Shu Yan-Ping, Zhang Qin, Hou Yong-Zhe, Liang Shuang, Zheng Zu-Li, Li Jia-Lin, Wu Gang
Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang 550000, Guizhou Province, China.
Department of Radiology, The Second People's Hospital of Guizhou Province, Guiyang 550000, Guizhou Province, China.
World J Psychiatry. 2024 Jul 19;14(7):1106-1117. doi: 10.5498/wjp.v14.i7.1106.
Major depressive disorder (MDD) in adolescents and young adults contributes significantly to global morbidity, with inconsistent findings on brain structural changes from structural magnetic resonance imaging studies. Activation likelihood estimation (ALE) offers a method to synthesize these diverse findings and identify consistent brain anomalies.
To identify consistent brain structural changes in adolescents and young adults with MDD using ALE meta-analysis.
We performed a comprehensive literature search in PubMed, Web of Science, Embase, and Chinese National Knowledge Infrastructure databases for neuroimaging studies on MDD among adolescents and young adults published up to November 19, 2023. Two independent researchers performed the study selection, quality assessment, and data extraction. The ALE technique was employed to synthesize findings on localized brain function anomalies in MDD patients, which was supplemented by sensitivity analyses.
Twenty-two studies comprising fourteen diffusion tensor imaging (DTI) studies and eight voxel-based morphometry (VBM) studies, and involving 451 MDD patients and 465 healthy controls (HCs) for DTI and 664 MDD patients and 946 HCs for VBM, were included. DTI-based ALE demonstrated significant reductions in fractional anisotropy (FA) values in the right caudate head, right insula, and right lentiform nucleus putamen in adolescents and young adults with MDD compared to HCs, with no regions exhibiting increased FA values. VBM-based ALE did not demonstrate significant alterations in gray matter volume. Sensitivity analyses highlighted consistent findings in the right caudate head (11 of 14 analyses), right insula (10 of 14 analyses), and right lentiform nucleus putamen (11 of 14 analyses).
Structural alterations in the right caudate head, right insula, and right lentiform nucleus putamen in young MDD patients may contribute to its recurrent nature, offering insights for targeted therapies.
青少年和青年的重度抑郁症(MDD)对全球发病率有重大影响,而结构磁共振成像研究关于脑结构变化的结果并不一致。激活可能性估计(ALE)提供了一种综合这些不同研究结果并识别一致脑异常的方法。
使用ALE荟萃分析确定青少年和青年MDD患者一致的脑结构变化。
我们在PubMed、科学网、Embase和中国知网数据库中进行了全面的文献检索,以查找截至2023年11月19日发表的关于青少年和青年MDD的神经影像学研究。两名独立研究人员进行了研究筛选、质量评估和数据提取。采用ALE技术综合MDD患者局部脑功能异常的研究结果,并进行敏感性分析。
纳入了22项研究,其中包括14项扩散张量成像(DTI)研究和8项基于体素的形态学测量(VBM)研究,DTI研究涉及451例MDD患者和465例健康对照(HC),VBM研究涉及664例MDD患者和946例HC。基于DTI的ALE显示,与HC相比,青少年和青年MDD患者右侧尾状核头部、右侧岛叶和右侧豆状核壳核的分数各向异性(FA)值显著降低,没有区域FA值升高。基于VBM的ALE未显示灰质体积有显著变化。敏感性分析突出了右侧尾状核头部(14项分析中的11项)、右侧岛叶(14项分析中的10项)和右侧豆状核壳核(14项分析中的11项)的一致结果。
年轻MDD患者右侧尾状核头部、右侧岛叶和右侧豆状核壳核的结构改变可能导致其复发性,为靶向治疗提供了思路。