title: Effects of fish oil supplementation on prefrontal metabolite concentrations in adolescents with major depressive disorder: a preliminary 1H MRS study.
abstract: OBJECTIVE
  To use proton magnetic resonance spectroscopy ((1)H MRS) to investigate the effects of fish oil (FO) supplementation on cortical metabolite concentrations in adolescents with major depressive disorder (MDD).
  
  
  METHODS
  Metabolite concentrations were determined by (1)H MRS in the anterior cingulate cortex and bilateral dorsolateral prefrontal cortex (DLPFC) of adolescents with MDD before and following 10-week open-label supplementation with low (2.4 g/day, n = 7) or high (16.2 g/day, n = 7) dose FO. Depressive symptom severity scores and erythrocyte fatty acid levels were also determined.
  
  
  RESULTS
  Baseline erythrocyte eicosapentaenoic acid (EPA) composition was positively correlated, and arachidonic acid (AA) and the AA/EPA ratio were inversely correlated, with choline (Cho) concentrations in the right DLPFC. Docosahexaenoic acid (DHA) composition was inversely correlated with myo-inositol (mI) concentrations in the left DLPFC. Erythrocyte EPA and DHA composition increased, and AA decreased, significantly following low-dose and high-dose FO supplementation. In the intent-to-treat sample, depressive symptom severity scores decreased significantly in the high-dose group (-40%, P < 0.0001) and there was a trend in the low-dose group (-20%, P = 0.06). There were no significant baseline-endpoint changes in metabolite levels in each voxel. In the low-dose group there were changes with large effect sizes, including a decrease in mI in the left DLPFC (-12%, P = 0.18, d = 0.8) and increases in glutamate + glutamine (Glx) (+12%, P = 0.19, d = 0.8) and Cho (+15%, P = 0.08, d = 1.2) in the right DLPFC. In the high-dose group, there was a trend for increases in Cho in the right DLPFC (+10%, P = 0.09, d = 1.2).
  
  
  CONCLUSIONS
  These preliminary data suggest that increasing the LCn-3 fatty acid status of adolescent MDD patients is associated with subtle changes in Glx, mI, and Cho concentrations in the DLPFC that warrant further evaluation in a larger controlled trial.
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Robert K
authors.initials: RK
authors.lastname: McNamara
authors.affiliation: b Department of Pathology , University of Cincinnati , Cincinnati , OH , USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Jandacek
authors.affiliation: b Department of Pathology , University of Cincinnati , Cincinnati , OH , USA.
authors.forename: Therese
authors.initials: T
authors.lastname: Rider
authors.affiliation: b Department of Pathology , University of Cincinnati , Cincinnati , OH , USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tso
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Wen-Jang
authors.initials: WJ
authors.lastname: Chu
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Wade A
authors.initials: WA
authors.lastname: Weber
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Welge
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Strawn
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Caleb M
authors.initials: CM
authors.lastname: Adler
authors.affiliation: a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors.forename: Melissa P
authors.initials: MP
authors.lastname: DelBello
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003677:Deficiency Diseases / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019587:Dietary Supplements; D005228:Fatty Acids, Essential / Q000172:deficiency / Q000378:metabolism / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage / Q000627:therapeutic use*; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D057194:Intention to Treat Analysis; D059012:Lost to Follow-Up; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000378:metabolism; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
chemical_list: D005228:Fatty Acids, Essential; D005395:Fish Oils
keywords: Adolescent; Anterior cingulated cortex; Docosahexaenoic acid; Dorsolateral prefrontal cortex; Major depressive disorder; Proton magnetic resonance spectroscopy