Turk Psikiyatri Derg. 2020 Summer;31(2):75-83. doi: 10.5080/u22978.
. The aim of the study is to investigate, by using proton magnetic resonance spectroscopy (1H-MRS), the effects of major depression on the biochemistry of the brain, the relationship between the parametric changes demonstrated and cognitive functions, and the effects of antidepressant treatment.
The study included 30 patients, diagnosed with moderate/ severe non-chronic major depression disorder (NC-MDD) according to the DSM-5 diagnostic criteria, and 30 healthy individuals as the control group. The dorsolateral prefrontal cortex (DLPFC) areas of the patients and the control individuals were scanned bilaterally by 1H-MRS. The participants were also tested on the brief computerized version of the Wisconsin Card Sorting Test (or, Berg's "Wisconsin" Card Sorting TestWCST). After antidepressant treatment for a minimum of 8 weeks, the patients who scored below 7 on the Hamilton Depression Rating Scale (HAM-D), were assessed with the 1H-MRS scan and the WCST.
The Glx level in the left DLPFC was significantly lower in the patient group. Differences were not determined between the NAA, Cr, Cho levels in the right and the left DLPFC of the patient and the control groups. After the treatment, Glx level in the left DLPFC increased; but the levels of the other metabolites did not change. Before the treatment, the abilities of the patient group in changing strategy and problem solving, as assessed by the WCST, were lower in comparison to the control group. After the treatment the patient group improved clinically and performed significantly better on the WCST.
In the present neuroimaging (NI) study, it was determined that the Glx level in the left DLPFC of patients with moderate/severe NC-MDD improved together with the clinical features after treatment. Neurocognitive functions also improved after treatment. However, a correlation between the change in the metabolite levels and the performance on the WCST could not be demonstrated.
......。本研究旨在通过质子磁共振波谱（1H-MRS）研究重度/中度非慢性重度抑郁症（NC-MDD）对大脑生化的影响，探讨显示的参数变化与认知功能之间的关系，以及抗抑郁治疗的效果。
本研究纳入 30 名患者，根据 DSM-5 诊断标准诊断为中度/重度非慢性重度抑郁症（NC-MDD），30 名健康个体作为对照组。通过 1H-MRS 对患者和对照组双侧背外侧前额叶皮质（DLPFC）进行扫描。还对参与者进行了简短的计算机版威斯康星卡片分类测试（或 Berg 的“威斯康星”卡片分类测试 WCST）测试。经过至少 8 周的抗抑郁治疗后，汉密尔顿抑郁评定量表（HAM-D）评分低于 7 的患者进行 1H-MRS 扫描和 WCST 评估。
患者组左侧 DLPFC 的 Glx 水平明显较低。患者组和对照组右侧和左侧 DLPFC 的 NAA、Cr、Cho 水平无差异。治疗后，左侧 DLPFC 的 Glx 水平升高，但其他代谢物水平没有变化。治疗前，患者组在 WCST 中改变策略和解决问题的能力低于对照组。治疗后，患者组的临床状况得到改善，在 WCST 中表现明显更好。
在本神经影像学（NI）研究中，确定了中度/重度 NC-MDD 患者左侧 DLPFC 的 Glx 水平在治疗后与临床特征一起改善。神经认知功能也在治疗后得到改善。然而，未能证明代谢物水平的变化与 WCST 上的表现之间存在相关性。
