Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Mar 19, 2024; 14(3): 456-466
Published online Mar 19, 2024. doi: 10.5498/wjp.v14.i3.456
Vulnerable brain regions in adolescent major depressive disorder: A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis
Hui Ding, Qin Zhang, Yan-Ping Shu, Bin Tian, Ji Peng, Yong-Zhe Hou, Gang Wu, Li-Yun Lin, Jia-Lin Li
Hui Ding, Qin Zhang, Bin Tian, Ji Peng, Department of Radiology, The Second People’s Hospital of Guizhou Province, Guiyang 550000, Guizhou Province, China
Qin Zhang, Department of Radiology, Guizhou Provincial People’s Hospital, Guiyang 550000, Guizhou Province, China
Yan-Ping Shu, Yong-Zhe Hou, Gang Wu, Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang 550000, Guizhou Province, China
Li-Yun Lin, Department of Radiology, Zhijin County People's Hospital, Bijie 552100, Guizhou Province, China
Jia-Lin Li, Medical Humanities College, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Co-first authors: Hui Ding and Qin Zhang.
Co-corresponding authors: Yan-Ping Shu and Yong-Zhe Hou.
Author contributions: Ding H, Zhang Q, Hou YZ, Shu YP and Wu G proposed the concept of this article and wrote the orginal draft; Tian B, Peng J, Lin LY and Li JL analyzed the data; Hou YZ and Shu YP aided critical editing and revisions to the article; Ding H and Zhang Q contributed equally to this manuscript and are therefore listed as co-first authors; Shu YP and Hou YZ contributed equally to this manuscript and are therefore listed as co-corresponding authors. Ding H and Zhang Q made equal contributions to the conception, design, and execution of the research project, conducted data analysis, and co-drafted the manuscript. Their collective efforts also encompassed the acquisition and interpretation of data, thereby ensuring the integrity and accuracy of the study's outcomes. Throughout the research process, they collaborated closely to navigate the complexities inherent in investigating major depressive disorder in adolescents and were actively involved in the meticulous review and refinement of the manuscript. Shu YP and Hou YZ contribute equally to the study and as co-corresponding authors. They have provided substantial support in guiding the research direction, refining the study design, and ensuring the analytical rigor of the data. Their contributions extend to overseeing the drafting and revision of the manuscript, providing critical intellectual content, and addressing the reviewers' comments. They have also taken responsibility for correspondence during the manuscript submission, peer review, and publication process, ensuring effective communication with the journal and among the research team. Their joint efforts as co-corresponding authors have been pivotal in bringing this research to fruition and maintaining the high standards of scientific integrity and accuracy.
Supported by The 2024 Guizhou Provincial Health Commission Science and Technology Fund Project, No. gzwkj2024-4750; and 2022 Provincial Clinical Key Specialty Construction Project.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Ping Shu, PhD, Professor, Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, No. 318 South Section of Xintian Avenue, Yunyan District, Guiyang 550000, Guizhou Province, China. syp_8053@163.com
Received: November 28, 2023
Peer-review started: November 28, 2023
First decision: January 25, 2024
Revised: February 4, 2024
Accepted: March 6, 2024
Article in press: March 6, 2024
Published online: March 19, 2024
Processing time: 111 Days and 21.4 Hours
Abstract
BACKGROUND

Adolescent major depressive disorder (MDD) is a significant mental health concern that often leads to recurrent depression in adulthood. Resting-state functional magnetic resonance imaging (rs-fMRI) offers unique insights into the neural mechanisms underlying this condition. However, despite previous research, the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.

AIM

To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation (ALE) meta-analysis.

METHODS

We performed a comprehensive literature search through July 12, 2023, for studies investigating brain functional changes in adolescent MDD patients. We utilized regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) analyses. We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls (HCs) using ALE.

RESULTS

Ten studies (369 adolescent MDD patients and 313 HCs) were included. Combining the ReHo and ALFF/fALFF data, the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs (voxel size: 648 mm3, P < 0.05), and no brain region exhibited increased activity. Based on the ALFF data, we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients (voxel size: 736 mm3, P < 0.05), with no regions exhibiting increased activity.

CONCLUSION

Through ALE meta-analysis, we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients, increasing our understanding of the neuropathology of affected adolescents.

Keywords: Major depressive disorder; Resting-state functional magnetic resonance imaging; Adolescent; Activation likelihood estimation; Meta-analysis

Core Tip: Utilizing activation likelihood estimation meta-analysis, this study identified consistently vulnerable brain regions in adolescent major depressive disorder (MDD) patients. The findings of this study revealed distinct neural alterations, specifically decreased activity in the precuneus and cuneus areas, indicating the potential neurobiological underpinnings specific to adolescent MDD. This study offers crucial insights into the unique neural signatures of depression in adolescents, paving the way for targeted interventions and advancing our understanding of adolescent mental health.