and might damage some dimensions. Interoceptive dimensions might predict depressive symptoms, primarily enhancing negative thinking patterns. The predictive model based on interoception was built with random split verification and demonstrated good discrimination and predictive performance in identifying MDD. CONCLUSIONS:Early alterations in the preclinical stage, multivariate associations with depressive symptoms, and good discrimination and predictive performance highlight the importance of interoception in MDD management, pointing to a paradigm shift in diagnostic and therapeutic approaches.