Major depressive disorder (MDD) is increasingly conceptualized as a dysconnection syndrome involving widespread brain network disruptions. However, most neuroimaging studies rely on within-sample case–control comparisons, leaving unclear whether identified connectivity patterns generalize across populations or explain clinical variation within patients. In this cross-sectional observational study, we test whether a depression-related connectivity pattern from a Japanese cohort (824 controls, 229 MDD) generalizes to a German cohort (923 controls, 694 MDD) using polyconnectomic scores (PCS), a metric for quantifying whole-brain connectivity disturbances.
PCSMDD significantly distinguished patients from controls (z = 5.1, P
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