Brain Features of Treatment-Resistant Depression: A Review of Structural and Functional Connectivity Magnetic Resonance Imaging Studies

Psychiatr Clin North Am. 2023 Jun;46(2):391-401. doi: 10.1016/j.psc.2023.02.009. Epub 2023 Mar 25.

Abstract

Increased awareness of the growing disease burden of treatment resistant depression (TRD), in combination with technological advances in MRI, affords the unique opportunity to research biomarkers that characterize TRD. We provide a narrative review of MRI studies investigating brain features associated with treatment-resistance and treatment outcome in those with TRD. Despite heterogeneity in methods and outcomes, relatively consistent findings include reduced gray matter volume in cortical regions and reduced white matter structural integrity in those with TRD. Alterations in resting state functional connectivity of the default mode network were also found. Larger studies with prospective designs are warranted.

Keywords: Anterior cingulate cortex; Depression; Magnetic resonance imaging; Neuroimaging; Resting-state functional connectivity; Treatment-resistant depression.

Publication types

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

MeSH terms

  • Brain
  • Brain Mapping
  • Depression
  • Depressive Disorder, Treatment-Resistant* / diagnostic imaging
  • Depressive Disorder, Treatment-Resistant* / drug therapy
  • Humans
  • Magnetic Resonance Imaging