Conjoint and dissociated structural and functional abnormalities in first-episode drug-naive patients with major depressive disorder: a multimodal meta-analysis

Weina Wang,Xinyu Hu,Weihong Kuang,Youjin Zhao,Xiaoqi Huang,Graham J Kemp,Su Lui,Qiyong Gong

doi:10.1038/s41598-017-08944-5

Abstract

Published MRI evidence of structural and resting-state functional brain abnormalities in MDD has been inconsistent. To eliminate interference by repeated disease episodes and antidepressant treatment, we conducted the first multimodal voxel-wise meta-analysis of studies of voxel-based morphometry (VBM) and the amplitude of low-frequency fluctuation (ALFF) in first-episode drug-naive MDD patients, using the Seed-based d Mapping method (SDM). Fifteen VBM data sets and 11 ALFF data sets were included. SDM-based multimodal meta-analysis was used to highlight brain regions with both structural and functional abnormalities. This identified conjoint structural and functional abnormalities in left lateral orbitofrontal cortex and right supplementary motor area, and also dissociated abnormalities of structure (decreased grey matter in right dorsolateral prefrontal cortex and right inferior temporal gyrus; increased grey matter in right insula, right putamen, left temporal pole, and bilateral thalamus) and function (increased brain activity in left supplementary motor area, left parahippocampal gyrus, and hippocampus; decreased brain activity in right lateral orbitofrontal cortex). This study reveals a complex pattern of conjoint and dissociated structural and functional abnormalities, supporting the involvement of basal ganglia-thalamocortical circuits, representing emotional, cognitive and psychomotor abnormalities, in the pathophysiology of early-stage MDD. Specifically, this study adds to Psychoradiology, an emerging subspecialty of radiology, which seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with mental disorder.

Highlights

In the Egger test, we found publication bias in right SMA and right ITG in the VBM analysis, and in bilateral SMA and right PGH in the ALFF analysis, so another important limitation is the possibility of selective positive reporting and publication bias
First-episode drug naive MDD patients showed increase in GM as well as decrease in brain activity in the left lateral OFC, and decrease in GM as well as increase in brain activity in right SMA, which could serve as a specific ROI template for future studies
This study adds to Psychoradiology, an emerging subspecialty of radiology, which seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with mental disorder[116, 117]

Summary

Objectives

We aimed to conduct a whole-brain voxel-wise meta–analysis to explore in a preliminary way the most robust findings across a range of published VBM and ALFF studies

Methods

Results

Discussion

Conclusion