A proton MRSI study of brain N-acetylaspartate level after 12 weeks of citalopram treatment in drug-naive patients with obsessive-compulsive disorder.
OBJECTIVE
Reductions in the level of N-acetylaspartate within subcortical structures of patients with obsessive-compulsive disorder (OCD) have been reported in several studies. However, there have been, as yet, no reports regarding N-acetylaspartate levels in the prefrontal cortex of adult drug-naive OCD patients. The authors used proton magnetic resonance spectroscopic imaging ((1)H-MRSI) to investigate regional N-acetylaspartate level abnormalities and changes after 12 weeks of pharmacotherapy with citalopram in drug-naive OCD patients.


METHODS
Thirteen drug-naive OCD patients and 13 age- and sex-matched healthy comparison subjects were included in this study. N-acetylaspartate levels (obtained from ratios of N-acetylaspartate with creatine, choline, and creatine plus choline) in the prefrontal cortex, parietal cortex, anterior cingulate, posterior cingulate, frontal white matter, and parietal white matter were measured by (1)H-MRSI. In OCD patients, measurements were taken before and after 12 weeks of citalopram treatment. Correlations between N-acetylaspartate concentrations in regions of interest and clinical measures were also assessed.


RESULTS
Drug-naive OCD patients exhibited significantly lower N-acetylaspartate levels in the prefrontal cortex, frontal white matter, and anterior cingulate at baseline than did comparison subjects. Significant increases in N-acetylaspartate level were detected in the prefrontal cortex and frontal white matter in OCD patients after 12 weeks of citalopram treatment.


CONCLUSIONS
These data suggest that reductions in neuronal viability occur in the frontal region of OCD patients and that these reductions may be partly reversible.
Jang
Joon Hwan
JH
Department of Psychiatry, Seoul National University College of Medicine, 28 Yeongon-dong, Chongno-gu, Seoul, Korea. kwonjs@plaza.snu.ac.kr
Kwon
Jun Soo
JS
Jang
Dong Pyo
DP
Moon
Won-Jin
WJ
Lee
Jong-Min
JM
Ha
Tae Hyun
TH
Chung
Eun Chul
EC
Kim
In Young
IY
Kim
Sun I
SI
D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001921:Brain / Q000187:drug effects / Q000378:metabolism*; D001923:Brain Chemistry / Q000187:drug effects; D002794:Choline / Q000378:metabolism; D015283:Citalopram / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D003401:Creatine / Q000378:metabolism; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000378:metabolism; D006179:Gyrus Cinguli / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008137:Longitudinal Studies; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D010555:Personality Inventory; D017397:Prefrontal Cortex / Q000187:drug effects / Q000378:metabolism; D011522:Protons; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use*
D001224:Aspartic Acid; D002794:Choline; D015283:Citalopram; D003401:Creatine; D011522:Protons; D017367:Selective Serotonin Reuptake Inhibitors; C000179:N-acetylaspartate