Sobral Mónica, Guiomar Raquel, Rezaeian Manya, Vasileiadi Maria, Cruz Sara, Pacheco Francisca, Mateus Vera, Palau-Costafreda Roser, Pozo-Neira Johanna, Weidenauer Ana, Moreira Helena, Tik Martin, Ganho-Ávila Ana, Schuler Anna-Lisa
Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-315, Portugal.
Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-315, Coimbra, Portugal.
Mol Psychiatry. 2025 Sep 8. doi: 10.1038/s41380-025-03227-2.
Peripartum depression (PPD) is a form of major depressive disorder (MDD) that begins during the peripartum period and poses a significant mental health challenge affecting 10 to 29% of women.
This systematic review and multimodal activation likelihood estimation (ALE) meta-analysis explored the distinct structural, functional, and metabolic features of the PPD brain as compared to female non-peripartum MDD.
For this purpose, we conducted a comprehensive literature search in PubMed, Embase and PsycINFO databases to identify peer-reviewed original studies investigating the neural correlates associated with PPD or fMDD.
Forty-five studies in PPD and 55 in fMDD were included in the qualitative synthesis. From these, 25 PPD and 32 fMDD studies were included in the meta-analysis. Both shared and distinct neural underpinnings of PPD and fMDD were observed. Specifically, we found alterations in the cognitive control, salience and default mode networks for both PPD and fMDD, although with reversed structural and functional activity patterns in the insula, amygdala, precentral gyrus and precuneus.
These findings support the consistent pattern of dysregulation associated with emotional regulation, cognition and maternal caregiving in women with PPD, as well as possible differential sensitivity to hormonal influences, highlighting the need for targeted interventions.
产后抑郁症（PPD）是一种重度抑郁症（MDD），始于围产期，对心理健康构成重大挑战，影响10%至29%的女性。
本系统评价和多模态激活可能性估计（ALE）荟萃分析探讨了与非围产期女性重度抑郁症相比，产后抑郁症患者大脑独特的结构、功能和代谢特征。
为此，我们在PubMed、Embase和PsycINFO数据库中进行了全面的文献检索，以识别经同行评审的关于产后抑郁症或女性重度抑郁症神经相关性的原始研究。
定性综合分析纳入了45项产后抑郁症研究和55项女性重度抑郁症研究。其中，荟萃分析纳入了25项产后抑郁症研究和32项女性重度抑郁症研究。观察到产后抑郁症和女性重度抑郁症共同的和独特的神经基础。具体而言，我们发现产后抑郁症和女性重度抑郁症在认知控制、突显和默认模式网络方面均有改变，尽管岛叶、杏仁核、中央前回和楔前叶的结构和功能活动模式相反。
这些发现支持了产后抑郁症女性在情绪调节、认知和母婴照料方面与失调相关的一致模式，以及对激素影响可能存在的不同敏感性，强调了针对性干预的必要性。
