Choline elevation in amygdala region at recovery indicates longer survival without depressive episode: a magnetic resonance spectroscopy study

Potential Impact of Choline Alphoscerate on Depressive Symptoms in Association with Insulin Resistance in Elderly Patients with Type 2 Diabetes

Background/Objectives: The aim of this study was to investigate whether Gliatamin (choline alphoscerate), an acetylcholine precursor originally used to treat dementia, improves depressive symptoms in patients with type 2 diabetes. Methods: We conducted a 6-month double-blind, randomized, and placebo-controlled trial involving 49 participants with type 2 diabetes, older than 50 years, and with mild depressive symptoms; 33 and 16 participants received choline alphoscerate (800 mg/day) and a placebo, respectively. Results: At 6 months, the Hamilton Depression Rating Scale was significantly decreased in both the choline alphoscerate (15.9 ± 6.5 to 12.6 ± 5.8, p = 0.001) and placebo (15.4 ± 4.7 to 10.2 ± 3.9, p = 0.004) groups compared with baseline, without inter-group difference (p = 0.297). Meanwhile, the choline alphoscerate group showed favorable results in insulin resistance-related parameters at 6 months, including the waist circumference (WC) and the low-density lipoprotein cholesterol (LDL)/high-density lipoprotein cholesterol (HDL) ratio (p for inter-group difference vs. placebo = 0.009 and 0.092). Even after adjusting for multiple confounding factors, choline alphoscerate use was associated with an increased odds for reduction in WC (OR 18.28 [95% CI 2.27-461.35]) and a decreased odds for a high LDL/HDL ratio at 6 months (OR 0.16 [95% CI 0.03-0.76]). Conclusions: Choline alphoscerate did not show superiority over the placebo in terms of the alleviation of depressive symptoms, despite significant pre-post changes observed within the choline alphoscerate group. Nevertheless, given its positive potential for insulin resistance, the effects of choline alphoscerate on depressive mood in relation to insulin resistance in patients with type 2 diabetes require further validation.

Evidence of persistent glial cell dysfunction in the anterior cingulate cortex of juvenile idiopathic arthritis children: a proton MRS study

BACKGROUND

This study aims to investigate whether the neurometabolites of the anterior cingulate cortex (ACC) were distinct in patients with active and inactive juvenile idiopathic arthritis (JIA) using the proton magnetic resonance spectroscopy.

METHODS

We measured the levels of total N-acetylaspartate (tNAA), choline (Cho), myo-inositol (ml), glutamate (Glu) and the complex of glutamate and glutamine (Glx) relative to total creatine (tCr) in ACC of each participant.

RESULTS

Compared with the healthy controls, a significant decrease of total Cho/tCr and Glx/tCr ratio in ACC occurred in active and inactive JIA group. The tCho/Cr level was negatively associated with the serum level of ESR in active JIA patients. There was no difference in NAA/tCr ratio among the three groups, which may imply that no neuron and axonal losses occurred in either active or inactive JIA patients.

CONCLUSIONS

The abnormal neurometabolites in tCho/tCr and Glx/tCr in ACC may indicate that persistent dysfunction of glial cell, while neither neuron nor axonal losses occurred in active and inactive JIA patients.

Circulating choline pathway nutrients and depression after ischemic stroke

BACKGROUND AND PURPOSE

Choline pathway nutrients, including choline and betaine, are reported to exert antidepressant effects. However, there is little population-based evidence on the relationships between circulating choline and betaine and poststroke depression (PSD). We aimed to prospectively explore the associations between plasma choline and betaine and depression after ischemic stroke.

METHODS

This study was based on the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 612 participants with plasma choline and betaine concentrations were included in the analysis. The study outcome was depression 3 months after ischemic stroke. Logistic regression models were performed to estimate the relationships between plasma choline and betaine and the risk of PSD. Risk reclassification and calibration of models with choline or betaine were analyzed.

RESULTS

Patients with PSD had lower choline and betaine levels than those without PSD (p < 0.05). Compared with tertile 1, the multivariable-adjusted odds ratios (95% CIs) for tertile 3 of choline and betaine were 0.54 (0.35-0.83) and 0.59 (0.38-0.92), respectively. Per 1 SD increase in choline or betaine was associated with a 25% (95% CI 9%-37%) or an 19% (95% CI 3%-32%) decreased risk of PSD, respectively. Furthermore, the addition of choline or betaine to the established risk factors model improved the risk reclassification for PSD, as shown by an increase in the net reclassification index and integrated discrimination improvement (all p < 0.05).

CONCLUSIONS

Patients with elevated levels of choline and betaine had a lower risk of depression after acute ischemic stroke, suggesting the protective significance of choline pathway nutrients for PSD.

Plasma alterations in cholinergic and serotonergic systems in early Alzheimer Disease: Diagnosis utility

BACKGROUND

Alzheimer Disease (AD) is the most common cause of dementia and it involves a high social and economic cost worldwide, and the health system still does not count with an effective treatment. This may be explained by the lack of a reliable early diagnosis and the complex physiological mechanisms involved in the disease development. In this sense, the cholinergic and serotonergic systems may be altered in the disease course.

METHODS

In this study, metabolites from these pathways were determined in order to develop a non-invasive and early diagnosis model, as well as to advance in the knowledge of the physiopathological mechanisms of the disease. For this, plasma samples from mild cognitive impairment due to AD patients (MCI-AD, n = 25) and healthy controls (n = 25) were analysed.

RESULTS

choline and tryptophan pathways were deregulated in MCI-AD. Therefore, a model based on betaine, cytidine, uridine, choline, acetylcholine, serotonin and tryptophan was developed, showing an AUC-ROC of 0.862, and sensitivity and specificity of 96% and 72%, respectively.

CONCLUSION

Alterations in metabolites from these pathways are related to cognitive impairment and neurodegeneration, and they could be useful in AD diagnosis. Nevertheless, further research is required in order to validate this diagnosis model.