Coordinate-Based Network Mapping of Brain Structure in Major Depressive Disorder in Younger and Older Adults: A Systematic Review and Meta-Analysis.
Coordinate-Based Network Mapping of Brain Structure in Major Depressive Disorder in Younger and Older Adults: A Systematic Review and Meta-Analysis.
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年轻人和老年人重度抑郁症大脑结构的基于坐标的网络映射：系统回顾和荟萃分析。
DOI：
10.1176/appi.ajp.2021.21010088
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Voineskos,AristotleN
中科院分区：
文献类型：
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作者：
Zhukovsky,Peter;Anderson,JohnAE;Coughlan,Gillian;Mulsant,BenoitH;Cipriani,Andrea;Voineskos,AristotleN
年轻和老年重度抑郁症（MDD）患者的结构神经影像学表现高度异质性，可能是由于方法学限制，MDD和晚期抑郁症（LLD）之间缺乏区分，或临床调节因素。使用一种新的荟萃分析网络映射方法，作者试图确定在不同临床亚型的MDD.MethodsThe作者确定了所有基于体素和基于表面的形态测量研究发表到2020年10月，比较年轻的成年人与MDD或老年人与LLD非精神对照参与者的电路。激活似然估计（ALE）分析和一种新的基于坐标的网络映射方法被用来识别在MDD和LLD受影响的脑回路。荟萃回归分析的影响，发病年龄在老年患者LLD和抗抑郁药治疗的年轻患者MDD. ResultsTheauthors分析了145比较从143篇文章，包括共14,318名参与者（MDD：N=6,362; LLD：N=535;对照组：N=7,421）。显著的ALE结果证实了先前的发现，即MDD患者的左右海马旁和前扣带回以及LLD患者的前扣带回。相反，基于坐标的网络映射显示，MDD和LLD的额顶，背侧注意和视觉网络的差异。荟萃回归分析显示，迟发性与LLD广泛的结构异常显著相关，抗抑郁药物治疗与前扣带回异常显著相关（布罗德曼32区）和背外侧前额叶皮层（Brodmann's Area 9）结论这些发现有助于阐明抑郁症在成年人一生中的共享回路，并突出了一些与抑郁症相关的独特回路。迟发性抑郁症，这可能解释了认知能力下降和痴呆症的一些风险。
ObjectiveStructural neuroimaging findings in younger and older adults with major depressive disorder (MDD) are highly heterogeneous, possibly as a result of methodological limitations, lack of distinction between MDD and late-life depression (LLD), or clinical moderators. Using a novel meta-analytic network mapping approach, the authors sought to identify the circuits affected in different clinical subtypes of MDD.MethodsThe authors identified all voxel-based and surface-based morphometry studies published through October 2020 that compared younger adults with MDD or older adults with LLD to nonpsychiatric control participants. An activation likelihood estimation (ALE) analysis and a novel coordinate-based network mapping approach were used to identify brain circuits affected in MDD and LLD. Meta-regressions examined the impact of age at onset in older patients with LLD and treatment with antidepressants in younger patients with MDD.ResultsThe authors analyzed 145 comparisons from 143 articles, including a total of 14,318 participants (MDD: N=6,362; LLD: N=535; control subjects: N=7,421). Significant ALE results confirmed previous findings implicating the left and right parahippocampus and anterior cingulate in MDD and the anterior cingulate in LLD. In contrast, coordinate-based network mapping showed differences in the frontoparietal, dorsal attention, and visual networks both in MDD and LLD. Meta-regressions showed that late onset was significantly associated with widespread structural abnormalities in LLD, and treatment with antidepressants showed a significant association with abnormalities in the anterior cingulate (Brodmann’s area 32) and dorsolateral prefrontal cortex (Brodmann’s area 9) in MDD.ConclusionsThese findings help to clarify the shared circuitry of depression across the adult lifespan and highlight some unique circuitry relevant to late-onset depression, which may explain some of the risk for cognitive decline and dementia.