Effects of Fish Oil Monotherapy on Depression and Prefrontal Neurochemistry in Adolescents at High Risk for Bipolar I Disorder: A 12-Week Placebo-Controlled Proton Magnetic Resonance Spectroscopy Trial.
Effects of Fish Oil Monotherapy on Depression and Prefrontal Neurochemistry in Adolescents at High Risk for Bipolar I Disorder: A 12-Week Placebo-Controlled Proton Magnetic Resonance Spectroscopy Trial.
复制标题
鱼油单一疗法对 I 型双相情感障碍高危青少年抑郁和前额神经化学的影响：为期 12 周的安慰剂对照质子磁共振波谱试验。
DOI：
10.1089/cap.2019.0124
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发表时间：
2020
影响因子：
1.9
通讯作者：
DelBello,MelissaP
中科院分区：
文献类型：
--
作者：
McNamara,RobertK;Strawn,JeffreyR;Tallman,MaxJ;Welge,JeffreyA;Patino,LRodrigo;Blom,ThomasJ;DelBello,MelissaP
Objectives：To evaluate the clinical and neurochemical effects of 12 week fish oil，a source of omega-3 polyunsaturated fatty acids（n-3 PUFAs），in Depressive adolescents with a family history of bipolar I disorder.Methods：青少年与当前的诊断和统计手册的精神障碍，第4版，文本修订诊断为重度抑郁症或抑郁症，未另行说明，儿童抑郁评定量表修订版（CDRS-R）原始评分≥40，和至少一个生物父母与双相I障碍被随机双盲治疗鱼油（2100毫克/天）或安慰剂12周。主要结局指标是CDRS-R总分的变化，次要结局指标是躁狂症状的变化（Young躁狂评定量表），总体症状和功能测量（临床总体印象-严重程度[CGI-S] /CGI改善[CGI-I]、儿童总体评估量表和儿童行为检查表）、安全性和实验室指标，和前扣带皮层（ACC）和双侧腹外侧前额叶皮质神经代谢物浓度使用质子磁共振波谱在4 T。结果：五十六例患者被随机分组，42人完成了12周的试验（安慰剂：n= 21;鱼油，n= 21）。随机分配至鱼油组（而非安慰剂组）的受试者表现出红细胞蛋白-3 PUFA的基线至终点显著增加。治疗组间CDRS-R评分降低无差异（p= 0.15），观察到相似的缓解率（p= 0.58）和应答率（p= 0.77）。与安慰剂相比，鱼油使CGI-S（p= 0.0042）和CGI-I（p= 0.036）评分显著降低。两组间ACC肌酸（p= 0.004）和ACC胆碱（Cho）（p= 0.024）的基线至终点变化存在显著差异。基线ACC Cho水平与基线和基线至终点的CDRS-R评分变化呈负相关，基线至终点的ACC Cho变化与基线至终点的CDRS-R评分变化和n-3 PUFA相关。有没有组间差异的安全性和耐受性评级或实验室measurement.Conclusions：鱼油单药治疗是不是上级安慰剂，以减少抑郁症状的高危青年评估的CDRS-R，但安全，耐受性良好，上级安慰剂的临床评分的全球症状改善。ACC Cho水平、抑郁症状严重程度和n-3 PUFA之间的关联需要进一步研究。
Objectives:To evaluate the clinical and neurochemical effects of 12-week fish oil, a source of omega-3 polyunsaturated fatty acids (n-3 PUFAs), in depressed adolescents with a family history of bipolar I disorder.Methods:Adolescents with a current Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision diagnosis of Major Depressive Disorder or Depressive Disorder not otherwise specified, a Childhood Depression Rating Scale-Revised (CDRS-R) Version raw score of ≥40, and at least one biological parent with bipolar I disorder were randomized to double-blind treatment with fish oil (2100 mg/day) or placebo for 12 weeks. The primary outcome measure was change in CDRS-R total score, and secondary outcomes measures were change in manic symptoms (Young Mania Rating Scale), global symptom and functioning measures (Clinical Global Impression-Severity [CGI-S] /CGI Improvement [CGI-I], Children's Global Assessment Scale, and Child Behavior Checklist), safety and laboratory measures, and anterior cingulate cortex (ACC) and bilateral ventrolateral prefrontal cortex neurometabolite concentrations using proton magnetic resonance spectroscopy at 4 T.Results:Fifty-six patients were randomized, and 42 completed the 12-week trial (placebo:n= 21; fish oil,n= 21). Subjects randomized to fish oil, but not placebo, exhibited a significant baseline to endpoint increase in erythrocyten-3 PUFAs. Reductions in CDRS-R scores did not differ between treatment groups (p= 0.15), and similar remission (p= 0.58) and response (p= 0.77) rates were observed. Fish oil produced a significantly greater decrease in CGI-S (p= 0.0042) and CGI-I (p= 0.036) scores compared with placebo. Baseline to endpoint change in ACC creatine (p= 0.004) and ACC choline (Cho) (p= 0.024) differed significantly between groups. Baseline ACC Cho levels were inversely correlated with baseline and baseline to endpoint change in CDRS-R scores, and baseline to endpoint change in ACC Cho correlated with baseline-endpoint change in CDRS-R scores andn-3 PUFA. There were no group differences in safety and tolerability ratings or laboratory measures.Conclusions:Fish oil monotherapy was not superior to placebo for reducing depressive symptoms in high-risk youth as assessed by the CDRS-R, but was safe and well tolerated and superior to placebo on clinician ratings of global symptom improvement. Associations among ACC Cho levels, depression symptom severity, andn-3 PUFA warrant additional investigation.