1
|
Mohammadi S, Seyedmirzaei H, Salehi MA, Jahanshahi A, Zakavi SS, Dehghani Firouzabadi F, Yousem DM. Brain-based Sex Differences in Depression: A Systematic Review of Neuroimaging Studies. Brain Imaging Behav 2023; 17:541-569. [PMID: 37058182 PMCID: PMC10102695 DOI: 10.1007/s11682-023-00772-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
Major depressive disorder (MDD) is a common psychiatric illness with a wide range of symptoms such as mood decline, loss of interest, and feelings of guilt and worthlessness. Women develop depression more often than men, and the diagnostic criteria for depression mainly rely on female patients' symptoms. By contrast, male depression usually manifests as anger attacks, aggression, substance use, and risk-taking behaviors. Various studies have focused on the neuroimaging findings in psychiatric disorders for a better understanding of their underlying mechanisms. With this review, we aimed to summarize the existing literature on the neuroimaging findings in depression, separated by male and female subjects. A search was conducted on PubMed and Scopus for magnetic resonance imaging (MRI), functional MRI (fMRI), and diffusion tensor imaging (DTI) studies of depression. After screening the search results, 15 MRI, 12 fMRI, and 4 DTI studies were included. Sex differences were mainly reflected in the following regions: 1) total brain, hippocampus, amygdala, habenula, anterior cingulate cortex, and corpus callosum volumes, 2) frontal and temporal gyri functions, along with functions of the caudate nucleus and prefrontal cortex, and 3) frontal fasciculi and frontal projections of corpus callosum microstructural alterations. Our review faces limitations such as small sample sizes and heterogeneity in populations and modalities. But in conclusion, it reflects the possible roles of sex-based hormonal and social factors in the depression pathophysiology.
Collapse
Affiliation(s)
- Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Jahanshahi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Sina Zakavi
- School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, USA.
| |
Collapse
|
2
|
Continuous Ingestion of Lacticaseibacillus rhamnosus JB-1 during Chronic Stress Ensures Neurometabolic and Behavioural Stability in Rats. Int J Mol Sci 2022; 23:ijms23095173. [PMID: 35563564 PMCID: PMC9106030 DOI: 10.3390/ijms23095173] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 11/29/2022] Open
Abstract
The intestinal microbiome composition and dietary supplementation with psychobiotics can result in neurochemical alterations in the brain, which are possible due to the presence of the brain–gut–microbiome axis. In the present study, magnetic resonance spectroscopy (MRS) and behavioural testing were used to evaluate whether treatment with Lacticaseibacillus rhamnosus JB-1 (JB-1) bacteria alters brain metabolites’ levels and behaviour during continuous exposure to chronic stress. Twenty Wistar rats were subjected to eight weeks of a chronic unpredictable mild stress protocol. Simultaneously, half of them were fed with JB-1 bacteria, and the second half was given a daily placebo. Animals were examined at three-time points: before starting the stress protocol and after five and eight weeks of stress onset. In the elevated plus maze behavioural test the placebo group displayed increased anxiety expressed by almost complete avoidance of exploration, while the JB-1 dietary supplementation mitigated anxiety which resulted in a longer exploration time. Hippocampal MRS measurements demonstrated a significant decrease in glutamine + glutathione concentration in the placebo group compared to the JB-1 bacteria-supplemented group after five weeks of stress. With the progression of stress, the decrease of glutamate, glutathione, taurine, and macromolecular concentrations were observed in the placebo group as compared to baseline. The level of brain metabolites in the JB-1-supplemented rats were stable throughout the experiment, with only the taurine level decreasing between weeks five and eight of stress. These data indicated that the JB-1 bacteria diet might stabilize levels of stress-related neurometabolites in rat brain and could prevent the development of anxiety/depressive-like behaviour.
Collapse
|
3
|
Demchenko I, Tassone VK, Kennedy SH, Dunlop K, Bhat V. Intrinsic Connectivity Networks of Glutamate-Mediated Antidepressant Response: A Neuroimaging Review. Front Psychiatry 2022; 13:864902. [PMID: 35722550 PMCID: PMC9199367 DOI: 10.3389/fpsyt.2022.864902] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Conventional monoamine-based pharmacotherapy, considered the first-line treatment for major depressive disorder (MDD), has several challenges, including high rates of non-response. To address these challenges, preclinical and clinical studies have sought to characterize antidepressant response through monoamine-independent mechanisms. One striking example is glutamate, the brain's foremost excitatory neurotransmitter: since the 1990s, studies have consistently reported altered levels of glutamate in MDD, as well as antidepressant effects following molecular targeting of glutamatergic receptors. Therapeutically, this has led to advances in the discovery, testing, and clinical application of a wide array of glutamatergic agents, particularly ketamine. Notably, ketamine has been demonstrated to rapidly improve mood symptoms, unlike monoamine-based interventions, and the neurobiological basis behind this rapid antidepressant response is under active investigation. Advances in brain imaging techniques, including functional magnetic resonance imaging, magnetic resonance spectroscopy, and positron emission tomography, enable the identification of the brain network-based characteristics distinguishing rapid glutamatergic modulation from the effect of slow-acting conventional monoamine-based pharmacology. Here, we review brain imaging studies that examine brain connectivity features associated with rapid antidepressant response in MDD patients treated with glutamatergic pharmacotherapies in contrast with patients treated with slow-acting monoamine-based treatments. Trends in recent brain imaging literature suggest that the activity of brain regions is organized into coherent functionally distinct networks, termed intrinsic connectivity networks (ICNs). We provide an overview of major ICNs implicated in depression and explore how treatment response following glutamatergic modulation alters functional connectivity of limbic, cognitive, and executive nodes within ICNs, with well-characterized anti-anhedonic effects and the enhancement of "top-down" executive control. Alterations within and between the core ICNs could potentially exert downstream effects on the nodes within other brain networks of relevance to MDD that are structurally and functionally interconnected through glutamatergic synapses. Understanding similarities and differences in brain ICNs features underlying treatment response will positively impact the trajectory and outcomes for adults suffering from MDD and will facilitate the development of biomarkers to enable glutamate-based precision therapeutics.
Collapse
Affiliation(s)
- Ilya Demchenko
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Vanessa K Tassone
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katharine Dunlop
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Center for Depression and Suicide Studies, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Keenan Research Center for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
4
|
Abnormalities of cortical structures in patients with postpartum depression: A surface-based morphometry study. Behav Brain Res 2021; 410:113340. [PMID: 33945830 DOI: 10.1016/j.bbr.2021.113340] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is a serious postpartum mental health problem worldwide. However, the cortical structural alterations in patients with PPD remain unclear. This study investigated the cortical structural alterations of PPD patients through multidimensional structural patterns and their potential correlations with clinical severity. METHODS High-resolution 3D T1 structural images were acquired from 21 drug-naive patients with PPD and 18 healthy postpartum women matched for age, educational level, and body mass index. The severity of PPD was assessed by using the Hamilton Depression Scale (HAMD) and Edinburgh Postnatal Depression Scale (EPDS) scores. Cortical morphological parameters including cortical thickness, surface area, and mean curvature were calculated using the surface-based morphometric (SBM) method. General linear model (GLM) analyses were performed to evaluate the relationship of cortical morphological parameters with clinical scales. RESULTS In the present study, PPD patients showed a thinner cortical thickness in the right inferior parietal lobule compared with the healthy controls. Increased surface area was observed in the left superior frontal gyrus, caudal middle frontal gyrus, middle temporal gyrus, insula, and right supramarginal cortex in PPD patients. Likewise, PPD patients exhibited a higher mean curvature in the left superior and right inferior parietal lobule. Furthermore, increased cortical surface area in the left insula had a positive correlation with EPDS scores, and higher mean curvature in the left superior parietal lobule was negatively correlated with EPDS scores. LIMITATIONS First, SBM cannot reflect the changes of subcortical structures that are considered to play a role in the development of PPD. Second, the sample size of this study is small. These positive results should be interpreted with caution. Third, this cross-sectional study does not involve a comparison of structural MRI before and after pregnancy. CONCLUSIONS The complex cortical structural alterations of patients with PPD mainly involved the prefrontal and parietal regions. The morphometric alterations in these specific regions may provide promising markers for assessing the severity of PPD.
Collapse
|
5
|
Neurotransmitters and Neurometabolites in Late-Life Depression: A Preliminary Magnetic Resonance Spectroscopy Study at 7T. J Affect Disord 2021; 279:417-425. [PMID: 33120242 PMCID: PMC8606178 DOI: 10.1016/j.jad.2020.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/27/2020] [Accepted: 10/05/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Magnetic resonance spectroscopy (MRS) methods have quantified changes in levels of neurotransmitters and neurometabolites in patients with major depression across the lifespan. The application of 7T field strengths and greater have not been a major focus of study in patients with late-life depression (LLD). METHODS Nine LLD patients who met DSM-IV criteria for a current major depressive episode and nine non-depressed, healthy, age-matched controls underwent clinical and neuropsychological assessment and single-voxel 7T 1H-MRS at baseline and after 10-12 weeks of antidepressant treatment (Citalopram; patients only). Spectra were acquired from two brain regions implicated in both depressive symptoms and neuropsychological deficits in LLD, the anterior (ACC) and posterior cingulate (PCC). Levels of γ-aminobutyric acid (GABA), glutamate (Glu), glutathione (GSH), N-acetylaspartylglutamate (NAAG), N-acetylaspartate (NAA), and myo-inositol (mI) were quantified relative to total creatine (tCr) using linear-combination modeling. RESULTS Baseline Glu/tCr levels were not significantly different between groups. Decreased Glu/tCr levels after Citalopram treatment were observed in a subset of LLD patients. Exploratory analyses showed that LLD patients had lower NAA levels in the PCC relative to controls. Higher levels of ml in the LLD patients relative to the controls and decreases after Citalopram treatment had large effect sizes but were not statistically significant. Further, decreases in PCC Glu/tCr and increases in ACC GSH/tCr were associated with improvement in depressive symptoms. LIMITATIONS Sample size. CONCLUSIONS These preliminary results suggest a role of neurochemicals and neurometabolites in the neurobiology of LLD and antidepressant treatment response.
