Zhang Yifan, Han Yu, Wang Yongzhi, Zhang Yinfeng, Li Li, Jin Erhu, Deng Ligang, Watts Brandi, Golden Teresa, Wu Ning
Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China.
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
BMC Psychiatry. 2015 May 2;15:99. doi: 10.1186/s12888-015-0489-7.
Proton magnetic resonance spectroscopy provides a non-invasive technology to study brain metabolite levels in vivo, which can be used to measure biochemical compounds or metabolite concentrations in circumscribed brain regions. Previous research has highlighted the role of glial cells in brain white matter. It has been assumed that antidepressant treatment with SSRIs not only affects neurons, but also activates glial cells. This study focused on the observation of any potential changes in the metabolite levels of the ventral prefrontal white matter in major depressive disorder (MDD) patients who have received antidepressant treatment.
17 female patients diagnosed as MDD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria with the scores of 18 and above on the 24-item Hamilton Depression Rating Scale (HDRS) were recruited. MRS studies were performed on a 3.0 T MR system, single voxel PRESS spectroscopy with chemical-shift selective saturation water suppression. The volume of interest was localized at the bilateral ventral prefrontal white matter regions (voxel size: 2 × 2 × 2 mm(3)). The spectral data analysis was performed by using the instrument manufacturer supplied software.
The bilateral ventral prefrontal white matter of MDD patients showed significantly lower Cho/Cr (p < 0.05) before receiving treatment. The HDRS, as the indicator of treatment response, showed a significant decrease in patients who had gone through 12 weeks treatment (p < 0.01). The bilateral Cho/Cr values of post-treatment patients were increased significantly compared to that of pre-treatment (p < 0.05).
The alteration of ventral prefrontal white matter metabolite levels are likely involved in MDD pathophysiology and imply a crucial role of white matter in MDD.
质子磁共振波谱提供了一种在体研究脑代谢物水平的非侵入性技术，可用于测量特定脑区的生化化合物或代谢物浓度。先前的研究强调了胶质细胞在脑白质中的作用。据推测，使用选择性5-羟色胺再摄取抑制剂（SSRI）进行抗抑郁治疗不仅会影响神经元，还会激活胶质细胞。本研究聚焦于观察接受抗抑郁治疗的重度抑郁症（MDD）患者腹侧前额叶白质代谢物水平的任何潜在变化。
招募17名根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准诊断为MDD且24项汉密尔顿抑郁量表（HDRS）得分在18分及以上的女性患者。采用3.0T磁共振系统进行磁共振波谱研究，使用化学位移选择性饱和水抑制的单体素点分辨波谱序列。感兴趣区定位于双侧腹侧前额叶白质区域（体素大小：2×2×2mm³）。使用仪器制造商提供的软件进行光谱数据分析。
MDD患者在接受治疗前双侧腹侧前额叶白质的胆碱/肌酸（Cho/Cr）显著降低（p<0.05）。作为治疗反应指标的HDRS显示，经过12周治疗的患者显著下降（p<0.01）。治疗后患者的双侧Cho/Cr值与治疗前相比显著升高（p<0.05）。
腹侧前额叶白质代谢物水平的改变可能参与了MDD的病理生理过程，并暗示白质在MDD中起关键作用。
