A systematic review of resting-state functional-MRI studies in the diagnosis, comorbidity and treatment of postpartum depression.

BACKGROUND

Postpartum depression (PPD) is a common and serious mental health problem that affects many new mothers and their families worldwide. In recent years, there has been an increasing number of studies using magnetic resonance techniques (MRI), particularly functional MRI (fMRI), to explore the neuroimaging biomarker of this disease.

METHODS

PubMed database was used to search for English literature focusing on resting-state fMRI and PPD published up to June 2024.

RESULTS

After screening, 17 studies were finally identified, among which all 17 studies reported abnormal regions or connectivity compared to health controls (HC), 4 studies reported results considering the differences between PPD and PPD with anxiety (PPD-A), and 2 studies reported biomarkers for the treatment of PPD. The existing studies indicate that PPD is characterized by functional impairments in multiple brain regions, especially the medial prefrontal cortex (MPFC), precentral gyrus and cerebellum. Abnormal functional connectivity has been widely reported in the dorsomedial prefrontal cortex (dmPFC), anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC). However, none of the four comorbidity studies identified overlapping discriminative biomarkers between PPD and PPD-A. Additionally, the two treatment-related studies consistently reported functional improvements in the amygdala after effective treatment.

CONCLUSION

The affected brain regions were highly overlapped with major depressive disorder (MDD), suggesting that PPD may be categorized as a potential subtype of MDD. Considering the negative effects of medication on PPD, future efforts should focus on developing non-pharmacological therapies, such as transcranial magnetic stimulation (TMS) and acupuncture, to support women with PPD in overcoming this unique and important phase.