Frontal white matter biochemical abnormalities in first-episode, treatment-naive patients with major depressive disorder: a proton magnetic resonance spectroscopy study.

BACKGROUND

Previous neuroimaging studies found evidence of brain functional and structural abnormalities in patients with major depressive disorder (MDD), but they rarely excluded compounding effects of some important factors, such as medication and brain degeneration. This study sought to explore the brain biochemical changes of first-episode, treatment-naive, non-late-life adult patients with MDD in the frontal white matter and gray matter by using proton magnetic resonance spectroscopy (1H MRS).

METHODS

Twenty-four first-episode, treatment-naive, non-late-life adult depressed patients and 13 healthy controls were enrolled in this study. Subjects underwent two-dimensional multivoxel 1H MRS at 1.5 T to obtain bilateral metabolite levels from the dorsolateral prefrontal white matter and anterior cingulate gray matter.

RESULTS

Patients with MDD showed significantly lower N-acetylaspartate/creatine (NAA/Cr) and choline/creatine (Cho/Cr) ratios in the left dorsolateral prefrontal white matter, and lower NAA/Cr ratios in the right dorsolateral prefrontal white matter when compared with the control subjects. There were no significant differences in the metabolite ratios in the bilateral anterior cingulate gray matter.

CONCLUSIONS

These findings suggest that biochemical abnormalities in prefrontal white matter may occur early in the course of MDD and may be related to the neuropathology of depression.