Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2018.59.244
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
Neven Henigsberg
; Croatian Institute for Brain Research, University of ZagrebSchool of Medicine, Zagreb, Croatia
Aleksandar Savić
; Department of Psychiatric Research, University Psychiatric Hospital Vrapče, Zagreb, Croatia
Marko Radoš
; Croatian Institute for Brain Research, University of ZagrebSchool of Medicine, Zagreb, Croatia
Helena Šarac
; Department of Clinical Pharmacology, University Hospital Center Zagreb, Zagreb, Croatia
Milan Radoš
; Croatian Institute for Brain Research, University of ZagrebSchool of Medicine, Zagreb, Croatia
David Ozretić
; Department of Clinical Pharmacology, University Hospital Center Zagreb, Zagreb, Croatia
Maja Bajs Janović
; Department of Clinical Pharmacology, University Hospital Center Zagreb, Zagreb, Croatia
Viktorija Erdeljić Turk
; Department of Clinical Pharmacology, University Hospital Center Zagreb, Zagreb, Croatia
Ana Šečić
; 5Clinic for Rheumatology, Physical5Clinic for Rheumatology, Physical Medicine and RehabilitationUniversity Hospital Center SestreMilosrdnice, Zagreb, Croatia
Petra Kalember
; Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
Pero Hrabač
; Croatian Institute for Brain Research, University of ZagrebSchool of Medicine, Zagreb, Croatia
Sažetak
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.
Ključne riječi
Hrčak ID:
239189
URI
Datum izdavanja:
16.10.2018.
Posjeta: 620 *