Collapse
|
6
|
Krause-Sorio B, Siddarth P, Milillo MM, Vlasova R, Ercoli L, Narr KL, Lavretsky H. Regional White Matter Integrity Predicts Treatment Response to Escitalopram and Memantine in Geriatric Depression: A Pilot Study. Front Psychiatry 2020; 11:548904. [PMID: 33329088 PMCID: PMC7718009 DOI: 10.3389/fpsyt.2020.548904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Geriatric depression with subjective memory complaints increases the risk for Alzheimer's Disease. Memantine, a neuroprotective drug, can improve depression and help prevent cognitive decline. In our 6-months clinical trial, escitalopram/memantine (ESC/MEM) improved mood and cognition compared to escitalopram/placebo treatment (ESC/PBO; NCT01902004). In this report, we investigated whether baseline brain white matter integrity in fronto-limbic-striatal tracts can predict clinical outcomes using fractional anisotropy (FA). Methods: Thirty-eight older depressed adults (mean age = 70.6, SD = 7.2) were randomized to ESC/MEM or ESC/PBO and underwent diffusion-weighted imaging (DWI) at 3 Tesla at baseline. Mood was assessed using the Hamilton Depression Rating Scale (HAMD), apathy using the Apathy Evaluation Scale (AES) and anxiety using the Hamilton Anxiety Scale (HAMA) at baseline and 6-months follow-up. FA was extracted from seven tracts of interest (six in each hemisphere and one commissural tract) associated with geriatric depression. Non-parametric General Linear Models were used to examine group differences in the association between FA and symptom improvement, controlling for age, sex, baseline symptom scores and scanner model, correcting for false discovery rate (FDR). Post-hoc tests further investigated group differences in axial, mean and radial diffusivity (AD, MD, and RD, respectively). Lastly, we performed an exploratory whole-brain model to test whether FA might be related to treatment response with memantine. Results: There were no differences in remission rates or HAMD change between groups. In bilateral anterior and posterior internal capsule tracts and bilateral inferior and right superior fronto-occipital (IFO and SFO) fasciculus, higher FA was associated with larger improvements in depressive symptoms for ESC/MEM, but not ESC/PBO, correcting for FDR. Lower MD in the left IFO and RD in the right anterior internal capsule were associated with improved treatment responses. We found no significant associations in the whole-brain analysis. Limitations: Included small sample size and high dropout. Conclusions: Higher baseline FA and lower RD and MD in hypothesized fronto-limbic-striatal tracts predicted greater improvement in mood and anxiety with ESC/MEM compared to ESC/PBO in geriatric depression. FA as a biomarker for white matter integrity may serve as a predictor of treatment response but requires confirmation in larger future studies.
Collapse
Affiliation(s)
- Beatrix Krause-Sorio
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Prabha Siddarth
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michaela M. Milillo
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roza Vlasova
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Linda Ercoli
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L. Narr
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Helen Lavretsky
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
7
|
An early increase in glutamate is critical for the development of depression-like behavior in a chronic restraint stress (CRS) model. Brain Res Bull 2020; 162:59-66. [PMID: 32505508 DOI: 10.1016/j.brainresbull.2020.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 11/17/2022]
Abstract
Dysfunction in glutamate homeostasis contributes to the pathology of depression-like behavior. Using a chronic restraint stress (CRS) model of depression in C57BL/6 mice, we measured glutamate levels in the cerebrospinal fluid at different restraint time points (CRS 1 d, CRS 3 d, CRS 5 d, CRS 7 d, CRS 14 d, and CRS 21 d). Glutamate levels were increased in the early stage of stress (CRS 1 d and CRS 5 d) but returned to basal levels at the other time points (CRS 7 d-21 d). We hypothesized that glutamate-induced excitotoxicity is critical for the development of depression-like behavior in the CRS model. Treatment with sodium valproate (VPA) or lamotrigine (LTG), two drugs that prevent excitotoxicity in neurons by increasing inhibitory inputs or blocking sodium channels, in the early stage (CRS 1 d-5 d) was sufficient to correct depression-like behavior. In contrast, treatment with the classic antidepressant fluoxetine (FLX) during the same time period was not sufficient to correct depressive behavior. Western blot of two markers of dendritic spines PSD95 and VGluT1 showed that restraining mice for 5 d resulted in the loss of dendritic spines, which was rescued by VPA or LTG. In conclusion, an initial increase in glutamate levels plays an important role in the development of depression-like behavior in the CRS model.
Collapse
|
8
|
Sharma S, Akundi RS. Mitochondria: A Connecting Link in the Major Depressive Disorder Jigsaw. Curr Neuropharmacol 2019; 17:550-562. [PMID: 29512466 PMCID: PMC6712299 DOI: 10.2174/1570159x16666180302120322] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 02/02/2018] [Accepted: 02/27/2018] [Indexed: 12/19/2022] Open
Abstract
Background Depression is a widespread phenomenon with varying degrees of pathology in different patients. Various hypotheses have been proposed for the cause and continuance of depression. Some of these include, but not limited to, the monoamine hypothesis, the neuroendocrine hypothesis, and the more recent epigenetic and inflammatory hypotheses. Objective In this article, we review all the above hypotheses with a focus on the role of mitochondria as the connecting link. Oxidative stress, respiratory activity, mitochondrial dynamics and metabolism are some of the mitochondria-dependent factors which are affected during depression. We also propose exogenous ATP as a contributing factor to depression. Result Literature review shows that pro-inflammatory markers are elevated in depressive individuals. The cause for elevated levels of cytokines in depression is not completely understood. We propose exogenous ATP activates purinergic receptors which in turn increase the levels of various pro-inflammatory factors in the pathophysiology of depression. Conclusion Mitochondria are integral to the function of neurons and undergo dysfunction in major depressive disorder patients. This dysfunction is reflected in all the various hypotheses that have been proposed for depression. Among the newer targets identified, which also involve mitochondria, includes the role of exogenous ATP. The diversity of purinergic receptors, and their differential expression among various individuals in the population, due to genetic and environmental (prenatal) influences, may influence the susceptibility and severity of depression. Identifying specific receptors involved and using patient-specific purinergic receptor antagonist may be an appropriate therapeutic course in the future.
Collapse
Affiliation(s)
- Shilpa Sharma
- Neuroinflammation Research Lab, Faculty of Life Sciences and Biotechnology, South Asian University, New Delhi, India
| | - Ravi S Akundi
- Neuroinflammation Research Lab, Faculty of Life Sciences and Biotechnology, South Asian University, New Delhi, India
| |
Collapse
|
9
|
Moriguchi S, Takamiya A, Noda Y, Horita N, Wada M, Tsugawa S, Plitman E, Sano Y, Tarumi R, ElSalhy M, Katayama N, Ogyu K, Miyazaki T, Kishimoto T, Graff-Guerrero A, Meyer JH, Blumberger DM, Daskalakis ZJ, Mimura M, Nakajima S. Glutamatergic neurometabolite levels in major depressive disorder: a systematic review and meta-analysis of proton magnetic resonance spectroscopy studies. Mol Psychiatry 2019; 24:952-964. [PMID: 30315224 PMCID: PMC6755980 DOI: 10.1038/s41380-018-0252-9] [Citation(s) in RCA: 191] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/13/2018] [Accepted: 08/10/2018] [Indexed: 12/22/2022]
Abstract
Alterations in glutamatergic neurotransmission are implicated in the pathophysiology of depression, and the glutamatergic system represents a treatment target for depression. To summarize the nature of glutamatergic alterations in patients with depression, we conducted a meta-analysis of proton magnetic resonance (1H-MRS) spectroscopy studies examining levels of glutamate. We used the search terms: depress* AND (MRS OR "magnetic resonance spectroscopy"). The search was performed with MEDLINE, Embase, and PsycINFO. The inclusion criteria were 1H-MRS studies comparing levels of glutamate + glutamine (Glx), glutamate, or glutamine between patients with depression and healthy controls. Standardized mean differences (SMD) were calculated to assess group differences in the levels of glutamatergic neurometabolites. Forty-nine studies met the eligibility criteria, which included 1180 patients and 1066 healthy controls. There were significant decreases in Glx within the medial frontal cortex (SMD = -0.38; 95% CI, -0.69 to -0.07) in patients with depression compared with controls. Subanalyses revealed that there was a significant decrease in Glx in the medial frontal cortex in medicated patients with depression (SMD = -0.50; 95% CI, -0.80 to -0.20), but not in unmedicated patients (SMD = -0.27; 95% CI, -0.76 to 0.21) compared with controls. Overall, decreased levels of glutamatergic metabolites in the medial frontal cortex are linked with the pathophysiology of depression. These findings are in line with the hypothesis that depression may be associated with abnormal glutamatergic neurotransmission.
Collapse
Affiliation(s)
- Sho Moriguchi
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan ,0000 0001 2157 2938grid.17063.33Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Akihiro Takamiya
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| | - Nobuyuki Horita
- 0000 0001 1033 6139grid.268441.dDepartment of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masataka Wada
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sakiko Tsugawa
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Eric Plitman
- 0000 0001 2157 2938grid.17063.33Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Yasunori Sano
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Tarumi
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Muhammad ElSalhy
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Nariko Katayama
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kamiyu Ogyu
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Miyazaki
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taishiro Kishimoto
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ariel Graff-Guerrero
- 0000 0001 2157 2938grid.17063.33Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Jeffrey H. Meyer
- 0000 0001 2157 2938grid.17063.33Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Daniel M. Blumberger
- 0000 0001 2157 2938grid.17063.33Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Zafiris J. Daskalakis
- 0000 0001 2157 2938grid.17063.33Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Masaru Mimura
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Nakajima
- 0000 0004 1936 9959grid.26091.3cDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan ,0000 0001 2157 2938grid.17063.33Research Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| |
Collapse
|
10
|
Godfrey KEM, Gardner AC, Kwon S, Chea W, Muthukumaraswamy SD. Differences in excitatory and inhibitory neurotransmitter levels between depressed patients and healthy controls: A systematic review and meta-analysis. J Psychiatr Res 2018; 105:33-44. [PMID: 30144668 DOI: 10.1016/j.jpsychires.2018.08.015] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 12/14/2022]
Abstract
Dysfunction of gamma-aminobutyric acid (GABA) and/or glutamate neurotransmitter systems have increasingly been implicated in the aetiology of Major Depressive Disorder (MDD). It has been proposed that alterations in GABA and/or glutamate result in an imbalance of inhibition and excitation. In a review of the current literature, we identified studies using Magnetic Resonance Spectroscopy (MRS) to examine the neurotransmitters GABA, glutamate, and the composite glutamate/glutamine measure Glx in patients diagnosed with MDD and healthy controls. Results showed patients with MDD had significantly lower GABA levels compared to controls (-0.35 [-0.61,-0.10], p = 0.007). No significant difference was found between levels of glutamate. Sub-analyses were performed, including only studies where the Anterior Cingulate Cortex (ACC) was the region of interest. GABA and Glx levels were lower in the ACC of MDD patients (-0.56 [-0.93,-0.18] p = 0.004, and 0.40 [-0.81,0.01] p = 0.05). This review indicates widespread cortical reduction of GABA in MDD, with a trend towards a localised reduction of Glx in the ACC. However, given both GABA and glutamate appear decreased a simple interpretation in terms of an imbalance of overall excitation-inhibition is not feasible.
