Neurotransmitters and Neurometabolites in Late-Life Depression: A Preliminary Magnetic Resonance Spectroscopy Study at 7T

J Affect Disord. 2021 Jan 15:279:417-425. doi: 10.1016/j.jad.2020.10.011. Epub 2020 Oct 7.

Abstract

Background: Magnetic resonance spectroscopy (MRS) methods have quantified changes in levels of neurotransmitters and neurometabolites in patients with major depression across the lifespan. The application of 7T field strengths and greater have not been a major focus of study in patients with late-life depression (LLD).

Methods: Nine LLD patients who met DSM-IV criteria for a current major depressive episode and nine non-depressed, healthy, age-matched controls underwent clinical and neuropsychological assessment and single-voxel 7T 1H-MRS at baseline and after 10-12 weeks of antidepressant treatment (Citalopram; patients only). Spectra were acquired from two brain regions implicated in both depressive symptoms and neuropsychological deficits in LLD, the anterior (ACC) and posterior cingulate (PCC). Levels of γ-aminobutyric acid (GABA), glutamate (Glu), glutathione (GSH), N-acetylaspartylglutamate (NAAG), N-acetylaspartate (NAA), and myo-inositol (mI) were quantified relative to total creatine (tCr) using linear-combination modeling.

Results: Baseline Glu/tCr levels were not significantly different between groups. Decreased Glu/tCr levels after Citalopram treatment were observed in a subset of LLD patients. Exploratory analyses showed that LLD patients had lower NAA levels in the PCC relative to controls. Higher levels of ml in the LLD patients relative to the controls and decreases after Citalopram treatment had large effect sizes but were not statistically significant. Further, decreases in PCC Glu/tCr and increases in ACC GSH/tCr were associated with improvement in depressive symptoms.

Limitations: Sample size.

Conclusions: These preliminary results suggest a role of neurochemicals and neurometabolites in the neurobiology of LLD and antidepressant treatment response.

Keywords: Citalopram; depression; late-life; magnetic resonance spectroscopy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aspartic Acid
  • Creatine
  • Depression
  • Depressive Disorder, Major* / diagnostic imaging
  • Depressive Disorder, Major* / drug therapy
  • Glutamic Acid
  • Gyrus Cinguli / diagnostic imaging
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Neurotransmitter Agents
  • Proton Magnetic Resonance Spectroscopy

Substances

  • Neurotransmitter Agents
  • Aspartic Acid
  • Glutamic Acid
  • Creatine