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Variation in Thyroid-Stimulating Hormone and Cognitive Disorders in Unmedicated Middle-Aged Patients with Major Depressive Disorder: A Proton Magnetic Resonance Spectroscopy Study. Mediators Inflamm 2022; 2022:1623478. [PMID: 36105682 PMCID: PMC9467792 DOI: 10.1155/2022/1623478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 01/10/2023] Open
Abstract
Background Middle-aged (45-59 years old) patients with major depressive disorder (MDD) have a predilection for dementia and cognitive disorders (CDs); however, the characteristics and mechanisms of CDs in these patients remain unclear. There are also known connections between thyroid-stimulating hormone (TSH), brain biochemical metabolism, and cognitive function (CF); however, there is scanty of information about these connections in middle-aged MDD patients. Methods Cognitive assessment was performed on 30 first-episode, untreated middle-aged patients with MDD and 30 well-matched healthy controls (HCs) using the MATRICS Consensus Cognitive Battery (MCCB). N-acetyl aspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the prefrontal cortex (PFC) and cerebellum were also obtained via proton magnetic resonance spectroscopy (1H-MRS), and the TSH level was measured by chemiluminescence analysis. Results MDD patients presented significantly lower processing speed, working memory, verbal learning, reasoning problem-solving, visual learning, and composite cognition scores than controls, with a statistically lower NAA/Cr ratio in the right cerebellum. Age was positively related to reasoning problem-solving in the MDD group (r = 0.6249, p = 0.0220). Education also showed a positive association with visual learning, social cognition, and composite cognition. The 24-item Hamilton Depression Rating Scale (HDRS-24) score was negatively related to all domains of CF. TSH levels were markedly decreased in the MDD group, and a positive connection was determined between the NAA/Cr ratio in the right PFC and the TSH level. Conclusions Middle-aged MDD patients have multidimensional CDs. There are changes in PFC and cerebellar biochemical metabolism in middle-aged patients with MDD, which may be related to CDs or altered TSH levels.
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Childhood trauma history is linked to abnormal brain metabolism of non-medicated adult patients with major depressive disorder. J Affect Disord 2022; 302:101-109. [PMID: 34965400 DOI: 10.1016/j.jad.2021.12.103] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 12/19/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Childhood trauma is a risk factor that may lead to persistent brain metabolic abnormalities, predisposing individuals to major depressive disorder (MDD). To better elucidate the pathogenesis of MDD, we investigated the neurometabolic changes in unmedicated MDD patients who had experienced childhood trauma (CT). METHODS In this study, 37 unmedicated MDD patients with CT, 35 unmedicated MDD patients without CT, and 30 healthy control participants underwent high-resolution proton magnetic resonance spectroscopy (1H-MRS) examination. Bilateral metabolic ratios of N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr in the prefrontal white matter (PWM), anterior cingulate cortex (ACC), putamen, and cerebellum were obtained. RESULTS MDD patients showed neurometabolic changes in the cortico-striato-cerebellar (CSC) circuit. Furthermore, MDD patients showed significantly lower NAA/Cr and higher Cho/Cr ratio in the bilateral ACC and putamen, and higher NAA/Cr and lower Cho/Cr ratio in the cerebellum. Childhood trauma reduced the Cho/Cr ratio in the left ACC, which played an important role in longer and more episodes of depression. CONCLUSION Early childhood trauma has a long-lasting impact on the metabolism of adult MDD patients, leading to abnormal choline metabolism of the left ACC. Abnormal biochemical metabolism in the CSC circuit may be an underlying pathophysiology of MDD. LIMITATION As this is a small cross-sectional study, the impact of childhood trauma on the different stages of depression has not been observed.
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Liao X, Lai S, Zhong S, Wang Y, Zhang Y, Shen S, Huang H, Chen G, Chen F, Jia Y. Interaction of Serum Copper and Neurometabolites on Executive Dysfunction in Unmedicated Patients With Major Depressive Disorder. Front Psychiatry 2021; 12:564375. [PMID: 33746789 PMCID: PMC7965952 DOI: 10.3389/fpsyt.2021.564375] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 01/19/2021] [Indexed: 12/28/2022] Open
Abstract
Objective: The mechanism of executive function (EF) impairment in major depressive disorder (MDD) remains unclear. Previous studies have demonstrated that altered serum copper levels and neurometabolic alterations may be associated with the psychopathology and cognitive impairment of MDD. While, their inter-relationships in MDD remain uncertain. The present study aims to assess whether the interaction between serum copper levels and neurometabolic alterations is involved in the deficit of executive function (EF) in patients with unmedicated MDD. Methods: Serum copper levels and EFs were measured in 41 MDD patients and 50 control subjects. EFs were evaluated by Trail Making Test, Part-B (TMT-B), Digit Symbol Substitution Test (DSST), Wisconsin Card Sorting Task (WCST), and Semantic Verbal Fluency testing (SVFT). Additionally, 41 patients and 41 healthy controls underwent proton magnetic resonance spectroscopy (1H-MRS) to obtain ratios of N-acetyl aspartate to creatine (NAA/Cr) and choline-containing compounds to creatine (Cho/Cr) in the lenticular nucleus (LN) of basal ganglia (BG). Finally, association and interaction analysis were conducted to investigate their inter-relationships. Results: The results showed that patients performed worse in the DSST, WCST, TMT-B time and SVFT. Moreover, patients had higher serum copper levels, but lower NAA/Cr ratios in left LN of BG than healthy controls. In patients, serum copper levels were found to significantly negative associated with Categories Completed (CC) number of WCST (r = -0.408, p = 0.008), and positive associated with the Total Errors (TE) and Nonperseverative Errors (PE) number of WCST (r = 0.356, p = 0.023; r = -0.356, p = 0.022). In addition, the NAA/Cr ratios of left LN were found to significantly negative associated with VFS (r = -0.401, p = 0.009), as well as negative associated with serum copper levels (r = -0.365, p = 0.019). Finally, the interaction between copper and NAA may as influencing factors for SVFT and CC number of WCST in patients. Conclusion: Our results indicated that the interaction of abnormal copper levels and NAA/Cr neurometabolic disruption of the LN may impact executive dysfunction, and this may relevant to the pathophysiology of executive impairment in MDD patients.
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Affiliation(s)
- Xiaoxiao Liao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China.,Jiangmen Central Hospital, Jiangmen, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shiyi Shen
- School of Management, Jinan University, Guangzhou, China
| | - Hui Huang
- School of Management, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
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Kotb MA, Kamal AM, Aldossary NM, Alsify AA, Ahmed YM. Value of magnetic resonance spectroscopy in geriatric patients with cognitive impairment. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-0147-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mild cognitive impairment is a transitional stage prior to dementia, and it is reported in depressed patients. Early diagnosis could predict the reversible etiologies and prevent further deterioration. Proton magnetic resonance spectroscopy has been used for early diagnosis and differential diagnosis of cognitive impairment.
Objective
We aimed to study the difference of hippocampal and frontal white matter metabolites between patients with Alzheimer’s disease, mild cognitive impairment, and cognitive impairment associated with depression, and if those metabolites can differentiate between them.
Subjects and methods
Geriatric patients with cognitive impairment were recruited from neurology and psychiatry clinics. All subjects underwent comprehensive medical evaluations, neuropsychological testing, laboratory tests as well as brain MRI and 1H-MRS studies.
Results
The present study included 85 subjects. Patients with MCI and AD had lower hippocampal NAA and NAA/Cr ratio than patients with depression and normal controls, while, frontal NAA and NAA/Cr ratio were lower in all patient’s subgroups compared to normal control.
Conclusion
Hippocampal NAA and NAA/Cr ratio might help to differentiate between MCI and cognitive impairment associated with depression.
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Song Y, Shen X, Mu X, Mao N, Wang B. A study on BOLD fMRI of the brain basic activities of MDD and the first-degree relatives. Int J Psychiatry Clin Pract 2020; 24:236-244. [PMID: 32228280 DOI: 10.1080/13651501.2020.1744663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: The present study aims to explore the characteristics and differences of the ReHo, ALFF and fALFF of brain in the resting state of depression and first-degree relatives, in order to identify candidate central prodromal biomarkers of depression.Method: Three groups of medication-free patients (39-59 years old) was involved in this study, including the patients with major depression disorder (MDD group, n = 15), healthy volunteers with first-degree relatives with MDD (first-degree relatives group, n = 15), healthy volunteers with no personal or family history of MDD (the control group [HC], n = 15). Participants underwent functional MRI while staying in a resting state after a conventional MRI scanning on a clinical 3 T system(Siemens Skyra, Germany).Results: The ReHo, ALFF and fALFF values are different in brain of MDD, first-degree relatives, and HC (p<.05). MDD patients exhibited abnormal spontaneous activity in multiple brain regions which are closely related to emotion regulation and perception. The present findings provide further insight into the pathological mechanisms underlying MDD.Conclusion: With the widespread abnormal values of brain in MDD and first-degree relatives measured, we can get a hypothesis that these abnormalities may be associated with cognitive network disorders and emotional distress in MDD.Key pointsThe fMRI could increase the early validity of MDD as a new diagnostic and disease-monitoring tool.Monitoring ReHo, ALFF, fALFF values using fMRI can provide insight into the presence and evolution of MDD disease and permit objective evaluation of brain abnormalities.It appears that ReHo, ALFF, fALFF could be used as markers for monitoring disease progression and treatment effects in MDD patients in the future.
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Affiliation(s)
- Yulu Song
- Department of Imaging and Nuclear Medicine, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaojun Shen
- Department of Imaging and Nuclear Medicine, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Department of Radiology, School of Medicine, Medical Imaging Research Institute, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China
| | - Xinnuan Mu
- Department of Radiology, School of Medicine, The Affiliated Hospital of Binzhou Medical University, Binzhou Medical University, Binzhou, Shandong, China
| | - Ning Mao
- Department of Radiology, Yantai Yu Huang Ding Hospital, Yantai, Shandong, China
| | - Bin Wang
- Department of Radiology, School of Medicine, Medical Imaging Research Institute, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China
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Mao N, Che K, Chu T, Li Y, Wang Q, Liu M, Ma H, Wang Z, Lin F, Wang B, Ji H. Aberrant Resting-State Brain Function in Adolescent Depression. Front Psychol 2020; 11:1784. [PMID: 32903315 PMCID: PMC7396538 DOI: 10.3389/fpsyg.2020.01784] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/29/2020] [Indexed: 12/11/2022] Open
Abstract
To explore the changes of brain function and conduct clinical differential diagnosis based on support vector machine (SVM) in adolescent patients with depression. A total of 24 adolescent patients with depression according to CCMD-3 and DSM-5 and 23 gender, education level, body mass index, and age matched healthy controls were assessed with 17-item Hamilton Depression Rating Scale (HAMD). HAMD scores were requested from ≥17 of patients. Three−dimensional T1 and resting-state functional magnetic resonance imaging data were acquired from all participants. The data were analyzed using SPM 12 and REST1.8. Two-sample t-test was conducted to compare regional homogeneity (ReHo) values among the groups of participants. Finally, based on SVM classification, clinical differential diagnosis of the patients was carried out. The receiver operator characteristic (ROC) curve were used to confirm the performance of the SVM model. An increase ReHo values were observed in the lingual gyrus, middle occipital gyrus, postcentral gyrus, and precentral gyrus, whereas a decrease in ReHo was found in vermis compared with the control group. The SVM model showed good performance in classification prediction of adolescent depression, with an area under curve (AUC) of 0.778 [95% confidence interval (CI), 0.661–0.797]. The changes in the spontaneous neural activity of these regions may play an important role in the neuropathological mechanism of adolescent depression and may provide promising markers for clinical evaluation.
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Affiliation(s)
- Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Kaili Che
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Tongpeng Chu
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Yuna Li
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Qinglin Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Meijie Liu
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Zhongyi Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Fan Lin
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Bin Wang
- Medical Imaging Research Institute, Binzhou Medical University, Yantai, China
| | - Haixia Ji
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
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Polyunsaturated fatty acids metabolism, purine metabolism and inosine as potential independent diagnostic biomarkers for major depressive disorder in children and adolescents. Mol Psychiatry 2019; 24:1478-1488. [PMID: 29679072 PMCID: PMC6756100 DOI: 10.1038/s41380-018-0047-z] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/03/2018] [Accepted: 01/31/2018] [Indexed: 12/28/2022]
Abstract
Major depressive disorder (MDD) in children and adolescents is a recurrent and disabling condition globally but its pathophysiology remains poorly elucidated and there are limited effective treatments available. We performed metabolic profiling of plasma samples based on ultra-high-performance liquid chromatography equipped with quadrupole time-offlight mass spectrometry to explore the potential biomarkers of depression in children and adolescents with MDD. We identified several perturbed pathways, including fatty acid metabolism-particularly the polyunsaturated fatty acids metabolism, and purine metabolism-that were associated with MDD in these young patients. In addition, inosine was shown as a potential independent diagnostic biomarker for MDD, achieving an area under the ROC curve of 0.999 in discriminating drug-naive MDD patients and 0.866 in discriminating drug-treated MDD from healthy controls. Moreover, we found evidence for differences in the pathophysiology of MDD in children and adolescents to that of adult MDD, specifically with tryptophan metabolism. Through metabolomic analysis, we have identified links between a framework of metabolic perturbations and the pathophysiology and diagnostic biomarker of child and adolescent MDD.
