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 (CROSBI ID 297367)
Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija
Podaci o odgovornosti
Henigsberg, Neven ; Savić, Aleksandar ; Radoš, Marko ; Šarac, Helena ; Radoš, Milan ; Ozretić, David ; Bajs Janović, Maja ; Erdeljić Turk, Viktorija ; Šečić, Ana ; Kalember, Petra ; Hrabač, Pero
engleski
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
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.
depression ; antidepressant ; therapy ; recurrence ; recovery ; magnetic resonance spectroscopy ; NAA ; Cho ; Glx
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Podaci o izdanju
59 (5)
2018.
244-252
objavljeno
0353-9504
1332-8166
10.3325/cmj.2018.59.244
Povezanost rada
Kliničke medicinske znanosti