Proton MR spectroscopy of the hippocampus at 3 T in patients with unipolar major depressive disorder: correlates and predictors of treatment response
Proton MR spectroscopy of the hippocampus at 3 T in patients with unipolar major depressive disorder: correlates and predictors of treatment response
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DOI：
10.1017/s1461145708009516
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发表时间：
2009-04-01
影响因子：
4.8
通讯作者：
Jessen, Frank
中科院分区：
文献类型：
--
作者：
Block, Wolfgang;Traeber, Frank;Jessen, Frank
各种研究表明，海马中的神经营养过程是重度抑郁症的关键机制，与抗抑郁治疗的反应有关。我们对18名未经药物治疗的单相抑郁症患者和10名年龄和性别匹配的健康志愿者进行了3 T的海马质子磁共振波谱（（1）H-MRS）。13例患者接受西酞普兰（n = 7）或去甲替林（n = 6）治疗8周后进行第二次检查。在这些患者中，11个MRS数据集可用于评估治疗相关性。在横断面比较中，我们观察到患者组的代谢比Glx/Cr（Glx =谷氨酰胺、谷氨酸和γ-氨基丁酸）和谷氨酰胺（Gln）/Cr显著降低。Gln/Glx比值也显示出显著降低的趋势。治疗的个体效应与N-乙酰天冬氨酸（NAA）和胆碱化合物（Cho）的绝对浓度增加相关。低基线NAA和Cho水平预测积极的治疗效果。两个治疗组（西酞普兰、去甲替林）在基线或随访时的任何临床或代谢指标均无差异。我们的数据提供了第一个证据，减少谷氨酰胺在受试者的抑郁症的海马。此外，我们提供了第一个证据，在重度抑郁症患者的神经恢复作用，在海马的药物治疗表示的相关性NAA和Cho增加与治疗反应。这尤其是那些NAA和Cho基线水平较低的患者。
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 ((1)H-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.