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. 2021 May 1:231:117865.
doi: 10.1016/j.neuroimage.2021.117865. Epub 2021 Feb 14.

Mind the brain gap: The worldwide distribution of neuroimaging research on adolescent depression

Lucas Battel  1 , Fernanda Cunegatto  1 , Anna Viduani  1 , Helen L Fisher  2 , Brandon A Kohrt  3 , Valeria Mondelli  4 , Johnna R Swartz  5 , Christian Kieling  6
Affiliations

Mind the brain gap: The worldwide distribution of neuroimaging research on adolescent depression

Lucas Battel et al. Neuroimage. .

Abstract

Adolescents comprise one fourth of the world's population, with about 90% of them living in low- and middle-income countries (LMICs). The incidence of depression markedly increases during adolescence, making the disorder a leading cause of disease-related disability in this age group. However, most research on adolescent depression has been performed in high-income countries (HICs). To ascertain the extent to which this disparity operates in neuroimaging research, a systematic review of the literature was performed. A total of 148 studies were identified, with neuroimaging data available for 4,729 adolescents with depression. When stratified by income group, 122 (82%) studies originated from HICs, while 26 (18%) were conducted in LMICs, for a total of 3,705 and 1,024 adolescents with depression respectively. A positive Spearman rank correlation was observed between country per capita income and sample size (rs=0.673, p = 0.023). Our results support the previous reports showing a large disparity between the number of studies and the adolescent population per world region. Future research comparing neuroimaging findings across populations from HICs and LMICs may provide unique insights to enhance our understanding of the neurobiological processes underlying the development of depression.

Keywords: Adolescence; Depression; Developing countries; Income; Inequality; Neuroimaging.

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Conflict of interest statement

Declaration of Competing Interest Drs. Battel, Cunegatto, Viduani, Fisher, Kohrt, Swartz, and Kieling report no competing interests. Dr. Mondelli has received research funding from Johnson & Johnson, a pharmaceutical company interested in the development of anti-inflammatory strategies for depression, but the research described in this paper is unrelated to this funding.

Figures

Fig. 1.
Fig. 1.
Proportion of neuroimaging studies performed in high-income vs. low-income countries and proportion of adolescents in the population of each country income group. Population data from the most current World Bank database (World Bank, 2018b). HICs, High income countries; LMICs, low- and middle-income countries.
Fig. 2.
Fig. 2.
Number of neuroimaging publications on adolescent depression per year according to country income group. HICs, high-income countries; LMICs, low- and middle-income countries.
Fig. 3.
Fig. 3.
Representativeness of MRI study samples in youth depression worldwide – the index represents the number of participants in MRI studies per 100,000 adolescents in each country, showing that most adolescents included were from high-income countries.
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