J Psychiatry Neurosci 2014;39(6):397-406
Mingying Du, MD*; Jia Liu, MD*; Ziqi Chen, MD; Xiaoqi Huang, MD, PhD; Jing Li, MD; Weihong Kuang, MD; Yanchun Yang, MD; Wei Zhang, MD; Dong Zhou, MD; Feng Bi, MD; Keith Maurice Kendrick, PhD; Qiyong Gong, MD, PhD
Du, Liu, Chen, Huang, Gong — Huaxi MR Research Center(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Li, Kuang, Yang, Zhang — Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China; Zhou — Department of Neurology, West China Hospital of Sichuan University, Chengdu, China; Bi — Department of Oncology, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Kendrick — Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
Background: Voxel-based morphometry (VBM) studies have demonstrated that grey matter abnormalities are involved in the pathophysiology of late-life depression (LLD), but the findings are inconsistent and have not been quantitatively reviewed. The aim of the present study was to conduct a meta-analysis that integrated the reported VBM studies, to determine consistent grey matter alterations in individuals with LLD.
Methods: A systematic search was conducted to identify VBM studies that compared patients with LLD and healthy controls. We performed a meta-analysis using the effect size signed differential mapping method to quantitatively estimate regional grey matter abnormalities in patients with LLD.
Results: We included 9 studies with 11 data sets comprising 292 patients with LLD and 278 healthy controls in our meta-analysis. The pooled and subgroup meta-analyses showed robust grey matter reductions in the right lentiform nucleus extending into the parahippocampus, the hippocampus and the amygdala, the bilateral medial frontal gyrus and the right subcallosal gyrus as well as a grey matter increase in the right lingual gyrus. Meta-regression analyses showed that mean age and the percentage of female patients with LLD were not significantly related to grey matter changes.
Limitations: The analysis techniques, patient characteristics and clinical variables of the studies included were heterogeneous, and most participants were medicated.
Conclusion: The present meta-analysis is, to our knowledge, the first to overcome previous inconsistencies in the VBM studies of LLD and provide robust evidence for grey matter alterations within fronto–striatal–limbic networks, thereby implicating them in the pathophysiology of LLD. The mean age and the percentage of female patients with LLD did not appear to have a measurable impact on grey matter changes, although we cannot rule out the contributory effects of medication.
*These authors contributed equally to this work.
Submitted Nov. 29, 2013; Revised Feb. 20, Apr. 6, 2014; Accepted Apr. 9, 2014; Early-released June 24, 2014.
Acknowledgements: This study was supported by the National Natural Science Foundation (Grant Nos. 81030027, 81227002, 81220108013 and 91132720), National Key Technologies R&D Program (Program No. 2012BAI01B03) and Program for Changjiang Scholars and Innovative Research Team in University (PCSIRT, Grant No.IRT1272) of China. Dr. Gong would also like to acknowledge his Visiting Adjunct Professor appointment in the Department of Radiology at the University of Illinois Hospital & Health Sciences System, USA.
Competing interests: None declared.
Contributors: Q. Gong designed the study. M. Du, J. Lui and K.M. Kendrick acquired the data, which all authors analyzed. M. Du, J. Liu, K.M. Kendrick and Q. Gong wrote the article, which Z. Chen, X. Huang, J. Li, W. Kwang, K. Yang, W. Zhang, D. Zhou, F. Bi and Q. Gong reviewed. All authors approved the final version for publication.
Correspondence to: Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China; firstname.lastname@example.org