1
|
Kranaster L, Hoyer C, Mindt S, Neumaier M, Müller N, Zill P, Schwarz MJ, Moll N, Lutz B, Bindila L, Zerr I, Schmitz M, Blennow K, Zetterberg H, Haffner D, Leifheit-Nestler M, Ozbalci C, Sartorius A. The novel seizure quality index for the antidepressant outcome prediction in electroconvulsive therapy: association with biomarkers in the cerebrospinal fluid. Eur Arch Psychiatry Clin Neurosci 2020; 270:911-919. [PMID: 31760473 DOI: 10.1007/s00406-019-01086-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/16/2019] [Indexed: 12/14/2022]
Abstract
For patients with depression treated with electroconvulsive therapy (ECT), the novel seizure quality index (SQI) can predict the risk of non-response (and non-remission)-as early as after the second ECT session-based the extent of several ictal parameters of the seizure. We aim to test several CSF markers on their ability to predict the degree of seizure quality, measured by the SQI to identify possible factors, that could explain some variability of the seizure quality. Baseline CSF levels of metabolites from the kynurenine pathway, markers of neurodegeneration (tau proteins, β-amyloids and neurogranin), elements of the innate immune system, endocannabinoids, sphingolipids, neurotrophic factors (VEGF) and Klotho were measured before ECT in patients with depression (n = 12) to identify possible correlations with the SQI by Pearson's partial correlation. Negative, linear relationships with the SQI for response were observed for CSF levels of T-tau (rpartial = - 0.69, p = 0.019), phosphatidylcholines (rpartial = - 0.52, p = 0.038) and IL-8 (rpartial = - 0.67, p = 0.047). Regarding the SQI for remission, a negative, linear relationship was noted with CSF levels of the endocannabinoid AEA (rpartial = - 0.70, p = 0.024) and CD163 (rpartial = - 0.68, p = 0.029). In sum, CSF Markers for the innate immune system, for neurodegeneration and from lipids were found to be associated with the SQI for response and remission after adjusting for age. Consistently, higher CSF levels of the markers were always associated with lower seizure quality. Based on these results, further research regarding the mechanism of seizure quality in ECT is suggested.
Collapse
Affiliation(s)
- Laura Kranaster
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany.
| | - Carolin Hoyer
- Department of Neurology, University Medical Centre Mannheim, Mannheim, Germany
| | - Sonani Mindt
- Institute for Clinical Chemistry, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Neumaier
- Institute for Clinical Chemistry, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Norbert Müller
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany.,Marion Von Tessin Memory-Zentrum, München, Germany
| | - Peter Zill
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany
| | - Markus J Schwarz
- Institute of Laboratory Medicine, University Hospital LMU Munich, Munich, Germany
| | - Natalie Moll
- Institute of Laboratory Medicine, University Hospital LMU Munich, Munich, Germany
| | - Beat Lutz
- Institute for Physiological Chemistry, University Medical Center Mainz of the Johannes Gutenberg University, Mainz, Germany
| | - Laura Bindila
- Institute for Physiological Chemistry, University Medical Center Mainz of the Johannes Gutenberg University, Mainz, Germany
| | - Inga Zerr
- Department of Neurology, National TSE (Transmissible Spongiform Encephalopathies) Reference Centre, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Matthias Schmitz
- Department of Neurology, National TSE (Transmissible Spongiform Encephalopathies) Reference Centre, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Maren Leifheit-Nestler
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Cagakan Ozbalci
- Randall Centre for Cell and Molecular Biophysics, King's College London, London, UK.,Heidelberg University Biochemistry Center, Heidelberg, Germany
| | - Alexander Sartorius
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| |
Collapse
|
2
|
Tosun Ş, Tosun M, Akansel G, Gökbakan AM, Ünver H, Tural Ü. Proton magnetic resonance spectroscopic analysis of changes in brain metabolites following electroconvulsive therapy in patients with major depressive disorder. Int J Psychiatry Clin Pract 2020; 24:96-101. [PMID: 31825726 DOI: 10.1080/13651501.2019.1699118] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: The aim of this study was to evaluate the metabolic changes in the anterior cingulate cortex (ACC) induced by electroconvulsive therapy (ECT) in patients with MDD via 1H-MRS.Methods: The study was conducted on 13 MDD patients receiving ECT treatment and 14 healthy controls matched in terms of age, gender and education. The patients underwent six sessions of ECT. 1H-MRS imaging and psychometric evaluations obtained before 1st and after the 6th sessions. The control group also went through the same procedures except for ECT. N-Acetyl aspartate (NAA), choline (Cho) and creatine (Cr) metabolite levels and the creatine to metabolite ratios were measured.Results: There was no significant difference in the ACC metabolite levels of the patients and those of the controls at the baseline. ECT associated with a statistically significant decrease in the NAA/Cr ratio in ACC. All of the patients had responded to ECT treatment as measured with the clinical scales.Conclusions: The results has suggested that indirect proof of an increase in energy metabolism without any evidence of impaired neuronal viability in the ACC induced by ECT. The relative increase in Cr levels following ECT in MDD seems to be associated with improvement in clinical severity.Key pointsECT is one the most effective method in the treatment of acute MDD.The mechanism of ECT's antidepressant activity remains unclear but it is thought to be related to the regulation of prefrontal cortical or cingulate areas.In this study the patients underwent six sessions of ECT and after 1H-MRS imaging.The study revealed that baseline levels of metabolites in patients with MDD were not significantly different than those of control group.
Collapse
Affiliation(s)
- Şakir Tosun
- Department of Psychiatry, Turkish Ministry of Health Kocaeli State Hospital, Kocaeli, Turkey
| | - Mesude Tosun
- Department of Radiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey
| | - Gür Akansel
- Department of Radiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey
| | - Aziz Mehmet Gökbakan
- Department of Psychiatry, Erenköy Research and Training Hospital, Istanbul, Turkey
| | - Hatice Ünver
- Child and Adolescent Psychiatry Clinic, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey
| | - Ümit Tural
- The Nathan S. Kline Psychiatric Research Institute, Orangeburg, NY, USA
| |
Collapse
|
3
|
McIntosh AL, Gormley S, Tozzi L, Frodl T, Harkin A. Recent Advances in Translational Magnetic Resonance Imaging in Animal Models of Stress and Depression. Front Cell Neurosci 2017; 11:150. [PMID: 28596724 PMCID: PMC5442179 DOI: 10.3389/fncel.2017.00150] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/09/2017] [Indexed: 12/28/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a valuable translational tool that can be used to investigate alterations in brain structure and function in both patients and animal models of disease. Regional changes in brain structure, functional connectivity, and metabolite concentrations have been reported in depressed patients, giving insight into the networks and brain regions involved, however preclinical models are less well characterized. The development of more effective treatments depends upon animal models that best translate to the human condition and animal models may be exploited to assess the molecular and cellular alterations that accompany neuroimaging changes. Recent advances in preclinical imaging have facilitated significant developments within the field, particularly relating to high resolution structural imaging and resting-state functional imaging which are emerging techniques in clinical research. This review aims to bring together the current literature on preclinical neuroimaging in animal models of stress and depression, highlighting promising avenues of research toward understanding the pathological basis of this hugely prevalent disorder.
Collapse
Affiliation(s)
| | - Shane Gormley
- Institute of Neuroscience, Trinity College DublinDublin, Ireland
| | - Leonardo Tozzi
- Institute of Neuroscience, Trinity College DublinDublin, Ireland
| | - Thomas Frodl
- Institute of Neuroscience, Trinity College DublinDublin, Ireland.,Universitätsklinikum A.ö.R, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Otto von Guericke UniversitätMagdeburg, Germany
| | - Andrew Harkin
- Institute of Neuroscience, Trinity College DublinDublin, Ireland.,School of Pharmacy and Pharmaceutical sciences, Trinity College DublinDublin, Ireland
| |
Collapse
|
4
|
Jorgensen A, Magnusson P, Hanson LG, Kirkegaard T, Benveniste H, Lee H, Svarer C, Mikkelsen JD, Fink-Jensen A, Knudsen GM, Paulson OB, Bolwig TG, Jorgensen MB. Regional brain volumes, diffusivity, and metabolite changes after electroconvulsive therapy for severe depression. Acta Psychiatr Scand 2016; 133:154-164. [PMID: 26138003 DOI: 10.1111/acps.12462] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the role of hippocampal plasticity in the antidepressant effect of electroconvulsive therapy (ECT). METHOD We used magnetic resonance (MR) imaging including diffusion tensor imaging (DTI) and proton MR spectroscopy (1 H-MRS) to investigate hippocampal volume, diffusivity, and metabolite changes in 19 patients receiving ECT for severe depression. Other regions of interest included the amygdala, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex, and hypothalamus. Patients received a 3T MR scan before ECT (TP1), 1 week (TP2), and 4 weeks (TP3) after ECT. RESULTS Hippocampal and amygdala volume increased significantly at TP2 and continued to be increased at TP3. DLPFC exhibited a transient volume reduction at TP2. DTI revealed a reduced anisotropy and diffusivity of the hippocampus at TP2. We found no significant post-ECT changes in brain metabolite concentrations, and we were unable to identify a spectral signature at ≈1.30 ppm previously suggested to reflect neurogenesis induced by ECT. None of the brain imaging measures correlated to the clinical response. CONCLUSION Our findings show that ECT causes a remodeling of brain structures involved in affective regulation, but due to their lack of correlation with the antidepressant effect, this remodeling does not appear to be directly underlying the antidepressant action of ECT.
