title: Increased pregenual anterior cingulate glucose and lactate concentrations in major depressive disorder.
abstract: There is ample evidence that glucose metabolism in the pregenual anterior cingulate cortex (PACC) is increased in major depressive disorder (MDD), whereas it is still unknown whether glucose levels per se are also elevated. Elevated cerebrospinal fluid (CSF) lactate concentrations in MDD patients might indicate that increased glycolytical metabolization of glucose to lactate in astrocytes either alone or in conjunction with mitochondrial dysfunction results in an accumulation of lactate and contributes to pathophysiological mechanisms of MDD. However, until now, no study investigated in vivo PACC glucose and lactate levels in MDD. Proton magnetic resonance spectroscopy was therefore used to test the hypothesis that patients with MDD have increased PACC glucose and lactate levels. In 40 healthy and depressed participants, spectra were acquired from the PACC using a maximum echo J-resolved spectroscopy protocol. Results show significant increases of glucose and lactate in patients, which are also associated with depression severity. These findings indicate impaired brain energy metabolism in MDD with increased fraction of energy utilization via glycolysis and reduced mitochondrial oxidative clearance of lactate. Targeting these metabolic disturbances might affect the balance of metabolic pathways regulating neuronal energetics and result in an attenuation of the elevated basal activity of brain regions within the neural circuitry of depression.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Ernst
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.|Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Hock
authors.affiliation: Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.|Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.|Max Planck Institute for Biological Cybernetics, Tuebingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Henning
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.|Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Seifritz
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Boeker
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.|Department of Psychiatry, Charité, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Grimm
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000378:metabolism; D001921:Brain / Q000378:metabolism; D003865:Major Depressive Disorder / Q000378:metabolism*; D004734:Energy Metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism; D006179:Gyrus Cinguli / Q000378:metabolism* / Q000502:physiology; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D066244:Proton Magnetic Resonance Spectroscopy
chemical_list: D001224:Aspartic Acid; D019344:Lactic Acid; D005947:Glucose