Volumetric brain differences in clinical depression in association with anxiety: a systematic review with meta-analysis

Structural differences associated with depression have not been confirmed in brain regions apart from the hippocampus. Comorbid anxiety has been inconsistently assessed, and may explain discrepancies in previous findings. We investigated the link between depression, comorbid anxiety and brain struct...

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Vydané v:Journal of psychiatry & neuroscience Ročník 45; číslo 6; s. 406 - 429
Hlavní autori: Espinoza Oyarce, Daniela A., Alateeq, Khawlah, Cherbuin, Nicolas, Shaw, Marnie E.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Canada Canadian Medical Association 01.11.2020
NRC Research Press
Joule Inc
Cooperative Education Association
Predmet:
Adults
Age
Amygdala
Anxiety
Anxiety disorders
Brain
Cognitive ability
Comorbidity
Complications and side effects
Demography
Depression (Mood disorder)
Depression, Mental
Globus pallidus
Hippocampus
Magnetic resonance imaging
Mental depression
Mental disorders
Meta-analysis
Physiological aspects
Psychiatric/Mental Health
Putamen
Research Paper
Risk factors
Segmentation
Substantia grisea
Suicides & suicide attempts
Systematic review
Thalamus
Australia
ISSN:1180-4882, 1488-2434, 1488-2434
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Shrnutí:Structural differences associated with depression have not been confirmed in brain regions apart from the hippocampus. Comorbid anxiety has been inconsistently assessed, and may explain discrepancies in previous findings. We investigated the link between depression, comorbid anxiety and brain structure. We followed Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42018089286). We searched the Cochrane Library, MEDLINE, PsycInfo, PubMed and Scopus, from database inception to Sept. 13, 2018, for MRI case–control studies that reported brain volumes in healthy adults and adults with clinical depression. We summarized mean volumetric differences using meta-analyses, and we assessed demographics, depression factors and segmentation procedure as moderators using meta-regressions. We included 112 studies in the meta-analyses, assessing 4911 healthy participants and 5934 participants with depression (mean age 49.8 yr, 68.2% female). Volume effects were greater in late-onset depression and in multiple episodes of depression. Adults with depression and no comorbidity showed significantly lower volumes in the putamen, pallidum and thalamus, as well as significantly lower grey matter volume and intracranial volume; the largest effects were in the hippocampus (6.8%, p < 0.001). Adults with depression and comorbid anxiety showed significantly higher volumes in the amygdala (3.6%, p < 0.001). Comorbid anxiety lowered depression effects by 3% on average. Sex moderated reductions in intracranial volume. High heterogeneity in hippocampus effects could not be accounted for by any moderator. Data on symptom severity and medication were sparse, but other factors likely made significant contributions. Depression-related differences in brain structure were modulated by comorbid anxiety, chronicity of symptoms and onset of illness. Early diagnosis of anxiety symptomatology will prove crucial to ensuring effective, tailored treatments for improving long-term mental health and mitigating cognitive problems, given the effects in the hippocampus.
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ISSN:1180-4882
1488-2434
1488-2434
DOI:10.1503/jpn.190156