TY - JOUR
T1 - Structural neuroimaging studies in major depressive disorder
T2 - Meta-analysis and comparison with bipolar disorder
AU - Kempton, Matthew J
AU - Salvador, Zainab
AU - Munafò, Marcus R
AU - Geddes, John R
AU - Simmons, Andrew
AU - Frangou, Sophia
AU - Williams, Steven C R
PY - 2011/7
Y1 - 2011/7
N2 - Context: Although differences in clinical characteristics exist between major depressive disorder (MDD) and bipolar disorder (BD), consistent structural brain abnormalities that distinguish the disorders have not been identified.
Objectives: To investigate structural brain changes in MDD using meta-analysis of primary studies; assess the effects of medication, demographic, and clinical variables; and compare the findings with those of a metaanalysis of studies on BD.
Data Sources: The MEDLINE, EMBASE, and PsycINFO databases were searched for studies from January 1, 1980, to February 2, 2010.
Study Selection: Two hundred twenty-five studies that used magnetic resonance imaging or x-ray computed tomography to compare brain structure in patients with MDD with that of controls were included in an online database, and 143 that measured common brain structures were selected for meta-analysis.
Data Extraction: Twenty-five variables, including demographic and clinical data, were extracted from each study, when available. For the meta-analysis, mean structure size and standard deviation were extracted for continuous variables, and the proportion of patients and controls with an abnormality in brain structure was extracted for categorical variables.
Data Synthesis: Compared with the structure of a healthy brain, MDD was associated with lateral ventricle enlargement; larger cerebrospinal fluid volume; and smaller volumes of the basal ganglia, thalamus, hippocampus, frontal lobe, orbitofrontal cortex, and gyrus rectus. Patients during depressive episodes had significantly smaller hippocampal volume than patients during remission. Compared with BD patients, those with MDD had reduced rates of deep white matter hyperintensi ties, increased corpus callosum cross-sectional area, and smaller hippocampus and basal ganglia. Both disorders were associated with increased lateral ventricle volume and increased rates of subcortical gray matter hyperintensities compared with healthy controls.
Conclusions: The meta-analyses revealed structural brain abnormalities in MDD that are distinct from those observed in BD. These findings may aid investigators attempting to discriminate mood disorders using structural magnetic resonance imaging data.
AB - Context: Although differences in clinical characteristics exist between major depressive disorder (MDD) and bipolar disorder (BD), consistent structural brain abnormalities that distinguish the disorders have not been identified.
Objectives: To investigate structural brain changes in MDD using meta-analysis of primary studies; assess the effects of medication, demographic, and clinical variables; and compare the findings with those of a metaanalysis of studies on BD.
Data Sources: The MEDLINE, EMBASE, and PsycINFO databases were searched for studies from January 1, 1980, to February 2, 2010.
Study Selection: Two hundred twenty-five studies that used magnetic resonance imaging or x-ray computed tomography to compare brain structure in patients with MDD with that of controls were included in an online database, and 143 that measured common brain structures were selected for meta-analysis.
Data Extraction: Twenty-five variables, including demographic and clinical data, were extracted from each study, when available. For the meta-analysis, mean structure size and standard deviation were extracted for continuous variables, and the proportion of patients and controls with an abnormality in brain structure was extracted for categorical variables.
Data Synthesis: Compared with the structure of a healthy brain, MDD was associated with lateral ventricle enlargement; larger cerebrospinal fluid volume; and smaller volumes of the basal ganglia, thalamus, hippocampus, frontal lobe, orbitofrontal cortex, and gyrus rectus. Patients during depressive episodes had significantly smaller hippocampal volume than patients during remission. Compared with BD patients, those with MDD had reduced rates of deep white matter hyperintensi ties, increased corpus callosum cross-sectional area, and smaller hippocampus and basal ganglia. Both disorders were associated with increased lateral ventricle volume and increased rates of subcortical gray matter hyperintensities compared with healthy controls.
Conclusions: The meta-analyses revealed structural brain abnormalities in MDD that are distinct from those observed in BD. These findings may aid investigators attempting to discriminate mood disorders using structural magnetic resonance imaging data.
KW - Magnetic Resonance Imaging
KW - Bipolar Disorder
KW - Hippocampus
KW - Humans
KW - Tomography, X-Ray Computed
KW - Brain
KW - Depressive Disorder, Major
KW - Organ Size
KW - Thalamus
KW - Basal Ganglia
KW - Frontal Lobe
KW - Middle Aged
KW - Female
KW - Male
UR - http://www.scopus.com/inward/record.url?partnerID=yv4JPVwI&eid=2-s2.0-79960295368&md5=c1021413b390518be0a418816c2ca6ca
U2 - 10.1001/archgenpsychiatry.2011.60
DO - 10.1001/archgenpsychiatry.2011.60
M3 - Article
C2 - 21727252
SN - 2168-622X
VL - 68
SP - 675
EP - 690
JO - JAMA Psychiatry
JF - JAMA Psychiatry
IS - 7
ER -