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Peer-reviewedCC BY-NC-ND 4.0Journal of Psychiatry & Neuroscience: JPN

Neurobiological insights into psychotic depression from magnetic resonance imaging: a systematic review

  • Yue Ming1,2
  • Qian Zhang1
  • Aoxiang Zhang1
  • Xianpeng Zhang1
  • Qian Li1
  • Huawei Zhang1
  • Graham J. Kemp3
  • Youjin Zhao1
  1. 1Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
  2. 2Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  3. 3Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 3BX, United Kingdom
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Abstract

Psychotic depression (PD) is increasingly recognized as a distinct psychiatric condition with unique neurobiological features. To identify neuroimaging biomarkers of PD, we systematically reviewed evidence across structural magnetic resonance imaging (MRI), functional MRI, diffusion tensor imaging, and magnetic resonance spectroscopy, following PRISMA guidelines. PubMed, MEDLINE, and Embase were searched through December 2025; 28 of 1195 records met PICOS-based inclusion criteria. PD showed distinct structural and functional abnormalities versus healthy controls and non-psychotic depression, particularly involving lower gray matter volume in prefrontal, insular, anterior cingulate, and temporal regions; aberrant temporoparietal and frontoparietal function; altered dorsal anterior cingulate metabolism; and default mode network-cortical hypoconnectivity. Pharmacological and electroconvulsive therapies may partially reverse frontotemporal and visual network abnormalities. Evidence for subcortical volume changes was inconsistent. Despite small, heterogeneous studies precluding meta-analysis, symptom-correlated fronto-insular-limbic, and precuneus alterations may represent potential biomarkers warranting further investigation.

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Cite

BibTeXRIS
BibTeX
@article{ming2026neurobiological,
  title = {{Neurobiological insights into psychotic depression from magnetic resonance imaging: a systematic review}},
  author = {Yue Ming and Qian Zhang and Aoxiang Zhang and Xianpeng Zhang and Qian Li and Huawei Zhang and Graham J. Kemp and Youjin Zhao},
  journal = {Journal of Psychiatry \& Neuroscience: JPN},
  year = {2026},
  month = oct,
  doi = {10.1139/jpn-2026-0096},
  url = {https://doi.org/10.1139/jpn-2026-0096},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Neurobiological insights into psychotic depression from magnetic resonance imaging: a systematic review
AU  - Yue Ming
AU  - Qian Zhang
AU  - Aoxiang Zhang
AU  - Xianpeng Zhang
AU  - Qian Li
AU  - Huawei Zhang
AU  - Graham J. Kemp
AU  - Youjin Zhao
PY  - 2026
DA  - 2026/10/29
JO  - Journal of Psychiatry & Neuroscience: JPN
DO  - 10.1139/jpn-2026-0096
UR  - https://doi.org/10.1139/jpn-2026-0096
AB  - Psychotic depression (PD) is increasingly recognized as a distinct psychiatric condition with unique neurobiological features. To identify neuroimaging biomarkers of PD, we systematically reviewed evidence across structural magnetic resonance imaging (MRI), functional MRI, diffusion tensor imaging, and magnetic resonance spectroscopy, following PRISMA guidelines. PubMed, MEDLINE, and Embase were searched through December 2025; 28 of 1195 records met PICOS-based inclusion criteria. PD showed distinct structural and functional abnormalities versus healthy controls and non-psychotic depression, particularly involving lower gray matter volume in prefrontal, insular, anterior cingulate, and temporal regions; aberrant temporoparietal and frontoparietal function; altered dorsal anterior cingulate metabolism; and default mode network-cortical hypoconnectivity. Pharmacological and electroconvulsive therapies may partially reverse frontotemporal and visual network abnormalities. Evidence for subcortical volume changes was inconsistent. Despite small, heterogeneous studies precluding meta-analysis, symptom-correlated fronto-insular-limbic, and precuneus alterations may represent potential biomarkers warranting further investigation.
SN  - 1180-4882
SN  - 1488-2434
ER  -