Intrinsic cerebral activity at resting state in adults with major depressive disorder: A meta-analysis

•The AES-SDM was applied to investigate changes in ALFF/fALFF in depression.•We performed subgroup analysis and group comparison on medicated and drug naïve MDD patients.•Conjunction analysis was used to identify congruent results between the two methods.•We found increased activity of the ACC is more likely to be associated with antidepressant treatment.

Numerous neuroimaging studies have been undertaken to detect cerebral intrinsic activity in major depressive disorder (MDD) with resting state fMRI (rs-fMRI). However, the inconsistent results have hindered our understanding of the exact neuropathology related to MDD. The current meta-analysis used state-of-the-art conjunction analysis techniques to systematically review and summarize all available neuroimaging studies using rs-fMRI with amplitude of low frequency fluctuation (ALFF) and/or fractional ALFF (fALFF) on MDD patients and further explored the effect of antidepressants on the intrinsic activity of the brain. The anisotropic effect size version of signed differential mapping (AES-SDM) was applied to investigate changes in ALFF/fALFF in depression. We performed a subgroup analysis and group comparison on medicated and drug naïve patients to detect drug effect on MDD patients and conjunction analysis to identify congruent results between the two methods. Meta-regression was used to explore the effects of demographics and clinical characteristics. Adult MDD patients showed a robust increase in intrinsic activity in the resting state in the anterior cingulate cortex (ACC) in both ALFF (P < 0.001) and fALFF (P < 0.01) studies. The subgroup analysis demonstrated that the increased activity in the ACC was prominent in medicated patients only and not seen in drug-naïve MDD patients, while medication-naïve patients showed a specific decreased activity in the cerebellum (P < 0.01). Group comparison showed that the intrinsic ACC activity is elevated in medicated MDD patients compared with drug naïve MDD patients. Meta-regression analysis demonstrated that the increased ACC activation was positively correlated with illness duration (P < 0.001). Our findings suggest that increased activity of the ACC is more likely to be associated with antidepressant treatment, while decreased intrinsic activity of the cerebellum might be a specific biomarker for current MDD.