Choline and N-acetyl aspartate levels in the dorsolateral prefrontal cortex at the beginning of the recovery phase as markers of increased risk for depressive episode recurrence under different duration of maintenance therapy and after it: a retrospective cohort study

Henigsberg, Neven and Savić, Aleksandar and Radoš, Marko and Šarac, Helena and Radoš, Milan and Ozretić, David and Bajs Janović, Maja and Erdeljić Turk, Viktorija and Šečić, Ana and Kalember, Petra and Hrabač, Pero (2018) Choline and N-acetyl aspartate levels in the dorsolateral prefrontal cortex at the beginning of the recovery phase as markers of increased risk for depressive episode recurrence under different duration of maintenance therapy and after it: a retrospective cohort study. Croatian Medical Journal, 59 (5). pp. 244-252. ISSN 0353-9504

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Abstract

Aim: To evaluate the relationship between the dynamics of proton magnetic resonance spectroscopy (1H-MRS) brain metabolite levels at the beginning of the recovery phase of the index depressive episode and the time to the recurrence of depression. Methods: This retrospective cohort study analyzed the changes in N-acetyl aspartate (NAA), choline (Cho), and glutamate-glutamine in 48 patients with recurrent depression treated with maintenance antidepressant monotherapy at a stable dose. 1H-MRS was performed at the start of the recovery phase and 6 months later. 1H-MRS parameters, index episode descriptors, and depressive disorder course were analyzed by Cox proportional hazards model. Results: NAA and Cho decrease six months after the beginning of the recovery period were time-independent risk factors for depressive episode recurrence. Hazard ratio associated with NAA decrease was 2.02 (95% confidence interval 1.06-3.84) and that associated with Cho decrease was 2.06 (95% confidence interval 1.02-4.17). These changes were not related to symptoms severity, as Montgomery-Asberg Depression Scale score remained generally unchanged (mean -0.01; standard deviation 1.6) over the first 6 months of recovery. Conclusion: Patients receiving maintenance antidepressant therapy after recovery who experience a decrease in NAA or Cho levels early in the recovery phase have a double risk of depressive episode recurrence. Sustained NAA and Cho levels at the beginning of the recovery phase may indicate increased brain resilience conferred by antidepressant therapy, while NAA and Cho decrease may indicate only the trait-related temporal effect of therapy in another stratum of patients.

Item Type: Article
MeSH: Adolescent ; Adult ; Antidepressive Agents/therapeutic use ; Aspartic Acid/analogs & derivatives ; Aspartic Acid/metabolism ; Biomarkers/metabolism ; Choline/metabolism ; Depressive Disorder/drug therapy ; Depressive Disorder/metabolism ; Female ; Humans ; Male ; Middle Aged ; Prefrontal Cortex/metabolism ; Proportional Hazards Models ; Proton Magnetic Resonance Spectroscopy ; Psychiatric Status Rating Scales ; Recurrence ; Retrospective Studies ; Risk Factors ; Young Adult
Departments: Hrvatski institut za istraživanje mozga
Depositing User: Anja Majstorović
Status: Published
Creators:
CreatorsEmail
Henigsberg, NevenUNSPECIFIED
Savić, AleksandarUNSPECIFIED
Radoš, MarkoUNSPECIFIED
Šarac, HelenaUNSPECIFIED
Radoš, MilanUNSPECIFIED
Ozretić, DavidUNSPECIFIED
Bajs Janović, MajaUNSPECIFIED
Erdeljić Turk, ViktorijaUNSPECIFIED
Šečić, AnaUNSPECIFIED
Kalember, PetraUNSPECIFIED
Hrabač, PeroUNSPECIFIED
Date: 31 October 2018
Date Deposited: 04 Apr 2019 11:00
Last Modified: 25 Aug 2020 07:47
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/3214

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