title: Increased myo-inositol level in dorsolateral prefrontal cortex in migraine patients with major depression.
abstract: BACKGROUND
  Although the comorbidity between migraine and major depressive disorder (MDD) has been recognized, the pathophysiology remains unclear. The dorsolateral prefrontal cortex (DLPFC) is a well-known neural substrate for MDD. We investigated the relationship between brain metabolites in DLPFC and comorbid MDD in migraine patients.
  
  
  METHODS
  We recruited migraine patients from a tertiary headache clinic. A board-certified psychiatrist conducted a structured interview for MDD diagnosis. The severity of depression was evaluated by the Beck Depression Inventory (BDI). Thirty migraine patients (five men, 25 women; mean age: 40.4 ± 12.4 years) completed the study, and 16 of them were diagnosed with MDD. All patients underwent a magnetic resonance spectroscopy (MRS) examination focusing on bilateral DLPFC. The ratios of N-acetylaspartate (NAA), choline (Cho), and myo-inositol (mI) to total creatine (tCr) were compared between migraine patients with and without MDD, and were correlated with BDI scores.
  
  
  RESULTS
  Relative to patients without MDD, migraine patients with MDD had higher mI/tCr ratios in the bilateral DLPFC (p = 0.02, left; p = 0.02, right, Mann-Whitney U test). The mI/tCr ratios in the right DLPFC were positively correlated with BDI scores (r = 0.52, p = 0.003). The NAA/tCr and Cho/tCr ratios did not differ between migraine patients with and without MDD.
  
  
  CONCLUSIONS
  Increased mI/tCr within the DLPFC might be associated with the presence of MDD in migraine patients.
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan Department of Radiology, Taipei Veterans General Hospital, Taiwan.
authors.forename: Jiing-Feng
authors.initials: JF
authors.lastname: Lirng
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan Department of Radiology, Taichung Veterans General Hospital, Taiwan.
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan Brain Research Center, National Yang-Ming University, Taiwan Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan Institute of Brain Science, National Yang-Ming University, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taiwan.
authors.forename: Chia-Fen
authors.initials: CF
authors.lastname: Tsai
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan jflirng@vghtpe.gov.tw sjwang@vghtpe.gov.tw.
authors.forename: Jen-Feng
authors.initials: JF
authors.lastname: Liang
authors.affiliation: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taiwan Brain Research Center, National Yang-Ming University, Taiwan Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan Institute of Brain Science, National Yang-Ming University, Taiwan.
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D007294:Inositol / Q000032:analysis*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000378:metabolism* / Q000523:psychology; D017397:Prefrontal Cortex / Q000378:metabolism*; D055815:Young Adult
chemical_list: D007294:Inositol
keywords: Migraine; dorsolateral prefrontal cortex (DLPFC); magnetic resonance spectroscopy (MRS); major depressive disorder (MDD); psychiatric comorbidity