A MRS study of metabolic alterations in the frontal white matter of major depressive disorder patients with the treatment of SSRIs.
BACKGROUND
Proton magnetic resonance spectroscopy provides a non-invasive technology to study brain metabolite levels in vivo, which can be used to measure biochemical compounds or metabolite concentrations in circumscribed brain regions. Previous research has highlighted the role of glial cells in brain white matter. It has been assumed that antidepressant treatment with SSRIs not only affects neurons, but also activates glial cells. This study focused on the observation of any potential changes in the metabolite levels of the ventral prefrontal white matter in major depressive disorder (MDD) patients who have received antidepressant treatment.


METHODS
17 female patients diagnosed as MDD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria with the scores of 18 and above on the 24-item Hamilton Depression Rating Scale (HDRS) were recruited. MRS studies were performed on a 3.0 T MR system, single voxel PRESS spectroscopy with chemical-shift selective saturation water suppression. The volume of interest was localized at the bilateral ventral prefrontal white matter regions (voxel size: 2 × 2 × 2 mm(3)). The spectral data analysis was performed by using the instrument manufacturer supplied software.


RESULTS
The bilateral ventral prefrontal white matter of MDD patients showed significantly lower Cho/Cr (p < 0.05) before receiving treatment. The HDRS, as the indicator of treatment response, showed a significant decrease in patients who had gone through 12 weeks treatment (p < 0.01). The bilateral Cho/Cr values of post-treatment patients were increased significantly compared to that of pre-treatment (p < 0.05).


CONCLUSIONS
The alteration of ventral prefrontal white matter metabolite levels are likely involved in MDD pathophysiology and imply a crucial role of white matter in MDD.
Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China. yifan0vally@sina.com.
Yifan
Y
Zhang
Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China. hanyu81116@163.com.
Yu
Y
Han
Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China. wangyongzhi_1978@sina.com.
Yongzhi
Y
Wang
Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China. agzyf0927@126.com.
Yinfeng
Y
Zhang
Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China. liliqin_1999@yahoo.com.
Li
L
Li
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. erhujin1@hotmail.com.
Erhu
E
Jin
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. ligangdeng@sina.com.
Ligang
L
Deng
Department of Biological Sciences, Southeastern Oklahoma State University, Durant, OK, 74701, USA. brandi5watts@gmail.com.
Brandi
B
Watts
Department of Biological Sciences, Southeastern Oklahoma State University, Durant, OK, 74701, USA. tgolden@se.edu.
Teresa
T
Golden
Department of Biological Sciences, Southeastern Oklahoma State University, Durant, OK, 74701, USA. nwu@se.edu.
Ning
N
Wu
D000328:Adult; D000928:Antidepressive Agents / Q000494:pharmacology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000378:metabolism; D017397:Prefrontal Cortex / Q000378:metabolism*; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology*; D066127:White Matter / Q000378:metabolism*
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors