Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
Mental Health Centre, Xiangya Hospital, Central South University, Changsha, China.
J Affect Disord. 2022 Dec 1;318:263-271. doi: 10.1016/j.jad.2022.09.001. Epub 2022 Sep 7.
Previous studies have shown major depressive disorder (MDD) is associated with altered neuro-metabolites in the anterior cingulate cortex (ACC). However, the regional metabolic heterogeneity in the ACC in individuals with MDD remains unclear.
We recruited 59 first-episode, treatment-naive young adults with MDD and 50 healthy controls who underwent multi-voxel H-MRS scanning at 3 T (Tesla) with voxels placed in the ACC, which was divided into two subregions, pregenual ACC (pACC) and anterior midcingulate cortex (aMCC). Between and within-subjects metabolite concentration variations were analyzed with SPSS.
Compared with control subjects, patients with MDD exhibited higher glutamate (Glu) and glutamine (Gln) levels in the pACC and higher myo-inositol (MI) level in the aMCC. We observed higher Glu and Gln levels and lower N-acetyl-aspartate (NAA) level in the pACC than those in the aMCC in both MDD and healthy control (HC) groups. More importantly, the metabolite concentration gradients of Glu, Gln and NAA were more pronounced in MDD patients relative to HCs. In the MDD group, the MI level in the aMCC positively correlated with the age of onset.
The use of the relative concentration of metabolites constitutes a key study limitation.
We observed inconsistent alterations and distribution of neuro-metabolites concentration in the pACC and aMCC, revealing regional metabolic heterogeneity of ACC in first-episode, treatment-naive young individuals with MDD. These results provided new evidence for abnormal neuro-metabolites of ACC in the pathophysiology of MDD and suggested that pACC and aMCC might play different roles in MDD.
先前的研究表明，重度抑郁症（MDD）与前扣带皮层（ACC）中的神经代谢物改变有关。然而，MDD 个体中 ACC 的区域代谢异质性仍不清楚。
我们招募了 59 名首发、未经治疗的年轻 MDD 患者和 50 名健康对照者，他们在 3T（特斯拉）上进行了多体素 H-MRS 扫描，在 ACC 中放置了体素，将其分为前扣带皮质（pACC）和前中扣带皮质（aMCC）两个亚区。使用 SPSS 分析了组内和组间代谢物浓度的变化。
与对照组相比，MDD 患者的 pACC 中谷氨酸（Glu）和谷氨酰胺（Gln）水平升高，aMCC 中的肌醇（MI）水平升高。我们观察到 MDD 和健康对照组（HC）中 pACC 的 Glu 和 Gln 水平升高，N-乙酰天冬氨酸（NAA）水平降低。更重要的是，MDD 患者的 pACC 中 Glu、Gln 和 NAA 的代谢物浓度梯度比 HC 更为明显。在 MDD 组中，aMCC 中的 MI 水平与发病年龄呈正相关。
代谢物相对浓度的使用是本研究的一个关键局限性。
我们观察到 pACC 和 aMCC 中神经代谢物浓度的不一致变化和分布，揭示了首发、未经治疗的年轻 MDD 患者中 ACC 的区域代谢异质性。这些结果为 MDD 病理生理学中 ACC 的异常神经代谢物提供了新的证据，并表明 pACC 和 aMCC 可能在 MDD 中发挥不同的作用。
