Frye Mark A, Watzl June, Banakar Shida, O'Neill Joseph, Mintz Jim, Davanzo Pablo, Fischer Jeffrey, Chirichigno Jason W, Ventura Joseph, Elman Shana, Tsuang John, Walot Irwin, Thomas M Albert
UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 55905, USA.
Neuropsychopharmacology. 2007 Dec;32(12):2490-9. doi: 10.1038/sj.npp.1301387. Epub 2007 Apr 11.
Proton magnetic resonance spectroscopy ((1)HMRS) is an in vivo brain imaging method that can be used to investigate psychotropic drug mechanism of action. This study evaluated baseline (1)HMRS spectra of bipolar depressed patients and whether the level of cerebral metabolites changed after an open trial of lamotrigine, an anti-glutamatergic mood stabilizer. Twenty-three bipolar depressed and 12 control subjects underwent a MRS scan of the anterior cingulate/medial prefrontal cortex. The scan was performed on a GE whole-body 1.5 T MRI scanner using single-voxel PRESS (TE/TR=30/3000 ms, 3 x 3 x 3 cm(3) and post-processed offline with LCModel. Baseline CSF-corrected absolute concentrations of glutamate+glutamine ([Glx]), glutamate ([Glu]), and creatine+phosphocreatine ([Cr]) were significantly higher in bipolar depressed subjects vs healthy controls. The non-melancholic subtype had significantly higher baseline [Glx] and [Glu] levels than the melancholic subtype. Remission with lamotrigine was associated with significantly lower post-treatment glutamine ([Gln]) in comparison to non-remission. These data suggest that non-melancholic bipolar depression is characterized by increased glutamate coupled with increased energy expenditure. Lamotrigine appears to reduce glutamine levels associated with treatment remission. Further study is encouraged to determine if these MR spectroscopic markers can delineate drug mechanism of action and subsequent treatment response.
质子磁共振波谱（（1）HMRS）是一种可用于研究精神药物作用机制的活体脑成像方法。本研究评估了双相抑郁患者的基线（1）HMRS波谱，以及在进行抗谷氨酸能心境稳定剂拉莫三嗪开放试验后，脑代谢物水平是否发生变化。23名双相抑郁患者和12名对照受试者接受了前扣带回/内侧前额叶皮质的磁共振波谱扫描。扫描在GE全身1.5T磁共振成像仪上进行，使用单体素PRESS序列（TE/TR = 30/3000 ms，3×3×3 cm³），并在离线状态下用LCModel进行后处理。双相抑郁受试者的基线脑脊液校正后的谷氨酸 + 谷氨酰胺（[Glx]）、谷氨酸（[Glu]）和肌酸 + 磷酸肌酸（[Cr]）的绝对浓度显著高于健康对照。非忧郁型亚型的基线[Glx]和[Glu]水平显著高于忧郁型亚型。与未缓解相比，拉莫三嗪缓解与治疗后谷氨酰胺（[Gln]）显著降低有关。这些数据表明，非忧郁型双相抑郁的特征是谷氨酸增加并伴有能量消耗增加。拉莫三嗪似乎降低了与治疗缓解相关的谷氨酰胺水平。鼓励进一步研究以确定这些磁共振波谱标记物是否能描述药物作用机制及后续治疗反应。
