Effective electroconvulsive therapy reverses glutamate/glutamine deficit in the left anterior cingulum of unipolar depressed patients

• Published in: Psychiatry research Vol. 122; no. 3; pp. 185 - 192
• Main Authors: Pfleiderer, Bettina, Michael, Nikolaus, Erfurth, Andreas, Ohrmann, Patricia, Hohmann, Ulrike, Wolgast, Matthias, Fiebich, Martin, Arolt, Volker, Heindel, Walter
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.04.2003; Elsevier
• Subjects: Biological and medical sciences; Depressive Disorder - metabolism; Depressive Disorder - therapy; Electroconvulsive therapy; Electroconvulsive Therapy - instrumentation; Excitatory amino acids; Female; Glutamate; Glutamic Acid - deficiency; Glutamic Acid - metabolism; Glutamine - deficiency; Glutamine - metabolism; Gyrus Cinguli - metabolism; Gyrus Cinguli - pathology; Humans; Magnetic Resonance Spectroscopy; Major depressive disorder; Medical sciences; Middle Aged; Proton magnetic resonance; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Spectroscopy; Treatment Outcome; Treatments; Proton magnetic resonance; Excitatory amino acids; Spectroscopy; Electroconvulsive therapy; Glutamate; Major depressive disorder; Mood disorder; Human; Cerebral cortex; Treatment; Central nervous system; Medical imagery; Depression; Nuclear magnetic resonance imaging; Brain (vertebrata); Glutamine
• ISSN: 0925-4927; 0165-1781; 1872-7506
• DOI: 10.1016/S0925-4927(03)00003-9

Cortical glutamate/glutamine (Glx) metabolism seems to be affected by a major depressive disorder. Recently, a Glx deficit was detected by proton magnetic resonance spectroscopy ( 1H-MRS) in the bilateral anterior cingulum of depressives. The aim of this study was to assess the effect of successful electroconvulsive therapy (ECT) on Glx levels in the anterior cingulum. The left anterior cingulum of 17 severely depressed unipolar patients was measured by 1H STEAM spectroscopy before and after ECT, and the results were compared with those for 17 age- and gender-matched controls. We observed significantly reduced Glx levels in the patients’ left cingulum compared to healthy controls. In ECT responders, in contrast to non-responders, Glx levels normalized ( P=0.04) and then did not differ statistically from controls. Severe depression seems to be associated with a Glx deficit and increasing Glx may be an important mechanism of ECT action.