TY - JOUR
T1 - Region and state specific glutamate downregulation in major depressive disorder
T2 - A meta-analysis of 1H-MRS findings
AU - Luykx, J. J.
AU - Laban, K. G.
AU - van den Heuvel, M. P.
AU - Boks, M. P.M.
AU - Mandl, R. C.W.
AU - Kahn, R. S.
AU - Bakker, S. C.
PY - 2012/1/1
Y1 - 2012/1/1
N2 - For major depressive disorder (MDD), magnetic resonance spectroscopy ( 1H-MRS) studies of glutamate, glutamine and Glx (the composite measure of mainly glutamate and glutamine) have yielded inconclusive or seemingly inconsistent results. We therefore systematically reviewed whether in vivo concentrations of glutamate, glutamine and Glx measured with 1H-MRS differ between MDD patients and controls. Meta-analysis including meta-regression, sensitivity, statistical heterogeneity, and publication bias analyses were conducted. Glutamate and Glx concentrations were found to be lower in the anterior cingulate cortex (ACC) in patients compared to controls (standardized mean difference (SMD) for glutamate with 95% CIs: -0.86, -1.55 to -0.17; and for Glx: -1.15, -1.86 to -0.44). In addition, Glx was decreased in all brain regions together in current episode patients (SMD: -0.62, -1.17 to -0.07). We conclude that in MDD, glutamate and possibly glutamine are downregulated primarily in the ACC and during depressive states. These results fit the central role of the ACC in depressive symptomatology and suggest that in MDD changes in glutamatergic neurotransmission are state-dependent.
AB - For major depressive disorder (MDD), magnetic resonance spectroscopy ( 1H-MRS) studies of glutamate, glutamine and Glx (the composite measure of mainly glutamate and glutamine) have yielded inconclusive or seemingly inconsistent results. We therefore systematically reviewed whether in vivo concentrations of glutamate, glutamine and Glx measured with 1H-MRS differ between MDD patients and controls. Meta-analysis including meta-regression, sensitivity, statistical heterogeneity, and publication bias analyses were conducted. Glutamate and Glx concentrations were found to be lower in the anterior cingulate cortex (ACC) in patients compared to controls (standardized mean difference (SMD) for glutamate with 95% CIs: -0.86, -1.55 to -0.17; and for Glx: -1.15, -1.86 to -0.44). In addition, Glx was decreased in all brain regions together in current episode patients (SMD: -0.62, -1.17 to -0.07). We conclude that in MDD, glutamate and possibly glutamine are downregulated primarily in the ACC and during depressive states. These results fit the central role of the ACC in depressive symptomatology and suggest that in MDD changes in glutamatergic neurotransmission are state-dependent.
KW - Anterior cingulate cortex
KW - Glutamate
KW - Glutamine
KW - Magnetic resonance spectroscopy (MRS)
KW - Major depressive disorder
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=82855165185&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.neubiorev.2011.05.014
DO - https://doi.org/10.1016/j.neubiorev.2011.05.014
M3 - Review article
C2 - 21672551
SN - 0149-7634
VL - 36
SP - 198
EP - 205
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
IS - 1
ER -