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De Jaeger M, Goudman L, Van Schuerbeek P, De Mey J, Keymeulen B, Brouns R, Moens M. Cerebral Biochemical Effect of Pregabalin in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial. Diabetes Ther 2018; 9:1591-1604. [PMID: 29951977 PMCID: PMC6064591 DOI: 10.1007/s13300-018-0460-y] [Citation(s) in RCA: 2] [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] [Received: 05/07/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION With the development of new neuroimaging tools it has become possible to assess neurochemical alterations in patients experiencing chronic pain and to determine how these factors change during pharmacological treatment. The goal of this study was to examine the exact neurochemical mechanism underlying pregabalin treatment, utilizing magnetic resonance spectroscopy (1H-MRS), in a population of patients with painful diabetic polyneuropathy (PDN), with the overall aim to ultimately objectify the clinical effect of pregabalin. METHODS A double blind, randomized, placebo-controlled study was conducted. A total of 27 patients with PDN were enrolled in the study, of whom 13 received placebo treatment (control group) and 14 received pregabalin (intervention group). Pregabalin treatment consisted of stepwise dose escalation over the study period from 75 mg daily ultimately to 600 mg daily. 1H-MRS was performed at 3T on four regions of interest in the brain: the rostral anterior cingulate cortex (rACC), left and right thalamus and prefrontal cortex. The absolute concentrations of N-acetyl aspartate, glutamate, glutamine, gamma-amino-butyric-acid (GABA), glucose (Glc) and myo-inositol (mINS) were determined using LCModel. RESULTS The concentration of most neurometabolites in the placebo and pregabalin group did not significantly differ over time, with only a small significant difference in Glc level in the left thalamus (p = 0.049). Comparison of the effects of the different doses revealed significant differences for mINS in the rACC (baseline 2.42 ± 1.21 vs. 450 mg 1.58 ± 0.94; p = 0.022) and dorsolateral prefrontal cortex (75 mg 2.38 ± 0.89 vs. 450 mg 1.59 ± 0.85; p = 0.042) and also for GABA in the rACC (75 mg 0.53 ± 0.51 vs. 225 mg 0.28 ± 0.19; p = 0.014). CONCLUSION No differences were found in metabolite concentrations between the placebo (control) and intervention groups, but some differences, although small, were found between the different doses. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov (NCT01180608). FUNDING Lyrica Independent Investigator Research Award (LIIRA) 2010 (Pfizer) funded the study.
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Affiliation(s)
- Mats De Jaeger
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Johan De Mey
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Bart Keymeulen
- Department of Diabetology, Universitait Ziekenhuis Brussel, Brussels, Belgium
| | - Raf Brouns
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Neurology, ZorgSaam Hospital, Terneuzen, The Netherlands
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium.
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Metabolic Changes Associated with a Rat Model of Diabetic Depression Detected by Ex Vivo 1H Nuclear Magnetic Resonance Spectroscopy in the Prefrontal Cortex, Hippocampus, and Hypothalamus. Neural Plast 2018; 2018:6473728. [PMID: 29849562 PMCID: PMC5911311 DOI: 10.1155/2018/6473728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/12/2018] [Accepted: 03/11/2018] [Indexed: 01/08/2023] Open
Abstract
Diabetic patients often present with comorbid depression. However, the pathogenetic mechanisms underlying diabetic depression (DD) remain unclear. To explore the mechanisms underpinning the pathogenesis of the disease, we used ex vivo 1H nuclear magnetic resonance spectroscopy and immunohistochemistry to investigate the main metabolic and pathological changes in various rat brain areas in an animal model of DD. Compared with the control group, rats in the DD group showed significant decreases in neurotransmitter concentrations of glutamate (Glu) and glutamine (Gln) in the prefrontal cortex (PFC), hippocampus, and hypothalamus and aspartate and glycine in the PFC and hypothalamus. Gamma-aminobutyric acid (GABA) was decreased only in the hypothalamus. Levels of the energy product, lactate, were higher in the PFC, hippocampus, and hypothalamus of rats with DD than those in control rats, while creatine was lower in the PFC and hippocampus, and alanine was lower in the hypothalamus. The levels of other brain metabolites were altered, including N-acetyl aspartate, taurine, and choline. Immunohistochemistry analysis revealed that expressions of both glutamine synthetase and glutaminase were decreased in the PFC, hippocampus, and hypothalamus of rats with DD. The metabolic changes in levels of Glu, Gln, and GABA indicate an imbalance of the Glu-Gln metabolic cycle between astrocytes and neurons. Our results suggest that the development of DD in rats may be linked to brain metabolic changes, including inhibition of the Glu-Gln cycle, increases in anaerobic glycolysis, and disturbances in the lactate-alanine shuttle, and associated with dysfunction of neurons and astrocytes.
