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重性抑郁障碍的脑容量异常:磁共振成像研究的荟萃分析。

Brain volume abnormalities in major depressive disorder: a meta-analysis of magnetic resonance imaging studies.

机构信息

Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Hum Brain Mapp. 2009 Nov;30(11):3719-35. doi: 10.1002/hbm.20801.

Abstract

OBJECTIVE

So far, there have been no attempts to integrate the growing number of all brain volumetric magnetic resonance imaging studies in depression. In this comprehensive meta-analysis the magnitude and extent of brain volume differences between 2,418 patients with major depressive disorder and 1,974 healthy individuals from 64 studies was determined.

METHODS

A systematic research was conducted for volumetric magnetic resonance imaging studies of patients with major depressive disorder in relation to healthy control subjects. Studies had to report sufficient data for computation of effect sizes. For each study, the Cohen's d was calculated. All analyses were performed using the random effects model. Additionally, meta-regression analyses were done to explore the effects of potential sources of heterogeneity.

RESULTS

Patients showed large volume reductions in frontal regions, especially in the anterior cingulate and orbitofrontal cortex with smaller reductions in the prefrontal cortex. The hippocampus, the putamen and caudate nucleus showed moderate volume reductions.

CONCLUSIONS

This is the first comprehensive meta-analysis in major depressive disorder demonstrating structural brain abnormalities, particularly in those brain areas that are involved in emotion processing and stress-regulation.

摘要

目的

到目前为止,还没有人尝试将越来越多的全脑容积磁共振成像研究整合到抑郁症中。在这项综合荟萃分析中,我们确定了 64 项研究中 2418 名重度抑郁症患者和 1974 名健康个体之间的脑体积差异的幅度和范围。

方法

对与健康对照相关的重度抑郁症患者的容积磁共振成像研究进行了系统研究。研究必须报告足够的数据以计算效应量。对于每项研究,计算了 Cohen 的 d。所有分析均采用随机效应模型进行。此外,还进行了元回归分析,以探讨潜在异质性来源的影响。

结果

患者在前额区域显示出较大的体积减少,尤其是在前扣带和眶额皮质,而前额皮质的减少较小。海马体、壳核和尾状核显示出中等程度的体积减少。

结论

这是首次在重度抑郁症中进行的综合荟萃分析,证明了结构脑异常,特别是在涉及情绪处理和应激调节的脑区。

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