Single voxel proton magnetic resonance spectroscopy in post-stroke depression

• Published in: Psychiatry research 2006-12, Vol.148 (2), p.111-120
• Main Authors: Glodzik-Sobanska, Lidia, Slowik, Agnieszka, McHugh, Pauline, Sobiecka, Barbara, Kozub, Justyna, Rich, Kenneth E., Urbanik, Andrzej, Szczudlik, Andrzej
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Aspartic Acid - analogs & derivatives; Aspartic Acid - metabolism; Biological and medical sciences; Cerebral Infarction - diagnosis; Cerebral Infarction - physiopathology; Cerebral Infarction - psychology; Choline - metabolism; Creatine - metabolism; Depression; Depressive Disorder - diagnosis; Depressive Disorder - physiopathology; Depressive Disorder - psychology; Dominance, Cerebral - physiology; Energy Metabolism - physiology; Female; Follow-Up Studies; Frontal Lobe - physiopathology; Glutamic Acid - metabolism; Glutamine - metabolism; Humans; Inositol - metabolism; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Male; Medical sciences; Middle Aged; Mood disorders; Neurology; Neuropsychological Tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Stroke; Synaptic Transmission - physiology; Tomography, X-Ray Computed; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0925-4927; 0165-1781; 1872-7506
• DOI: 10.1016/j.pscychresns.2006.08.004

Mood disorders are associated with structural, metabolic and spectroscopic changes in prefrontal regions. In the case of depression associated with stroke, there is little information about the biochemical profile of these regions, as assessed by proton magnetic resonance spectroscopy ( 1H-MRS). In a group of first-ever stroke patients, we studied the association between post-stroke depression and 1H-MRS measurements in unaffected frontal lobes. Twenty-six patients with a first ischemic stroke located outside the frontal lobes were included in the study. Single voxel proton magnetic resonance spectroscopy ( 1H-MRS) was performed to assess N-acetylaspartate/creatine (NAA)/Cr, glutamate + glutamine (Glx)/Cr, choline (Cho)/Cr and myo-inositol (mI)/Cr ratios. Patients were assessed within the first 10 days after stroke and again four months later. The diagnosis of depression was made on the basis of clinical observation, interview and Hamilton Depression Rating Scale scores. In a group of 26 patients, eight (31%) met criteria for depression at the first assessment, and nine (35%) met criteria for depression at follow-up. Patients with depression in the immediate post-stroke phase had significantly higher Glx/Cr ratios in the contralesional hemisphere than non-depressive patients. No biochemical differences were found between the groups at 4-month follow-up. These findings suggest that post-stroke depression is accompanied by changes in frontal lobe glutamate/glutamine levels, perhaps reflecting abnormalities in glutamatergic transmission in the immediate post-stroke period.