Anterior cingulate cortex choline levels in female adolescents with unipolar versus bipolar depression: a potential new tool for diagnosis.
Anterior cingulate cortex choline levels in female adolescents with unipolar versus bipolar depression: a potential new tool for diagnosis.
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DOI：
10.1016/j.jad.2014.05.051
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发表时间：
2014
影响因子：
6.6
通讯作者：
Kondo DG
中科院分区：
文献类型：
--
作者：
Shi XF;Forrest LN;Kuykendall MD;Prescot AP;Sung YH;Huber RS;Hellem TL;Jeong EK;Renshaw PF;Kondo DG
双相情感障碍(BD)因误诊为重度抑郁障碍(MDD)而延误诊断是一个重大的公共卫生问题。因此，识别相关的诊断生物标记物是一个关键的未得到满足的需求，特别是在病程的早期。前扣带回被认为在心境障碍的病理生理学中起着重要作用。利用质子-1磁共振波谱(1H-MRS)进行的病例对照研究发现，MDD患者的几个脑区总胆碱水平增加。然而，还没有发表的1H-MRS报告直接比较青少年与MDD和BD。我们假设在患有单相和双相抑郁的青少年中，ACC胆碱水平会增加。我们研究了患有MDD(n=28，平均年龄17.0±2.1岁)和BD(n=9，17.3±3.1岁)的抑郁青少年。使用西门子Verio 3-Tesla临床磁共振系统获取扫描，使用单体素PRESS序列。体素(18.75 cm~3)位于正中矢状面的ACC上。为了消除潜在的性别影响，只纳入了青少年女性参与者。数据分析采用方差分析和后处理的Tukey检验。MDD患者的Acc胆碱/肌酸比值(平均值=0.253±0.021)显著高于BD患者(平均值=0.219±0.020)(p=0.0002)。其他1H-MRS代谢物的差异无统计学意义。横断面设计，单性别样本，样本量有限。目前的发现表明，ACC总胆碱可能有可能作为青少年情绪障碍的诊断生物标志物。
Delayed diagnosis in bipolar disorder (BD) due to misdiagnosis as major depressive disorder (MDD) is a significant public health concern. Thus, identification of relevant diagnostic biomarkers is a critical unmet need, particularly early in the course of illness. The anterior cingulate cortex (ACC) is thought to play an important role in mood disorder pathophysiology. Case-control studies utilizing proton-1 magnetic resonance spectroscopy (1H-MRS) have found increased total choline levels in several brain regions in MDD. However, there are no published 1H-MRS reports directly comparing adolescents with MDD and BD. We hypothesized that ACC choline levels would be increased in adolescents with unipolar versus bipolar depression. We studied depressed adolescents with MDD (n=28; mean age 17.0±2.1 years) and BD (n=9; 17.3±3.1 years). A Siemens Verio 3-Tesla clinical MRI system was used to acquire scans, using a single-voxel PRESS sequence. The voxel (18.75 cm3) was positioned on the ACC in the midsagittal plane. To remove potential gender effects, only female adolescent participants were included. Data were analyzed using the ANOVA and post-hoc Tukey tests. A significantly increased ACC choline/creatine ratio was observed in participants with MDD (mean=0.253±0.021) compared to BD (mean=0.219±0.020) (p=0.0002). There were no significant differences in the other 1H-MRS metabolites. Cross sectional design, single gender sample, limited sample size. The present findings suggest that ACC total choline may have the potential to serve as a diagnostic biomarker in adolescent mood disorders.