Collapse
Affiliation(s)
- A Jorgensen
- Psychiatric Centre Copenhagen (Rigshospitalet), Denmark.,Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark
| | - P Magnusson
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
| | - L G Hanson
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.,Biomedical Engineering, DTU Elektro, Technical University of Denmark, Lyngby, Denmark
| | - T Kirkegaard
- Psychiatric Centre Copenhagen (Rigshospitalet), Denmark
| | - H Benveniste
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, USA.,Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - H Lee
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, USA.,Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - C Svarer
- Neurobiology Research Unit, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - J D Mikkelsen
- Neurobiology Research Unit, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - A Fink-Jensen
- Psychiatric Centre Copenhagen (Rigshospitalet), Denmark.,Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark
| | - G M Knudsen
- Neurobiology Research Unit, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - O B Paulson
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.,Neurobiology Research Unit, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - T G Bolwig
- Psychiatric Centre Copenhagen (Rigshospitalet), Denmark
| | - M B Jorgensen
- Psychiatric Centre Copenhagen (Rigshospitalet), Denmark.,Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
5
|
Brandt MD, Brandt K, Werner A, Schönfeld R, Loewenbrück K, Donix M, Schaich M, Bornhäuser M, von Kummer R, Leplow B, Storch A. Preventive brain radio-chemotherapy alters plasticity associated metabolite profile in the hippocampus but seems to not affect spatial memory in young leukemia patients. Brain Behav 2015; 5:e00368. [PMID: 26442754 PMCID: PMC4589814 DOI: 10.1002/brb3.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/07/2015] [Accepted: 06/13/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Neuronal plasticity leading to evolving reorganization of the neuronal network during entire lifespan plays an important role for brain function especially memory performance. Adult neurogenesis occurring in the dentate gyrus of the hippocampus represents the maximal way of network reorganization. Brain radio-chemotherapy strongly inhibits adult hippocampal neurogenesis in mice leading to impaired spatial memory. METHODS To elucidate the effects of CNS radio-chemotherapy on hippocampal plasticity and function in humans, we performed a longitudinal pilot study using 3T proton magnetic resonance spectroscopy ((1)H-MRS) and virtual water-maze-tests in 10 de-novo patients with acute lymphoblastic leukemia undergoing preventive whole brain radio-chemotherapy. Patients were examined before, during and after treatment. RESULTS CNS radio-chemotherapy did neither affect recall performance in probe trails nor flexible (reversal) relearning of a new target position over a time frame of 10 weeks measured by longitudinal virtual water-maze-testing, but provoked hippocampus-specific decrease in choline as a metabolite associated with cellular plasticity in (1)H-MRS. CONCLUSION Albeit this pilot study needs to be followed up to definitely resolve the question about the functional role of adult human neurogenesis, the presented data suggest that (1)H-MRS allows the detection of neurogenesis-associated plasticity in the human brain.
Collapse
Affiliation(s)
- Moritz D Brandt
- Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden 01307, Dresden, Germany ; German Center for Neurodegenerative Diseases (DZNE) Dresden 10307, Dresden, Germany ; Center for Regenerative Therapies Dresden (CRTD), Technische Universität Dresden 01307, Dresden, Germany
| | - Kalina Brandt
- Department of Haematology and Oncology, University Hospital Dresden 01307, Dresden, Germany
| | - Annett Werner
- Department of Neuroradiology, Technische Universität Dresden 01307, Dresden, Germany
| | - Robby Schönfeld
- Institute for Psychology, University of Halle Halle, Germany
| | - Kai Loewenbrück
- Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden 01307, Dresden, Germany ; German Center for Neurodegenerative Diseases (DZNE) Dresden 10307, Dresden, Germany ; Center for Regenerative Therapies Dresden (CRTD), Technische Universität Dresden 01307, Dresden, Germany
| | - Markus Donix
- German Center for Neurodegenerative Diseases (DZNE) Dresden 10307, Dresden, Germany ; Department of Psychiatry, University Hospital Dresden 01307, Dresden, Germany
| | - Markus Schaich
- Department of Haematology and Oncology, University Hospital Dresden 01307, Dresden, Germany
| | - Martin Bornhäuser
- Center for Regenerative Therapies Dresden (CRTD), Technische Universität Dresden 01307, Dresden, Germany ; Department of Haematology and Oncology, University Hospital Dresden 01307, Dresden, Germany
| | - Rüdiger von Kummer
- Department of Neuroradiology, Technische Universität Dresden 01307, Dresden, Germany
| | - Bernd Leplow
- Institute for Psychology, University of Halle Halle, Germany
| | - Alexander Storch
- Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden 01307, Dresden, Germany ; German Center for Neurodegenerative Diseases (DZNE) Dresden 10307, Dresden, Germany ; Center for Regenerative Therapies Dresden (CRTD), Technische Universität Dresden 01307, Dresden, Germany
| |
Collapse
|
6
|
