Major Depresyon Bozukluğu Olan Hastalarda H-MRS Yöntemi ile Dorsolateral Prefrontal Korteks Nörokimyasal Metabolit Düzeyleri

2020; 31(2): 75-83
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Study on Dorsolateral Prefrontal Cortex Neurochemical Metabolite Levels of Patients with Major Depression Using H-MRS Technique

Objective:. The aim of the study is to investigate, by using proton
magnetic resonance spectroscopy (1H-MRS), the effects of major
depression on the biochemistry of the brain, the relationship between
the parametric changes demonstrated and cognitive functions, and the
effects of antidepressant treatment.
Method: The study included 30 patients, diagnosed with moderate/
severe non-chronic major depression disorder (NC-MDD) according to
the DSM-5 diagnostic criteria, and 30 healthy individuals as the control
group. The dorsolateral prefrontal cortex (DLPFC) areas of the patients
and the control individuals were scanned bilaterally by 1H-MRS. The
participants were also tested on the brief computerized version of the
Wisconsin Card Sorting Test (or, Berg’s “Wisconsin” Card Sorting TestWCST). After antidepressant treatment for a minimum of 8 weeks, the
patients who scored below 7 on the Hamilton Depression Rating Scale
(HAM-D), were assessed with the 1H-MRS scan and the WCST.
Results: The Glx level in the left DLPFC was significantly lower in
the patient group. Differences were not determined between the NAA,
Cr, Cho levels in the right and the left DLPFC of the patient and
the control groups. After the treatment, Glx level in the left DLPFC
increased; but the levels of the other metabolites did not change. Before
the treatment, the abilities of the patient group in changing strategy and
problem solving, as assessed by the WCST, were lower in comparison
to the control group. After the treatment the patient group improved
clinically and performed significantly better on the WCST.
Conclusion: In the present neuroimaging (NI) study, it was determined
that the Glx level in the left DLPFC of patients with moderate/severe
NC-MDD improved together with the clinical features after treatment.
Neurocognitive functions also improved after treatment. However,
a correlation between the change in the metabolite levels and the
performance on the WCST could not be demonstrated.
Key Words: Depression, magnetic resonance spectroscopy, prefrontal cortex, neurochemical metabolite, cognitive function