1H magnetic resonance spectroscopy study of thalamus in treatment resistant depressive patients

doi:10.1016/j.neulet.2007.08.004

Neuroscience Letters

Volume 425, Issue 1, 20 September 2007, Pages 49-52

https://doi.org/10.1016/j.neulet.2007.08.004 Get rights and content

Abstract

Treatment-resistant depression (TRD) is a common clinical problem, and represents a considerable challenge to treatment, however, the pathogenesis of this disease is poorly understood. Thalamus is generally believed to have a role in the pathophysiology of depression. In this study, we adopted 1.5 T ¹H magnetic resonance spectroscopy (¹H MRS) to examine possible alterations of thalamus metabolism in 20 adult TRD patients. Our results suggested there might be damage and loss of neurons, as well as membrane phospholipids associated metabolism abnormality in the TRD thalamus.

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Acknowledgments

This work is supported by a grant from National Nature Science Foundation of China (no. 30570657). We are grateful to Shuo Luo for editing the manuscript.

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Cited by (15)

Functional MRI markers for treatment-resistant depression: Insights and challenges
2023, Progress in Brain Research
Imaging studies of treatment-resistant depression (TRD) have examined brain activity, structure, and metabolite concentrations to identify critical areas of investigation in TRD as well as potential targets for treatment interventions. This chapter provides an overview of the main findings of studies using three imaging modalities: structural magnetic resonance imaging (MRI), functional MRI (fMRI), and magnetic resonance spectroscopy (MRS). Decreased connectivity and metabolite concentrations in frontal brain areas appear to characterize TRD, although results are not consistent across studies. Treatment interventions, including rapid-acting antidepressants and transcranial magnetic stimulation (TMS), have shown some efficacy in reversing these changes while alleviating depressive symptoms. However, comparatively few TRD imaging studies have been conducted, and these studies often have relatively small sample sizes or employ different methods to examine a variety of brain areas, making it difficult to draw firm conclusions from imaging studies about the pathophysiology of TRD. Larger studies with more unified hypotheses, as well as data sharing, could help TRD research and spur better characterization of the illness, providing critical new targets for treatment intervention.
Correlations between facial emotion processing and biochemical abnormalities in untreated adolescent patients with major depressive disorder: A proton magnetic resonance spectroscopy study
2022, Journal of Affective Disorders
Citation Excerpt :
We found increased NAA/Cr ratios of the right thalamus in adolescent patients with MDD, which may seem somewhat counterintuitive. Actually, different studies reported conflicting results, with thalamus NAA levels being decreased (Huang et al., 2010; Mu et al., 2007) or unchanged in patients with depression (Mirza et al., 2006; Zhao et al., 2015). Other studies consistently reported on the hyperactivity in the thalamus during episodes of depression, which decreased with efficient control of MDD by treatment (Greicius et al., 2007; Holthoff et al., 2004; Lai, 2014; Velasco et al., 2005).
Studies show that disturbances of the fronto-striato-thalamic-cerebellar circuit could be correlated to facial emotion processing (FEP) biases in major depressive disorder (MDD). Nevertheless, the underlying mechanism of natural metabolism-emotion relationships in adolescent MDD remains unclear.
Thirty-seven adolescent patients with MDD and 30 healthy controls completed FEP tasks using the Chinese Facial Affective Picture System (CAFPS). Proton magnetic resonance spectroscopy (¹H-MRS) was also used to obtain ratios of N-acetylaspartate (NAA) /creatine (Cr) and choline (Cho) /Cr ratios in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), putamen, thalamus and cerebellum. Correlations between abnormal neurometabolic ratios and FEP were also computed.
Compared with the control group, the MDD group had significantly lower accuracy and perception intensity of happiness, and significantly higher accuracy of disgust and perception intensity of sad and fearful faces in FEP tasks. Compared to healthy controls, adolescent patients with MDD showed significantly lower NAA/Cr ratios in the left PFC, higher NAA/Cr ratios in the right thalamus, and higher Cho/Cr ratios in the right putamen, although there were no significant differences in metabolites in the ACC and cerebellum between two groups. In the MDD group, NAA/Cr ratios of the right thalamus were negatively correlated with happy reaction time and positively correlated with sad, anger, and fear intensity; Cho/Cr ratios in the right putamen were positively correlated with fear reaction time.
Our findings suggest that FEP bias may exist in adolescents with MDD, while the impairment of FEP may be associated with abnormal metabolites in the fronto-striato-thalamic circuit.
Brain choline in major depression: A review of the literature
2018, Psychiatry Research - Neuroimaging
Citation Excerpt :
From the 19 adult studies, we found 10 reporting significant differences in choline values between controls and MDD subjects. These significant differences were found in the left dorsal lateral prefrontal cortex (DLPFC), right dorsolateral prefrontal cortex, ventromedial prefrontal cortex, white matter in the frontal lobe, putamen, basal ganglia, left thalamus, hippocampus, and the amygdala (Chen et al., 2012; Gruber et al., 2003; Herman-Sucharska et al., 2010; Jia et al., 2015; Jollant et al., 2017; Mervaala et al., 2000; Milne et al., 2009; Mu et al., 2007; Portella et al., 2011; Vythilingam et al., 2003; Wang et al., 2012a, 2012b). Five papers reported significant differences in the frontal lobes of depressed individuals (Gruber et al., 2003; Jia et al., 2015; Wang et al., 2012a, 2012b).
