Bell Charles J M, Mehta Mitul, Mirza Luwaiza, Young Allan H, Beck Katherine
Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King's College, Psychology & Neuroscience, London, UK.
South West London and St George's NHS Foundation Trust, London, UK.
Psychopharmacology (Berl). 2025 Apr;242(4):717-724. doi: 10.1007/s00213-024-06735-1. Epub 2024 Dec 21.
Major depressive disorder (MDD) is a common and serious psychiatric disorder associated with significant morbidity. There is mounting evidence for the role of oxidative stress in the pathophysiology of depression.
To investigate alterations in the brain antioxidant glutathione in depression by undertaking a meta-analysis of proton magnetic resonance spectroscopy (1H-MRS).
MEDLINE, EMBASE and Psych Info databases were searched for case-control studies that reported brain glutathione levels in patients with depression and healthy controls. Means and variances (SDS) were extracted for each measure to calculate effect sizes. Hedges g was used to quantify mean differences. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.
8 studies that reported measurements for 230 patients with depression and 216 controls were included. Three studies included data for the occipital cortex and five studies for the medial frontal cortex. In the occipital cortex, GSH was lower in the patient group as compared to controls (g = -0.98, 95% [CI, -1.45--0.50], P = < 0.001). In both the medial frontal cortex and in the combined all areas analysis there was no significant difference in GSH levels between cases and controls.
This study found reduced levels of GSH specifically in the occipital region of patients with MDD. This provides some support for the role of oxidative stress in depression and suggests that targeting this system may provide future therapeutic opportunities. However, the meta-analysis was limited by the small number and quality of the included studies. More studies using high quality MRS methods in a variety of brain regions are needed in the future to test this putative hypothesis.
重度抑郁症（MDD）是一种常见且严重的精神疾病，伴有显著的发病率。越来越多的证据表明氧化应激在抑郁症的病理生理学中起作用。
通过对质子磁共振波谱（1H-MRS）进行荟萃分析，研究抑郁症患者大脑抗氧化剂谷胱甘肽的变化。
检索MEDLINE、EMBASE和Psych Info数据库，查找报告抑郁症患者和健康对照者大脑谷胱甘肽水平的病例对照研究。提取每项测量的均值和方差（标准差）以计算效应量。使用Hedges g来量化均值差异。遵循流行病学观察性研究的荟萃分析（MOOSE）和系统评价与荟萃分析的首选报告项目（PRISMA）指南。
纳入了8项报告了230例抑郁症患者和216例对照测量结果的研究。3项研究纳入了枕叶皮质的数据，5项研究纳入了内侧额叶皮质的数据。在枕叶皮质中，患者组的谷胱甘肽水平低于对照组（g = -0.98，95%[CI，-1.45--0.50]，P = < 0.001）。在内侧额叶皮质和所有区域合并分析中，病例组和对照组的谷胱甘肽水平均无显著差异。
本研究发现MDD患者枕叶区域的谷胱甘肽水平降低。这为氧化应激在抑郁症中的作用提供了一些支持，并表明针对该系统可能提供未来的治疗机会。然而，荟萃分析受到纳入研究数量少和质量低的限制。未来需要更多在各种脑区使用高质量MRS方法的研究来验证这一假设。