Collapse
Affiliation(s)
- Kate E M Godfrey
- The University of Auckland, School of Pharmacy, 85 Park Road, Auckland, 1023, New Zealand.
| | - Abby C Gardner
- The University of Auckland, School of Pharmacy, 85 Park Road, Auckland, 1023, New Zealand
| | - Sarah Kwon
- The University of Auckland, School of Pharmacy, 85 Park Road, Auckland, 1023, New Zealand
| | - William Chea
- The University of Auckland, School of Pharmacy, 85 Park Road, Auckland, 1023, New Zealand
| | | |
Collapse
|
11
|
Brain Metabolite Changes in the Anterior Cingulate Cortex of Chronic Low Back Pain Patients and Correlations Between Metabolites and Psychological State. Clin J Pain 2018; 34:657-663. [DOI: 10.1097/ajp.0000000000000583] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
12
|
Wickens MM, Bangasser DA, Briand LA. Sex Differences in Psychiatric Disease: A Focus on the Glutamate System. Front Mol Neurosci 2018; 11:197. [PMID: 29922129 PMCID: PMC5996114 DOI: 10.3389/fnmol.2018.00197] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/18/2018] [Indexed: 12/21/2022] Open
Abstract
Alterations in glutamate, the primary excitatory neurotransmitter in the brain, are implicated in several psychiatric diseases. Many of these psychiatric diseases display epidemiological sex differences, with either males or females exhibiting different symptoms or disease prevalence. However, little work has considered the interaction of disrupted glutamatergic transmission and sex on disease states. This review describes the clinical and preclinical evidence for these sex differences with a focus on two conditions that are more prevalent in women: Alzheimer's disease and major depressive disorder, and three conditions that are more prevalent in men: schizophrenia, autism spectrum disorder, and attention deficit hyperactivity disorder. These studies reveal sex differences at multiple levels in the glutamate system including metabolic markers, receptor levels, genetic interactions, and therapeutic responses to glutamatergic drugs. Our survey of the current literature revealed a considerable need for more evaluations of sex differences in future studies examining the role of the glutamate system in psychiatric disease. Gaining a more thorough understanding of how sex differences in the glutamate system contribute to psychiatric disease could provide novel avenues for the development of sex-specific pharmacotherapies.
Collapse
Affiliation(s)
- Megan M Wickens
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, United States
| | - Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, United States.,Neuroscience Program, Temple University, Philadelphia, PA, United States
| | - Lisa A Briand
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, United States.,Neuroscience Program, Temple University, Philadelphia, PA, United States
| |
Collapse
|
13
|
Correlations between working memory impairment and neurometabolites of prefrontal cortex and lenticular nucleus in patients with major depressive disorder. J Affect Disord 2018; 227:236-242. [PMID: 29102838 DOI: 10.1016/j.jad.2017.10.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/06/2017] [Accepted: 10/19/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND The mechanism of working memory (WM) impairment in MDD remains unclear. We aimed to find out the mechanism by using neuropsychological tests and proton magnetic resonance spectroscopy (1H-MRS). METHODS 31 MDD patients and 31 healthy controls were recruited in our study. The WM performance and neurometabolite ratios of prefrontal cortex (PFC) and lenticular nucleus (LN) between two groups were evaluated and compared. And the correlations between abnormal neurometabolite ratios and WM dysfunction were computed. RESULTS Scores of SDMT, DST(forwards), VRS and 2-back Task(accuracy rate) in MDD were lower than HCs. NAA/Cr ratios of bilateral PFC in MDD were significantly lower than HCs, while no significant differences showed in NAA/Cr ratios of LN and Cho/Cr, mI/Cr values of the bilateral PFC and LN between two groups. And for MDD patients, NAA/Cr ratios in the right PFC were positively correlated with scores of DST (Forwards). CONCLUSIONS Our findings suggest that depressed patients may have impairments in working memory, including phonological loop, visual-spatial sketchpad, episodic buffer and central executive. And the impairment of verbal WM and WM capacity may be associated with the abnormal neurometabolites in the right PFC.
Collapse
|
14
|
Riley CA, Renshaw PF. Brain choline in major depression: A review of the literature. Psychiatry Res Neuroimaging 2018; 271:142-153. [PMID: 29174766 DOI: 10.1016/j.pscychresns.2017.11.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/03/2017] [Accepted: 11/13/2017] [Indexed: 12/18/2022]
Abstract
The focus of this review is to provide a synthesis of the current literature on the role of brain choline, as measured by proton magnetic resonance spectroscopy (1H-MRS), in major depressive disorder (MDD). The most recent 1H-MRS literature review took place over 10 years ago and, reflecting the high level of research on this topic, much has been learned since then. Higher brain choline levels have been linked to an increase in depression, and a cholinergic model for MDD development has been postulated. However, current 1H-MRS studies have been inconclusive regarding the role of choline in depression. Data from eighty-six peer-reviewed studies were analyzed for a random-effects model meta-analysis. Two significant findings are reported. Papers that did not report segmentation had a significant, moderate effect size. Higher choline concentrations in the frontal lobe were found in depressed patients, both in those who responded to treatment and those who did not, after treatment with psychiatric medication, repetitive transcranial magnetic stimulation, or electroconvulsive therapy. Findings from this review may add to existing information regarding the role of brain choline in MDD. This may provide a future target for treatment and drug development. It also may serve as a biomarker for treatment progress.
Collapse
Affiliation(s)
- Colin A Riley
- University of Utah, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT, USA; Rocky Mountain MIRECC, Department of Veterans Affairs, 500 Foothill Drive, Salt Lake City, UT, USA.
| | - Perry F Renshaw
- University of Utah, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT, USA; Rocky Mountain MIRECC, Department of Veterans Affairs, 500 Foothill Drive, Salt Lake City, UT, USA
| |
Collapse
|
15
|
Mathias LK, Monette PJ, Harper DG, Forester BP. Application of magnetic resonance spectroscopy in geriatric mood disorders. Int Rev Psychiatry 2017; 29:597-617. [PMID: 29199890 DOI: 10.1080/09540261.2017.1397608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The prevalence of mood disorders in the rapidly-growing older adult population merits attention due to the likelihood of increased medical comorbidities, risk of hospitalization or institutionalization, and strains placed on caregivers and healthcare providers. Magnetic resonance spectroscopy (MRS) quantifies biochemical compounds in vivo, and has been used specifically for analyses of neural metabolism and bioenergetics in older adults with mood disorders, usually via proton or phosphorous spectroscopy. While yet to be clinically implemented, data gathered from research subjects may help indicate potential biomarkers of disease state or trait or putative drug targets. Three prevailing hypotheses for these mood disorders are used as a framework for the present review, and the current biochemical findings within each are discussed with respect to particular metabolites and brain regions. This review covers studies of MRS in geriatric mood disorders and reveals persisting gaps in research knowledge, especially with regard to older age bipolar disorder. Further MRS work, using higher field strengths and larger sample sizes, is warranted in order to better understand the neurobiology of these prevalent late-life disorders.
Collapse
Affiliation(s)
- Liana K Mathias
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA
| | - Patrick J Monette
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA
| | - David G Harper
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA.,b Department of Psychiatry , Harvard Medical School , Boston , MA , USA
| | - Brent P Forester
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA.,b Department of Psychiatry , Harvard Medical School , Boston , MA , USA
| |
Collapse
|
16
|
Bogner W, Hangel G, Esmaeili M, Andronesi OC. 1D-spectral editing and 2D multispectral in vivo 1H-MRS and 1H-MRSI - Methods and applications. Anal Biochem 2017; 529:48-64. [PMID: 28034791 DOI: 10.1016/j.ab.2016.12.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 12/16/2016] [Accepted: 12/23/2016] [Indexed: 12/27/2022]
Abstract
This article reviews the methodological aspects of detecting low-abundant J-coupled metabolites via 1D spectral editing techniques and 2D nuclear magnetic resonance (NMR) methods applied in vivo, in humans, with a focus on the brain. A brief explanation of the basics of J-evolution will be followed by an introduction to 1D spectral editing techniques (e.g., J-difference editing, multiple quantum coherence filtering) and 2D-NMR methods (e.g., correlation spectroscopy, J-resolved spectroscopy). Established and recently developed methods will be discussed and the most commonly edited J-coupled metabolites (e.g., neurotransmitters, antioxidants, onco-markers, and markers for metabolic processes) will be briefly summarized along with their most important applications in neuroscience and clinical diagnosis.
Collapse
Affiliation(s)
- Wolfgang Bogner
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria.
| | - Gilbert Hangel
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria.
| | - Morteza Esmaeili
- Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| | - Ovidiu C Andronesi
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| |
Collapse
|
17
|
Mohamed RE, Aboelsafa AA. Multivoxel proton magnetic resonance spectroscopy detects thalamic neurochemical metabolic changes in patients with major depressive disorder. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
18
|
Ludka FK, Dal-Cim T, Binder LB, Constantino LC, Massari C, Tasca CI. Atorvastatin and Fluoxetine Prevent Oxidative Stress and Mitochondrial Dysfunction Evoked by Glutamate Toxicity in Hippocampal Slices. Mol Neurobiol 2016; 54:3149-3161. [DOI: 10.1007/s12035-016-9882-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Accepted: 03/21/2016] [Indexed: 01/04/2023]
|
19
|
Mao N, Fang J, Xie H, Liu X, Jiang X, Wang G, Cui M, Wang B, Liu Q. Correlation between neurochemical metabolism and memory function in adolescent patients with depression: A multi-voxel ¹H magnetic resonance spectroscopy study. Psychiatry Clin Neurosci 2016; 70:167-74. [PMID: 26556039 DOI: 10.1111/pcn.12372] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 11/02/2015] [Accepted: 11/07/2015] [Indexed: 12/21/2022]
Abstract
AIMS We utilized multi-voxel proton magnetic resonance spectroscopy ((1)H-MRS) to detect biochemical abnormalities in dorsolateral prefrontal white matter and anterior cingulate gray matter and to determine the correlation of biochemical changes with memory function in depressed adolescents. METHODS A total of 24 depressed patients and 23 healthy controls were enrolled in this study. MRS was performed to assess the N-acetylaspartate (NAA)/creatine Cr and choline (Cho)/Cr ratios in dorsolateral prefrontal white matter and anterior cingulate gray matter of participants. Memory function was measured on the basis of Wechsler Memory Scale scores, and depression was diagnosed on the basis of clinical observation, interview, and Hamilton Depression Rating Scale scores. RESULTS Compared with controls, depressed patients had significantly lower NAA/Cr and Cho/Cr ratios in left dorsolateral prefrontal white matter and lower NAA/Cr ratios in right dorsolateral prefrontal white matter (P < 0.05). No biochemical differences were identified in the bilateral anterior cingulate gray matter between the two groups. Nevertheless, the depressed patients showed significantly lower memory quotient than controls (P < 0.05). The NAA/Cr ratio in dorsolateral prefrontal white matter positively correlated with memory quotient (left: P < 0.01; right: P < 0.05). CONCLUSIONS These findings suggest that biochemical abnormalities in prefrontal white matter are involved in the pathophysiology of adolescent depression. In particular, such abnormalities are already present at the early stage of the disorder, and low NAA/Cr in bilateral anterior frontal white matter may be associated with memory impairment and related neuropathology.