The focus of this review is to provide a synthesis of the current literature on the role of brain choline, as measured by proton magnetic resonance spectroscopy (1H-MRS), in major depressive disorder (MDD). The most recent ¹H-MRS literature review took place over 10 years ago and, reflecting the high level of research on this topic, much has been learned since then. Higher brain choline levels have been linked to an increase in depression, and a cholinergic model for MDD development has been postulated. However, current ¹H-MRS studies have been inconclusive regarding the role of choline in depression. Data from eighty-six peer-reviewed studies were analyzed for a random-effects model meta-analysis. Two significant findings are reported. Papers that did not report segmentation had a significant, moderate effect size. Higher choline concentrations in the frontal lobe were found in depressed patients, both in those who responded to treatment and those who did not, after treatment with psychiatric medication, repetitive transcranial magnetic stimulation, or electroconvulsive therapy. Findings from this review may add to existing information regarding the role of brain choline in MDD. This may provide a future target for treatment and drug development. It also may serve as a biomarker for treatment progress.
Multivoxel proton magnetic resonance spectroscopy detects thalamic neurochemical metabolic changes in patients with major depressive disorder
2017, Egyptian Journal of Radiology and Nuclear Medicine
Major depressive disorder (MDD) is one of the most commonly encountered psychiatric disorders in daily medical practice. Severity of depression may relate to thalamic neurochemical metabolic changes. Proton magnetic resonance spectroscopy (1H-MRS) can give an idea about the mechanisms that possibly underlie MDD and the response to therapy.
To detect the possible neurochemical metabolic changes that may occur in both thalami of patients with MDD by multivoxel 1H-MRS of the brain.
Forty-three drug-naïve patients with MDD and 15 age- and sex-matched normal controls were subjected to brain imaging with multivoxel 1.5 T 1H-MRS for measuring the NAA/Cho, NAA/Cr, Cho/Cr, mI/NAA and mI/Cr ratios in the thalamus bilaterally. The severity of depression was assessed by the Hamilton Depression Rating Scale (HDRS).
Patients with MDD showed a significant decrease in the NAA/Cr and NAA/Cho ratios in both thalami compared to normal controls (P < 0.05). Also, the severity of depression was significantly associated with decreased thalamic NAA/Cr and NAA/Cho ratios.
The multi-voxel 1H-MRS can provide an insight to the neurochemical metabolic changes occurring in both thalami in patients with MDD. Increased severity of depression is significantly related to these thalamic neurochemical changes.
Neuroimaging Approaches to the Understanding of Depression and the Identification of Novel Antidepressants
2013, Translational Neuroimaging
Hippocampal neurometabolite changes in depression treatment: A <sup>1</sup>H magnetic resonance spectroscopy study
2012, Psychiatry Research - Neuroimaging
Previous studies using magnetic resonance spectroscopy have related abnormalities in hippocampal metabolism to depression. Current evidence is consistent with the conclusion that the hippocampal formation plays an important role in the presentation of depressive symptoms. Eighteen adult patients with major depressive disorder, aged 20 to 60 years, underwent magnetic resonance spectroscopy of the hippocampus during a period of depressive symptomatology and after 7–11 weeks of antidepressant medication with at least 50% reduction in the Montgomery-Åsberg Depression Rating Scale ()MADRS score. During therapy, we found a significantly decreased Lac/Cr ratio in the left hippocampus. The Ins/Cr ratio showed a significant negative correlation with the severity of depression as assessed by the MADRS at baseline. Moreover, we found a negative association of NAA/Cho with age and a positive association of Cho/Cr with age, both on the left and right sides at baseline. In light of our findings and previous studies results we hypothesize that mitochondrial dysfunction leading to predominantly anaerobic glycolysis in connection with the intracellular signaling pathways disturbances and decreased astrocytic function/number might subsequently lead to decreased brain neuroplasticity in depression. These mechanisms could be positively influenced by antidepressant treatment with selective serotonin or norepineprine reuptake inhibitors, with potential effects on untimely neuronal aging in depression.

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1H magnetic resonance spectroscopy study of thalamus in treatment resistant depressive patients

Abstract

Section snippets

Acknowledgments

Biol. Psychiatry

Psychiatry Res.

Psychiatry Res.

Brain Res.

J. Psychiatr. Res.

Neuroscience

Eur. Neuropsychopharmacol.

Depression after stereotactic thalamotomy in patients with abnormal movements

Ital. J. Neurol. Sci.

Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions

Brain

Cerebral blood flow related to induction of a depressed mood within and out of the realm of attention in normal volunteers

Psychiatry Res.

Neuronal plasticity and survival in mood disorders

Biol. Psychiatry

A patient with a resistant major depression disorder treated with deep brain stimulation in the inferior thalamic peduncle

Neurosurgery

Recovery of N-acetylaspartate in corticomotor neurons of patients with ALS after riluzole therapy

NeuroReport

¹H magnetic resonance spectroscopy study of thalamus in treatment resistant depressive patients