Gray matter alterations in adolescent major depressive disorder and adolescent bipolar disorder

J Affect Disord. 2023 Mar 15:325:550-563. doi: 10.1016/j.jad.2023.01.049. Epub 2023 Jan 17.


Background: Gray matter volume (GMV) alterations in several emotion-related brain areas are implicated in mood disorders, but findings have been inconsistent in adolescents with major depressive disorder (MDD) or bipolar disorder (BD).

Methods: We conducted a comprehensive meta-analysis of 35 region-of-interest (ROI) and 18 whole-brain voxel-based morphometry (VBM) MRI studies in adolescent MDD and adolescent BD, and indirectly compared the results in the two groups. The effects of age, sex, and other demographic and clinical scale scores were explored using meta-regression analysis.

Results: In the ROI meta-analysis, right putamen volume was decreased in adolescents with MDD, while bilateral amygdala volume was decreased in adolescents with BD compared to healthy controls (HC). In the whole-brain VBM meta-analysis, GMV was increased in right middle frontal gyrus and decreased in left caudate in adolescents with MDD compared to HC, while in adolescents with BD, GMV was increased in left superior frontal gyrus and decreased in limbic regions compared with HC. MDD vs BD comparison revealed volume alteration in the prefrontal-limbic system.

Limitation: Different clinical features limit the comparability of the samples, and small sample size and insufficient clinical details precluded subgroup analysis or meta-regression analyses of these variables.

Conclusions: Distinct patterns of GMV alterations in adolescent MDD and adolescent BD could help to differentiate these two populations and provide potential diagnostic biomarkers.

Keywords: Adolescent; Bipolar disorder (BD); Magnetic resonance imaging (MRI); Major depressive disorder (MDD); Psychoradiology; Voxel-based morphometry (VBM).

Publication types

  • Meta-Analysis
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bipolar Disorder* / diagnostic imaging
  • Brain / diagnostic imaging
  • Cerebral Cortex / diagnostic imaging
  • Depressive Disorder, Major* / diagnostic imaging
  • Gray Matter / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods