Evidence map›Paper›PMID 42199997›Full record

ArticleDepression and anxiety2026

Prefrontal Structural Asymmetry Mediates Body Mass Index and Treatment Response in Major Depressive Disorder.

Kaini Qiao, Zhenxiang Zang, Yun Wang, Xiongying Chen, Ke Liu, Zhifang Zhang, Rui Liu, Dong Li, Yanting Luo, Le Xiao and 4 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Depression and anxiety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Kaini QiaoNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.ORCID 0000-0003-0115-6413
Zhenxiang ZangNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Yun WangNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.ORCID 0000-0001-8803-6777
Xiongying ChenNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Ke LiuNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Zhifang ZhangNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.ORCID 0000-0002-3806-2093
Rui LiuNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Dong LiNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Yanting LuoNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Le XiaoNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Xuequan ZhuNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Jingjing ZhouNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.
Zhi YangNational Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.ORCID 0000-0002-2222-2312
Gang WangBeijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, ccmu.edu.cn.ORCID 0000-0003-3949-1188

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Elevated body mass index (BMI) predicts poor treatment response in major depressive disorder (MDD), yet the neurobiological mechanisms underlying this association remain poorly understood. Cortical thickness asymmetry has been proposed as a structural correlate of affective regulation and may represent a pathway through which metabolic factors influence treatment outcomes. We investigated whether BMI-related alterations in prefrontal cortical asymmetry mediate antidepressant treatment resistance in MDD. Methods: We analyzed baseline structural MRI (sMRI) and 12-week clinical outcome data from 312 adults with MDD across a discovery cohort ( Results: Across both cohorts, higher BMI was consistently associated with greater leftward cortical thickness asymmetry in the prefrontal cortex (PFC). This structural asymmetry significantly mediated the relationship between BMI and poorer treatment response. Sex-stratified analyses revealed additional female-specific mediation through prefrontal opercular regions, with no corresponding effect in males. Transcriptomic annotation of implicated regions identified enrichment for genes involved in metabolic and cytoplasmic signaling pathways. Conclusions: BMI-associated leftward prefrontal asymmetry statistically mediates antidepressant resistance in MDD via both a sex-shared structural pathway and a female-specific opercular circuit. These findings suggest that metabolic factors may influence treatment outcomes partly through hemispheric structural imbalance in prefrontal regions and position cortical thickness asymmetry as a candidate neuroimaging biomarker for patient stratification in precision psychiatry.

Indexed as

Antidepressive AgentsBody Mass IndexDepressive Disorder, Treatment-ResistantMajor Depressive DisorderPrefrontal CortexAdultFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedTreatment Effect HeterogeneityAntidepressive AgentsBMIbrain asymmetrymajor depressive disorderprefrontal cortex

Identifiers

PMID42199997
PMCPMC13199996

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.