# Postpartum depression-associated localized neural dysfunction: a voxel-wise meta-analysis of amplitude and synchronization alterations in resting-state fMRI

## TL;DR

This study identifies brain regions with abnormal activity in postpartum depression using a meta-analysis of resting-state fMRI data.

## Contribution

The study provides a quantitative meta-analysis of amplitude and synchronization alterations in postpartum depression using voxel-wise fMRI data.

## Key findings

- PPD patients showed increased activity in the left fusiform and middle occipital gyri and decreased activity in regions like the anterior cingulate and insula.
- Abnormal activity in the visual cortex and prefrontal-limbic system may be linked to postpartum depression.
- Meta-regression found a correlation between middle occipital gyrus activity and depression severity scores.

## Abstract

Resting-state fMRI studies in postpartum depression (PPD) have reported voxel-wise alterations in measures of neural amplitude and synchronization, yet scarce meta-analysis has quantitatively synthesized these findings. We performed a coordinate-based meta-analysis to identify convergent amplitude and synchronization dysfunction in PPD.

We conducted a comprehensive search for whole-brain voxel-wise resting-state fMRI studies comparing PPD patients with healthy postpartum controls that reported local amplitude or synchronization metrics. Peak coordinates were analyzed using the Anisotropic effect size-signed differential mapping to delineate whole-brain functional alterations.

Ten studies (288 PPD patients, 279 controls) contributed 62 peak foci. Our analysis revealed that PPD patients exhibited increased activity in the left fusiform gyrus (FFG.L), left middle occipital gyrus (MOG.L), while showing decreased activity in the left anterior cingulate gyrus (ACG.L), the right superior temporal gyrus (STG.R), the right insula (INS.R) and the right precentral gyrus (PreCG.R) compared to healthy subjects. Jackknife sensitivity analysis indicated minimal impact on the overall results when eliminating any single study. Meta-regression analysis revealed a correlation between MOG.L functional activity and Edinburgh postnatal depression scale scores.

Abnormally elevated functional activity in the FFG.L, MOG.L, along with reduced activity in the ACG.L, STG.R, INS.R and PreCG.R, may serve as potential biomarkers for PPD. Additionally, abnormal functional activity in the visual cortex, and the prefrontal cortex-limbic system may be associated with PPD.