Common and distinct patterns of intrinsic brain activity alterations in major depression and bipolar disorder: voxel-based meta-analysis

Abstract

Identification of intrinsic brain activity differences and similarities between major depression (MDD) and bipolar disorder (BD) is necessary. However, results have not yet yielded consistent conclusions. A meta-analysis of whole-brain resting-state functional MRI (rs-fMRI) studies that explored differences in the amplitude of low-frequency fluctuation (ALFF) between patients (including MDD and BD) and healthy controls (HCs) was conducted using seed-based d mapping software. Systematic literature search identified 50 studies comparing 1399 MDD patients and 1332 HCs, and 15 studies comparing 494 BD patients and 593 HCs. MDD patients displayed increased ALFF in the right superior frontal gyrus (SFG) (including the medial orbitofrontal cortex, medial prefrontal cortex [mPFC], anterior cingulate cortex [ACC]), bilateral insula extending into the striatum and left supramarginal gyrus and decreased ALFF in the bilateral cerebellum, bilateral precuneus, and left occipital cortex compared with HCs. BD showed increased ALFF in the bilateral inferior frontal gyrus, bilateral insula extending into the striatum, right SFG, and right superior temporal gyrus (STG) and decreased ALFF in the bilateral precuneus, left cerebellum (extending to the occipital cortex), left ACC, and left STG. In addition, MDD displayed increased ALFF in the left lingual gyrus, left ACC, bilateral precuneus/posterior cingulate gyrus, and left STG and decreased ALFF in the right insula, right mPFC, right fusiform gyrus, and bilateral striatum relative to BD patients. Conjunction analysis showed increased ALFF in the bilateral insula, mPFC, and decreased ALFF in the left cerebellum in both disorders. Our comprehensive meta-analysis suggests that MDD and BD show a common pattern of aberrant regional intrinsic brain activity which predominantly includes the insula, mPFC, and cerebellum, while the limbic system and occipital cortex may be associated with spatially distinct patterns of brain function, which provide useful insights for understanding the underlying pathophysiology of brain dysfunction in affective disorders, and developing more targeted and efficacious treatment and intervention strategies.

Dynamic Altered Amplitude of Low-Frequency Fluctuations in Patients With Major Depressive Disorder

“…Abnormal structure and function in the cerebellum have been demonstrated in MDD patients ( 73 ), including abnormalities of gray-matter volume ( 74 , 75 ), glucose metabolism ( 76 , 77 ), functional activity, and connectivity ( 78 – 84 ). A previous meta-analysis demonstrated decreased sALFF in the bilateral cerebellum in MDD ( 85 ), which was in line with our results. Moreover, the current findings of increased dALFF (more variability) in cerebellum were in line with previous studies and may reflect the instability of neurofluctuation and information integration in MDD patients.…”

Mood disorders disrupt the functional dynamics, not spatial organization of brain resting state networks

“…This approach may even increase our ability to uncover crucial alterations in mood disorders beyond specific diagnostic categories and thus help refine the current, historically defined divisions between these categories ( Biswal, 2021 ). Examples of this are numerous ( Gong et al, 2020 , Luo et al, 2021 ). For instance a recent metanalysis of whole- brain rs-fMRI studies on ALFF in MDD and BD patients found aberrant regional intrinsic cerebral activity in common brain areas (i.e.…”

Neurocognition Function of Patients With Bipolar Depression, Unipolar Depression, and Depression With Bipolarity

“…However, they also find that increasing ALFF of the right insula was significantly greater in BD than MDD, which suggested that the impairment of cognition function in BD might be more severe than that in UD. Moreover, several regions, including the limbic system and occipital cortex, differed between conditions, indicating that these disorders may be associated with spatially distinct patterns of brain function ( 32 ). A previous triple-network model study (involving the default mode network, central executive network, and salience network, which is associated with cognitive function, such as attention and working memory) also provided evidence about the shared and specific functional and structural alterations in BD and MDD ( 33 ).…”