Psychiatric University Hospital, University of Bern, 3000, Bern 60, Switzerland.
Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 31752 Villars-sur-Glâne, Fribourg, Switzerland.
Transl Psychiatry. 2019 Jun 18;9(1):170. doi: 10.1038/s41398-019-0500-z.
There is growing evidence for GABA and glutamate-glutamine dysfunction in the pathogenesis of mood and anxiety disorders. It is important to study this pathology in the early phases of the illness in order to develop new approaches to secondary prevention. New magnetic resonance spectroscopy (MRS) measures allow determining glutamine, the principal metabolite of synaptic glutamate that is directly related to glutamate levels in the synaptic cleft, as well as glutamate and GABA. In contrast to previous investigations, this study used community-based recruitment methods and a combined categorical and dimensional approach to psychopathology. In the study protocol, neuroticism was defined as the primary outcome. Neuroticism shares a large proportion of its genetic variance with mood and anxiety disorders. We examined young adult participants recruited from the general population in a cross-sectional study using 3-T 1H-MRS with one voxel in the left dorsolateral prefrontal cortex (DLPFC). The total sample of N = 110 (61 females) included 18 individuals suffering from MDD and 19 individuals suffering from DSM-IV anxiety disorders. We found that glutamine and glutamine-to-glutamate ratio were correlated with neuroticism in the whole sample (r = 0.263, p = 0.005, and n = 110; respectively, r = 0.252, p = 0.008, and n = 110), even when controlling for depression and anxiety disorder diagnoses (for glutamine: beta = 0.220, p = 0.047, and n = 110). Glutamate and GABA were not significantly correlated with neuroticism (r = 0.087, p = 0.365, and n = 110; r = -0.044, p = 0.645, and n = 110). Lack of self-confidence and emotional instability were the clinical correlates of glutamate-glutamine dysfunction. In conclusion, this study suggests that prefrontal glutamine is increased in early phases of mood and anxiety disorders. Further understanding of glutamate-glutamine dysfunction in stress-related disorders may lead to new therapeutic strategies to prevent and treat these disorders.
越来越多的证据表明,在心境和焦虑障碍的发病机制中存在 GABA 和谷氨酸-谷氨酰胺功能障碍。为了开发二级预防的新方法,重要的是在疾病的早期阶段研究这种病理学。新的磁共振波谱(MRS)测量方法允许确定谷氨酰胺,即突触谷氨酸的主要代谢物,它与突触间隙中的谷氨酸水平直接相关,以及谷氨酸和 GABA。与之前的研究不同,本研究使用基于社区的招募方法和分类和维度相结合的精神病理学方法。在研究方案中,神经质被定义为主要结果。神经质与心境和焦虑障碍有很大一部分遗传变异。我们使用左背外侧前额叶皮质(DLPFC)中的一个体素在横断面研究中检查了从普通人群中招募的年轻成年参与者,使用 3-T 1H-MRS。共有 110 名(61 名女性)参与者的总样本包括 18 名患有 MDD 的个体和 19 名患有 DSM-IV 焦虑障碍的个体。我们发现,在整个样本中,谷氨酰胺和谷氨酰胺与谷氨酸的比率与神经质相关(r=0.263,p=0.005,n=110;分别为 r=0.252,p=0.008,n=110),即使在控制抑郁和焦虑障碍诊断时也是如此(对于谷氨酰胺:β=0.220,p=0.047,n=110)。谷氨酸和 GABA 与神经质无显著相关性(r=0.087,p=0.365,n=110;r=-0.044,p=0.645,n=110)。缺乏自信和情绪不稳定是谷氨酸-谷氨酰胺功能障碍的临床相关性。总之,本研究表明,在心境和焦虑障碍的早期阶段,前额叶的谷氨酰胺增加。进一步了解应激相关障碍中的谷氨酸-谷氨酰胺功能障碍可能会导致预防和治疗这些障碍的新治疗策略。