Background

Neuroimaging studies have provided valuable insights into the macroscale impacts of antidepressants on brain functions in patients with major depressive disorder. However, the findings of individual studies are inconsistent. Here, we aimed to provide a quantitative synthesis of the literature to identify convergence of the reported findings at both regional and network levels and to examine their associations with neurotransmitter systems.

Methods

Through a comprehensive search in PubMed and Scopus databases, we reviewed 5258 abstracts and identified 36 eligible functional neuroimaging studies on antidepressant effects in major depressive disorder. Activation likelihood estimation was used to investigate regional convergence of the reported foci of antidepressant effects, followed by functional decoding and connectivity mapping of the convergent clusters. Additionally, utilizing group-averaged data from the Human Connectome Project, we assessed convergent resting-state functional connectivity patterns of the reported foci. Next, we compared the convergent circuit with the circuits targeted by transcranial magnetic stimulation therapy. Last, we studied the association of regional and network-level convergence maps with selected neurotransmitter receptors/transporters maps.

Results

No regional convergence was found across foci of treatment-associated alterations in functional imaging. Subgroup analysis in the Treated > Untreated contrast revealed a convergent cluster in the left dorsolateral prefrontal cortex, which was associated with working memory and attention behavioral domains. Moreover, we found network-level convergence of the treatment-associated alterations in a circuit more prominent in the frontoparietal areas. This circuit was co-aligned with circuits targeted by “anti-subgenual” and “Beam F3” transcranial magnetic stimulation therapy. We observed no significant correlations between our meta-analytic findings with the maps of neurotransmitter receptors/transporters.

Conclusion

Our findings highlight the importance of the frontoparietal network and the left dorsolateral prefrontal cortex in the therapeutic effects of antidepressants, which may relate to their role in improving executive functions and emotional processing.

中文翻译：

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抗抑郁药对重度抑郁症的收敛功能影响：神经影像学荟萃分析

 背景

神经影像学研究为抗抑郁药对重度抑郁症患者大脑功能的宏观影响提供了宝贵的见解。然而，个别研究的结果并不一致。在这里，我们旨在提供文献的定量综合，以确定区域和网络水平上报告的结果的收敛性，并检查它们与神经递质系统的关联。

 方法

通过在 PubMed 和 Scopus 数据库中进行全面检索，我们回顾了 5258 篇摘要，并确定了 36 项关于重度抑郁症抗抑郁作用的合格功能性神经影像学研究。激活似然估计用于研究已报道的抗抑郁作用焦点的区域收敛，然后是收敛簇的功能解码和连接映射。此外，利用来自 Human Connectome 项目的组平均数据，我们评估了报告病灶的收敛静息态功能连接模式。接下来，我们将会聚回路与经颅磁刺激疗法针对的回路进行了比较。最后，我们研究了区域和网络水平收敛图与选定的神经递质受体/转运蛋白图的关联。

 结果

在治疗相关功能成像改变的病灶中未发现区域收敛。处理 > 未处理对比中的亚组分析显示左侧背外侧前额叶皮层存在收敛簇，这与工作记忆和注意力行为域相关。此外，我们发现在额顶叶区域更为突出的回路中治疗相关改变的网络水平收敛。该回路与“抗膝下”和“Beam F3”经颅磁刺激疗法所针对的回路共同对齐。我们观察到我们的荟萃分析结果与神经递质受体/转运蛋白的图谱之间没有显着相关性。

 结论

我们的研究结果强调了额顶叶网络和左背外侧前额叶皮层在抗抑郁药治疗效果中的重要性，这可能与它们在改善执行功能和情绪处理方面的作用有关。