Collapse
Affiliation(s)
- Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, China
| | | | - Haizhu Xie
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, China
| | | | | | - Guangbin Wang
- Shandong Medical Imaging Research Institute, Shan Dong University, Jinan, China
| | - Minghu Cui
- Binzhou Medical University, Yantai, China
| | - Bin Wang
- Binzhou Medical University, Yantai, China
| | - Qiang Liu
- Shandong Medical Imaging Research Institute, Shan Dong University, Jinan, China
| |
Collapse
|
20
|
Jayaweera HK, Lagopoulos J, Duffy SL, Lewis SJG, Hermens DF, Norrie L, Hickie IB, Naismith SL. Spectroscopic markers of memory impairment, symptom severity and age of onset in older people with lifetime depression: Discrete roles of N-acetyl aspartate and glutamate. J Affect Disord 2015; 183:31-8. [PMID: 26000754 DOI: 10.1016/j.jad.2015.04.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 04/10/2015] [Accepted: 04/10/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Glutamate (Glu) and N-acetyl aspartate (NAA) are markers of excitatory processes and neuronal compromise respectively. Increased Glu and decreased NAA concentrations have been implicated in the pathophysiology of depression and cognitive impairment respectively. OBJECTIVE To determine the relationship between NAA, Glu, memory and key clinical features in older people with lifetime depression compared to comparison subjects. METHOD Thirty-five health-seeking older adults (mean age=63.57 years), with a lifetime depression diagnosis, and 21 age-matched healthy comparison subjects (mean age=65.48 years) underwent neuropsychological testing, psychiatric assessment and proton magnetic resonance spectroscopy from which Glu and NAA were measured (reported as a ratio to creatine). RESULTS Compared to comparison subjects, the depressed subjects showed poorer verbal learning and memory retention. Hippocampal NAA and Glu did not differ significantly between groups. However, in comparison subjects, lower levels of hippocampal Glu were associated with poorer memory retention (r=0.55, p=0.018). In the depressed subjects, lower levels of hippocampal NAA were related to poorer verbal learning (r=0.44, p=0.008) and memory retention (r=0.41, p=0.018). Greater hippocampal Glu was associated with more severe depressive symptoms (r=0.35, p=0.039) and an earlier age of illness onset (r=-0.37, p=0.031). LIMITATIONS This is a cross sectional study with a heterogeneous group of depressed subjects. CONCLUSION Our findings highlight that hippocampal neurometabolites are entwined with both clinical and cognitive features associated with depression in older adults and further suggest that differential mechanisms may underpin these features.
Collapse
Affiliation(s)
- Hirosha K Jayaweera
- Healthy Brain Ageing Program, Brain & Mind Research Institute, University of Sydney NSW Australia; Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, Brain & Mind Research Institute, University of Sydney NSW Australia; Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia; School of Psychology, University of Sydney NSW Australia
| | - Simon J G Lewis
- Healthy Brain Ageing Program, Brain & Mind Research Institute, University of Sydney NSW Australia; Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia
| | - Louisa Norrie
- Healthy Brain Ageing Program, Brain & Mind Research Institute, University of Sydney NSW Australia; Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia
| | - Ian B Hickie
- Healthy Brain Ageing Program, Brain & Mind Research Institute, University of Sydney NSW Australia; Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain & Mind Research Institute, University of Sydney NSW Australia; Clinical Research Unit, Brain & Mind Research Institute, University of Sydney NSW Australia; School of Psychology, University of Sydney NSW Australia.
| |
Collapse
|
21
|
Age-related increases in basal ganglia glutamate are associated with TNF, reduced motivation and decreased psychomotor speed during IFN-alpha treatment: Preliminary findings. Brain Behav Immun 2015; 46:17-22. [PMID: 25500218 PMCID: PMC4414678 DOI: 10.1016/j.bbi.2014.12.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/09/2014] [Accepted: 12/02/2014] [Indexed: 12/31/2022] Open
Abstract
Inflammation-induced alterations in central nervous system (CNS) metabolism have focused on glutamate. At excessive concentrations, glutamate is toxic to glia and neurons, and inflammatory cytokines have been shown to influence glutamate turnover by blocking glutamate reuptake and increasing glutamate release. Increased glutamate has also been found in depression, a disorder associated with increased inflammation. Data by our group have shown increased glutamate as measured by magnetic resonance spectroscopy (MRS) in basal ganglia and dorsal anterior cingulate cortex of patients administered the inflammatory cytokine interferon (IFN)-alpha. Given data that increasing age is associated with an exaggerated CNS inflammatory response, we examined whether older age (>55years) would be associated with a greater IFN-alpha-induced increase in CNS glutamate. Using a longitudinal design, 31 patients with hepatitis C virus (HCV) underwent MRS, blood sampling for inflammatory markers, and behavioral assessments before (Visit 1) and after 4weeks (Visit 2) of either IFN-alpha (n=17) or no treatment (n=14). Older patients treated with IFN-alpha exhibited a significantly greater increase in glutamate from Visit 1 to Visit 2 as reflected by the glutamate/creatine ratio (Glu/Cr) in left basal ganglia compared to older controls and younger IFN-alpha-treated and untreated subjects. In addition, increased Glu/Cr in older but not younger IFN-alpha-treated and untreated patients was associated with increased tumor necrosis factor, reduced motivation as measured by the Multidimensional Fatigue Inventory and increased choice movement time on the Cambridge Neuropsychological Test Automated Battery. Taken together, these preliminary data support the notion that older age may interact with inflammation to exaggerate the effects of inflammatory stimuli on CNS glutamate and behavior.
Collapse
|
22
|
Holston EC. Describing brain activity of persons with AD and depressive symptoms. Arch Psychiatr Nurs 2014; 28:413-9. [PMID: 25457693 DOI: 10.1016/j.apnu.2014.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/30/2014] [Accepted: 09/01/2014] [Indexed: 11/18/2022]
Abstract
The purpose of this retrospective pilot study was to characterize depression of AD using electrophysiological changes in the brain activity of persons with AD and depressive symptoms. Participants had a mean age of 70.12±12.68. Participants manifested an increase in absolute/relative theta activity (p=.000) over entire brain when compared to normative population-based database. Electrophysiological changes did not differ by age or gender except for increased absolute theta activity in the right lateral frontal areas (t-test=-2.31 to -2.39, p=.04) in females. An increased theta activity suggests that depressive symptoms may be part of AD symptomatology, not a co-morbid feature.
Collapse
Affiliation(s)
- Ezra C Holston
- University of Tennessee-Knoxville College of Nursing, Knoxville, TN.
| |
Collapse
|
23
|
Lirng JF, Chen HC, Fuh JL, Tsai CF, Liang JF, Wang SJ. Increased myo-inositol level in dorsolateral prefrontal cortex in migraine patients with major depression. Cephalalgia 2014; 35:702-9. [DOI: 10.1177/0333102414557048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 10/04/2014] [Indexed: 11/17/2022]
Abstract
Background Although the comorbidity between migraine and major depressive disorder (MDD) has been recognized, the pathophysiology remains unclear. The dorsolateral prefrontal cortex (DLPFC) is a well-known neural substrate for MDD. We investigated the relationship between brain metabolites in DLPFC and comorbid MDD in migraine patients. Methods We recruited migraine patients from a tertiary headache clinic. A board-certified psychiatrist conducted a structured interview for MDD diagnosis. The severity of depression was evaluated by the Beck Depression Inventory (BDI). Thirty migraine patients (five men, 25 women; mean age: 40.4 ± 12.4 years) completed the study, and 16 of them were diagnosed with MDD. All patients underwent a magnetic resonance spectroscopy (MRS) examination focusing on bilateral DLPFC. The ratios of N-acetylaspartate (NAA), choline (Cho), and myo-inositol (mI) to total creatine (tCr) were compared between migraine patients with and without MDD, and were correlated with BDI scores. Results Relative to patients without MDD, migraine patients with MDD had higher mI/tCr ratios in the bilateral DLPFC ( p = 0.02, left; p = 0.02, right, Mann-Whitney U test). The mI/tCr ratios in the right DLPFC were positively correlated with BDI scores ( r = 0.52, p = 0.003). The NAA/tCr and Cho/tCr ratios did not differ between migraine patients with and without MDD. Conclusion Increased mI/tCr within the DLPFC might be associated with the presence of MDD in migraine patients.
Collapse
Affiliation(s)
- Jiing-Feng Lirng
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taiwan
| | - Hung-Chieh Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan
- Department of Radiology, Taichung Veterans General Hospital, Taiwan
| | - Jong-Ling Fuh
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan
- Brain Research Center, National Yang-Ming University, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
| | - Chia-Fen Tsai
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
| | - Jen-Feng Liang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
| | - Shuu-Jiun Wang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan
- Brain Research Center, National Yang-Ming University, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taiwan
| |
Collapse
|
24
|
Bogdanova OV, Abdullah O, Kanekar S, Bogdanov VB, Prescot AP, Renshaw PF. Neurochemical alterations in frontal cortex of the rat after one week of hypobaric hypoxia. Behav Brain Res 2014; 263:203-9. [PMID: 24486259 PMCID: PMC4699295 DOI: 10.1016/j.bbr.2014.01.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 01/16/2014] [Accepted: 01/20/2014] [Indexed: 12/16/2022]
Abstract
Residing at high altitude may lead to reduced blood oxygen saturation in the brain and altered metabolism in frontal cortical brain areas, probably due to chronic hypobaric hypoxia. These changes may underlie the increased rates of depression and suicidal behavior that have been associated with life at higher altitudes. To test the hypothesis that hypobaric hypoxia is responsible for development of mood disorders due to alterations in neurochemistry, we assessed depression-like behavior in parallel to levels of brain metabolites in rats housed at simulated altitude. 32 female Sprague Dawley rats were housed either in a hypobaric hypoxia chamber at 10,000 ft of simulated altitude for 1 week or at local conditions (4500 ft of elevation in Salt Lake City, Utah). Depression-like behavior was assessed using the forced swim test (FST) and levels of neurometabolites were estimated by in vivo proton magnetic resonance spectroscopy in the frontal cortex, the striatum and the hippocampus at baseline and after a week of exposure to hypobaric hypoxia. After hypoxia exposure the animals demonstrated increased immobility behavior and shortened latency to immobility in the FST. Elevated ratios of myo-inositol, glutamate, and the sum of myo-inositol and glycine to total creatine were observed in the frontal cortex of hypoxia treated rats. A decrease in the ratio of alanine to total creatine was also noted. This study shows that hypoxia induced alterations in frontal lobe brain metabolites, aggravated depression-like behavior and might be a factor in increased rates of psychiatric disorders observed in populations living at high altitudes.
Collapse
Affiliation(s)
- Olena V Bogdanova
- Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City 84108, UT USA.
| | - Osama Abdullah
- Department of Bioengineering, University of Utah, 36 S. Wasatch Drive, Salt Lake City 84112, UT USA
| | - Shami Kanekar
- Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City 84108, UT USA; Psychiatry Department, University of Utah, 383 Colorow Drive, Salt Lake City 84108, UT USA
| | - Volodymyr B Bogdanov
- INRA, Nutrition et Neurobiologie Intégrée and University Bordeaux, Nutrition et Neurobiologie Intégrée, UMR 1286, 146 rue Léo-Saignat, Bordeaux Cedex 33076, France
| | - Andrew P Prescot
- Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City 84108, UT USA; Department of Radiology, University of Utah, 30 North 1900 East, Salt Lake City 84132, UT USA
| | - Perry F Renshaw
- Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City 84108, UT USA; Psychiatry Department, University of Utah, 383 Colorow Drive, Salt Lake City 84108, UT USA; VISN19 MIRECC Salt Lake City UAMC, 500 Foothill Drive, Salt Lake City 84148, UT USA
| |
Collapse
|
25
|
Jun C, Choi Y, Lim SM, Bae S, Hong YS, Kim JE, Lyoo IK. Disturbance of the glutamatergic system in mood disorders. Exp Neurobiol 2014; 23:28-35. [PMID: 24737937 PMCID: PMC3984954 DOI: 10.5607/en.2014.23.1.28] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 02/24/2014] [Accepted: 02/24/2014] [Indexed: 12/11/2022] Open
Abstract
The role of glutamatergic system in the neurobiology of mood disorders draws increasing attention, as disturbance of this system is consistently implicated in mood disorders including major depressive disorder and bipolar disorder. Thus, the glutamate hypothesis of mood disorders is expected to complement and improve the prevailing monoamine hypothesis, and may indicate novel therapeutic targets. Since the contribution of astrocytes is found to be crucial not only in the modulation of the glutamatergic system but also in the maintenance of brain energy metabolism, alterations in the astrocytic function and neuroenergetic environment are suggested as the potential neurobiological underpinnings of mood disorders. In the present review, the evidence of glutamatergic abnormalities in mood disorders based on postmortem and magnetic resonance spectroscopy (MRS) studies is presented, and disrupted energy metabolism involving astrocytic dysfunction is proposed as the underlying mechanism linking altered energy metabolism, perturbations in the glutamatergic system, and pathogenesis of mood disorders.
Collapse
Affiliation(s)
- Chansoo Jun
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 120-750, Korea. ; Ewha Brain Institute, Ewha Womans University, Seoul 120-750, Korea
| | - Yera Choi
- Ewha Brain Institute, Ewha Womans University, Seoul 120-750, Korea. ; Interdisciplinary Program in Neuroscience, Seoul National University College of Natural Sciences, Seoul 151-747, Korea
| | - Soo Mee Lim
- Ewha Brain Institute, Ewha Womans University, Seoul 120-750, Korea. ; Department of Radiology, Ewha Womans University College of Medicine, Seoul 158-710, Korea
| | - Sujin Bae
- Brain Institute and Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah 84112, USA
| | - Young Sun Hong
- Ewha Brain Institute, Ewha Womans University, Seoul 120-750, Korea. ; Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 158-710, Korea
| | - Jieun E Kim
- Ewha Brain Institute, Ewha Womans University, Seoul 120-750, Korea. ; Department of Brain and Cognitive Sciences, Ewha Womans University Graduate School, Seoul 120-750, Korea
| | - In Kyoon Lyoo
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 120-750, Korea. ; Ewha Brain Institute, Ewha Womans University, Seoul 120-750, Korea
| |
Collapse
|
26
|
Reynolds S, Carrey N, Jaworska N, Langevin LM, Yang XR, MacMaster FP. Cortical thickness in youth with major depressive disorder. BMC Psychiatry 2014; 14:83. [PMID: 24645731 PMCID: PMC3994552 DOI: 10.1186/1471-244x-14-83] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 03/05/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies in adults with major depressive disorder (MDD) have implicated dysregulation of frontal-limbic circuits in the symptomology of this disorder. We hypothesized that the middle frontal gyrus (MFG; a core portion of the dorsolateral prefrontal cortex or DLPFC) and the anterior cingulate (caudal), regions implicated in emotive and cognitive control, would display a reduced cortical thickness in youth with MDD as compared to healthy, non-depressed adolescents. METHODS Sixteen healthy control adolescents (17.19 ± 1.87 years; 7 males, 9 females) and thirty MDD participants (16.89 ± 2.01 years; 9 males, 21 females) underwent magnetic resonance imaging (MRI). Cortical thickness analysis was carried out using FreeSurfer software. RESULTS Counter to our hypothesis, we observed thicker right and left rostral MFG in MDD adolescents as compared to controls (p = 0.004 and p = 0.005, respectively). Furthermore, the left caudal anterior cingulate cortex was thicker in MDD subjects as compared to controls (p = 0.009). In MDD subjects, there was a significant inverse correlation between age and left MFG thickness (r = -0.45, p = 0.001). CONCLUSIONS These results have implications for the developmental trajectory of the frontal lobe in adolescent MDD. The MFG is implicated in the frontal-limbic circuits underlying executive functioning and their interaction with affective processing. Alterations in this region are likely involved with the symptoms of MDD. Limitations include a small sample size and cross sectional design.
Collapse
Affiliation(s)
- Stephanie Reynolds
- Department of Psychiatry, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada,Department of Pediatrics, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| | - Normand Carrey
- Department of Psychiatry, Dalhousie University, Halifax NS, Canada
| | - Natalia Jaworska
- Department of Psychiatry, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada,Department of Pediatrics, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| | - Lisa Marie Langevin
- Department of Psychiatry, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada,Department of Pediatrics, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| | - Xiao-Ru Yang
- Department of Psychiatry, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada,Department of Pediatrics, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| | - Frank P MacMaster
- Department of Psychiatry, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada,Department of Pediatrics, University of Calgary, Behavioral Research Unit, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| |
Collapse
|
27
|
Sözeri-Varma G, Kalkan-Oğuzhanoglu N, Efe M, Kıroglu Y, Duman T. Neurochemical metabolites in prefrontal cortex in patients with mild/moderate levels in first-episode depression. Neuropsychiatr Dis Treat 2013; 9:1053-9. [PMID: 23976854 PMCID: PMC3747025 DOI: 10.2147/ndt.s42627] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous studies have determined the neurochemical metabolite abnormalities in major depressive disorder (MDD). The results of studies are inconsistent. Severity of depression may relate to neurochemical metabolic changes. The aim of this study is to investigate neurochemical metabolite levels in the prefrontal cortex (PFC) of patients with mild/moderate MDD. METHODS Twenty-one patients with mild MDD, 18 patients with moderate MDD, and 16 matched control subjects participated in the study. Patients had had their first episode. They had not taken treatment. The severity of depression was assessed by the Hamilton Rating Scale for Depression (HAM-D). Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho), and creatine-containing compounds (Cr) were measured using proton magnetic resonance spectroscopy (1H-MRS) at 1.5 T, with an 8-cm(3) single voxel placed in the right PFC. RESULTS The moderate MDD patients had lower NAA/Cr levels than the control group. No differences were found in neurochemical metabolite levels between the mild MDD and control groups. No correlation was found between the patients' neurochemical metabolite levels and HAM-D scores. CONCLUSION Our findings suggest that NAA/Cr levels are low in moderate-level MDD in the PFC. Neurochemical metabolite levels did not change in mild depressive disorder. Our results suggest that the severity of depression may affect neuronal function and viability. Studies are needed to confirm this finding, including studies on severely depressive patients.
Collapse
|
28
|
GluA1 and its PDZ-interaction: a role in experience-dependent behavioral plasticity in the forced swim test. Neurobiol Dis 2012; 52:160-7. [PMID: 23262314 DOI: 10.1016/j.nbd.2012.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 12/05/2012] [Accepted: 12/08/2012] [Indexed: 01/10/2023] Open
Abstract
Glutamate receptor dependent synaptic plasticity plays an important role in the pathophysiology of depression. Hippocampal samples from clinically depressed patients display reduced mRNA levels for GluA1, a major subunit of AMPA receptors. Moreover, activation and synaptic incorporation of GluA1-containing AMPA receptors are required for the antidepressant-like effects of NMDA receptor antagonists. These findings argue that GluA1-dependent synaptic plasticity might be critically involved in the expression of depression. Using an animal model of depression, we demonstrate that global or hippocampus-selective deletion of GluA1 impairs expression of experience-dependent behavioral despair. This impairment is mediated by the interaction of GluA1 with PDZ-binding domain proteins, as deletion of the C-terminal leucine alone is sufficient to replicate the behavioral phenotype. Our results provide evidence for a significant role of hippocampal GluA1-containing AMPA receptors and their PDZ-interaction in experience-dependent expression of behavioral despair and link mechanisms of hippocampal synaptic plasticity with behavioral expression of depression.
Collapse
|
29
|
Abdallah CG, Coplan JD, Jackowski A, Sato JR, Mao X, Shungu DC, Mathew SJ. Riluzole effect on occipital cortex: a structural and spectroscopy pilot study. Neurosci Lett 2012; 530:103-7. [PMID: 23043888 DOI: 10.1016/j.neulet.2012.09.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 09/25/2012] [Accepted: 09/27/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND To investigate the mechanism underlying the anxiolytic properties of riluzole, a glutamate-modulating agent, we previously studied the effect of this drug on hippocampal N-acetylaspartate (NAA) and volume in patients with generalized anxiety disorder (GAD). In the same cohort, we now extend our investigation to the occipital cortex, a brain region that was recently implicated in the antidepressant effect of riluzole. METHODS Fourteen medication-free adult patients with GAD received 8-week of open-label riluzole. Ten healthy subjects served as a comparison group. The healthy group did not receive riluzole treatment. Both groups underwent magnetic resonance imaging and spectroscopy at baseline and at the end of Week 8. Hamilton Anxiety Rating Scale (HAM-A) and Penn State Worry Questionnaire (PSWQ) were used as the primary and secondary outcome measures, respectively. RESULTS At baseline, we found clusters of increased cortical thickness in the occipital region in GAD compared to healthy subjects. In the right hemisphere, 8 weeks of treatment reduced occipital cortical thickness in the GAD group (t=3.67, p=0.004). In addition, the improvement in HAM-A scores was negatively correlated with post-treatment right occipital NAA (r=-0.68, p=0.008), and with changes in NAA levels (r=-0.53, p=0.051). In the left hemisphere, we found positive associations between changes in occipital cortical thickness and improvement in HAM-A (r=0.60, p=0.04) and PSWQ (r=0.62, p=0.03). CONCLUSION These pilot findings implicate the occipital cortex as a brain region associated with pathology and clinical improvement in GAD. In addition, the region specific effect of riluzole implies a distinct pathophysiology in the occipital cortex - compared to other, previously studied, frontolimbic brain structures.
