Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut.
Biol Psychiatry. 2023 Jun 15;93(12):1099-1107. doi: 10.1016/j.biopsych.2022.10.018. Epub 2022 Nov 8.
Understanding the neurobiology underlying bipolar disorder (BD) versus major depressive disorder (MDD) is crucial for accurate diagnosis and for driving the discovery of novel treatments. A promising target is the metabotropic glutamate receptor 5 (mGluR5), a modulator of glutamate transmission associated with synaptic plasticity. We measured mGluR5 availability in individuals with MDD and BD for the first time using positron emission tomography.
Individuals with BD (n = 17 depressed; n = 10 euthymic) or MDD (n = 17) and healthy control (HC) individuals (n = 18) underwent imaging with [F]FPEB positron emission tomography to quantify mGluR5 availability in regions of the prefrontal cortex, which was compared across groups and assessed in relation to depressive symptoms and cognitive function.
Prefrontal cortex mGluR5 availability was significantly different across groups (F = 2.18, p = .050). Specifically, mGluR5 was lower in BD versus MDD and HC groups, with no difference between MDD and HC groups. Furthermore, after dividing the BD group, mGluR5 was lower in both BD-depression and BD-euthymia groups versus both MDD and HC groups across regions of interest. Interestingly, lower dorsolateral prefrontal cortex mGluR5 was associated with worse depression in MDD (r = -0.67, p = .005) but not in BD. Significant negative correlations were observed between mGluR5 and working memory in MDD and BD-depression groups.
This work suggests that mGluR5 could be helpful in distinguishing BD and MDD as a possible treatment target for depressive symptoms in MDD and for cognitive alterations in both disorders. Further work is needed to confirm differentiating roles for mGluR5 in BD and MDD and to probe modulation of mGluR5 as a preventive/treatment strategy.
理解双相情感障碍 (BD) 与重度抑郁症 (MDD) 的神经生物学基础对于准确诊断和推动新疗法的发现至关重要。一个有前途的靶点是代谢型谷氨酸受体 5(mGluR5),它是一种与突触可塑性相关的谷氨酸传递调节剂。我们首次使用正电子发射断层扫描 (PET) 测量了 MDD 和 BD 个体的 mGluR5 可用性。
BD 患者(抑郁期 17 例,缓解期 10 例)或 MDD 患者(17 例)和健康对照组(18 例)接受 [F]FPEB PET 成像,以量化前额叶皮质区域的 mGluR5 可用性,并比较组间差异,并评估与抑郁症状和认知功能的关系。
前额叶皮质 mGluR5 可用性在各组之间存在显著差异(F=2.18,p=0.050)。具体来说,BD 患者的 mGluR5 低于 MDD 和 HC 组,而 MDD 和 HC 组之间无差异。此外,在将 BD 组分组后,BD 抑郁期和 BD 缓解期患者的 mGluR5 均低于 MDD 和 HC 组。有趣的是,背外侧前额叶皮质 mGluR5 与 MDD 患者的抑郁程度呈负相关(r=-0.67,p=0.005),而与 BD 患者无关。MDD 和 BD 抑郁组的 mGluR5 与工作记忆之间存在显著负相关。
这项工作表明,mGluR5 可能有助于区分 BD 和 MDD,作为 MDD 抑郁症状的潜在治疗靶点,以及两种疾病的认知改变的潜在治疗靶点。需要进一步的工作来确认 mGluR5 在 BD 和 MDD 中的区分作用,并探索 mGluR5 的调节作为一种预防/治疗策略。