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Lu X, Lai S, Luo A, Huang X, Wang Y, Zhang Y, He J, Chen G, Zhong S, Jia Y. Biochemical metabolism in the anterior cingulate cortex and cognitive function in major depressive disorder with or without insomnia syndrome. J Affect Disord 2023; 335:256-263. [PMID: 37164065 DOI: 10.1016/j.jad.2023.04.132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/20/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) and insomnia have been linked to deficiencies in cognitive performance. However, the underlying mechanism of cognitive impairment in MDD patients with insomnia symptoms (IS) remains unclear. This study aimed to explore the effects of IS in patients with MDD by comparing cognitive function indices among those with IS, those without insomnia symptoms (NIS), and healthy controls (HCs). In addition, we assessed whether the dysfunction of central nervous system (CNS) is one of the important pathophysiologic mechanisms of IS in patients with MDD by comparing the biochemical metabolism ratios in the anterior cingulate cortex (ACC). METHOD Fifty-five MDD with IS, 39 MDD without IS, and 47 demographically matched HCs underwent the MATRICS Consensus Cognitive Battery (MCCB) assessment and proton magnetic resonance spectroscopy (1H-MRS). MCCB cognitive scores and biochemical metabolism in ACC were assessed and compared between groups. RESULTS Compared to the HCs group, IS and NIS groups scored significantly lower in seven MCCB cognitive domains (speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning problem solving and social cognition). IS group showed a lower speed of processing and lower Cho/Cr ratio in the left ACC vs. NIS group and HCs. Also, in IS group, the Cho/Cr ratio in the left ACC was positively correlated with the composite T-score. CONCLUSION Patients with comorbidity of MDD with IS may exhibit more common MCCB cognitive impairments than those without IS, particularly speed of processing. Also, dysfunction of ACC may underlie the neural substrate of cognitive impairment in MDD with IS.
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Affiliation(s)
- Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China; Department of Psychiatry, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Jinan University, Heyuan 517000, China
| | - Aimin Luo
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China; Guangzhou Baiyun Psychological Hospital, Guangzhou 510440, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Department of Psychiatry, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Jinan University, Heyuan 517000, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China; Department of Psychiatry, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Jinan University, Heyuan 517000, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China; Department of Psychiatry, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Jinan University, Heyuan 517000, China.
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Chenji S, Cox E, Jaworska N, Swansburg RM, MacMaster FP. Body mass index and variability in hippocampal volume in youth with major depressive disorder. J Affect Disord 2021; 282:415-425. [PMID: 33422817 DOI: 10.1016/j.jad.2020.12.176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/31/2020] [Accepted: 12/24/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The hippocampus has been implicated in major depressive disorder (MDD), in both adults and youth. However, possible sources of variability for the hippocampus have not been well delineated. Here, we explored the relationship between body mass index (BMI) and hippocampal volume in youth with MDD. METHODS Twenty-two controls (9 male, 13 female, 12-24 years), 24 youth with MDD and normal BMI (12 male, 12 female, 14-24 years), and 20 youth with MDD and high BMI (14 male, 6 female, 13-22 years) underwent magnetic resonance (MR) imaging and spectroscopy (1H-MRS). Hippocampal volume was determined through manual tracing of high-resolution anatomical T1 scans, and LCModel quantified neurochemical concentrations. Intracranial volume was used as a covariate in analysis to control for effects of brain volume on hippocampus. RESULTS In youth with MDD and normal BMI, right hippocampal volume was reduced (p = 0.006, Bonferroni) and a trend for reduced left hippocampal volume was noted when compared to healthy controls (p = 0.054, Bonferroni). Left hippocampal volumes were negatively associated with BMI in youth with MDD and high BMI group (r = -0.593, p = 0.006). No associations were found between the right hippocampus and BMI and there were no group differences for metabolite concentrations. LIMITATIONS Larger sample sizes would enable researchers to explore overweight vs obese groups and effect of sex in MDD-BMI groups. CONCLUSIONS BMI may account for some of the variability observed in previous studies of hippocampal volume in MDD, and therefore BMI impacts should be considered in future analyses.
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Affiliation(s)
- Sneha Chenji
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Emily Cox
- Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Natalia Jaworska
- University of Ottawa Institute of Mental Health Research, Ontario, Canada
| | - Rose M Swansburg
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Frank P MacMaster
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada; Addictions and Mental Health Strategic Clinical Network, Alberta, Canada.
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Guan J, Ding Y, Rong Y, Geng Y, Lai L, Qi D, Tang Y, Yang L, Li J, Zhou T, Wu E, Wu R. Early Life Stress Increases Brain Glutamate and Induces Neurobehavioral Manifestations in Rats. ACS Chem Neurosci 2020; 11:4169-4178. [PMID: 33179901 DOI: 10.1021/acschemneuro.0c00454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Early life stress (ELS) is associated with an increased risk of developing depression and anxiety disorders. Disturbances of the neurobiological glutamatergic system are implicated in depression; however, the long-term effects of ELS on glutamate (Glu) metabolites remain unclear. Our study used 7T proton magnetic resonance spectroscopy (7T 1H MRS) to detect metabolic Glu in a rat model to investigate maternal deprivation (MD)-induced ELS. MD was established in Sprague-Dawley rats by periodic separation from mothers and peers. Changes in the hippocampal volume and Glu metabolism were detected by 7T 1H MRS after testing for depression-like behavior via open field, sucrose preference, and Morris water maze tests. Adult MD offspring exhibited depression-like behavior. Compared to the control, the MD group exhibited reduced ratio of central activity time to total time and decreased sucrose consumption (p < 0.05). MD rats spent less time in the fourth quadrant, where the platform was originally placed, in the Morris water maze test. According to 7T 1H MRS, hippocampus of MD rats had elevated Glu and glutamate + glutamine (Glu+Gln) levels compared with the control group hippocampi, but Gln, γ-aminobutyric acid (GABA), and glutamate + glutamine (Glu+Gln) in the prefrontal cortex of MD rats showed a downward trend. Depression-like behavior and cognition deficits related to ELS may induce region-specific changes in Glu metabolism in the prefrontal cortex and hippocampus. The novel, noninvasive 7T 1H MRS-identified associations between Glu levels and ELS may guide future clinical studies.
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Affiliation(s)
- Jitian Guan
- Department of Radiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
- Department of Neurosurgery, Baylor Scott & White Health, Temple, Texas 76502, United States
- Neuroscience Institute, Baylor Scott & White Health, Temple, Texas 76502, United States
| | - Yan Ding
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - Yunjie Rong
- Department of Radiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Yiqun Geng
- Department of Neurosurgery, Baylor Scott & White Health, Temple, Texas 76502, United States
- Neuroscience Institute, Baylor Scott & White Health, Temple, Texas 76502, United States
- Laboratory of Molecular Pathology, Shantou University Medical College, Shantou 515031, China
| | - Lingfeng Lai
- Department of Radiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Dan Qi
- Department of Neurosurgery, Baylor Scott & White Health, Temple, Texas 76502, United States
- Neuroscience Institute, Baylor Scott & White Health, Temple, Texas 76502, United States
| | - Yanyan Tang
- Department of Radiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Lin Yang
- Department of Radiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Juntao Li
- Department of Breast Surgery, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450003, China
| | - Teng Zhou
- Department of Computer Science, Shantou University, Shantou 515041, China
| | - Erxi Wu
- Department of Neurosurgery, Baylor Scott & White Health, Temple, Texas 76502, United States
- Neuroscience Institute, Baylor Scott & White Health, Temple, Texas 76502, United States
- Department of Surgery, Texas A & M University Health Science Center College of Medicine, Temple 76508, Texas United States
- Department of Pharmaceutical Sciences, College of Pharmacy, Texas A & M University Health Science Center, College Station, Texas 77843, United States
- LIVESTRONG Cancer Institutes, Dell Medical School, the University of Texas at Austin, Austin, Texas 78712, United States
| | - Renhua Wu
- Department of Radiology, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
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Kang I, Kondo D, Kim J, Lyoo IK, Yurgelun-Todd D, Hwang J, Renshaw PF. Elevating the level of hypoxia inducible factor may be a new potential target for the treatment of depression. Med Hypotheses 2020; 146:110398. [PMID: 33246695 DOI: 10.1016/j.mehy.2020.110398] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 12/28/2022]
Abstract
Hypoxia inducible factor-1 (HIF-1) is a transcriptional factor that regulates gene expressions in response to decreased oxygen levels in the tissue, or hypoxia. HIF-1 exerts protective effects against hypoxia by mediating mitochondrial metabolism and consequently reducing oxidative stress. Recently, increased levels of oxidative stress and abnormal energy metabolism in the brain have been suggested to play essential roles in the pathogenesis of depression. Given that HIF-1 activates creatine metabolism and increases phosphocreatine levels in the intestinal epithelial cells, we assume that HIF-1 may induce similar processes in the brain. Elevated phosphocreatine levels in the brain, as measured by magnetic resonance spectroscopy, were associated with better treatment response to the antidepressants in individuals with depression. In addition, oral creatine supplements, which led to increased phosphocreatine levels in the brain, also enhanced the effects of antidepressants in individuals with depression. As such, we hypothesized that increasing the HIF-1, which potentially facilitates creatine metabolism in the brain, might be a new therapeutic target in depression. With this regard, we suggested that interventions to elevate the HIF-1 levels in the brain, including the intermittent hypoxia conditioning and hyperbaric oxygen therapy, might be considered as new additional treatments for depression.
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Affiliation(s)
- Ilhyang Kang
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea
| | - Douglas Kondo
- Department of Psychiatry, University of Utah, Salt Lake City, USA; The Brian Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea; Department of Psychiatry, University of Utah, Salt Lake City, USA; The Brian Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah, Salt Lake City, USA; The Brian Institute, University of Utah School of Medicine, Salt Lake City, USA; Veterans Integrated Service Network 19 Mental Illness Research Education Clinical, Centers of Excellence, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Jaeuk Hwang
- Department of Psychiatry, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, USA; The Brian Institute, University of Utah School of Medicine, Salt Lake City, USA; Veterans Integrated Service Network 19 Mental Illness Research Education Clinical, Centers of Excellence, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, Utah, USA.
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Wang J, Zhou T, Liu J, Shangguan J, Liu X, Li Z, Zhou X, Ren Y, Wang C. Application of 1H-MRS in end-stage renal disease with depression. BMC Nephrol 2020; 21:225. [PMID: 32539705 PMCID: PMC7294641 DOI: 10.1186/s12882-020-01863-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the metabolite changes in the frontal lobe of the end-stage renal disease (ESRD) patients with depression using proton magnetic resonance spectroscopy (1H-MRS). METHODS All subjects were divided into three groups: ESRD patients with depression (30 cases), ESRD patients without depression (27 cases) and 32 normal subjects. ESRD with depression patients were further divided into two groups according to the severity of depression: 14 cases of ESRD with severe depression group (Hamilton Depression Rating Scale (HAMD) score ≥ 35) and 16 cases of ESRD with mild to moderate depression group (20 ≤ HAMD score<35). 1H-MRS was used in brain regions of all subjects to measure N-acetylaspartate/creatine (NAA/Cr), choline-containing compounds/creatine (Cho/Cr) and myo-inositol/creatine (MI/Cr) ratios of the frontal lobe. Correlations between the metabolite ratio and HAMD score as well as clinical finding were confirmed, respectively. RESULTS ESRD patients with depression showed lower NAA/Cr ratio and higher Cho/Cr ratio compared with ESRD patients without depression and normal subjects. NAA/Cr ratio was negatively correlated with the HAMD score. Cho/Cr ratio was positively correlated with the HAMD score. There were positive correlations between NAA/Cr ratio and blood urea notrogen (BUN) as well as creatinine (CRE) concentration, respectively. There was a negative correlation between Cho/Cr ratio and sodium concentration. The Cho/Cr ratio was positively correlated with the potassium concentration. CONCLUSIONS MR spectroscopy identified some metabolite changes in ESRD patients with depression.
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Affiliation(s)
- Jiachen Wang
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
| | - Tong Zhou
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
| | - Jihua Liu
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
| | - Jingjun Shangguan
- Department of Radiology, Qilu Hospital of Shandong University, Qingdao Branch, 758 He-Fei Road, Qingdao, PR China
| | - Xuejun Liu
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
| | - Zhiming Li
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
| | - Xiaoming Zhou
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
| | - Yande Ren
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China.
| | - Chengjian Wang
- Department of Medical Imaging Center, The Affiliated Hospital of Qingdao University, 16 Jiang-Su Road, Qingdao, PR China
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Liu X, Zhong S, Yan L, Zhao H, Wang Y, Hu Y, Jia Y. Correlations Among mRNA Expression Levels of ATP7A, Serum Ceruloplasmin Levels, and Neuronal Metabolism in Unmedicated Major Depressive Disorder. Int J Neuropsychopharmacol 2020; 23:642-652. [PMID: 32427278 PMCID: PMC7727471 DOI: 10.1093/ijnp/pyaa038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/08/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies have found that elevated copper levels induce oxidation, which correlates with the occurrence of major depressive disorder (MDD). However, the mechanism of abnormal cerebral metabolism of MDD patients remains ambiguous. The main function of the enzyme ATPase copper-transporting alpha (ATP7A) is to transport copper across the membrane to retain copper homeostasis, which is closely associated with the onset of mental disorders and cognitive impairment. However, less is known regarding the association of ATP7A expression in MDD patients. METHODS A total of 31 MDD patients and 21 healthy controls were recruited in the present study. Proton magnetic resonance spectroscopy was used to assess the concentration levels of N-acetylaspartate, choline (Cho), and creatine (Cr) in brain regions of interest, including prefrontal white matter (PWM), anterior cingulate cortex (ACC), thalamus, lentiform nucleus, and cerebellum. The mRNA expression levels of ATP7A were measured using polymerase chain reaction (SYBR Green method). The correlations between mRNA expression levels of ATP7A and/or ceruloplasmin levels and neuronal biochemical metabolite ratio in the brain regions of interest were evaluated. RESULTS The decline in the mRNA expression levels of ATP7A and the increase in ceruloplasmin levels exhibited a significant correlation in MDD patients. In addition, negative correlations were noted between the decline in mRNA expression levels of ATP7A and the increased Cho/Cr ratios of the left PWM, right PWM, and right ACC in MDD patients. A positive correlation between elevated ceruloplasmin levels and increased Cho/Cr ratio of the left PWM was noted in MDD patients. CONCLUSIONS The findings suggested that the decline in the mRNA expression levels of ATP7A and the elevated ceruloplasmin levels induced oxidation that led to the disturbance of neuronal metabolism in the brain, which played important roles in the pathophysiology of MDD. The decline in the mRNA expression levels of ATP7A and the elevated ceruloplasmin levels affected neuronal membrane metabolic impairment in the left PWM, right PWM, and right ACC of MDD patients.
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Affiliation(s)
- Xuanjun Liu
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, China,Correspondence: Yanbin Jia, PhD, 613 West Huangpu Avenue Tianhe District, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China ()
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lan Yan
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yilei Hu
- Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
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Liu X, Zhong S, Li Z, Chen J, Wang Y, Lai S, Miao H, Jia Y. Serum copper and zinc levels correlate with biochemical metabolite ratios in the prefrontal cortex and lentiform nucleus of patients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109828. [PMID: 31778759 DOI: 10.1016/j.pnpbp.2019.109828] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 11/18/2019] [Accepted: 11/23/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Previous studies have demonstrated that copper and zinc metabolism are associated with the development of major depressive disorder (MDD). Abnormal copper and zinc levels may be related to neurotransmission and biochemical metabolism in the brains of MDD patients, especially in the prefrontal cortex (PFC) and lentiform nucleus (LN). However, the mechanism of how copper and zinc levels contribute to neural metabolism in MDD patients remains to be deciphered. This study aimed to correlate copper and zinc levels with biochemical metabolite ratios in the PFC and LN of MDD patients. METHOD Twenty-nine MDD patients and thirty-two healthy control (HC) volunteers were enrolled in this study. Proton magnetic resonance spectroscopy (1H-MRS) was used to determine the levels of the N-acetylaspartate (NAA), choline (Cho) and creatine (Cr) in the brain, and specifically in the PFC and LN regions. Serum copper and zinc levels were measured using atomic emission spectrometry (AES). Afterwards, copper and zinc levels were correlated with biochemical metabolite ratios in the PFC and LN regions of the brain. RESULTS Higher serum copper and lower serum zinc levels with higher copper/zinc ratios were observed in MDD patients. NAA/Cr ratios in the PFC of MDD patients were lower compared to HC volunteers. In MDD patients, serum copper levels were negatively correlated with NAA/Cr ratios in the right PFC and right LN, while copper/zinc ratios were negatively correlated with NAA/Cr ratios in the right LN. No significant differences in serum copper and zinc levels with NAA/Cr ratios in the left PFC and left LN were observed in MDD patients. CONCLUSION Our findings suggest that higher serum copper and lower serum zinc levels may contribute to neuronal impairment by affecting neuronal biochemical metabolite ratios in the right PFC and right LN of MDD patients. Abnormal copper and zinc levels may play an important role in the pathophysiology of MDD.
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Affiliation(s)
- Xuanjun Liu
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhinan Li
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510631, China
| | | | - Ying Wang
- Medical Imaging Center of The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | | | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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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.
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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
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Liu L, Zhou X, Zhang Y, Pu J, Yang L, Yuan S, Zhao L, Zhou C, Zhang H, Xie P. Hippocampal metabolic differences implicate distinctions between physical and psychological stress in four rat models of depression. Transl Psychiatry 2018; 8:4. [PMID: 29317595 PMCID: PMC5802536 DOI: 10.1038/s41398-017-0018-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/15/2017] [Accepted: 08/20/2017] [Indexed: 12/28/2022] Open
Abstract
Major depressive disorder (MDD) is a heterogeneous and multi-factorial disorder, and the underlying molecular mechanisms remain largely unknown. However, many studies have indicated that the molecular mechanisms underlying depression in response to different stress may differ. After screening, 28-30 rats were included in each model of depression (chronic unpredictable mild stress (CUMS); learned helplessness (LH); chronic restraint stress (CRS); or social defeat (SD)). Non-targeted gas chromatography-mass spectrometry was used to profile the metabolic changes in the hippocampus. As a result, all four models exhibited significant depression-like behavior. A total of 30, 24, 19, and 25 differential metabolites were identified in the CUMS, LH, CRS, and SD models, respectively. Interestingly, the hierarchical clustering results revealed two patterns of metabolic changes that are characteristic of the response to cluster 1 (CUMS, LH) and cluster 2 (CRS, SD) stress, which represent physical and psychological stress, respectively. Bioinformatic analysis suggested that physical stress was mainly associated with lipid metabolism and glutamate metabolism, whereas psychological stress was related to cell signaling, cellular proliferation, and neurodevelopment, suggesting the molecular changes induced by physical and psychological stress were different. Nine shared metabolites were opposite in the directions of change between physical and psychological models, and these metabolites were associated with cellular proliferation and neurodevelopment functions, indicating the response to physical and psychological stress was different in the activation and deactivation of the final common pathway to depression. Our results provide a further understanding of the heterogeneity in the molecular mechanisms of MDD that could facilitate the development of personalized medicine for this disorder.
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Affiliation(s)
- Lanxiang Liu
- grid.452206.7Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Xinyu Zhou
- 0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China ,grid.452206.7Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuqing Zhang
- grid.452206.7Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- grid.452206.7Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Lining Yang
- grid.452206.7Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Shuai Yuan
- 0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Libo Zhao
- 0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Chanjun Zhou
- 0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Hanping Zhang
- grid.452206.7Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China ,0000 0000 8653 0555grid.203458.8Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. .,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China.
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10
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Oluboka OJ, Katzman MA, Habert J, McIntosh D, MacQueen GM, Milev RV, McIntyre RS, Blier P. Functional Recovery in Major Depressive Disorder: Providing Early Optimal Treatment for the Individual Patient. Int J Neuropsychopharmacol 2017; 21:128-144. [PMID: 29024974 PMCID: PMC5793729 DOI: 10.1093/ijnp/pyx081] [Citation(s) in RCA: 54] [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] [Indexed: 12/28/2022] Open
Abstract
Major depressive disorder is an often chronic and recurring illness. Left untreated, major depressive disorder may result in progressive alterations in brain morphometry and circuit function. Recent findings, however, suggest that pharmacotherapy may halt and possibly reverse those effects. These findings, together with evidence that a delay in treatment is associated with poorer clinical outcomes, underscore the urgency of rapidly treating depression to full recovery. Early optimized treatment, using measurement-based care and customizing treatment to the individual patient, may afford the best possible outcomes for each patient. The aim of this article is to present recommendations for using a patient-centered approach to rapidly provide optimal pharmacological treatment to patients with major depressive disorder. Offering major depressive disorder treatment determined by individual patient characteristics (e.g., predominant symptoms, medical history, comorbidities), patient preferences and expectations, and, critically, their own definition of wellness provides the best opportunity for full functional recovery.
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Affiliation(s)
- Oloruntoba J Oluboka
- Department of Psychiatry, University of Calgary, Alberta, Canada,Correspondence: Oloruntoba J. Oluboka, MD, Director, PES/PORT, Consultant Psychiatrist, Addiction and Mental Health, South Health Campus, Alberta Health Services, Assistant Clinical Professor of Psychiatry, University of Calgary, Calgary, Canada ()
| | - Martin A Katzman
- START Clinic for Mood and Anxiety Disorders, Toronto, Ontario, Canada
| | - Jeffrey Habert
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Diane McIntosh
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Glenda M MacQueen
- Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Roumen V Milev
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
| | - Roger S McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Ontario, Canada
| | - Pierre Blier
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario
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11
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Variations in myo-inositol in fronto-limbic regions and clinical response to electroconvulsive therapy in major depression. J Psychiatr Res 2016; 80:45-51. [PMID: 27285661 PMCID: PMC4980182 DOI: 10.1016/j.jpsychires.2016.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 05/03/2016] [Accepted: 05/26/2016] [Indexed: 11/22/2022]
Abstract
Though electroconvulsive therapy (ECT) is an established treatment for severe depression, the neurobiological factors accounting for the clinical effects of ECT are largely unknown. Myo-inositol, a neurometabolite linked with glial activity, is reported as reduced in fronto-limbic regions in patients with depression. Whether changes in myo-inositol relate to the antidepressant effects of ECT is unknown. Using magnetic resonance spectroscopy ((1)H-MRS), we measured dorsomedial anterior cingulate cortex (dmACC) and left and right hippocampal myo-inositol in 50 ECT patients (mean age: 43.78, 14 SD) and 33 controls (mean age: 39.33, 12 SD) to determine cross sectional effects of diagnosis and longitudinal effects of ECT. Patients were scanned prior to treatment, after the second ECT and at completion of the ECT index series. Controls were scanned twice at intervals corresponding to patients' baseline and end of treatment scans. Myo-inositol increased over the course of ECT in the dmACC (p = 0.042). A significant hemisphere by clinical response effect was observed for the hippocampus (p = 0.003) where decreased myo-inositol related to symptom improvement in the left hippocampus. Cross-sectional differences between patients and controls at baseline were not detected. Changes in myo-inositol observed in the dmACC in association with ECT and in the hippocampus in association with ECT-related clinical response suggest the mechanisms of ECT could include gliogenesis or a reversal of gliosis that differentially affect dorsal and ventral limbic regions. Change in dmACC myo-inositol diverged from control values with ECT suggesting compensation, while hippocampal change suggested normalization.
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12
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Calderón-Garcidueñas L, Mora-Tiscareño A, Melo-Sánchez G, Rodríguez-Díaz J, Torres-Jardón R, Styner M, Mukherjee PS, Lin W, Jewells V. A Critical Proton MR Spectroscopy Marker of Alzheimer's Disease Early Neurodegenerative Change: Low Hippocampal NAA/Cr Ratio Impacts APOE ɛ4 Mexico City Children and Their Parents. J Alzheimers Dis 2016; 48:1065-75. [PMID: 26402110 DOI: 10.3233/jad-150415] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Severe air pollution exposures produce systemic, respiratory, myocardial, and brain inflammation and Alzheimer's disease (AD) hallmarks in clinically healthy children. We tested whether hippocampal metabolite ratios are associated with contrasting levels of air pollution, APOE, and body mass index (BMI) in paired healthy children and one parent sharing the same APOE alleles. We used 1H-MRS to interrogate bilateral hippocampal single-voxel in 57 children (12.45 ± 3.4 years) and their 48 parents (37.5 ± 6.78 years) from a low pollution city versus Mexico City (MC). NAA/Cr, Cho/Cr, and mI/Cr metabolite ratios were analyzed. The right hippocampus NAA/Cr ratio was significantly different between cohorts (p = 0.007). The NAA/Cr ratio in right hippocampus in controls versus APOE ɛ4 MC children and in left hippocampus in MC APOE ɛ4 parents versus their children was significantly different after adjusting for age, gender, and BMI (p = 0.027 and 0.01, respectively). The NAA/Cr ratio is considered reflective of neuronal density/functional integrity/loss of synapses/higher pTau burden, thus a significant decrease in hippocampal NAA/Cr ratios may constitute a spectral marker of early neurodegeneration in young urbanites. Decreases in NAA/Cr correlate well with cognitive function, behavioral symptoms, and dementia severity; thus, since the progression of AD starts decades before clinical diagnosis, our findings support the hypothesis that under chronic exposures to fine particulate matter and ozone above the standards, neurodegenerative processes start in childhood and APOE ɛ4 carriers are at higher risk. Gene and environmental factors are critical in the development of AD and the identification and neuroprotection of young urbanites at high risk must become a public health priority.
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Affiliation(s)
- Lilian Calderón-Garcidueñas
- The Center for Structural and Functional Neurosciences, The University of Montana, Missoula, MT, USA.,Escuela de Ciencias de la Salud, Universidad del Valle de México, Campus Saltillo, Saltillo, Coahuila, México
| | | | - Gastón Melo-Sánchez
- Escuela de Ciencias de la Salud, Universidad del Valle de México, Campus Saltillo, Saltillo, Coahuila, México
| | | | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Martin Styner
- Department of Psychiatry and Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | | | - Weili Lin
- Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Valerie Jewells
- Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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13
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Yang N, Ren Z, Zheng J, Feng L, Li D, Gao K, Zhang L, Liu Y, Zuo P. 5-(4-hydroxy-3-dimethoxybenzylidene)-rhodanine (RD-1)-improved mitochondrial function prevents anxiety- and depressive-like states induced by chronic corticosterone injections in mice. Neuropharmacology 2016; 105:587-593. [DOI: 10.1016/j.neuropharm.2016.02.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 01/05/2023]
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14
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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.
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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
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15
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Malykhin N, Coupland N. Hippocampal neuroplasticity in major depressive disorder. Neuroscience 2015; 309:200-13. [DOI: 10.1016/j.neuroscience.2015.04.047] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/17/2015] [Accepted: 04/21/2015] [Indexed: 01/31/2023]
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16
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Chen JL, Shi BY, Xiang H, Hou WJ, Qin XM, Tian JS, Du GH. (1)H NMR-based metabolic profiling of liver in chronic unpredictable mild stress rats with genipin treatment. J Pharm Biomed Anal 2015. [PMID: 26204246 DOI: 10.1016/j.jpba.2015.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Genipin, a hydrolyzed metabolite of geniposide extracted from the fruit of Gardenia jasminoides Ellis, has shown promise in alleviating depressive symptoms, however, the antidepressant mechanism of genipin remains unclear and incomprehensive. In this study, the metabolic profiles of aqueous and lipophilic extracts in liver of the chronic unpredictable mild stress (CUMS)-induced rat with genipin treatment were investigated using proton nuclear magnetic resonance ((1)H NMR) spectroscopy coupled with multivariate data analysis. Significant differences in the metabolic profiles of rats in the CUMS model group (MS) and the control group (NS) were observed with metabolic effects including decreasing in choline, glycerol and glycogen, increasing in lactate, alanine and succinate, and a disordered lipid metabolism, while the moderate dose (50mg/kg) of genipin could significantly regulate the concentrations of glycerol, lactate, alanine, succinate and the lipid to their normal levels. These biomakers were involved in metabolism pathways such as glycolysis/gluconeogensis, tricarboxylic acid (TCA) cycle and lipid metabolism, which may be helpful for understanding of antidepressant mechanism of genipin.
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Affiliation(s)
- Jian-Li Chen
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
| | - Bi-Yun Shi
- Departments of Chemistry, University of Louisville, Louisville, KY 40292, USA
| | - Huan Xiang
- Physical Education Departments of Shanxi University, Taiyuan 030006, PR China
| | - Wen-Jing Hou
- Department of Pharmacy, Beijing Charity Hospital of China Rehabilitation Research Center, Beijing 100068, PR China
| | - Xue-Mei Qin
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
| | - Jun-Sheng Tian
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China.
| | - Guan-Hua Du
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China; Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, PR China.
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17
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Bajs Janović M, Kalember P, Janović S, Hrabač P, Folnegović Grošić P, Grošić V, Radoš M, Henigsberg N. No change in N-acetyl aspartate in first episode of moderate depression after antidepressant treatment: (1)H magnetic spectroscopy study of left amygdala and left dorsolateral prefrontal cortex. Neuropsychiatr Dis Treat 2014; 10:1753-62. [PMID: 25278754 PMCID: PMC4179760 DOI: 10.2147/ndt.s64702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The role of brain metabolites as biological correlates of the intensity, symptoms, and course of major depression has not been determined. It has also been inconclusive whether the change in brain metabolites, measured with proton magnetic spectroscopy, could be correlated with the treatment outcome. METHODS Proton magnetic spectroscopy was performed in 29 participants with a first episode of moderate depression occurring in the left dorsolateral prefrontal cortex and left amygdala at baseline and after 8 weeks of antidepressant treatment with escitalopram. The Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Depression, and the Beck Depression Inventory were used to assess the intensity of depression at baseline and at the endpoint of the study. At endpoint, the participants were identified as responders (n=17) or nonresponders (n=12) to the antidepressant therapy. RESULTS There was no significant change in the N-acetyl aspartate/creatine ratio (NAA/Cr) after treatment with antidepressant medication. The baseline and endpoint NAA/Cr ratios were not significantly different between the responder and nonresponder groups. The correlation between NAA/Cr and changes in the scores of clinical scales were not significant in either group. CONCLUSION This study could not confirm any significant changes in NAA after antidepressant treatment in the first episode of moderate depression, or in regard to therapy response in the left dorsolateral prefrontal cortex or left amygdala. Further research is necessary to conclude whether NAA alterations in the first episode of depression could possibly be different from chronic or late-onset depression, and whether NAA alterations in stress-induced (reactive) depression are different from endogenous depression. The potential role of NAA as a biomarker of a treatment effect has yet to be established.
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Affiliation(s)
- Maja Bajs Janović
- University Department of Psychiatry, Clinical Hospital Center Zagreb, Zagreb, Croatia ; University North, Varaždin, Croatia
| | - Petra Kalember
- Polyclinic Neuron, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Spiro Janović
- University Department of Psychiatry, Clinical Hospital Center Zagreb, Zagreb, Croatia ; University North, Varaždin, Croatia
| | - Pero Hrabač
- Polyclinic Neuron, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | | | - Marko Radoš
- University Department of Radiology, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Neven Henigsberg
- Polyclinic Neuron, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia ; Psychiatric Clinic Vrapče, Zagreb, Croatia
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