Collapse
Affiliation(s)
- Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
| | | | | | | | | | | | | |
Collapse
|
30
|
Maddock RJ, Buonocore MH. MR spectroscopic studies of the brain in psychiatric disorders. Curr Top Behav Neurosci 2012; 11:199-251. [PMID: 22294088 DOI: 10.1007/7854_2011_197] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The measurement of brain metabolites with magnetic resonance spectroscopy (MRS) provides a unique perspective on the brain bases of neuropsychiatric disorders. As a context for interpreting MRS studies of neuropsychiatric disorders, we review the characteristic MRS signals, the metabolic dynamics,and the neurobiological significance of the major brain metabolites that can be measured using clinical MRS systems. These metabolites include N-acetylaspartate(NAA), creatine, choline-containing compounds, myo-inositol, glutamate and glutamine, lactate, and gamma-amino butyric acid (GABA). For the major adult neuropsychiatric disorders (schizophrenia, bipolar disorder, major depression, and the anxiety disorders), we highlight the most consistent MRS findings, with an emphasis on those with potential clinical or translational significance. Reduced NAA in specific brain regions in schizophrenia, bipolar disorder, post-traumatic stress disorder, and obsessive–compulsive disorder corroborate findings of reduced brain volumes in the same regions. Future MRS studies may help determine the extent to which the neuronal dysfunction suggested by these findings is reversible in these disorders. Elevated glutamate and glutamine (Glx) in patients with bipolar disorder and reduced Glx in patients with unipolar major depression support models of increased and decreased glutamatergic function, respectively, in those conditions. Reduced phosphomonoesters and intracellular pH in bipolar disorder and elevated dynamic lactate responses in panic disorder are consistent with metabolic models of pathogenesis in those disorders. Preliminary findings of an increased glutamine/glutamate ratio and decreased GABA in patients with schizophrenia are consistent with a model of NMDA hypofunction in that disorder. As MRS methods continue to improve, future studies may further advance our understanding of the natural history of psychiatric illnesses, improve our ability to test translational models of pathogenesis, clarify therapeutic mechanisms of action,and allow clinical monitoring of the effects of interventions on brain metabolicmarkers
Collapse
|
31
|
Gabbay V, Mao X, Klein RG, Ely BA, Babb JS, Panzer AM, Alonso CM, Shungu DC. Anterior cingulate cortex γ-aminobutyric acid in depressed adolescents: relationship to anhedonia. ACTA ACUST UNITED AC 2011; 69:139-49. [PMID: 21969419 DOI: 10.1001/archgenpsychiatry.2011.131] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Anhedonia, a core symptom of major depressive disorder (MDD) and highly variable among adolescents with MDD, may involve alterations in the major inhibitory amino acid neurotransmitter system of γ-aminobutyric acid (GABA). OBJECTIVE To test whether anterior cingulate cortex (ACC) GABA levels, measured by proton magnetic resonance spectroscopy, are decreased in adolescents with MDD. The associations of GABA alterations with the presence and severity of anhedonia were explored. DESIGN Case-control, cross-sectional study using single-voxel proton magnetic resonance spectroscopy at 3 T. SETTING Two clinical research divisions at 2 teaching hospitals. PARTICIPANTS Twenty psychotropic medication-free adolescents with MDD (10 anhedonic, 12 female, aged 12-19 years) with episode duration of 8 weeks or more and 21 control subjects group matched for sex and age. MAIN OUTCOME MEASURES Anterior cingulate cortex GABA levels expressed as ratios relative to unsuppressed voxel tissue water (w) and anhedonia scores expressed as a continuous variable. RESULTS Compared with control subjects, adolescents with MDD had significantly decreased ACC GABA/w (t = 3.2; P < .003). When subjects with MDD were categorized based on the presence of anhedonia, only anhedonic patients had decreased GABA/w levels compared with control subjects (t = 4.08; P < .001; P(Tukey) < .001). Anterior cingulate cortex GABA/w levels were negatively correlated with anhedonia scores for the whole MDD group (r = -0.50; P = .02), as well as for the entire participant sample including the control subjects (r = -0.54; P < .001). Anterior cingulate cortex white matter was also significantly decreased in adolescents with MDD compared with controls (P = .04). CONCLUSIONS These findings suggest that GABA, the major inhibitory neurotransmitter in the brain, may be implicated in adolescent MDD and, more specifically, in those with anhedonia. In addition, use of a continuous rather than categorical scale of anhedonia, as in the present study, may permit greater specificity in evaluating this important clinical feature.
Collapse
Affiliation(s)
- Vilma Gabbay
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University Langone Medical Center, New York, NY 10016, USA.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
Magnetic Resonance Spectroscopy (MRS) is a unique technique that can directly assess the concentration of various biochemical metabolites in the brain. Thus, it is used in the study of molecular pathophysiology of different neuropsychiatric disorders, such as, the major depressive disorder and has been an area of active research. We conducted a computer-based literature search using the Pubmed database with 'magnetic resonance spectroscopy', 'MRS', 'depression', and 'major depressive disorder' as the key words, supplemented by a manual search of bibliographic cross-referencing. Studies in depression report abnormalities in the frontal cortex, basal ganglia, hippocampus, anterior cingulate cortex, and the occipital cortex. These abnormalities improve after treatment with selective serotonin reuptake inhibitor, electroconvulsive therapy, and yoga, and thus, are possibly state-dependent. The findings are consistent with other morphometric and clinical studies and support the proposed pathophysiological theory of dysfunction in the neuronal circuits involving the frontal cortex, limbic cortex, and basal ganglia. Spectroscopy also has potential implications in predicting the response to treatment and formulating individualized pharmacotherapy.
Collapse
Affiliation(s)
- Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
| | | | | |
Collapse
|
33
|
Magnetic resonance imaging and spectroscopy reveal differential hippocampal changes in anhedonic and resilient subtypes of the chronic mild stress rat model. Biol Psychiatry 2011; 70:449-57. [PMID: 21762877 DOI: 10.1016/j.biopsych.2011.05.014] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 05/05/2011] [Accepted: 05/05/2011] [Indexed: 12/12/2022]
Abstract
BACKGROUND Repeated exposure to mild stressors induces anhedonia-a core symptom of major depressive disorder-in up to 70% of the stress-exposed rats, whereas the remaining show resilience to stress. This chronic mild stress (CMS) model is well documented as an animal model of major depressive disorder. We examined the morphological, microstructural, and metabolic characteristics of the hippocampus in anhedonic and stress resilient rats that may mark the differential behavioral outcome. METHODS Anhedonic (n = 8), resilient (n = 8), and control (n = 8) rats were subjected to in vivo diffusion kurtosis imaging, high-resolution three-dimensional magnetic resonance imaging and proton magnetic resonance spectroscopy. RESULTS Diffusion kurtosis parameters were decreased in both CMS-exposed groups. A significant inward displacement in the ventral part of the right hippocampus was apparent in the resilient subjects and an increase of the glutamate:total creatine ratio and N-acetylaspartylglutamate:total creatine was observed in the anhedonic subjects. CONCLUSIONS Diffusion kurtosis imaging discloses subtle substructural changes in the hippocampus of CMS-exposed animals irrespective of their anhedonic or resilient nature. In contrast, proton magnetic resonance spectroscopy and magnetic resonance imaging-based shape change analysis of the hippocampus allowed discrimination of these two subtypes of stress sensitivity. Although the precise mechanism discriminating their behavior is yet to be elucidated, the present study underlines the role of the hippocampus in the etiology of depression and the induction of anhedonia. Our results reflect the potency of noninvasive magnetic resonance methods in preclinical settings with key translational benefit to and from the clinic.
Collapse
|
34
|
Towards a glutamate hypothesis of depression: an emerging frontier of neuropsychopharmacology for mood disorders. Neuropharmacology 2011; 62:63-77. [PMID: 21827775 DOI: 10.1016/j.neuropharm.2011.07.036] [Citation(s) in RCA: 735] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 07/22/2011] [Accepted: 07/23/2011] [Indexed: 12/12/2022]
Abstract
Half a century after the first formulation of the monoamine hypothesis, compelling evidence implies that long-term changes in an array of brain areas and circuits mediating complex cognitive-emotional behaviors represent the biological underpinnings of mood/anxiety disorders. A large number of clinical studies suggest that pathophysiology is associated with dysfunction of the predominant glutamatergic system, malfunction in the mechanisms regulating clearance and metabolism of glutamate, and cytoarchitectural/morphological maladaptive changes in a number of brain areas mediating cognitive-emotional behaviors. Concurrently, a wealth of data from animal models have shown that different types of environmental stress enhance glutamate release/transmission in limbic/cortical areas and exert powerful structural effects, inducing dendritic remodeling, reduction of synapses and possibly volumetric reductions resembling those observed in depressed patients. Because a vast majority of neurons and synapses in these areas and circuits use glutamate as neurotransmitter, it would be limiting to maintain that glutamate is in some way 'involved' in mood/anxiety disorders; rather it should be recognized that the glutamatergic system is a primary mediator of psychiatric pathology and, potentially, also a final common pathway for the therapeutic action of antidepressant agents. A paradigm shift from a monoamine hypothesis of depression to a neuroplasticity hypothesis focused on glutamate may represent a substantial advancement in the working hypothesis that drives research for new drugs and therapies. Importantly, despite the availability of multiple classes of drugs with monoamine-based mechanisms of action, there remains a large percentage of patients who fail to achieve a sustained remission of depressive symptoms. The unmet need for improved pharmacotherapies for treatment-resistant depression means there is a large space for the development of new compounds with novel mechanisms of action such as glutamate transmission and related pathways. This article is part of a Special Issue entitled 'Anxiety and Depression'.
Collapse
|
35
|
Region and state specific glutamate downregulation in major depressive disorder: a meta-analysis of (1)H-MRS findings. Neurosci Biobehav Rev 2011; 36:198-205. [PMID: 21672551 DOI: 10.1016/j.neubiorev.2011.05.014] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 05/22/2011] [Accepted: 05/28/2011] [Indexed: 12/14/2022]
Abstract
For major depressive disorder (MDD), magnetic resonance spectroscopy ((1)H-MRS) studies of glutamate, glutamine and Glx (the composite measure of mainly glutamate and glutamine) have yielded inconclusive or seemingly inconsistent results. We therefore systematically reviewed whether in vivo concentrations of glutamate, glutamine and Glx measured with (1)H-MRS differ between MDD patients and controls. Meta-analysis including meta-regression, sensitivity, statistical heterogeneity, and publication bias analyses were conducted. Glutamate and Glx concentrations were found to be lower in the anterior cingulate cortex (ACC) in patients compared to controls (standardized mean difference (SMD) for glutamate with 95% CIs: -0.86, -1.55 to -0.17; and for Glx: -1.15, -1.86 to -0.44). In addition, Glx was decreased in all brain regions together in current episode patients (SMD: -0.62, -1.17 to -0.07). We conclude that in MDD, glutamate and possibly glutamine are downregulated primarily in the ACC and during depressive states. These results fit the central role of the ACC in depressive symptomatology and suggest that in MDD changes in glutamatergic neurotransmission are state-dependent.
Collapse
|
36
|
Yüksel C, Öngür D. Magnetic resonance spectroscopy studies of glutamate-related abnormalities in mood disorders. Biol Psychiatry 2010; 68:785-94. [PMID: 20728076 PMCID: PMC2955841 DOI: 10.1016/j.biopsych.2010.06.016] [Citation(s) in RCA: 349] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 06/08/2010] [Accepted: 06/09/2010] [Indexed: 12/13/2022]
Abstract
In mood disorders, there is growing evidence for glutamatergic abnormalities derived from peripheral measures of glutamatergic metabolites in patients, postmortem studies on glutamate-related markers, and animal studies on the mechanism of action of available treatments. Magnetic resonance spectroscopy (MRS) has the potential to corroborate and extend these findings with the advantage of in vivo assessment of glutamate-related metabolites in different disease states, in response to treatment, and in relation with functional imaging data. In this article, we first review the biological significance of glutamate, glutamine, and Glx (composed mainly of glutamate and glutamine). Next, we review the MRS literature in mood disorders, examining these glutamate-related metabolites. Here, we find a highly consistent pattern of Glx-level reductions in major depressive disorder and elevations in bipolar disorder. In addition, studies of depression, regardless of diagnosis, provide suggestive evidence for reduced glutamine/glutamate ratio and in mania for elevated glutamine/glutamate ratio. These patterns suggest that the glutamate-related metabolite pool (not all of it necessarily relevant to neurotransmission) is constricted in major depressive disorder and expanded in bipolar disorder. Depressive and manic episodes may be characterized by modulation of the glutamine/glutamate ratio in opposite directions, possibly suggesting reduced versus elevated glutamate conversion to glutamine by glial cells, respectively. We discuss the implications of these results for the pathophysiology of mood disorders and suggest future directions for MRS studies.
Collapse
Affiliation(s)
- Cagri Yüksel
- Istanbul University, Istanbul Medical School, Istanbul, Turkey
- McLean Hospital, Belmont, MA
| | - Dost Öngür
- McLean Hospital, Belmont, MA
- Harvard Medical School, Boston, MA
| |
Collapse
|
37
|
Smith GS, Kramer E, Ma Y, Kingsley P, Dhawan V, Chaly T, Eidelberg D. The functional neuroanatomy of geriatric depression. Int J Geriatr Psychiatry 2009; 24:798-808. [PMID: 19173332 PMCID: PMC2730507 DOI: 10.1002/gps.2185] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Positron Emission Tomography (PET) studies of cerebral glucose metabolism have demonstrated sensitivity in evaluating the functional neuroanatomy of treatment response variability in depression, as well as in the early detection of functional changes associated with incipient cognitive decline. The evaluation of cerebral glucose metabolism in late life depression may have implications for understanding treatment response variability, as well as evaluating the neurobiological basis of depression in late life as a risk factor for dementia. METHODS Sixteen patients with geriatric depression and 13 comparison subjects underwent resting PET studies of cerebral glucose metabolism, as well as magnetic resonance (MR) imaging scans to evaluate brain structure. RESULTS Cerebral glucose metabolism was elevated in geriatric depressed patients relative to comparison subjects in anterior (right and left superior frontal gyrus) and posterior (precuneus, inferior parietal lobule) cortical regions. Cerebral atrophy (increased cerebrospinal fluid [CSF] and decreased grey and white matter volumes) were observed in some of these regions, as well. Regional cerebral metabolism was positively correlated with severity of depression and anxiety symptoms. CONCLUSIONS In contrast to decreased metabolism observed in normal aging and neurodegenerative conditions such as Alzheimer's disease, cortical glucose metabolism was increased in geriatric depressed patients relative to demographically matched controls, particularly in brain regions in which cerebral atrophy was observed, which may represent a compensatory response.
Collapse
Affiliation(s)
- Gwenn S Smith
- Department of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, New York, USA.
| | | | | | | | | | | | | |
Collapse
|
38
|
Kaymak SU, Demir B, Oğuz KK, Sentürk S, Uluğ B. Antidepressant effect detected on proton magnetic resonance spectroscopy in drug-naïve female patients with first-episode major depression. Psychiatry Clin Neurosci 2009; 63:350-6. [PMID: 19566767 DOI: 10.1111/j.1440-1819.2009.01951.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Recent neuroimaging studies support functional and structural alterations in the dorsolateral prefrontal cortex (DLPFC), particularly on the left side in patients with major depressive disorders (MDD). The aim of the present study was to examine the biochemical characteristics of left DLPFC as measured on proton ((1)H) magnetic resonance spectroscopy (MRS) in patients with drug-naïve first-episode MDD and a healthy control group. A second aim was to assess the effect of antidepressant treatment on the metabolites of DLPFC. METHODS Short-echo single-voxel (1)H-MRS was done for the left DLPFC in 17 female drug-free MDD patients (mean age +/- SD, 30.9 +/- 6.9 years) and 13 matched control subjects (mean age +/- SD, 29.1 +/- 6.2 years) and was repeated at 8 weeks following antidepressant treatment. RESULTS Comparison of baseline values indicated that there were no significant differences in any of the metabolite ratios (N-acetyl aspartate/creatine [NAA/Cr], myoinositol [Ino]/Cr, and choline [Cho]/Cr) between patients and controls. Significant differences were detected between pre- and post-treatment Ino/Cr ratios (0.67 +/- 0.13, 0.58 +/- 0.22, P = 0.032, respectively), although there was no difference in NAA/Cr and Cho/Cr ratios. CONCLUSION Although no significant metabolic alterations exist in female patients with drug-naïve first-episode MDD as evaluated on (1)H-MRS, an increase in Ino/Cr was observed following 8-week antidepressant treatment. These findings give rise to the possibility that non-neuronal cells, particularly glial cells that are probably damaged, play a role in the action of antidepressant treatment.
Collapse
Affiliation(s)
- Semra Ulusoy Kaymak
- Psychiatry Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
| | | | | | | | | |
Collapse
|
39
|
Venkatraman TN, Krishnan KRR, Steffens DC, Song AW, Taylor WD. Biochemical abnormalities of the medial temporal lobe and medial prefrontal cortex in late-life depression. Psychiatry Res 2009; 172:49-54. [PMID: 19179054 PMCID: PMC2659332 DOI: 10.1016/j.pscychresns.2008.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 05/01/2008] [Accepted: 07/04/2008] [Indexed: 11/24/2022]
Abstract
We utilized single-voxel (1)H magnetic resonance spectroscopy (MRS) to investigate biochemical abnormalities related to late-life depression in the medial prefrontal cortex and medial temporal lobe. Fourteen elderly subjects whose depression responded to treatment and 12 nondepressed subjects were enrolled. Subjects were scanned using a GE 3.0 Tesla whole body MR scanner. Metabolite concentrations were quantified using the LC Model software and adjusted for CSF and ratio of gray to white matter. ANCOVA models tested for group differences while controlling for age and sex. Older previously depressed individuals showed significantly reduced concentrations of total N-acetyl aspartate (NAA), choline, and creatine in the prefrontal cortex and significantly elevated left medial temporal lobe concentrations of NAA and myo-inositol. There were no significant group differences in right temporal metabolite concentrations. The prefrontal cortex observations suggest that reduced neuronal, phospolipid, and energy metabolism is present even in clinically improved depression. In contrast, elevated NAA and myo-inositol concentrations in the left medial temporal lobe could be associated with neuronal and glial cell changes in the amygdala.
Collapse
Affiliation(s)
- T. N. Venkatraman
- Department of Radiology, Duke University Medical Center, Durham, NC, The Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC
| | - K. Ranga R. Krishnan
- Department of Psychiatry, Duke University Medical Center, Durham, NC, The Duke-NUS Graduate Medical School Singapore
| | - David C. Steffens
- Department of Psychiatry, Duke University Medical Center, Durham, NC
| | - Allen W. Song
- Department of Psychiatry, Duke University Medical Center, Durham, NC, Department of Radiology, Duke University Medical Center, Durham, NC, The Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC
| | - Warren D. Taylor
- Department of Psychiatry, Duke University Medical Center, Durham, NC,Corresponding author: Warren D. Taylor, MD, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC Box 3903, Durham, NC 27710, P: (919) 668-7887, F: (919) 681-7668,
| |
Collapse
|
40
|
Capizzano AA, Jorge RE, Acion LC, Robinson RG. In vivo proton magnetic resonance spectroscopy in patients with mood disorders: a technically oriented review. J Magn Reson Imaging 2008; 26:1378-89. [PMID: 17968885 DOI: 10.1002/jmri.21144] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Proton MR spectroscopy (1HMRS) has been extensively used among mood disorders patients. A review of the published literature in 1HMRS studies of mood disorders was carried out for the period 1991 to July 2006. Of 71 1HMRS studies, 77.5% were done at 1.5T and 66.2% used single voxel sequences (SVS), implying limitations of spectral resolution and anatomic coverage, respectively. In all, 47.9% of studies relied on creatine (Cr) as internal signal standard, although Cr changes were reported in major depression (MD). Most reported metabolic alterations related to mood state affected the left frontal lobe. Depressed adult and pediatric MD patients had reduced glutamate (Glu) in frontal lobe regions, which reversed with successful treatment. A consistent reduction of N-acetyl-aspartate (NAA) was reported in the hippocampal formation among bipolar disorder (BD) patients, along with an increment in frontal Glu. The differences in results of 1HMRS studies in mood disorders reflect heterogeneity of technical factors and subject selection. Future studies should benefit from higher spectral resolution and more extensive anatomic coverage as well as standardized data-processing protocols and subject selection criteria.
Collapse
Affiliation(s)
- Aristides A Capizzano
- Psychiatry Department, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
| | | | | | | |
Collapse
|
41
|
Hong ST, Choi CB, Park C, Hong KS, Cheong C, Jeon YW, Choe BY. Variation of the choline signal intensity in the dorsolateral prefrontal cortex of rats exposed to the forced swimming test as detected by in vivo 1H MR spectroscopy. J Neurosci Methods 2007; 165:89-94. [PMID: 17606300 DOI: 10.1016/j.jneumeth.2007.05.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2007] [Revised: 05/15/2007] [Accepted: 05/21/2007] [Indexed: 01/18/2023]
Abstract
BACKGROUND (1)H magnetic resonance spectroscopy (MRS) has documented an increased Cho/Cr ratio in the dorsolateral prefrontal cortex (DLPFC) in major depressive disorder (MDD). The aim of this study was to investigate neurochemical alterations in the left DLPFC, considered a main area of pathogenesis in depression, using rats exposed to the forced swimming test (FST). MATERIALS AND METHODS Twenty-four male rats were used for the MRI and in vivo(1)H MRS studies. Rats exposed to the FST to induce a depressed mental status. Using in vivo(1)H MRS, the metabolite ratios of the rats with a depressed mental status and the controls, were measured and the values of the two groups were compared. RESULTS The Cho/Cr and Cho/NAA ratios in the DLPFC of the rats with a depressed mental status were significantly higher than that in the controls. CONCLUSIONS The present study demonstrates a significantly increased Cho/Cr ratio in the DLPFC of rats with depression compared with controls. This result may suggest an accelerated turnover of membrane without neuronal loss is occurring in the DLPFC of the rats with depression.
