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Meta-analysis of volumetric abnormalities in cortico-striatal-pallidal-thalamic circuits in major depressive disorder

Published online by Cambridge University Press:  13 September 2011

E. Bora ,
B. J. Harrison ,
C. G. Davey ,
M. Yücel  and
C. Pantelis
E. Bora*
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
B. J. Harrison
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
C. G. Davey
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia Orygen Youth Health Research Centre, Melbourne, The University of Melbourne, VIC, Australia
M. Yücel
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia Orygen Youth Health Research Centre, Melbourne, The University of Melbourne, VIC, Australia
C. Pantelis
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
*
*Address for correspondence: Dr E. Bora, Alan Gilbert Building NNF level 3, Carlton 3053, Australia. (Email: [email protected])
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Abstract

Background

Abnormalities in cortico-striatal-pallidal-thalamic (CSPT) circuits have been implicated in major depressive disorder (MDD). However, the robustness of these findings across studies is unclear, as is the extent to which they are influenced by demographic, clinical and pharmacological factors.

Method

With the aim of clarifying these questions, we conducted a meta-analysis to map the volumetric abnormalities that were most robustly identified in CSPT circuits of individuals with MDD. A systematic search identified 41 studies meeting our inclusion criteria.

Results

There were significant volume reductions in prefrontal (especially orbitofrontal) and anterior cingulate cortices, and also in subcortical structures such as the caudate nucleus and putamen, with effect sizes ranging from small to moderate. The subgenual anterior cingulate and orbitofrontal cortices were significantly smaller in antidepressant-free samples compared to medicated patients. Late-life depression (LLD) tended to be associated with smaller volumes in circumscribed frontal and subcortical structures, with the most robust differences being found in thalamic volume.

Conclusions

Individuals with major depression demonstrate volumetric abnormalities of CSPT circuits. However, these observations may be restricted to certain subgroups, highlighting the clinical heterogeneity of the disorder. On the basis of this meta-analysis, CSPT abnormalities were more prominent in those with LLD whereas antidepressant use seemed to normalize certain cortical volumetric abnormalities.

Keywords

Anterior cingulate cortexfrontal lobemajor depressive disorderMRIstriatumthalamus
Type
Review Article
Information
Psychological Medicine , Volume 42 , Issue 4 , April 2012 , pp. 671 - 681
Copyright
Copyright © Cambridge University Press 2011

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Supplementary material: File

Bora Supplementary Figure

Fig. S1. Flow diagram for meta-analysis of volumetric studies of CSPT in MDD

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