Park JH, Lee H, Makaryus R, Yu M, Smith SD, Sayed K, Feng T, Holland E, Van der Linden A, Bolwig TG, Enikolopov G, Benveniste H. Metabolic profiling of dividing cells in live rodent brain by proton magnetic resonance spectroscopy (1HMRS) and LCModel analysis. PLoS One 2014; 9:e94755. [PMID: 24819091 PMCID: PMC4018321 DOI: 10.1371/journal.pone.0094755] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 03/19/2014] [Indexed: 02/04/2023] Open
Abstract
Rationale Dividing cells can be detected in the live brain by positron emission tomography or optical imaging. Here we apply proton magnetic resonance spectroscopy (1HMRS) and a widely used spectral fitting algorithm to characterize the effect of increased neurogenesis after electroconvulsive shock in the live rodent brain via spectral signatures representing mobile lipids resonating at ∼1.30 ppm. In addition, we also apply the same 1HMRS methodology to metabolically profile glioblastomas with actively dividing cells growing in RCAS-PDGF mice. Methods 1HMRS metabolic profiles were acquired on a 9.4T MRI instrument in combination with LCModel spectral analysis of: 1) rat brains before and after ECS or sham treatments and 2) RCAS-PDGF mice with glioblastomas and wild-type controls. Quantified 1HMRS data were compared to post-mortem histology. Results Dividing cells in the rat hippocampus increased ∼3-fold after ECS compared to sham treatment. Quantification of hippocampal metabolites revealed significant decreases in N-acetyl-aspartate but no evidence of an elevated signal at ∼1.3 ppm (Lip13a+Lip13b) in the ECS compared to the sham group. In RCAS-PDGF mice a high density (22%) of dividing cells characterized glioblastomas. Nile Red staining revealed a small fraction (3%) of dying cells with intracellular lipid droplets in the tumors of RCAS-PDGF mice. Concentrations of NAA were lower, whereas lactate and Lip13a+Lip13b were found to be significantly higher in glioblastomas of RCAS-PDGF mice, when compared to normal brain tissue in the control mice. Conclusions Metabolic profiling using 1HMRS in combination with LCModel analysis did not reveal correlation between Lip13a+Lip13b spectral signatures and an increase in neurogenesis in adult rat hippocampus after ECS. However, increases in Lip13a+Lip13b were evident in glioblastomas suggesting that a higher density of actively dividing cells and/or the presence of lipid droplets is necessary for LCModel to reveal mobile lipids.
Collapse
Affiliation(s)
- June-Hee Park
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, United States of America
| | - Hedok Lee
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York, United States of America
| | - Rany Makaryus
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York, United States of America
| | - Mei Yu
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York, United States of America
| | - S. David Smith
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York, United States of America
| | - Kasim Sayed
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, United States of America
| | - Tian Feng
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, United States of America
| | - Eric Holland
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Annemie Van der Linden
- Department of Biomedical Sciences, Bio-Imaging Laboratory, University of Antwerp, Belgium
| | - Tom G. Bolwig
- Neuropsychiatry Laboratory, Copenhagen University Hospital, Copenhagen, Denmark
| | - Grigori Enikolopov
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, United States of America
| | - Helene Benveniste
- Department of Anesthesiology, Stony Brook Medicine, Stony Brook, New York, United States of America
- Department of Radiology, Stony Brook Medicine, Stony Brook, New York, United States of America
- * E-mail:
| |
Collapse
|
7
|
Feng P, Huang C. Phospholipase D-mTOR signaling is compromised in a rat model of depression. J Psychiatr Res 2013; 47:579-85. [PMID: 23421961 DOI: 10.1016/j.jpsychires.2013.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 01/04/2013] [Accepted: 01/11/2013] [Indexed: 10/27/2022]
Abstract
Depression is associated with structural and neurochemical changes in limbic structures, including the hippocampus, that control emotion and mood. Structural abnormalities such as decrease in hippocampal cell proliferation, neurogenesis and hippocampal volume, and loss of neurons and glial cells have been widely reported in physical and psychosocial stress paradigms and animal model of depression, but corresponding neurochemical changes are largely unknown. Using neonatal clomipramine (CL)-treated rats as a model to elucidate the association of phospholipase D (PLD) and mammalian target of rapamycin (mTOR) signaling with depressive pathology, we found that the hippocampus of CL-treated rats showed significantly down-regulation of PLD1 expression and attenuation of PLD activity which leads to the less formation of phosphatidic acid (PA), an activator of mTOR, and free choline, a potential biomarker for depression. With lower PA levels which could affect mTOR signaling, we further observed that the phosphorylation of p70S6 kinase, one of the downstream effectors of mTOR, was also significantly decreased in the hippocampus of CL-treated rats compared to the controls. Down-regulation of PLD1 expression, PLD activity and p70S6 phosphorylation was also found in the hypothalamus and frontal cortex with CL-treated rats. Our results indicate that PLD-mTOR signaling is associated with depressive disorder.
Collapse
Affiliation(s)
- Pingfu Feng
- Louis Stokes Cleveland Veteran Affairs Medical Center, Cleveland, OH 44109, USA
| | | |
Collapse
|
8
|
Preclinical (1)H-MRS neurochemical profiling in neurological and psychiatric disorders. Bioanalysis 2012; 4:1787-804. [PMID: 22877223 DOI: 10.4155/bio.12.129] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The ongoing development of animal models of neurological and psychiatric disorders in combination with the development of advanced nuclear magnetic resonance (NMR) techniques and instrumentation has led to increased use of in vivo proton NMR spectroscopy ((1)H-MRS) for neurochemical analyses. (1)H-MRS is one of only a few analytical methods that can assay in vivo and longitudinal neurochemical changes associated with neurological and psychiatric diseases, with the added advantage of being a technique that can be utilized in both preclinical and clinical studies. In this review, recent progress in the use of (1)H-MRS to investigate animal models of neurological and psychiatric disorders is summarized with examples from the literature and our own work.
Collapse
|
9
|
Abstract
The cost of psychiatric illness to the UK economy was recently estimated at pound77 billion annually. Despite years of research no firm aetiological explanation exists, and with no physiological or biochemical markers diagnosis is made entirely on a behavioural basis. All current pharmacological therapies are associated with serious long-term side effects. Substantial evidence supports the involvement of one-carbon cycle dysregulation in psychiatric illness, but this is not currently used as a basis for diagnosis or treatment. The present paper reviews the evidence for one-carbon cycle dysregulation in schizophrenic, bipolar, depressed and autistic patients. Also presented are novel findings from the field of epigenetics, which demonstrate how the one-carbon cycle-derived methyl donor S-adenosylmethionine influences the expression of key genes in the brain affecting memory, learning, cognition and behaviour, genes whose expression is reduced to varying degrees in these patient groups. Clinical evidence that nutritional supplements can rectify one-carbon cycle activity, and restore normal gene expression, suggests a novel approach to the development of biochemical tests and simple, non-harmful treatments for some psychiatric patients. Conversely, evidence from animal studies highlights the dangers of exposing the unborn fetus to very high dietary levels of folic acid, a one-carbon cycle cofactor. Fetal adaptations to a high-folate environment may interfere with folate metabolism postnatally, with serious consequences for the epigenetic regulation of gene expression. The public health implications of these diverse scenarios indicate an urgent need for further research in this field.
Collapse
Affiliation(s)
- C Sugden
- Centre for Nutrition and Food Safety, School of Biomedical and Molecular Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
| |
Collapse
|
10
|
Gonzales MM, Tarumi T, Kaur S, Nualnim N, Fallow BA, Pyron M, Tanaka H, Haley AP. Aerobic fitness and the brain: increased N-acetyl-aspartate and choline concentrations in endurance-trained middle-aged adults. Brain Topogr 2012; 26:126-34. [PMID: 22926147 DOI: 10.1007/s10548-012-0248-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 08/10/2012] [Indexed: 11/28/2022]
Abstract
Engagement in regular aerobic exercise is associated with cognitive benefits, but information on the mechanisms governing these changes in humans is limited. The goal of the current study was to compare neurometabolite concentrations relating to cellular metabolism, structure, and viability in endurance-trained and sedentary middle-aged adults. Twenty-eight endurance-trained and 27 sedentary adults, aged 40-65 years, underwent general health assessment, cardiorespiratory fitness measurement, neuropsychological testing, and proton magnetic resonance spectroscopy ((1)H MRS). (1)H MRS was used to examine N-acetyl-aspartate (NAA), creatine (Cr), myo-inositol (mI), choline (Cho), and glutamate (Glu) concentrations in frontal and occipitoparietal grey matter. Group differences in concentrations of NAA, Cho, mI, and Glu, calculated as ratios over Cr, were explored using ANOVA. There were no significant differences in global cognitive function, memory, and executive function performance between the groups. In comparison to sedentary adults, the endurance-trained group displayed significantly higher NAA/Cr in the frontal grey matter (F(1, 53) = 5.367, p = 0.024) and higher Cho/Cr in the occipitoparietal grey matter (F(1, 53) = 5.138, p = 0.028). Within our middle-aged sample, endurance-trained adults demonstrated higher levels of NAA/Cr in the frontal grey matter and higher Cho/Cr in the occipitoparietal grey matter. Higher levels of NAA may indicate greater neuronal integrity and higher cerebral metabolic efficiency in association with cardiorespiratory fitness, whereas increased Cho may represent increased phospholipid levels secondary to neural plasticity.
Collapse
Affiliation(s)
- Mitzi M Gonzales
- Department of Psychology, The University of Texas at Austin, Austin, TX 78712, USA
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Silverstone PH, Asghar SJ, O'Donnell T, Ulrich M, Hanstock CC. Lithium and valproate protect against dextro-amphetamine induced brain choline concentration changes in bipolar disorder patients. World J Biol Psychiatry 2009; 5:38-44. [PMID: 15048634 DOI: 10.1080/15622970410029906] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Lithium may affect brain choline concentrations, and this effect has been proposed to potentially explain its clinical efficacy. Since dextro-amphetamine is a useful human model of mania, we were interested in determining firstly whether dextro-amphetamine would alter brain choline concentrations, and secondly to determine if lithium would protect against any such changes in bipolar patients. In addition, we wanted to determine if valproate would also have any effects upon choline levels. METHODS Healthy controls (n=18) were compared with euthymic Bipolar Disorder patients (Type I and Type II) who were taking lithium (n=14) or valproate (n=11). We utilized (1)H-magnetic resonance spectroscopy ((1)H-MRS) in a 3.0T scanner to examine brain choline/phosphocholine+creatine (Cho/Cr) ratios. Changes in this ratio were measured to determine any changes in choline concentrations in the temporal lobe. RESULTS The results showed that administration of dextro-amphetamine decreased the Cho/Cr ratios. In contrast, in both the lithium-treated and valproate-treated patients this decrease was not seen; this attenuation in the change in Cho/Cr ratio changes was statistically significant. It should be noted that Cho/Cr ratios were significantly higher at baseline in the controls compared to both groups of patients, which may have influenced the results. CONCLUSIONS These findings are the first to examine the effects of dextro-amphetamine on brain choline concentrations. They show that while in controls dextro-amphetamine decreases choline concentrations, lithium and valproate both appear to protect against this effect in bipolar patients. However, as brain ratios were measured rather than the absolute concentration of choline, and these ratios were lowered in patients at baseline, these results must be regarded as preliminary and require replication in future studies.
Collapse
Affiliation(s)
- Peter H Silverstone
- Department of Psychiatry, University of Alberta, 1E1.07 Mackenzie Center, 8440 - 112 Street, Edmonton AB, Canada.
| | | | | | | | | |
Collapse
|
12
|
Proton MR spectroscopy of the hippocampus at 3 T in patients with unipolar major depressive disorder: correlates and predictors of treatment response. Int J Neuropsychopharmacol 2009; 12:415-22. [PMID: 18845018 DOI: 10.1017/s1461145708009516] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Various lines of research suggest that neurotrophic processes in the hippocampus are key mechanisms in major depressive disorder and are of relevance for response to antidepressive treatment. We performed proton magnetic resonance spectroscopy (1H-MRS) of the hippocampus at 3 T in 18 unmedicated subjects with unipolar major depressive episodes and in 10 age- and gender-matched healthy volunteers. Thirteen patients underwent a second examination after 8 wk treatment with either citalopram (n=7) or nortriptyline (n=6). Of these patients, 11 MRS datasets could be used for the assessment of treatment correlates. In the cross-sectional comparison, we observed a significant reduction of the metabolic ratios Glx/Cr (Glx=glutamine, glutamate and gamma-aminobutyric acid) and glutamine (Gln)/Cr in the patient group. The Gln/Glx ratio also showed a trend towards significant reduction. The individual effect of treatment correlated with an increase in the absolute concentrations of N-acetylaspartate (NAA) and of choline compounds (Cho). Low baseline NAA and Cho levels predicted positive treatment effects. There was no difference in any clinical or metabolic measure, either at baseline or at follow-up between the two treatment groups (citalopram, nortriptyline). Our data provide first evidence for a reduction of Gln in the hippocampus of subjects with major depression. Furthermore, we provide first evidence in patients with major depression for neurorestorative effects in the hippocampus by pharmacological treatment expressed by a correlation of NAA and Cho increases with treatment response. This accounts in particular for those patients with low NAA and Cho baseline levels.
Collapse
|
13
|
Impact of the brain-derived neurotrophic factor Val66Met polymorphism on levels of hippocampal N-acetyl-aspartate assessed by magnetic resonance spectroscopic imaging at 3 Tesla. Biol Psychiatry 2008; 64:856-62. [PMID: 18707679 PMCID: PMC2586327 DOI: 10.1016/j.biopsych.2008.07.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 06/19/2008] [Accepted: 07/07/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND This study was conducted to corroborate prior evidence of an effect of the brain-derived neurotrophic factor (BDNF) valine (val) to methionine (met) amino acid substitution at codon 66 (val66met) polymorphism on measures of N-acetyl-aspartate (NAA) containing compounds in healthy subjects. METHODS The NAA to creatine (Cre) ratio (NAA/Cre), NAA to choline (Cho) ratio (NAA/Cho), and Cho to Cre ratio (Cho/Cre) were measured in the left and right hippocampi, left and right dorsolateral prefrontal cortices, occipital lobe, anterior cingulate, and white matter of the centrum semiovale of 69 carefully screened healthy volunteers utilizing proton magnetic resonance spectroscopic imaging (MRSI) at 3 Tesla (T). RESULTS Val/met subjects exhibited significantly reduced levels of left hippocampal NAA/Cre and NAA/Cho compared with val/val subjects. This effect was independent of age, IQ, number of voxels, hippocampal volume, or gray matter content in the voxels of interest. Analysis of other brain regions showed no effect of BDNF genotype on NAA measures. CONCLUSIONS We confirmed the association between the met-BDNF variant and reduced levels of hippocampal NAA found with a similar technique at 1.5T. The consonance of our results with prior findings adds to the evidence that the BDNF val/met genotype affects hippocampal biology with implications for a variety of neuropsychiatric disorders.
Collapse
|
14
|
|
15
|
Sartorius A, Schloss P, Vollmayr B, Ende G, Neumann-Haefelin C, Hoehn M, Henn FA. Correlation between MR-spectroscopic rat hippocampal choline levels and phospholipase A2. World J Biol Psychiatry 2007; 7:246-50. [PMID: 17071545 DOI: 10.1080/15622970600946446] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Hippocampal choline-containing compounds (Cho) determined with 1H MR spectroscopy (MRS) are decreased in major depression episodes and return to baseline levels after antidepressive electroconvulsive therapy (ECT). A rise in hippocampal Cho has been observed in rats upon electroconvulsive shocks (ECS), an analogue of human ECT. Choline production involves the activity of various phospholipases. In order to investigate whether the increase of Cho correlates with an enhanced expression of phosphoslipase A2 (PLA2) we took rectangular tissue samples from the region of the MRS voxel for immunoblotting. Our data show a significant inverse correlation (p = 0.018) between PLA2 protein levels and MRS Cho/NAA levels suggesting a possible downregulation of PLA2 in compensation for an upregulation of other phospholipases.
Collapse
|
16
|
Mason GF, Krystal JH. MR spectroscopy: its potential role for drug development for the treatment of psychiatric diseases. NMR IN BIOMEDICINE 2006; 19:690-701. [PMID: 16986118 DOI: 10.1002/nbm.1080] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Magnetic resonance spectroscopy (MRS) is likely in the near future to play a key role in the process of drug discovery and evaluation. As the pharmaceutical industry seeks biochemical markers of drug delivery, efficacy and toxicity, this non-invasive technique offers numerous ways to study adults and children repeatedly and without ionizing radiation. In this article, we survey an array of the information that MRS offers about neurochemistry in general and psychiatric disorders and their treatment in particular. We also present growing evidence of glial abnormalities in neuropsychiatric disorders and discuss what MRS is contributing to that line of investigation. The third major direction of this article is the discussion of where MRS techniques are headed and how those new techniques can contribute to studies of mechanisms of psychiatric disease and drug discovery.
Collapse
Affiliation(s)
- Graeme F Mason
- Department of Diagnostic Radiology, Yale University, School of Medicine, 300 Cedar St, New Haven, CT 06520-8043, USA.
| | | |
Collapse
|
17
|
Millan MJ. Multi-target strategies for the improved treatment of depressive states: Conceptual foundations and neuronal substrates, drug discovery and therapeutic application. Pharmacol Ther 2006; 110:135-370. [PMID: 16522330 DOI: 10.1016/j.pharmthera.2005.11.006] [Citation(s) in RCA: 419] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Accepted: 11/28/2005] [Indexed: 12/20/2022]
Abstract
Major depression is a debilitating and recurrent disorder with a substantial lifetime risk and a high social cost. Depressed patients generally display co-morbid symptoms, and depression frequently accompanies other serious disorders. Currently available drugs display limited efficacy and a pronounced delay to onset of action, and all provoke distressing side effects. Cloning of the human genome has fuelled expectations that symptomatic treatment may soon become more rapid and effective, and that depressive states may ultimately be "prevented" or "cured". In pursuing these objectives, in particular for genome-derived, non-monoaminergic targets, "specificity" of drug actions is often emphasized. That is, priority is afforded to agents that interact exclusively with a single site hypothesized as critically involved in the pathogenesis and/or control of depression. Certain highly selective drugs may prove effective, and they remain indispensable in the experimental (and clinical) evaluation of the significance of novel mechanisms. However, by analogy to other multifactorial disorders, "multi-target" agents may be better adapted to the improved treatment of depressive states. Support for this contention is garnered from a broad palette of observations, ranging from mechanisms of action of adjunctive drug combinations and electroconvulsive therapy to "network theory" analysis of the etiology and management of depressive states. The review also outlines opportunities to be exploited, and challenges to be addressed, in the discovery and characterization of drugs recognizing multiple targets. Finally, a diversity of multi-target strategies is proposed for the more efficacious and rapid control of core and co-morbid symptoms of depression, together with improved tolerance relative to currently available agents.
Collapse
Affiliation(s)
- Mark J Millan
- Institut de Recherches Servier, Centre de Recherches de Croissy, Psychopharmacology Department, 125, Chemin de Ronde, 78290-Croissy/Seine, France.