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Bridges NR, McKinley RA, Boeke D, Sherwood MS, Parker JG, McIntire LK, Nelson JM, Fletchall C, Alexander N, McConnell A, Goodyear C, Nelson JT. Single Session Low Frequency Left Dorsolateral Prefrontal Transcranial Magnetic Stimulation Changes Neurometabolite Relationships in Healthy Humans. Front Hum Neurosci 2018; 12:77. [PMID: 29632477 PMCID: PMC5879132 DOI: 10.3389/fnhum.2018.00077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/12/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Dorsolateral prefrontal cortex (DLPFC) low frequency repetitive transcranial magnetic stimulation (LF-rTMS) has shown promise as a treatment and investigative tool in the medical and research communities. Researchers have made significant progress elucidating DLPFC LF-rTMS effects—primarily in individuals with psychiatric disorders. However, more efforts investigating underlying molecular changes and establishing links to functional and behavioral outcomes in healthy humans are needed. Objective: We aimed to quantify neuromolecular changes and relate these to functional changes following a single session of DLPFC LF-rTMS in healthy participants. Methods: Eleven participants received sham-controlled neuronavigated 1 Hz rTMS to the region most activated by a 7-letter Sternberg working memory task (SWMT) within the left DLPFC. We quantified SWMT performance, functional magnetic resonance activation and proton Magnetic resonance spectroscopy (MRS) neurometabolite measure changes before and after stimulation. Results: A single LF-rTMS session was not sufficient to change DLPFC neurometabolite levels and these changes did not correlate with DLPFC activation changes. Real rTMS, however, significantly altered neurometabolite correlations (compared to sham rTMS), both with baseline levels and between the metabolites themselves. Additionally, real rTMS was associated with diminished reaction time (RT) performance improvements and increased activation within the motor, somatosensory and lateral occipital cortices. Conclusion: These results show that a single session of LF-rTMS is sufficient to influence metabolite relationships and causes widespread activation in healthy humans. Investigating correlational relationships may provide insight into mechanisms underlying LF-rTMS.
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Affiliation(s)
| | - Richard A McKinley
- Warfighter Interfaces Division, Applied Neuroscience Branch, Wright-Patterson AFB (WPAFB), Dayton, OH, United States
| | - Danielle Boeke
- Warfighter Interfaces Division, Applied Neuroscience Branch, Wright-Patterson AFB (WPAFB), Dayton, OH, United States
| | - Matthew S Sherwood
- Wright State Research Institute, Wright State University, Dayton, OH, United States
| | - Jason G Parker
- Kettering Health Network Innovation Center, Kettering, OH, United States
| | | | | | - Catherine Fletchall
- Grandview Medical Center, Kettering Health Network, Dayton, OH, United States
| | - Natasha Alexander
- Grandview Medical Center, Kettering Health Network, Dayton, OH, United States
| | - Amanda McConnell
- Grandview Medical Center, Kettering Health Network, Dayton, OH, United States
| | | | - Jeremy T Nelson
- Research Imaging Institute, School of Medicine, University of Texas Health Science Center, San Antonio, San Antonio, TX, United States
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11
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Lee JC, Lewis CP, Daskalakis ZJ, Croarkin PE. Transcranial Direct Current Stimulation: Considerations for Research in Adolescent Depression. Front Psychiatry 2017; 8:91. [PMID: 28638351 PMCID: PMC5461263 DOI: 10.3389/fpsyt.2017.00091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Adolescent depression is a prevalent disorder with substantial morbidity and mortality. Current treatment interventions do not target relevant pathophysiology and are frequently ineffective, thereby leading to a substantial burden for individuals, families, and society. During adolescence, the prefrontal cortex undergoes extensive structural and functional changes. Recent work suggests that frontolimbic development in depressed adolescents is delayed or aberrant. The judicious application of non-invasive brain stimulation techniques to the prefrontal cortex may present a promising opportunity for durable interventions in adolescent depression. Transcranial direct current stimulation (tDCS) applies a low-intensity, continuous current that alters cortical excitability. While this modality does not elicit action potentials, it is thought to manipulate neuronal activity and neuroplasticity. Specifically, tDCS may modulate N-methyl-d-aspartate receptors and L-type voltage-gated calcium channels and effect changes through long-term potentiation or long-term depression-like mechanisms. This mini-review considers the neurobiological rationale for developing tDCS protocols in adolescent depression, reviews existing work in adult mood disorders, surveys the existing tDCS literature in adolescent populations, reviews safety studies, and discusses distinct ethical considerations in work with adolescents.
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Affiliation(s)
- Jonathan C Lee
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Charles P Lewis
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul E Croarkin
- Mayo Clinic Depression Center, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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