Similarities of biochemical abnormalities between major depressive disorder and bipolar depression: A proton magnetic resonance spectroscopy study

Abstract Background Depression in the context of bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD), leading to mistreatments and poor clinical outcomes for many bipolar patients. Previous neuroimaging studies found mixed results on brain structure, and biochemical metabo...

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Bibliographic Details
Published in:Journal of affective disorders 2014-10, Vol.168, p.380-386
Main Authors: Zhong, Shuming, Wang, Ying, Zhao, Guoxiang, Xiang, Qi, Ling, Xueying, Liu, Sirun, Huang, Li, Jia, Yanbin
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adult and adolescent clinical studies
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Biological and medical sciences
Bipolar disorder
Bipolar Disorder - diagnosis
Bipolar Disorder - metabolism
Bipolar disorders
Brain - metabolism
Brain - pathology
Choline - metabolism
Creatine - metabolism
Depression
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - metabolism
Female
Humans
Magnetic resonance spectroscopy
Major depressive disorder
Male
Medical sciences
Middle Aged
Miscellaneous
Mood disorders
Proton Magnetic Resonance Spectroscopy - methods
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Young Adult
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Summary:Abstract Background Depression in the context of bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD), leading to mistreatments and poor clinical outcomes for many bipolar patients. Previous neuroimaging studies found mixed results on brain structure, and biochemical metabolism of the two disorders. To eliminate the compounding effects of medication, and aging, this study sought to investigate the brain biochemical changes of treatment-naïve, non-late-life patients with MDD and BD in white matter in prefrontal (WMP) lobe, anterior cingulate cortex (ACC) and hippocampus by using proton magnetic resonance spectroscopy (1 H-MRS). Methods Three groups of participants were recruited: 26 MDD patients, 20 depressed BD patients, and 13 healthy controls. The multi-voxel1 H-MRS [repetition time (TR)=1000 ms; echo-time (TE)=144 ms] was used for the measurement of N-acetylaspartate(NAA), choline containg compounds (Cho), and creatine (Cr) in three brain locations: white matter in prefrontal (WMP) lobe, anterior cingulate cortex (ACC), and hippocampus. Two ratios of NAA/Cr and Cho/Cr as a measure of brain biochemical changes were compared among three experimental groups. Results On the comparison of brain biochemical changes, both MDD patients and BD patients showed many similarities compared to the controls. They both had a significantly lower NAA/Cr ratio in the left WMP lobe. There were no significant differences among three experimental groups for Cho/Cr ratio in the WMP lobe, and for the ratios of NAA/Cr and Cho/Cr in the bilateral ACC and hippocampus. The only difference between MDD and BD patients existed for the NAA/Cr ratio in the right WMP lobe. While MDD patients had a significantly lower NAA/Cr ratio than controls, BD patients showed no such differences. On the comparison of correlation of medical variables and brain biochemical changes, all participants demonstrated no significant correlations. Conclusion Reduced NAA/Cr ratio at the left WMP lobe indicated the dysfunction of neuronal viability in deep white matter, in both MDD and BD patients who shared similarities of brain biochemical abnormalities, which might imply an overlap in neuropathology of depression.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2014.07.024