Functional neuroimaging studies have demonstrated abnormal activity and functional connectivity (FC) of the amygdala among individuals with major depressive disorder (MDD), which may be rectified with selective serotonin reuptake inhibitor (SSRI) treatment. This systematic review aimed to identify changes in the amygdala on functional magnetic resonance imaging (fMRI) scans among individuals with MDD who received SSRIs. A search for fMRI studies examining amygdala correlates of SSRI response via fMRI was conducted through OVID (MEDLINE, PsycINFO, and Embase). The end date was April 4th, 2023. In total, 623 records were screened, and 16 studies were included in this review. While the search pertained to SSRIs broadly, the included studies were escitalopram-, citalopram-, fluoxetine-, sertraline-, and paroxetine-specific. Decreases in event-related amygdala activity were found following 6-to-12-week SSRI treatment, particularly in response to negative stimuli. Eight-week courses of SSRI pharmacotherapy were associated with increased event-related amygdala FC (i.e., with the prefrontal [PFC] and anterior cingulate cortices, insula, thalamus, caudate nucleus, and putamen) and decreased resting-state effective connectivity (i.e., amygdala-PFC). Preliminary evidence suggests that SSRIs may alter amygdala activity and FC in MDD. Additional studies are needed to corroborate findings. Future research should employ long-term follow-ups to determine whether effects persist after treatment termination.

功能神经影像学研究表明，重度抑郁症 (MDD) 患者的杏仁核活动和功能连接 (FC) 异常，可以通过选择性血清素再摄取抑制剂 (SSRI) 治疗来纠正。本系统综述旨在通过功能性磁共振成像 (fMRI) 扫描来确定接受 SSRI 治疗的重度抑郁症患者杏仁核的变化。通过 OVID（MEDLINE、PsycINFO 和 Embase）进行了一项功能磁共振成像研究的搜索，该研究通过功能磁共振成像检查杏仁核与 SSRI 反应的相关性。结束日期为2023年4月4日。总共筛选了623条记录，本次综述纳入了16项研究。虽然搜索广泛涉及 SSRI，但纳入的研究针对艾司西酞普兰、西酞普兰、氟西汀、舍曲林和帕罗西汀。在 6 至 12 周的 SSRI 治疗后，发现与事件相关的杏仁核活动减少，特别是对负面刺激的反应。八周的 SSRI 药物治疗疗程与事件相关的杏仁核 FC（即前额叶 [PFC] 和前扣带皮层、岛叶、丘脑、尾状核和壳核）增加以及静息态有效连接减少（即，杏仁核-PFC）。初步证据表明，SSRIs 可能会改变重度抑郁症患者的杏仁核活性和 FC。需要更多的研究来证实研究结果。未来的研究应该采用长期随访来确定治疗终止后效果是否持续。