| |
Collapse
|
18
|
Gonul AS, Kitis O, Ozan E, Akdeniz F, Eker C, Eker OD, Vahip S. The effect of antidepressant treatment on N-acetyl aspartate levels of medial frontal cortex in drug-free depressed patients. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30:120-5. [PMID: 16236417 DOI: 10.1016/j.pnpbp.2005.08.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2005] [Indexed: 11/27/2022]
Abstract
The medial frontal cortex has been shown to modulate emotional behavior and stress responses, suggesting that the dysfunction of this region may be involved in the pathogenesis of depressive symptoms. The present study was performed to determine whether there was any effect of antidepressant treatment on the metabolite levels in the left medial frontal cortex as measured by proton magnetic resonance spectroscopy in depressed patients. Twenty patients diagnosed as having major depressive disorder according to DSM-IV and 18 healthy volunteer subjects were included in the study. Twelve of patients had their first episode and were drug-naïve. Other depressed patients were drug-free for at least 4 weeks. The severity of depression was assessed by HAM-D and Clinical Global Impression Scale-Severity (CGI-S). Single voxel, 8 cm(3), 1H MR spectra of left medial frontal cortex was acquired both before and following antidepressant treatment. The concentrations and ratios of N-acetyl aspartate (NAA), Creatine+Phosphocreatine (Cr+PCr) and Choline (Cho) were measured. Pretreatment NAA/Cr values of patients were lower than those of healthy controls, but this difference did not reach to statistically significant levels (t=1.83, df=36, p=0.07). However, antidepressant treatment had significant effect on NAA/Cr ratios (groupxtreatment interaction: F=9.93 df=1,36, p=0.03). After the treatment, NAA/Cr values of patients increased significantly compared to pretreatment values (t=3.32, df=19, p=0.004). No significant difference was observed between the post-treatment NAA/Cr values of patients and those of controls (t=1.64, df=36, p=0.19). Correlation analysis detected negative correlation between pretreatment CGI-S scores and NAA/Cr ratios (r=-0.51, p=0.02). This preliminary result suggests that there might be a possible defect in the neuronal integrity in the left medial frontal cortex (mainly left anterior cingulate cortex) of depressed patients. Antidepressant treatment with its neurotrophic effects might play a positive role in restoring the neuronal integrity. Further studies are needed to support these initial findings.
Collapse
Affiliation(s)
- Ali Saffet Gonul
- Department of Psychiatry Affective Disorders Unit, Ege University, School of Medicine, 35100 Izmir, Turkey.
| | | | | | | | | | | | | |
Collapse
|
19
|
|
20
|
Wu RH, O'Donnell T, Ulrich M, Asghar SJ, Hanstock CC, Silverstone PH. Brain choline concentrations may not be altered in euthymic bipolar disorder patients chronically treated with either lithium or sodium valproate. ANNALS OF GENERAL HOSPITAL PSYCHIATRY 2004; 3:13. [PMID: 15283867 PMCID: PMC509421 DOI: 10.1186/1475-2832-3-13] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2003] [Accepted: 07/30/2004] [Indexed: 11/18/2022]
Abstract
Background It has been suggested that lithium increases choline concentrations, although previous human studies examining this possibility using 1H magnetic resonance spectroscopy (1H MRS) have had mixed results: some found increases while most found no differences. Methods The present study utilized 1H MRS, in a 3 T scanner to examine the effects of both lithium and sodium valproate upon choline concentrations in treated euthymic bipolar patients utilizing two different methodologies. In the first part of the study healthy controls (n = 18) were compared with euthymic Bipolar Disorder patients (Type I and Type II) who were taking either lithium (n = 14) or sodium valproate (n = 11), and temporal lobe choline/creatine (Cho/Cr) ratios were determined. In the second part we examined a separate group of euthymic Bipolar Disorder Type I patients taking sodium valproate (n = 9) and compared these to controls (n = 11). Here we measured the absolute concentrations of choline in both temporal and frontal lobes. Results The results from the first part of the study showed that bipolar patients chronically treated with both lithium and sodium valproate had significantly reduced temporal lobe Cho/Cr ratios. In contrast, in the second part of the study, there were no effects of sodium valproate on either absolute choline concentrations or on Cho/Cr ratios in either temporal or frontal lobes. Conclusions These findings suggest that measuring Cho/Cr ratios may not accurately reflect brain choline concentrations. In addition, the results do not support previous suggestions that either lithium or valproate increases choline concentrations in bipolar patients.
Collapse
Affiliation(s)
- Ren H Wu
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Tina O'Donnell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Michele Ulrich
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Sheila J Asghar
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | | | | |
Collapse
|
21
|
Sartorius A, Vollmayr B, Neumann-Haefelin C, Ende G, Hoehn M, Henn FA. Specific creatine rise in learned helplessness induced by electroconvulsive shock treatment. Neuroreport 2003; 14:2199-201. [PMID: 14625447 DOI: 10.1097/00001756-200312020-00013] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Metabolic changes in the hippocampus formation can be investigated with in vivo magnetic resonance spectroscopy (MRS). Learned helplessness (LH) is a well validated animal model of depression which we established in Sprague-Dawley rats defining some as "learned helpless" (LH) or not "learned helpless" (NLH). Helpless and non-helpless rats received a course of daily administered electroconvulsive shocks (ECS) for 6 days. MRS measurements were performed on a 4.7 T animal scanner with an average voxel size within the rat hippocampus of 10 microl. In LH rats hippocampal creatine/NAA rose significantly (14%) whereas creatine/NAA of NLH rats showed no increase at all. A possible connection between hippocampal creatine levels and major depressive disorders as a reflection of changes in energy metabolism is discussed.
Collapse
|