Table 2.
Overview of MRI studies on sex differences in depression
| Study | Tesla sequence | Measures | Brain areas | Methods for Sex Differences Analyses Sex by Diagnosis Effects |
Covariates | Results | ||
|---|---|---|---|---|---|---|---|---|
| Model | Tested? | Findings | ||||||
| Ancelin et al., 2019 |
1.5 T T1 |
Volume |
Hippocampus Amygdala Orbitofrontal cortex ACC |
GLM | Yes | Yes | Age, total brain volume, education level, head injury, cardiovascular ischemic pathologies and antidepressant use, lifetime anxiety disorder |
A positive association between lifetime MDD and smaller GM volumes in men's amygdala and caudate nucleus. No such association in women. Women exhibited larger rostral ACC volumes than men. |
| Carceller-Sindreu, 2015 |
3 T T1 |
Volume |
Habenular nuclei TIV |
GLM | Yes | Yes | Age, educational level, TIV, medication load | Increased Hb-WM volume in women with a first-episode MDD. |
| Cyprien et al., 2014 |
1.5 T T1 |
Volume |
Corpus callosum TBV |
GLM | Yes | Yes | Education, global cognitive impairment, ischemic pathologies, left-handedness, WML volume, intracranial volume, past major depression episode |
A positive association in women between the incidence of LLD and smaller anterior, mid, posterior, and total CC areas. No associations in men. |
| Furtado et al., 2008 |
1.5 T T1 |
Volume |
ERC ICV TBV |
GLM | Yes | Yes | Age, ICV, TBV |
Lower ICV and TBV/ICV in male patients than male controls. No such association in females. Lower TBV in female patients than female controls. Larger L and R ERC in male patients than female patients. |
| Hastings et al., 2004 |
1.5 T T1 |
Volume |
Amygdala Hippocampus IAC OPFC TCV |
GLM | Yes | Yes | Age, total years of education, age at first episode of major depression, and number of major depressive episodes, family history of depression, reported history of sexual or physical abuse, suicide attempt status |
Depressed females had a 23% smaller R amygdala and a 15% smaller L amygdala than healthy females. Depressed males had a 22% smaller IAC normalized volume than healthy males. |
| Kong et al., 2013 | 3 T |
GM volume GM density |
Bilateral amygdala, hippocampus, striatum, and PFC | ANOVA | Yes | Yes | N/A |
Reduced GM density in the bilateral amygdala and hippocampus of MDD females compared to HC females Reduced GM density in the bilateral caudate extending to the left ventral striatum of MDD males compared to the HC males Reduced GM volume in bilateral caudate of MDD males compared to HC males |
| Kronmuller et al., 2009 |
1.5 T T1 |
Volume |
Hippocampus TBV |
GLM | Yes | Yes | Age, diagnostic group, TCV |
A L-R asymmetry in hippocampal volume with smaller L hippocampal volume in FEMD males than Healthy males. No difference in TBV. |
| Lavretsky et al., 1998 |
1.5 T T1, T2 |
WMH, VBR | Whole brain | GLM | Yes | No | Age, age at onset |
More males had large WMH than females. No significant difference in VBR. |
| Lewine et al., 1995 |
1.5 T T2 |
Volume WMH Ventricular anomaly |
Whole brain | NR | Yes | Yes | History of substance abuse or physical trauma | Less normal scans in schizophrenic and MDD men than women in either group. |
| MacMaster et al., 2006 | 1.5 T | Volume | Pituitary gland | ANCOVA | Yes | Yes | Age, intracranial volume | Larger pituitary gland volumes in MDD males compared to HC males, while there were no significant diagnostic group differences in the pituitary volume of females. |
| Nielsen et al., 2020 | NR | CT | OFC | MLM | Yes | Yes | Age at the time of scan, maternal depression history |
Inverse association between depressive symptoms and CT of the L lateral OFC in males. Positive association in the L medial OFC in females between CT and depressive symptoms. |
| Piani et al., 2021 | 3 T | GM volume | Whole brain | GLM | Yes | Yes | None (univariate) |
Comparable regional GM volumes between MDD and HC groups across diagnosis by sex subsets. Larger normalized GM volumes of calcarine, olfactory, and orbitofrontal regions in healthy females than in healthy males, but lower in MDD females compared to MDD males. |
|
Ritter et al., 2021 (PWI) |
3 T | Perfusion | Whole brain | GLM | Yes | Yes | Whole-brain perfusion |
Negative association between perfusion and depressive symptoms in females for the HAM-D, BDI, and MADRS. Positive association in males for the MADRS. |
| Soriano-Mas et al., 2011 | 1.5 T | Gray and white matter volume | Whole brain | GLM | Yes | Yes | Age, time between scans, global tissue volume | A significant GM volume reduction in the R thalamus in male MDD patients. |
| Yang et al., 2017 | 3 T | GM volume | Whole brain | ANCOVA | Yes | Yes | Age, GM volume, whole brain volume |
Decreased GM volume of middle/superior temporal gyrus and ventromedial prefrontal gyrus in MDD males compared to HC males Increased GM volume of cerebellum in MDD males compared to HC males Decreased GM volume of dorsomedial prefrontal gyrus extending to SMA and lingual extending to parahippocampal gyrus in MDD females compared to HC females |
Abbreviations: MRI: Magnetic resonance imaging, ACC: Anterior cingulate cortex, TIV: Total intracranial volume, TBV: Total brain volume, ICV: Intracranial volume, TCV: Total cerebral volume, ERC: Entorhinal cortex, IAC: Inferior anterior cingulate, OPFC: Orbital prefrontal cortex, OFC: Orbitofrontal cortex, MDD: Major depressive disorder, GM: Gray matter, WM: White matter, WML: White matter lesions, Hb: Habenula, CC: Corpus callosum, LLD: Late-life depression, PFC: prefrontal cortex, FEMD: First episode major depression, MADRS: Montgomery-Asberg Depression Rating Scale, BDI: Beck’s Depression Inventory, HAM-D: Hamilton Depression Rating Scale, WMH: White-matter hyperintensities, VBR: Ventricle-to-brain ratio, CT: Cortical thickness, PWI: Perfusion-weighted imaging, GLM: General linear model, ANCOVA: Analysis of covariance, MLM: Multilevel modeling, SMA: supplementary motor area, T: Tesla, L: Left, R: Right, NR: Not reported, N/A: Not applicable.