Differential neurometabolite alterations in brains of medication‐free individuals with bipolar disorder and those with unipolar depression: a two‐dimensional proton magnetic resonance spectroscopy study

Li, Hui; Xu, Haiyun; Zhang, Yinnan; Guan, Jitian; Zhang, Jie; Xu, Chongtao; Shen, Zhiwei; Xiao, Bo; Liang, Chun-Ling; Chen, Kaiyuan; Zhang, Jinling; Wu, Renhua

doi:10.1111/bdi.12445

Cited by 60 publications

(19 citation statements)

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“…Psychotropic medication may have affected a few clusters, but the majority of the observations are likely independent of the medication. The clusters that reveal significant alterations in the DKI indices in this study are known to play a role in mood regulation, and abnormalities in these regions have been reported in affective disorders . The results of this study are thus thought to support the existing evidence about neural underpinnings associated with these affective disorders.…”

Section: Discussionsupporting

confidence: 82%

“…A positive correlation between the plasma cortisol level and serotonin transporter availability has been observed in the caudate nucleus and midbrain in MDD, but not in BD . Lower concentrations of choline and creatine compounds and N‐acetyl aspartate have been reported in the parietal cortex of BD patients and posterior cingulate cortex of MDD patients . Third, the findings of neuroimaging studies also suggest differences in cortical thickness, functional connectivity, and cerebral blood flow in the frontal, parietal, and temporal lobes between these two disorders .…”

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confidence: 98%

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Microstructural Alterations in Bipolar and Major Depressive Disorders: A Diffusion Kurtosis Imaging Study

Sawamura

Narita

Hashimoto

et al. 2020

Magnetic Resonance Imaging

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Background Identifying structural and functional abnormalities in bipolar (BD) and major depressive disorders (MDD) is important for understanding biological processes. Hypothesis Diffusion kurtosis imaging (DKI) may be able to detect the brain's microstructural alterations in BD and MDD and any differences between the two. Study Type Prospective. Subjects In all, 16 BD patients, 19 MDD patients, and 20 age‐ and gender‐matched healthy volunteers. Field Strength/Sequence DKI at 3.0T. Assessment The major DKI indices of the brain were compared voxel‐by‐voxel among the three groups. Significantly different voxels were tested for correlation with clinical variables (ie, Young Mania Rating Scale [YMRS], 17‐item Hamilton Depression Rating Scale [17‐HDRS], Montgomery‐Åsberg Depression Rating Scale, total disease duration, duration of current episode, and the number of past manic/depressive episodes). The performance of the DKI indices in identifying microstructural alterations was estimated. Statistical Tests One‐way analysis of variance (ANOVA) was used for group comparison of DKI indices. The performance of these indices in detecting microstructural alterations was determined by receiver operating characteristic (ROC) analysis. Pearson's product–moment correlation analyses were used to test the correlations of these indices with clinical variables. Results DKI revealed widespread microstructural alterations across the brain in each disorder (P < 0.05). Some were significantly different between the two disorders. Mean kurtosis (MK) in the gray matter of the right inferior parietal lobe was able to distinguish BD and MDD with an accuracy of 0.906. A strong correlation was revealed between MK in that region and YMRS in BD patients (r = −0.641, corrected P = 0.042) or 17‐HDRS in MDD patients (r = −0.613, corrected P = 0.030). There were also strong correlations between a few other DKI indices and disease duration (r = −0.676 or 0.626, corrected P < 0.05). Data Conclusion DKI detected microstructural brain alterations in BD and MDD. Its indices may be useful to distinguish the two disorders or to reflect disease severity and duration. Level of Evidence 2 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2020;52:1187–1196.

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 98%

Microstructural Alterations in Bipolar and Major Depressive Disorders: A Diffusion Kurtosis Imaging Study

Sawamura

Narita

Hashimoto

et al. 2020

Magnetic Resonance Imaging

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“…Although several studies in persons with depression have reported no difference in total creatine concentrations ([tCr]), which include concentrations of both creatine ([Cr]) and phosphocreatine ([PCr]), in multiple brain regions [113,114,115,116,117,118,119,120,121,122], others indicate increased [tCr] in some regions, such as in the inferior prefrontal white matter (WM) [123] and left caudate [124]. Studies have shown reduced [tCr] in MDD in the left dorsolateral prefrontal cortex (PFC) [125], posterior cingulate cortex (PCC) [126], and left hippocampus (HC) [127]. A study in of geriatric depression found reduced [tCr] in the PFC in persons with remitted depression compared to healthy controls [128].…”

