Meta-analysis of brain activation in depressive patients with emotional perception disorders

OBJECTIVE: To elucidate the distribution of abnormally activated brain regions in depressive patients during emotional perception processing using activation likelihood estimation, a quantitative meta-analytic technique. DATA SOURCES: Computer-based online retrieval was conducted using the PscyINFO, Pubmed and CNKI databases, searching literature from the establishment of each database until June 2010. STUDY SELECTION: Inclusion criteria: (1) studies examined emotion perception tasks using functional magnetic resonance imaging; (2) studies indicated regional brain activation abnormalities in depressive patients compared with controls in standard Talairach or MNI coordinates. Any analyzed coordinates based on the MNI system were converted to Talairach space with icbm2tal software. The map of activation likelihood estimation was finally created through the Gaussian smooth (full-width half-maximum = 8 mm), permutation test and corrected for multiple comparisons using the false discovery rate method (q = 0.05) with Ginger-ALE 2.0 software. MAIN OUTCOME MEASURES: Activation of brain regions in patients. RESULTS: Seventeen studies were identified, involving a total of 261 patients, 273 healthy controls and 201 foci. Meta-analysis revealed a dysfunctional emotion regulation loop in depressive patients, comprised of the prefrontal cortex, the basal ganglia and the limbic lobe, in which the amygdala was a key component. During emotion processing, the left prefrontal cortex and basal ganglia were hypoactive among depressive patients, whereas the opposite change was found in the limbic lobe. CONCLUSION: Abnormal connections among the prefrontal cortex, basal ganglia and limbic lobe may be involved in the pathophysiology of depressive disorder.