Depression and tryptophan metabolism in patients with primary brain tumors: Clinical and molecular imaging correlates.
Depression and tryptophan metabolism in patients with primary brain tumors: Clinical and molecular imaging correlates.
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DOI：
10.1007/s11682-020-00305-7
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发表时间：
2021-04
影响因子：
3.2
通讯作者：
Juhász C
中科院分区：
文献类型：
--
作者：
John F;Michelhaugh SK;Barger GR;Mittal S;Juhász C
脑肿瘤患者患抑郁症的风险增加，其潜在的病理机制可能涉及色氨酸/犬尿氨酸代谢失调。在这项研究中，我们分析了原发性脑肿瘤患者抑郁症状与临床和肿瘤特征以及大脑和全身色氨酸代谢的关系。对60例初发或复发的原发脑肿瘤患者进行了贝克抑郁量表-II测试，34例患者同时进行了α-[11C]甲基-L-色氨酸正电子发射断层扫描。BDI-II评分与临床和肿瘤相关变量、非肿瘤半球测量的大脑局部AMT代谢和血浆色氨酸代谢物水平相关。16名患者(27%)的BDI-II评分显示为抑郁，其中6名患者为中度/重度抑郁。除了较低的卡氏状态评分外，BDI-II评分较高与临床和肿瘤相关变量无关。在复发的恶性胶质瘤患者中，抑郁与较短的生存期有关(风险比：3.7p=0.048)。高BDI-II总分和躯体分量表得分与PET测量的额叶、皮质和丘脑AMT代谢值较高相关。相反，血浆色氨酸和犬尿氨酸代谢产物水平与BDI-II评分无关。总而言之，我们的结果证实了先前的数据，抑郁症影响了超过1/4的原发脑肿瘤患者，它在很大程度上与肿瘤特征无关，并与复发恶性胶质瘤患者的生存期缩短有关。在PET成像上，脑肿瘤相关性抑郁症患者额叶皮质和丘脑的色氨酸代谢较高，支持色氨酸/犬尿氨酸代谢失调在这种情况下的作用。
Patients with brain tumors have an increased risk for depression, whose underlying pathomechanism may involve dysregulated tryptophan/kynurenine metabolism. In this study, we analyzed the relation of depressive symptoms to clinical and tumor characteristics as well as cerebral and systemic tryptophan metabolism in patients with primary brain tumors. Sixty patients with newly-diagnosed or recurrent primary brain tumor underwent testing with the Beck Depression Inventory-II (BDI-II), and 34 patients also had positron emission tomography (PET) imaging with alpha-[11C]methyl-L-tryptophan (AMT). BDI-II scores were correlated with clinical and tumor-related variables, cerebral regional AMT metabolism measured in the non-tumoral hemisphere, and plasma tryptophan metabolite levels. Sixteen patients (27%) had BDI-II scores indicating depression, including 6 with moderate/severe depression. High BDI-II scores were independent of clinical and tumor-related variables except lower Karnofsky Performance Status scores. In patients with recurrent malignant gliomas, depression was associated with shorter survival (hazard ratio: 3.7; p=0.048). High BDI-II total and somatic subscale scores were associated with higher frontal cortical and thalamic AMT metabolic values measured on PET. In contrast, plasma tryptophan and kynurenine metabolite levels did not correlate with the BDI-II scores. In conclusion, our results confirm previous data that depression affects more than ¼ of patients with primary brain tumors, it is largely independent of tumor characteristics and is associated with shorter survival in patients with recurrent malignant gliomas. On PET imaging, higher tryptophan metabolism in the frontal cortex and thalamus was found in those with brain tumor-associated depression and supports the role of dysregulated tryptophan/kynurenine metabolism in this condition.
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影响因子：
3.2
作者：
Bosnyák E;Kamson DO;Behen ME;Barger GR;Mittal S;Juhász C
通讯作者：
Juhász C
影响因子：
3.1
作者：
Batista, Carlos E. A.;Juhasz, Csaba;Chugani, Diane C.
通讯作者：
Chugani, Diane C.
影响因子：
10.6
作者：
Greicius, Michael D.;Flores, Benjamin H.;Schatzberg, Alan F.
通讯作者：
Schatzberg, Alan F.
影响因子：
3.6
作者：
Bunevicius A
通讯作者：
Bunevicius A
影响因子：
4.2
作者：
Berney, Alexandre;Nishikawa, Masami;Diksic, Mirko
通讯作者：
Diksic, Mirko