Section: Methodsmentioning

confidence: 99%

“…BD has been associated with changes in [tCr]. It appears that [tCr] is reduced in several brain regions in BD, including in the frontal lobes [141], cerebellar vermis [142], hippocampi [143], caudate [144], medial PFC [145,146], dorsolateral PFC WM [146], and PCC [126], although some studies indicate that [tCr] is increased in BD in several brain regions [147,148,149]. Several studies have also failed to find alterations in [tCr], including in the left dorsolateral PFC [122,150,151] and ACC [152,153].…”

Section: Methodsmentioning

confidence: 99%

Creatine for the Treatment of Depression

2019

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Depressed mood, which can occur in the context of major depressive disorder, bipolar disorder, and other conditions, represents a serious threat to public health and wellness. Conventional treatments are not effective for a significant proportion of patients and interventions that are often beneficial for treatment-refractory depression are not widely available. There is, therefore, an immense need to identify novel antidepressant strategies, particularly strategies that target physiological pathways that are distinct from those addressed by conventional treatments. There is growing evidence from human neuroimaging, genetics, epidemiology, and animal studies that disruptions in brain energy production, storage, and utilization are implicated in the development and maintenance of depression. Creatine, a widely available nutritional supplement, has the potential to improve these disruptions in some patients, and early clinical trials indicate that it may have efficacy as an antidepressant agent.

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“…F18-fluorine-2-deoxy- d -glucose positron emission tomography can provide information regarding energy metabolism in the early stage of tumor formation [24]; however, this technique also has low specificity, high costs, and requires injection of radioactive substances [25]. Magnetic resonance spectroscopy is limited by its relatively poor detection sensitivity and poor spatial resolution in vivo [26, 27]. Moreover, the wide application of optical imaging is hindered by its intrinsic depth limitation [28].…”

Section: Introductionmentioning

confidence: 99%

Novel nanomedicine with a chemical-exchange saturation transfer effect for breast cancer treatment in vivo

et al. 2019

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BackgroundNanomedicine is a promising new approach to cancer treatment that avoids the disadvantages of traditional chemotherapy and improves therapeutic indices. However, the lack of a real-time visualization imaging technology to monitor drug distribution greatly limits its clinical application. Image-tracked drug delivery is of great clinical interest; it is useful for identifying those patients for whom the therapy is more likely to be beneficial. This paper discusses a novel nanomedicine that displays features of nanoparticles and facilitates functional magnetic resonance imaging but is challenging to prepare.ResultsTo achieve this goal, we synthesized an acylamino-containing amphiphilic block copolymer (polyethylene glycol-polyacrylamide-polyacetonitrile, PEG-b-P(AM-co-AN)) by reversible addition-fragmentation chain transfer (RAFT) polymerization. The PEG-b-P(AM-co-AN) has chemical exchange saturation transfer (CEST) effects, which enable the use of CEST imaging for monitoring nanocarrier accumulation and providing molecular information of pathological tissues. Based on PEG-b-P(AM-co-AN), a new nanomedicine PEG-PAM-PAN@DOX was constructed by nano-precipitation. The self-assembling nature of PEG-PAM-PAN@DOX made the synthesis effective, straightforward, and biocompatible. In vitro studies demonstrate decreased cytotoxicity of PEG-PAM-PAN@DOX compared to free doxorubicin (half-maximal inhibitory concentration (IC50), mean ~ 0.62 μg/mL vs. ~ 5 μg/mL), and the nanomedicine more efficiently entered the cytoplasm and nucleus of cancer cells to kill them. Further, in vivo animal experiments showed that the nanomedicine developed was not only effective against breast cancer, but also displayed an excellent sensitive CEST effect for monitoring drug accumulation (at about 0.5 ppm) in tumor areas. The CEST signal of post-injection 2 h was significantly higher than that of pre-injection (2.17 ± 0.88% vs. 0. 09 ± 0.75%, p < 0.01).ConclusionsThe nanomedicine with CEST imaging reflects the characterization of tumors and therapeutic functions has great potential medical applications.

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Differential neurometabolite alterations in brains of medication‐free individuals with bipolar disorder and those with unipolar depression: a two‐dimensional proton magnetic resonance spectroscopy study

Abstract: These results add to the evidence of brain metabolite differences in brains of patients with UD and BD which may be of help in differentiating these two mood disorders.

Cited by 60 publications

References 48 publications

Microstructural Alterations in Bipolar and Major Depressive Disorders: A Diffusion Kurtosis Imaging Study

Microstructural Alterations in Bipolar and Major Depressive Disorders: A Diffusion Kurtosis Imaging Study

Creatine for the Treatment of Depression

Novel nanomedicine with a chemical-exchange saturation transfer effect for breast cancer treatment in vivo

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