Regular Research Article
A Systematic Review and Meta-Analysis of Magnetic Resonance Imaging Studies in Late-Life Depression

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Gray matter abnormalities within frontal–subcortical and limbic networks are hypothesized to play a key role in the pathophysiology of late-life depression. In this work, gray matter abnormalities in late-life depression are examined in a systematic review and meta-analysis of magnetic resonance imaging studies. In the systematic review, 27 articles were identified that compared participants with late-life depression with comparison group participants, and 17 studies were suitable for inclusion in meta-analyses of volumes of the whole brain, orbitofrontal cortex, caudate, hippocampus, putamen, and thalamus. Volume reductions were detected in 7 of 15 comparisons of the hippocampus and a meta-analysis revealed a significant, but small, effect size. Although examined by fewer studies, meta-analyses also revealed significant volume reductions in the orbitofrontal cortex, putamen, and thalamus. A more systematic and comprehensive analysis of the global distribution of gray matter abnormalities, and an examination of subcortical abnormalities were identified as key areas for future research.

Section snippets

Methods

Online searches of the databases EMBASE and MEDLINE were done in August 2010, using the keywords ([“magnetic resonance imaging” or “MRI”] and [“depress*”] and [“elderly” or “geriatric” or “late life” or “late onset” or “old age” or “older”]). Reference lists of included studies and relevant reviews were also searched for additional studies.

For the systematic review, studies were screened for journal articles published in English that used MRI to analyze group differences in the volume or shape

Results

Titles and abstracts of 743 identified citations were screened; 27 met the inclusion criteria for the systematic review. A flow diagram of the identification and attrition of studies is provided in Figure 1.

Participant and data acquisition details of included studies are given in Table 1, results of 26 ROI comparisons in Table 2, results of 5 VBM comparisons in Table 3, and results of the meta-analysis in Table 4.

Of the 26 ROI and 5 VBM group comparisons included in the systematic review, 12

Conclusions

We examined GM abnormalities in LLD in a systematic review and meta-analysis of MRI studies. With regard to ROI studies, the hippocampus was the most frequently studied structure. Volume reductions were detected in LLD in 7 of 15 comparisons and a meta-analysis of hippocampal ROI revealed a significant, but small, effect size. Although examined by fewer studies, meta-analyses also revealed significant volume reductions in the OFC, putamen and thalamus in LLD. The anatomy and effect sizes of

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