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
ARTICLE HIGHLIGHTS
Research background

Major depressive disorder (MDD) significantly impacts adolescents, leading to recurrent depression in adulthood. Despite previous research, the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated. Resting-state functional magnetic resonance imaging (rs-fMRI) offers a unique opportunity to understand the neural mechanisms underlying this condition, focusing on spontaneous brain activity patterns.

Research motivation

Adolescent MDD poses a serious threat to the recurrence of depression in adulthood. By exploring the spontaneous neural activity in the brains of adolescents with MDD, this study not only contributes to a deeper understanding of the neurobiological mechanisms behind adolescent depression but also aims to pave the way for more targeted intervention measures and broader advancements in the field of mental health research.

Research objectives

To address the inconsistencies in existing neuroimaging studies on adolescent MDD, this research aims to identify consistent vulnerable brain regions through an activation likelihood estimation (ALE) meta-analysis of rs-fMRI data. The realized objectives include the integration of diverse studies to unveil specific brain regions with decreased activity in adolescents with MDD. Through the exploration of spontaneous neural activity, this research contributes to establishing critical knowledge for improving mental health outcomes in adolescents.

Research methods

A comprehensive literature search was conducted, encompassing studies up to July 12, 2023, employing regional homogeneity, amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF) analyses. Ten studies involving 369 adolescent MDD patients and 313 healthy controls (HCs) were included in the meta-analysis. The ALE method was utilized to aggregate peak activation coordinates, creating spatial probability maps and highlighting consistent brain regions with abnormal spontaneous activity.

Research results

The ALE meta-analysis revealed consistently decreased activity in the right cuneus and left precuneus in adolescents with MDD compared to HCs. No brain region exhibited increased activity. This consistent vulnerability in specific brain regions, particularly within the default mode network, sheds light on potential neurobiological mechanisms associated with adolescent MDD.

Research conclusions

This study consistently identifies the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD. The findings contribute to the comprehension of the neurophysiological mechanisms associated with depression in this demographic. By delineating specific brain regions with altered activity, this research lays a foundation for targeted interventions in adolescent MDD. The implications extend to future investigations, offering a nuanced understanding of the neuropathology that can inform advancements in therapeutic approaches and contribute to the broader discourse in mental health research.

Research perspectives

While the study provides crucial insights into the unique neural signatures of depression in adolescents, future research with larger sample sizes and advanced imaging techniques is warranted. Longitudinal studies could help establish causal associations between adolescent MDD and spontaneous brain function alterations, addressing current limitations and informing more targeted interventions.