Max-Planck-Institute for Human Cognitive and Brain Sciences, Stephanstrasse 1A, Leipzig, Germany.
J Affect Disord. 2012 Oct;140(2):142-8. doi: 10.1016/j.jad.2011.08.001. Epub 2011 Sep 3.
Depression has a lifetime prevalence of up to 20%. Neuroimaging methods have revealed various structural and functional changes that occur in a human brain during a depressive episode. However, we still lack information concerning the extent to which structural and functional changes co-occur in a depressed brain. Furthermore, it is difficult to evaluate from a merely qualitative literature review what regional brain changes in volume and activation are robust across depressed patient samples and consistent across imaging centers.
This study is a meta-analysis from 10 selected studies published previously. We applied the statistical anatomical/activation likelihood estimate method (ALE) in a total of 176 depressed patients and 175 controls for the MRI modality and in a total of 102 depressed patients and 94 controls for the PET modality to quantitatively identify those brain regions that show concordant alteration in the midst of a depressive episode across imaging modalities and study sites. We find a convergent change in the limbic-cortical brain circuit in depression compared to controls of both Positron Emission Tomography (PET) and Magnetic Resonance Imaging (MRI) data. The specific changes include lower gray matter volumes in the amygdala, the dorsal frontomedian cortex, and the right paracingulate cortex, as well as increases in glucose metabolism in the right subgenual and pregenual anterior cingulate cortices.
CONCLUSIONS/SIGNIFICANCE: Our current findings represent an important first step towards a more focused approach to neuroimaging unipolar depression. The regions identified could serve as a specific region-of-interest-for-disease template for both individual in vivo imaging studies and postmortem histopathologic exploration.
抑郁症的终生患病率高达 20%。神经影像学方法揭示了人类大脑在抑郁发作期间发生的各种结构和功能变化。然而，我们仍然缺乏关于在抑郁大脑中结构和功能变化共同发生的程度的信息。此外，仅从定性文献综述很难评估在体积和激活方面的哪些区域脑变化在抑郁患者样本中是稳健的，并且在各个成像中心是一致的。
这是一项来自之前发表的 10 项选定研究的荟萃分析。我们应用统计解剖/激活似然估计方法（ALE）对总共 176 名抑郁症患者和 175 名对照者进行 MRI 模式分析，对总共 102 名抑郁症患者和 94 名对照者进行正电子发射断层扫描（PET）模式分析，以定量识别在不同成像模式和研究地点中在抑郁发作期间表现出一致改变的那些脑区。我们发现与对照者相比，在抑郁症患者中存在边缘皮质脑回路的一致性变化，包括正电子发射断层扫描（PET）和磁共振成像（MRI）数据。具体变化包括杏仁核、背侧额中前皮质和右旁中央皮质的灰质体积减少，以及右前扣带回皮质和前扣带回皮质的葡萄糖代谢增加。
结论/意义：我们目前的发现代表了朝着更集中的方法研究单相抑郁症神经影像学的重要的第一步。确定的区域可以作为个体体内成像研究和死后组织病理学探索的特定疾病感兴趣区域模板。
