Localized connectivity in depression: A meta-analysis of resting state functional imaging studies

Resting-state fMRI studies investigating the pathophysiology of depression have identified prominent abnormalities in large-scale brain networks. However, it is unclear if localized dysfunction of specialized brain regions contribute to network-level abnormalities. We employed a meta-analytical procedure and reviewed studies conducted in China investigating changes in regional homogeneity (ReHo), a measure of localized intraregional connectivity, from resting-state fMRI in depression. Exploiting the statistical power gained from pooled analysis, we also investigated the effects of age, gender, illness duration and treatment on ReHo. The medial prefrontal cortex (MPFC) showed the most robust and reliable increase in ReHo in depression, with greater abnormality in medication-free patients with multiple episodes. Brain networks that relate to this region have been identified previously to show aberrant connectivity in depression, and we propose that the localized neuronal inefficiency of MPFC exists alongside wider network level disruptions involving this region.