N-乙酰半胱氨酸治疗双相情感障碍高危青少年及年轻成人左前额叶皮质谷氨酸改变的初步研究
N-acetylcysteine for depression and glutamate changes in the left prefrontal cortex in adolescents and young adults at risk for bipolar disorder: A pilot study.
机构信息
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
出版信息
Early Interv Psychiatry. 2022 Feb;16(2):195-199. doi: 10.1111/eip.13149. Epub 2021 Apr 1.
AIMS
To investigate the mechanism of action of N-acetylcysteine (NAC) in depressive symptoms in young individuals at familial risk for bipolar disorder.
METHODS
We conducted an 8-week open label clinical trial of NAC 2400 mg/days in 15-24 years old depressed offspring of a bipolar I disorder parent, with baseline and endpoint proton magnetic resonance spectroscopy acquired within the left ventrolateral prefrontal cortex (VLPFC).
RESULTS
Nine participants were enrolled and finished the study. NAC significantly improved depressive and anxiety symptom scores, and clinical global impression (all p < .001). There was a non-significant reduction in glutamate levels in the left VLPFC. Reduction in depressive symptom scores was positively associated with reduction in glutamate levels in the left VLPFC (p = .007).
CONCLUSIONS
This pilot study suggests that NAC might be efficacious for depressive symptoms in at-risk youth, and that its mechanism of action involves the modulation of glutamate in the left VLPFC.
目的
研究 N-乙酰半胱氨酸（NAC）在双相情感障碍家族高危年轻个体抑郁症状中的作用机制。
方法
我们对 15-24 岁的双相情感障碍 I 型障碍父母的抑郁后代进行了为期 8 周的 NAC（2400mg/d）开放性标签临床试验，在左腹外侧前额叶皮层（VLPFC）内采集基线和终点质子磁共振波谱。
结果
9 名参与者入组并完成了研究。NAC 显著改善了抑郁和焦虑症状评分以及临床总体印象（均 p<0.001）。左 VLPFC 中的谷氨酸水平有一定程度的非显著降低。抑郁症状评分的降低与左 VLPFC 中谷氨酸水平的降低呈正相关（p=0.007）。
结论
这项初步研究表明，NAC 可能对高危青年的抑郁症状有效，其作用机制涉及左 VLPFC 中谷氨酸的调节。
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