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Major Depressive Disorder in Youth and Adults: A Quantitative Whole-Brain Meta-Analysis of Functional Magnetic Resonance Imaging Studies.

Caitlin Baten, Gladys Zamora, Amanda M. Klassen, Justin Rackley, Akua F Nimarko, Ellen Woo, Arielle S Keller, J Paul Hamilton, Dawson W Hedges, Matthew D. Sacchet, Ian H Gotlib, Chris H. Miller

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging January 13, 2026 DOI: 10.1016/j.bpsc.2026.01.001 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Systematic review and meta-analysis Peer reviewed
Sample size 6,391
Population Participants diagnosed with major depressive disorder (MDD) and age-matched healthy controls (HCs)
Topics Depression
Keywords Adults Quantitative whole-brain meta-analysis Youth
Key findings Youth and adults with MDD show differential brain activation patterns in regions such as the sgACC and dlPFC, with illness duration also affecting activation differences among adults.

Abstract

Major depressive disorder (MDD) is a highly prevalent psychiatric disorder with limited treatment success in both youth and adults. Functional magnetic resonance imaging (fMRI) studies have reported partially differential patterns of activation in youth and adults diagnosed with MDD that may be attributable to age or length of illness. Following PRISMA guidelines, we searched PubMed through November 2023 and selected 135 primary studies (N = 6,391) based on the following inclusion criteria: (1)task-based fMRI activation, (2) voxel-wise whole-brain analyses, and (3) compared participants diagnosed with MDD to age-matched healthy controls (HCs). We used multilevel kernel density analysis with ensemble thresholding (P < .05 - .0001; FDR-corrected) to find activation differences between (1) youth with MDD and HCs, (2) youth and adults with MDD, (3) youth and adults with shorter-duration MDD, and (4) adults with longer and shorter-duration MDD. Relative to adults with MDD, youth with MDD demonstrated significant patterns of differential activation in regions such as the subgenual anterior cingulate cortex (sgACC) and dorsolateral prefrontal cortex (dlPFC; P < .0025). Second, after controlling for length of illness, relative to adults with shorter-duration MDD, youth demonstrated hypoactivation in regions such as the sgACC (P < .01). Lastly, when controlling for age, relative to adults with shorter-duration MDD, adults with longer-duration MDD demonstrated hypoactivation in regions such as the dlPFC (P < .05). These findings underscore the importance of considering age and length of illness in developmental models of MDD and inform neural models and clinical interventions for depression.

Comparable studies

Other systematic reviews and meta-analyses on depression, most cited first.

Study Year Design Participants
Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression Participants with major depression in placebo-controlled, double-blind, randomized... 2015 Systematic review and meta-analysis
Side-effects associated with ketamine use in depression: a systematic review. Patients with depression 2018 Systematic review
Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis Adults with unipolar or bipolar major depression 2020 Systematic review and meta-analysis n = 1,877
Single-dose infusion ketamine and non-ketamine N-methyl-D-aspartate receptor antagonists for unipolar and bipolar depression: a meta-analysis of efficacy, safety and time trajectories Patients with major depressive disorder or bipolar depression 2016 Systematic review and meta-analysis n = 588
Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... 2020 Systematic review n = 188

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