title: Metabolic change in the right dorsolateral prefrontal cortex and its correlation with symptom severity in patients with generalized anxiety disorder: Proton magnetic resonance spectroscopy at 3 Tesla.
abstract: OBJECTIVE
  A few neuroimaging studies have demonstrated the key brain areas associated with generalized anxiety disorder (GAD). However, the brain metabolic changes in the dorsolateral prefrontal cortex (DLPFC) of patients with GAD are unclear. This study utilized 3-Tesla proton magnetic resonance spectroscopy ((1) H-MRS) to assess the DLPFC metabolic change and its correlation with symptom severity in patients with GAD.
  
  
  METHODS
  Patients with GAD diagnosed using the DSM-IV-TR and age-matched healthy controls participated in this study. Brain metabolite concentrations were measured from a localized voxel on the DLPFC using 3-Tesla (1) H-MRS. Also, the volumetric composition of the gray matter and white matter volumes was assessed using voxel-based morphometry.
  
  
  RESULTS
  The choline/creatine and choline/N-acetylaspartate ratios were significantly lower in patients than in controls. However, there were no significant differences in other metabolite ratios between the two groups. Choline concentrations were negatively correlated with anxiety levels as measured by the Hamilton Anxiety Rating Scale and the Generalized Anxiety Disorder Scale 7. There was no significant difference in the gray matter and white matter volumes in the MRS voxel between the two groups.
  
  
  CONCLUSIONS
  The present study demonstrates that GAD is associated with low a level of choline/N-acetylaspartate in the DLPFC, which is closely related with symptom severity and cognitive dysfunction. This finding will be useful for an understanding of the neural mechanism associated with GAD.
authors.affiliation: Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Chung-Man
authors.initials: CM
authors.lastname: Moon
authors.affiliation: Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Heoung-Keun
authors.initials: HK
authors.lastname: Kang
authors.affiliation: Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea.|Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Gwang-Woo
authors.initials: GW
authors.lastname: Jeong
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D016022:Case-Control Studies; D002794:Choline / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D008297:Male; D059906:Neuroimaging; D017397:Prefrontal Cortex / Q000378:metabolism*; D066244:Proton Magnetic Resonance Spectroscopy; D011569:Psychiatric Status Rating Scales; D066127:White Matter / Q000473:pathology; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline
keywords: 1H-magnetic resonance spectroscopy; brain metabolites; dorsolateral prefrontal cortex; generalized anxiety disorder; voxel-based morphometry