title: Cerebral metabolism in major depressive disorder: a voxel-based meta-analysis of positron emission tomography studies.
abstract: BACKGROUND
  Major depressive disorder (MDD) is a common mental illness with high lifetime prevalence close to 20%. Positron emission tomography (PET) studies have reported decreased prefrontal, insular and limbic cerebral glucose metabolism in depressed patients compared with healthy controls. However, the literature has not always been consistent. To evaluate current evidence from PET studies, we conducted a voxel-based meta-analysis of cerebral metabolism in MDD.
  
  
  METHODS
  Data were collected from databases including PubMed and Web of Science, with the last report up to April 2013. Voxel-based meta-analyses were performed using the revised activation likelihood estimation (ALE) software.
  
  
  RESULTS
  Ten whole-brain-based FDG-PET studies in MDD were included in the meta-analysis, comprising 188 MDD patients and 169 healthy controls. ALE analyses showed the brain metabolism in bilateral insula, left lentiform nucleus putamen and extra-nuclear, right caudate and cingulate gyrus were significantly decreased. However, the brain activity in right thalamus pulvinar and declive of posterior lobe, left culmen of vermis in anterior lobe were significantly increased in MDD patients.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrates the specific brain regions where possible dysfunctions are more consistently reported in MDD patients. Altered metabolism in insula, limbic system, basal ganglia, thalamus, and cerebellum and thus these regions are likely to play a key role in the pathophysiology of depression.
authors.affiliation: Department of Psychiatry, Huashan Hospital, Fudan University, School of Medicine, No. 12 Wulumuqi Road (middle), Shanghai, 200040, People's Republic of China. lsu@fudan.edu.cn.|Department of Psychosis studies, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK. lsu@fudan.edu.cn.
authors.forename: Liang
authors.initials: L
authors.lastname: Su
authors.affiliation: Department of Psychiatry, Huashan Hospital, Fudan University, School of Medicine, No. 12 Wulumuqi Road (middle), Shanghai, 200040, People's Republic of China. caiyiyuncyy@gmail.com.|Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. caiyiyuncyy@gmail.com.
authors.forename: Yiyun
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. hyyyyb@gmail.com.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Psychosis studies, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK. anirban.dutt@kcl.ac.uk.
authors.forename: Anirban
authors.initials: A
authors.lastname: Dutt
authors.affiliation: Department of Psychiatry, Huashan Hospital, Fudan University, School of Medicine, No. 12 Wulumuqi Road (middle), Shanghai, 200040, People's Republic of China. shishenxun@163.com.|Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. shishenxun@163.com.
authors.forename: Shenxun
authors.initials: S
authors.lastname: Shi
authors.affiliation: Department of Psychosis studies, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK. e.bramon@ucl.ac.uk.|Mental Health Sciences Unit & Institute of Cognitive Neuroscience, University College London, London, UK. e.bramon@ucl.ac.uk.
authors.forename: Elvira
authors.initials: E
authors.lastname: Bramon
mesh_terms: D001479:Basal Ganglia / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D002540:Cerebral Cortex / Q000378:metabolism*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000378:metabolism*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016013:Likelihood Functions; D008032:Limbic System / Q000378:metabolism; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D013788:Thalamus / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18