Collapse
Affiliation(s)
- Sung-Tak Hong
- Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-040, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
42
|
Bhagwagar Z, Wylezinska M, Jezzard P, Evans J, Ashworth F, Sule A, Matthews PM, Cowen PJ. Reduction in occipital cortex gamma-aminobutyric acid concentrations in medication-free recovered unipolar depressed and bipolar subjects. Biol Psychiatry 2007; 61:806-12. [PMID: 17210135 DOI: 10.1016/j.biopsych.2006.08.048] [Citation(s) in RCA: 207] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Revised: 08/02/2006] [Accepted: 08/28/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies using proton magnetic resonance spectroscopy (MRS) have indicated that unmedicated, acutely depressed patients have decreased levels of gamma-aminobutyric acid (GABA) in occipital cortex. Cortical levels of glutamate (Glu) may be increased, although these data are less consistent. The aim of this study was to use MRS to determine whether changes in GABA and Glu levels were present in patients with mood disorders who had recovered and were no longer taking medication. METHODS An [1H]-MRS was used to measure levels of GABA, of the combined concentration of Glu and glutamine (Gln), and of N-acetylaspartate (NAA) in occipital cortex in medication-free, fully recovered subjects with a history of recurrent unipolar depression (n = 15), bipolar disorder (n = 16), and a group of healthy controls (n = 18). RESULTS Occipital levels of GABA and NAA were significantly lower in recovered depressed and bipolar subjects than in healthy controls, whereas Glu +Gln concentrations were higher. CONCLUSIONS Our data suggest that recovered unmedicated subjects with a history of mood disorder have changes in cortical concentrations of GABA, NAA, and Glu +Gln. These biochemical abnormalities may be markers of a trait vulnerability to mood disorder, rather than neurochemical correlates of an abnormal mood state.
Collapse
Affiliation(s)
- Zubin Bhagwagar
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Glodzik-Sobanska L, Slowik A, McHugh P, Sobiecka B, Kozub J, Rich KE, Urbanik A, Szczudlik A. Single voxel proton magnetic resonance spectroscopy in post-stroke depression. Psychiatry Res 2006; 148:111-20. [PMID: 17088051 DOI: 10.1016/j.pscychresns.2006.08.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Revised: 07/06/2006] [Accepted: 08/27/2006] [Indexed: 11/16/2022]
Abstract
Mood disorders are associated with structural, metabolic and spectroscopic changes in prefrontal regions. In the case of depression associated with stroke, there is little information about the biochemical profile of these regions, as assessed by proton magnetic resonance spectroscopy ((1)H-MRS). In a group of first-ever stroke patients, we studied the association between post-stroke depression and (1)H-MRS measurements in unaffected frontal lobes. Twenty-six patients with a first ischemic stroke located outside the frontal lobes were included in the study. Single voxel proton magnetic resonance spectroscopy ((1)H-MRS) was performed to assess N-acetylaspartate/creatine (NAA)/Cr, glutamate+glutamine (Glx)/Cr, choline (Cho)/Cr and myo-inositol (mI)/Cr ratios. Patients were assessed within the first 10 days after stroke and again four months later. The diagnosis of depression was made on the basis of clinical observation, interview and Hamilton Depression Rating Scale scores. In a group of 26 patients, eight (31%) met criteria for depression at the first assessment, and nine (35%) met criteria for depression at follow-up. Patients with depression in the immediate post-stroke phase had significantly higher Glx/Cr ratios in the contralesional hemisphere than non-depressive patients. No biochemical differences were found between the groups at 4-month follow-up. These findings suggest that post-stroke depression is accompanied by changes in frontal lobe glutamate/glutamine levels, perhaps reflecting abnormalities in glutamatergic transmission in the immediate post-stroke period.
Collapse
Affiliation(s)
- Lidia Glodzik-Sobanska
- Center for Brain Health, New York University School of Medicine, New York, NY 10016, USA.
| | | | | | | | | | | | | | | |
Collapse
|
44
|
McNamara RK, Ostrander M, Abplanalp W, Richtand NM, Benoit SC, Clegg DJ. Modulation of phosphoinositide-protein kinase C signal transduction by omega-3 fatty acids: implications for the pathophysiology and treatment of recurrent neuropsychiatric illness. Prostaglandins Leukot Essent Fatty Acids 2006; 75:237-57. [PMID: 16935483 DOI: 10.1016/j.plefa.2006.07.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The phosphoinositide (PI)-protein kinase C (PKC) signal transduction pathway is initiated by pre- and postsynaptic Galphaq-coupled receptors, and regulates several clinically relevant neurochemical events, including neurotransmitter release efficacy, monoamine receptor function and trafficking, monoamine transporter function and trafficking, axonal myelination, and gene expression. Mounting evidence for PI-PKC signaling hyperactivity in the peripheral (platelets) and central (premortem and postmortem brain) tissues of patients with schizophrenia, bipolar disorder, and major depressive disorder, coupled with evidence that PI-PKC signal transduction is down-regulated in rat brain following chronic, but not acute, treatment with antipsychotic, mood-stabilizer, and antidepressant medications, suggest that PI-PKC hyperactivity is central to an underlying pathophysiology. Evidence that membrane omega-3 fatty acids act as endogenous antagonists of the PI-PKC signal transduction pathway, coupled with evidence that omega-3 fatty acid deficiency is observed in peripheral and central tissues of patients with schizophrenia, bipolar disorder, and major depressive disorder, support the hypothesis that omega-3 fatty acid deficiency may contribute to elevated PI-PKC activity in these illnesses. The data reviewed in this paper outline a potential molecular mechanism by which omega-3 fatty acids could contribute to the pathophysiology and treatment of recurrent neuropsychiatric illness.
Collapse
Affiliation(s)
- Robert K McNamara
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0559, USA.
| | | | | | | | | | | |
Collapse
|
45
|
Yildiz-Yesiloglu A, Ankerst DP. Review of 1H magnetic resonance spectroscopy findings in major depressive disorder: a meta-analysis. Psychiatry Res 2006; 147:1-25. [PMID: 16806850 DOI: 10.1016/j.pscychresns.2005.12.004] [Citation(s) in RCA: 184] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2004] [Revised: 11/23/2005] [Accepted: 12/12/2005] [Indexed: 11/20/2022]
Abstract
In a review of the current literature, we identified (1)H MRS studies of major depressive disorder (MDD) that examined the metabolites N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), glutamate/glutamine/gamma-aminobutyric acid-GABA (Glx), and creatine (Cr). Separate meta-analyses comparing adult and pediatric MDD patients with healthy controls were performed. For adults, 14 studies with 227 patients/246 controls for NAA, 15 studies with 240 patients/261 controls for Cho, seven studies with 96 patients/104 controls for mI, six studies with 86 patients/109 controls for Glx, and nine studies with 146 patients/173 controls for Cr were identified. There were six studies containing a total of 79 pediatric depressed patients. We performed 15 separate meta-analyses to combine results from studies with similar characteristics. Adult MDD patients had higher Cho/Cr values than controls in the basal ganglia. In contrast, three studies on Glx levels indicated significantly lower Glx levels in the frontal lobe of MDD patients. The review indicated increased Cho/Cr in the basal ganglia in MDD and no alteration of NAA, suggesting an increased membrane turnover in MDD without a neurodegenerative outcome. Lower Glx levels in depressed patients in contrast to a likely hyperglutamatergic state in bipolar disorder may implicate a different pathophysiological ground in MDD.
Collapse
|
46
|
Abstract
The monoamine theory has implicated abnormalities in serotonin and norepinephrine in the pathophysiology of major depression and bipolar illness and contributed greatly to our understanding of mood disorders and their treatment. Nevertheless, some limitations of this model still exist that require researchers and clinicians to seek further explanation and develop novel interventions that reach beyond the confines of the monoaminergic systems. Recent studies have provided strong evidence that glutamate and other amino acid neurotransmitters are involved in the pathophysiology and treatment of mood disorders. Studies employing in vivo magnetic resonance spectroscopy have revealed altered cortical glutamate levels in depressed subjects. Consistent with a model of excessive glutamate-induced excitation in mood disorders, several antiglutamatergic agents, such as riluzole and lamotrigine, have demonstrated potential antidepressant efficacy. Glial cell abnormalities commonly associated with mood disorders may at least partly account for the impairment in glutamate action since glial cells play a primary role in synaptic glutamate removal. A hypothetical model of altered glutamatergic function in mood disorders is proposed in conjunction with potential antidepressant mechanisms of antiglutamatergic agents. Further studies elucidating the role of the glutamatergic system in the pathophysiology of mood and anxiety disorders and studies exploring the efficacy and mechanism of action of antiglutamatergic agents in these disorders, are likely to provide new targets for the development of novel antidepressant agents.
Collapse
Affiliation(s)
- Akira Kugaya
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | |
Collapse
|
47
|
Caetano SC, Fonseca M, Olvera RL, Nicoletti M, Hatch JP, Stanley JA, Hunter K, Lafer B, Pliszka SR, Soares JC. Proton spectroscopy study of the left dorsolateral prefrontal cortex in pediatric depressed patients. Neurosci Lett 2005; 384:321-6. [PMID: 15936878 DOI: 10.1016/j.neulet.2005.04.099] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2005] [Revised: 04/28/2005] [Accepted: 04/29/2005] [Indexed: 10/25/2022]
Abstract
The dorsolateral prefrontal cortex (DLPFC) plays an essential role in mood regulation and integration of cognitive functions that are abnormal in major depressive disorder (MDD). Few neuroimaging studies have evaluated the still maturing DLPFC in depressed children and adolescents. We conducted single voxel proton magnetic resonance spectroscopy ((1)H MRS) of the left DLPFC in 14 depressed children and adolescents (13.3 +/- 2.3 years old, 10 males) and 22 matched healthy controls (13.6 +/- 2.8 years old, 13 males). Depressed subjects had significantly lower levels of glycerophosphocholine plus phosphocholine (GPC + PC; or choline-containing compounds) and higher myo-inositol levels in the left DLPFC compared to healthy controls. In the depressed subjects, we found significant inverse correlations between glutamate levels and both duration of illness and number of episodes. In healthy controls there was a significant direct correlation between age and glutamine levels, which was not present in the patient group. Lower GPC + PC levels in pediatric MDD may reflect lower cell membrane content per volume in the DLPFC. Increased myo-inositol levels in MDD may represent a disturbed secondary messenger system. GPC + PC and myo-inositol abnormalities further demonstrate the involvement of DLPFC in pediatric MDD.
Collapse
Affiliation(s)
- Sheila C Caetano
- Division of Mood and Anxiety Disorders, Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|