AccScience Publishing / JCBP / Online First / DOI: 10.36922/jcbp.0896
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Pharmacological treatment-associated brain structural and functional alterations in major depressive disorder: A narrative review

Lulu Zhang1,2 ,  Jingping Zhao1 ,  Wenbin Guo1*
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1 Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
2 Department of Psychiatry, Guangzhou First People’s Hospital, the Second Affiliated Hospital, South China University of Technology, Guangzhou, Guangdong, China
JCBP 2023, 1(1), 0896 https://doi.org/10.36922/jcbp.0896
Submitted: 4 May 2023 | Accepted: 5 July 2023 | Published: 21 July 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Major depressive disorder (MDD) is a complicated mental disorder with an unclear etiology and a relatively limited response to treatment. Magnetic resonance imaging (MRI) can help identify the underlying neuropathophysiological mechanisms of MDD. A better understanding of structural and functional alterations in the brain before and after treatment is necessary to improve treatment targets at the brain level. This narrative review summarizes the literature on longitudinal MRI studies in MDD, which identify brain regions with changes in neural activity after antidepressant treatment, providing an objective imaging basis for early diagnosis and assessment of the efficacy of antidepressant therapy. It was found that the neural activity in the prefrontal cortex, cingulate cortex, precuneus, and hippocampus was reduced in patients with untreated MDD. In addition, functional connectivity of the default mode network (DMN), central executive, and salience networks was enhanced, gray matter volume was reduced, and white matter structure was damaged. After antidepressant treatment, neural activity in some brain regions increased and functional connectivity of brain networks and gray and white matter structures returned to normal states. Although the results have been inconsistent, amygdala hypoactivation and anterior cingulate cortex hyperactivation in response to negative emotional stimuli are promising predictors of successful treatment, and hyperconnectivity within and between the DMN and executive control network exhibit similar results.

Keywords
Major depressive disorder
Magnetic resonance imaging
Neuroimaging
Antidepressants
Treatment
Funding
Science and Technology Program of Guangzhou
Basic and Applied Basic Research Fund of Guangdong
National Natural Science Foundation of China
Conflict of interest
The authors have no conflicts to disclose.
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