Increased ratio of glutamate/glutamine to creatine in the right hippocampus contributes to depressive symptoms in patients with epilepsy

Epilepsy Behav. 2013 Oct;29(1):144-9. doi: 10.1016/j.yebeh.2013.07.004. Epub 2013 Aug 20.

Abstract

Purpose: Our study aimed to investigate whether the glutamatergic system in the hippocampus is correlated with depressive symptoms in patients with epilepsy.

Methods: Fifty patients with epilepsy were recruited and divided into three groups on the basis of their Hamilton Depression Rating Scale (HAMD) scores. Single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) was carried out. Pearson correlation analysis and multiple linear regression analysis were performed to investigate any correlation between the variables of hippocampal metabolites and HAMD scores.

Results: Proton magnetic resonance spectroscopy analysis showed that the ratio of glutamate/glutamine to creatine (Glx/Cr) in the right hippocampus was significantly increased in patients with moderate depression and correlated positively with HAMD scores. Multiple linear regression analysis showed that the ratio of Glx/Cr in the right hippocampus was an independent risk factor relating to depressive symptoms in patients with epilepsy.

Conclusion: A disturbance of the hippocampal glutamatergic system may be involved in the pathogenesis of depression in epilepsy.

Keywords: Depression; Epilepsy; Glutamate; Glutamine; Magnetic resonance spectroscopy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Creatine / metabolism*
  • Depression / etiology
  • Depression / pathology*
  • Epilepsy / complications
  • Female
  • Functional Laterality / physiology*
  • Glutamic Acid / metabolism*
  • Glutamine / metabolism*
  • Hippocampus / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Young Adult

Substances

  • Glutamine
  • Glutamic Acid
  • Creatine