Lateralized caudate metabolic abnormalities in adolescent major depressive disorder: a proton MR spectroscopy study.
OBJECTIVE
Proton magnetic resonance spectroscopy ((1)H-MRS) has been increasingly used to examine striatal neurochemistry in adult major depressive disorder. This study extends the use of this modality to pediatric major depression to test the hypothesis that adolescents with major depression have elevated concentrations of striatal choline and creatine and lower concentrations of N-acetylaspartate.


METHODS
Fourteen adolescents (ages 12-19 years, eight female) who had major depressive disorder for at least 8 weeks and a severity score of 40 or higher on the Children's Depression Rating Scale-Revised and 10 healthy comparison adolescents (six female) group-matched for gender, age, and handedness were enrolled. All underwent three-dimensional 3-T (1)H-MRS at high spatial resolution (0.75-cm(3) voxels). Relative levels of choline, creatine, and N-acetylaspartate in the left and right caudate, putamen, and thalamus were scaled into concentrations using phantom replacement, and levels were compared for the two cohorts.


RESULTS
Relative to comparison subjects, adolescents with major depressive disorder had significantly elevated concentrations of choline (2.11 mM versus 1.56 mM) and creatine (6.65 mM versus 5.26 mM) in the left caudate. No other neurochemical differences were observed between the groups.


CONCLUSIONS
These findings most likely reflect accelerated membrane turnover and impaired metabolism in the left caudate. The results are consistent with prior imaging reports of focal and lateralized abnormalities in the caudate in adult major depression.
NYU Child Study Center, Department of Psychiatry, New York University School of Medicine, 557 First Avenue, New York, NY 10016, USA. vilma.gabbay@med.nyu.edu
Vilma
V
Gabbay
David A
DA
Hess
Songtao
S
Liu
James S
JS
Babb
Rachel G
RG
Klein
Oded
O
Gonen
D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D002421:Caudate Nucleus / Q000378:metabolism*; D002794:Choline / Q000378:metabolism*; D015331:Cohort Studies; D003401:Creatine / Q000378:metabolism*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D009682:Magnetic Resonance Spectroscopy / Q000706:statistics & numerical data*; D008297:Male; D011569:Psychiatric Status Rating Scales; D000297:Psychology, Adolescent; D011699:Putamen / Q000378:metabolism; D012720:Severity of Illness Index; D013788:Thalamus / Q000378:metabolism
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline