The changes in kynurenine metabolites induced by rTMS in treatment-resistant depression: A pilot study
The changes in kynurenine metabolites induced by rTMS in treatment-resistant depression: A pilot study
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rTMS 在难治性抑郁症中引起的犬尿氨酸代谢物的变化：一项初步研究
DOI：
10.1016/j.jpsychires.2021.04.009
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Monji A.
中科院分区：
文献类型：
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作者：
Tateishi H;Setoyama D;Kang D;Matsushima J;Kojima R;Fujii Y;Mawatari S;Kikuchi J;Sakemura Y;Fukuchi J;Shiraishi T;Maekawa T;Kato TA;Asami T;Mizoguchi Y;Monji A.
研究背景重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）是一种无创性脑刺激技术，被认为是改善难治性抑郁症（treatment-resistant depression，TRD）患者抑郁症状的一种有价值和前景的技术。然而，确切的机制，rTMS改善抑郁症状仍有待澄清。本研究的目的是分析的代谢产物的变化与TRD患者在rTMS治疗，特别是专注于犬尿氨酸（KYN）pathway.MethodsThirteen参与者与TRD参加了高频（10 Hz）rTMS研究。认知功能，抑郁症状和血浆色氨酸（TRP）代谢产物的浓度测定在基线和终点的rTMS treatment.ResultsrTMS治疗显着改善抑郁症状评分和认知功能障碍的一些子量表。本研究表明，rTMS治疗显着增加血浆TRP水平和显着降低血浆5-羟色胺水平，而血浆KYN和犬尿烯酸水平以及KYN/TRP的比例保持不变。为了验证目前的结果，有必要增加包括对照组在内的病例数，使用脑脊液样本，并在rTMS治疗过程中随时间推移测量血药浓度。
BackgroundRepetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique that is considered a valuable and promising technique for improving depressive symptoms in treatment-resistant depression (TRD). However, the exact mechanism by which rTMS ameliorates depressive symptoms remains to be clarified.ObjectiveThe aim of the present study was to analyzed the changes in metabolites of patients with TRD in the rTMS treatment, especially focusing on the kynurenine (KYN) pathway.MethodsThirteen participants with TRD were enrolled in a high-frequency (10 Hz) rTMS study. Cognitive function, depressive symptoms and the concentration of plasma tryptophan (TRP) metabolites were measured at baseline and at the endpoint of rTMS treatment.ResultsrTMS treatment significantly improved depressive symptom scores and some subscales of cognitive dysfunction. The present study has demonstrated that rTMS treatment significantly increased plasma TRP levels and significantly decreased plasma serotonin levels, while plasma KYN and kynurenic acid level as well as KYN/TRP ratio remained unchanged.ConclusionsThis is the first metabolomic study of patients with TRD undergoing rTMS treatment. To validate the present results, it is necessary to increase the number of cases including controls, use a sample of cerebrospinal fluid, and measure blood concentration over time in the course of rTMS treatment.