Transcranial magnetic stimulation potentiates glutamatergic neurotransmission in depressed adolescents.
Transcranial magnetic stimulation potentiates glutamatergic neurotransmission in depressed adolescents.
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经颅磁刺激增强了抑郁的青少年谷氨酸能神经传递。
DOI：
10.1016/j.pscychresns.2015.11.005
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发表时间：
2016-01-30
期刊：
影响因子：
--
通讯作者：
Port JD
中科院分区：
文献类型：
--
作者：
Croarkin PE;Nakonezny PA;Wall CA;Murphy LL;Sampson SM;Frye MA;Port JD
谷氨酸神经传递异常可能在青少年抑郁症的病理生理中起作用。本初步研究考察了接受高频重复经颅磁刺激的抑郁青少年皮层谷氨酰胺/谷氨酸比值的变化。10名患有难治性重度抑郁症的青少年接受了多达30次的10赫兹重复经颅磁刺激，每次刺激频率为120%运动阈值，每次刺激3000次脉冲，施加于左背外侧前额皮质。基线、治疗后和随访6个月的质子磁共振波谱扫描在3T时收集前扣带皮层和左背外侧前额叶皮层的8-cm3体素。用两个不同的质子磁共振谱序列定量测定脑区谷氨酸代谢物。在重复经颅磁刺激和随访6个月后，两种测量结果显示，前扣带皮层和左背外侧前额叶皮层的谷氨酰胺/谷氨酸比值均增加。采用te优化后的前扣带皮层PRESS序列，谷氨酰胺/谷氨酸比值的增加达到了统计学意义。谷氨酰胺/谷氨酸比值随着抑郁症状的改善而增加。这与te优化的左背外侧前额皮质PRESS序列具有统计学意义。应用于左背外侧前额叶皮层的高频重复经颅磁刺激可能调节抑郁青少年的谷氨酸神经化学。
Abnormalities in glutamate neurotransmission may have a role in the pathophysiology of adolescent depression. The present pilot study examined changes in cortical glutamine/glutamate ratios in depressed adolescents receiving high-frequency repetitive transcranial magnetic stimulation. Ten adolescents with treatment-refractory major depressive disorder received up to 30 sessions of 10-Hz repetitive transcranial magnetic stimulation at 120% motor threshold with 3,000 pulses per session applied to the left dorsolateral prefrontal cortex. Baseline, posttreatment, and 6-month follow-up proton magnetic resonance spectroscopy scans of the anterior cingulate cortex and left dorsolateral prefrontal cortex were collected at 3T with 8-cm3 voxels. Glutamate metabolites were quantified with 2 distinct proton magnetic resonance spectroscopy sequences in each brain region. After repetitive transcranial magnetic stimulation and at 6 months of follow-up, glutamine/glutamate ratios increased in the anterior cingulate cortex and left dorsolateral prefrontal cortex with both measurements. The increase in the glutamine/glutamate ratio reached statistical significance with the TE-optimized PRESS sequence in the anterior cingulate cortex. Glutamine/glutamate ratios increased in conjunction with depressive symptom improvement. This reached statistical significance with the TE-optimized PRESS sequence in the left dorsolateral prefrontal cortex. High-frequency repetitive transcranial magnetic stimulation applied to the left dorsolateral prefrontal cortex may modulate glutamate neurochemistry in depressed adolescents.