Valizadeh Parya, Jannatdoust Payam, Bagherieh Sara, Cattarinussi Giulia, Squarcina Letizia, Maleki Samin, Sambataro Fabio, Barone Ylenia, Delvecchio Giuseppe
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Affect Disord. 2025 Jun 10;389:119661. doi: 10.1016/j.jad.2025.119661.
Mood disorders are linked to inflammation, suggesting anti-inflammatory treatments may influence mood regulation. Magnetic Resonance Spectroscopy (MRS) is effective in monitoring neurochemical changes associated with neuroinflammation and tracking the neurophysiological effects of anti-inflammatory agents. This systematic review summarizes clinical trials investigating the effects of anti-inflammatory agents on brain MRS measures in individuals with, or at risk for, mood disorders.
We conducted a systematic review following PRISMA 2020 guidelines in PubMed, Scopus, Embase, and Web of Science to identify relevant studies published before April 2024. Clinical trials evaluating the effects of anti-inflammatory agents on MRS measures in mood disorders were included. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the Effective Public Health Practice Project tool.
Ten studies were included. Omega-3 increased N-acetyl aspartate (NAA) in the corpus callosum in bipolar disorder (BD) and reduced choline (Cho) and creatine (Cr) in the anterior cingulate cortex (ACC) in offspring of BD patients. N-acetylcysteine was associated with higher NAA, glutamate, and glutamine (Glx) and lower myo-inositol levels in the ACC in major depressive disorder (MDD). Ebselen reduced inositol and Glx concentrations in the ACC in MDD. Infliximab reduced Glx in the prefrontal cortex in BD, and lovastatin increased NAA in the ACC and decreased the Cho/Cr ratio in the left basal ganglia in manic BD.
Anti-inflammatory agents induce neurochemical changes in mood disorders that can be measured with MRS. These shifts may relate to symptom improvement. Further research is needed to elucidate the mechanisms underlying these effects.
情绪障碍与炎症有关，这表明抗炎治疗可能会影响情绪调节。磁共振波谱（MRS）可有效监测与神经炎症相关的神经化学变化，并追踪抗炎药物的神经生理效应。本系统评价总结了调查抗炎药物对患有情绪障碍或有情绪障碍风险的个体脑MRS测量指标影响的临床试验。
我们按照PRISMA 2020指南在PubMed、Scopus、Embase和Web of Science中进行了系统评价，以识别2024年4月之前发表的相关研究。纳入评估抗炎药物对情绪障碍中MRS测量指标影响的临床试验。两名 reviewers 独立筛选研究、提取数据，并使用有效公共卫生实践项目工具评估偏倚风险。
纳入了10项研究。ω-3增加了双相情感障碍（BD）患者胼胝体中的N-乙酰天门冬氨酸（NAA），并降低了BD患者后代前扣带回皮质（ACC）中的胆碱（Cho）和肌酸（Cr）。N-乙酰半胱氨酸与重度抑郁症（MDD）患者ACC中较高的NAA、谷氨酸和谷氨酰胺（Glx）以及较低的肌醇水平相关。依布硒仑降低了MDD患者ACC中的肌醇和Glx浓度。英夫利昔单抗降低了BD患者前额叶皮质中的Glx，洛伐他汀增加了躁狂BD患者ACC中的NAA，并降低了左侧基底神经节中的Cho/Cr比值。
抗炎药物在情绪障碍中诱导可通过MRS测量的神经化学变化。这些变化可能与症状改善有关。需要进一步研究以阐明这些效应背后的机制。
