Tu Cheng-Hao, Chen Chun-Ming, Yang Chuan-Chih, Gałecki Piotr, Su Kuan-Pin
Graduate Institute of Acupuncture Science, China Medical University, Taichung 404333, Taiwan.
Mind-Body Interface Laboratory, Department of Psychiatry, China Medical University Hospital, Taichung 404332, Taiwan.
J Pers Med. 2020 Dec 16;10(4):283. doi: 10.3390/jpm10040283.
N-3 polyunsaturated fatty acid supplements improve the symptoms of major depressive disorder (MDD) in randomized-controlled trials and meta-analyses, with the higher efficacy from anti-inflammatory eicosapentaenoic acid (EPA) than brain-dominant docosahexaenoic acid (DHA). To investigate the specific brain mechanisms of the anti-inflammatory anti-depressant nutraceutical compounds, we recruited 24 MDD subjects in this double-blind, head-to-head study with a 12-week EPA or DHA treatment (clinical trial registration number: NCT03871088). The depression severity was assessed by Hamilton depression rating scale (HAM-D). Brain responses to emotional stimuli were measured by a 3-Tesla MRI. The correlation between HAM-D scores and brain responses also were tested. Compared to 18 healthy controls, the brain responses of untreated 24 MDD patients mainly revealed hypoactivity in the regions associated with emotion perception and emotion control when processing positive emotion. After treatment, more remitted MDD patients have been observed in the EPA as compared to the DHA groups. In addition, the EPA, but not DHA, treatment revealed increased activity in the regions associated with emotion perception and cognitive control when processing positive emotion. The correlation analysis further revealed negative correlation between HAM-D scores and brain responses in cognitive control regions. The results of this study may imply the compensatory brain responses of cognitive and emotion controls by EPA but not DHA and underpin personalized medicine with anti-inflammatory nutraceuticals toward depression treatments.
在随机对照试验和荟萃分析中，N-3多不饱和脂肪酸补充剂可改善重度抑郁症（MDD）的症状，其中具有抗炎作用的二十碳五烯酸（EPA）的疗效高于以脑为主的二十二碳六烯酸（DHA）。为了研究抗炎抗抑郁营养化合物的具体脑机制，我们在这项双盲、直接比较的研究中招募了24名MDD受试者，进行为期12周的EPA或DHA治疗（临床试验注册号：NCT03871088）。通过汉密尔顿抑郁量表（HAM-D）评估抑郁严重程度。通过3特斯拉磁共振成像测量大脑对情绪刺激的反应。还测试了HAM-D评分与大脑反应之间的相关性。与18名健康对照相比，24名未经治疗的MDD患者在处理积极情绪时，大脑反应主要显示与情绪感知和情绪控制相关区域的活动减退。治疗后，与DHA组相比，EPA组观察到更多症状缓解的MDD患者。此外，EPA治疗而非DHA治疗显示，在处理积极情绪时，与情绪感知和认知控制相关区域的活动增加。相关性分析进一步揭示了HAM-D评分与认知控制区域大脑反应之间的负相关。本研究结果可能意味着EPA而非DHA对认知和情绪控制具有代偿性大脑反应，并为使用抗炎营养保健品治疗抑郁症的个性化医疗提供依据。
