Page 9 - JCBP-1-1

Journal of Clinical and

Basic Psychosomatics

REVIEW ARTICLE
Pharmacological treatment-associated brain

structural and functional alterations in major
depressive disorder: A narrative review

1
1,2
1
Lulu Zhang , Jingping Zhao , and Wenbin Guo *
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

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
*Corresponding author: patients with untreated MDD. In addition, functional connectivity of the default mode
Wenbin Guo network (DMN), central executive, and salience networks was enhanced, gray matter
(guowenbin76@csu.edu.cn) volume was reduced, and white matter structure was damaged. After antidepressant
Citation: Zhang L, Zhao J, Guo W, treatment, neural activity in some brain regions increased and functional connectivity
Pharmacological treatment-associated of brain networks and gray and white matter structures returned to normal states.
brain structural and functional
alterations in major depressive Although the results have been inconsistent, amygdala hypoactivation and anterior
disorder: A narrative review. Journal cingulate cortex hyperactivation in response to negative emotional stimuli are
of Clinical and Basic Psychosomatics. promising predictors of successful treatment, and hyperconnectivity within and
1(1): 0896
https://doi.org/10.36922/jcbp.0896 between the DMN and executive control network exhibit similar results.
Received: May 4, 2023
Accepted: July 5, 2023 Keywords: Major depressive disorder; Magnetic resonance imaging; Neuroimaging;
Antidepressants; Treatment
Published Online: July 21, 2023
Copyright: © 2023 Author(s).
This is an Open Access article
distributed under the terms of the 1. Introduction
Creative Commons Attribution
License, permitting distribution, Major depressive disorder (MDD) is a leading cause of disability and contributes to
and reproduction in any medium,
provided the original work is the global disease burden. About 4 – 7% (95% uncertainty interval 4.4 – 5.0) of the
properly cited. world’s population have an episode of depression in any 12-month time period . The
[1]
[2]
Publisher’s Note: AccScience disorder is characterized by depressed mood, anhedonia, and cognitive impairment .
Publishing remains neutral with The pathogenesis of MDD is unclear but appears to involve various factors, such as
regard to jurisdictional claims in
published maps and institutional the presence of neurotransmitters, neurohormonal dysregulation, neuroplasticity,
affiliations. and immune inflammation [3-8] . The primary sources of the three aforementioned

Volume 1 Issue 1 (2023) 1 https://doi.org/10.36922/jcbp.0896