Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8502, Japan.
Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8502, Japan.
J Psychiatr Res. 2018 Oct;105:137-146. doi: 10.1016/j.jpsychires.2018.08.028. Epub 2018 Sep 4.
Altered monoaminergic functions have been implicated in the pathophysiology of depressive disorder. However, previously reported cerebrospinal fluid (CSF) monoamine metabolite concentrations in major depression have been inconsistent. We performed a meta-analysis of historic evidence to determine whether CSF monoamine metabolite levels were different between patients with depression and normal controls, and could be used as depression biomarkers. Relevant studies that investigated CSF 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) levels in patients with depression and normal controls were identified in PubMed, Web of Science, PsycINFO, and Embase databases through September 5, 2017, using a synonymous search for depression, CSF, normal, control, and each monoamine metabolite name, and in the reference lists of the acquired articles. Obtained records were individually scrutinized for eligibility. Our search strategy identified 26 studies, including our own. We employed random effects modeling and adopted "Hedges's g" as an index of effect size. In the meta-analyses, no significant difference was observed in CSF 5-HIAA or MHPG levels between patients with depressive disorder and controls. In contrast, CSF HVA was significantly decreased in patients with depression (Hedges's g = -0.30, P = 0.0000025), and these results remained significant after patients with bipolar disorder were excluded (Hedges's g = -0.37, P = 0.000061). In the meta-regression, sex was significantly associated with the Hedges's g of CSF HVA (Q = 4.41, P = 0.036). This meta-analysis revealed that only CSF HVA, and not 5-HIAA or MHPG, levels were decreased in depressive disorder. The reduction in the CSF HVA concentration in patients with depression may guide future studies on depression and serve as a useful biomarker of depressive disorder.
单胺能功能的改变与抑郁症的病理生理学有关。然而，之前报道的抑郁症患者的脑脊液（CSF）单胺代谢产物浓度并不一致。我们对历史证据进行了荟萃分析，以确定抑郁症患者和正常对照组之间的 CSF 单胺代谢产物水平是否不同，以及是否可以作为抑郁症的生物标志物。通过对 2017 年 9 月 5 日之前在 PubMed、Web of Science、PsycINFO 和 Embase 数据库中搜索抑郁症、CSF、正常、对照和每个单胺代谢产物名称的同义词，以及获取文章的参考文献列表，确定了研究抑郁症患者和正常对照组 CSF 5-羟吲哚乙酸（5-HIAA）、高香草酸（HVA）和 3-甲氧基-4-羟基苯乙二醇（MHPG）水平的相关研究。单独审查获得的记录以确定其是否符合入选标准。我们的搜索策略确定了 26 项研究，包括我们自己的研究。我们采用随机效应模型，并采用“Hedges's g”作为效应量的指标。荟萃分析显示，抑郁症患者和对照组之间 CSF 5-HIAA 或 MHPG 水平无显著差异。相反，抑郁症患者的 CSF HVA 明显降低（Hedges's g=-0.30，P=0.0000025），排除双相障碍患者后，这些结果仍有意义（Hedges's g=-0.37，P=0.000061）。在元回归中，性别与 CSF HVA 的 Hedges's g 显著相关（Q=4.41，P=0.036）。这项荟萃分析表明，只有 CSF HVA，而不是 5-HIAA 或 MHPG，在抑郁障碍中降低。抑郁症患者 CSF HVA 浓度的降低可能指导未来的抑郁研究，并作为抑郁障碍的有用生物标志物。
