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Tran KH, Luki J, Hanstock S, Hanstock CC, Seres P, Aitchison K, Shandro T, Le Melledo JM. Decreased GABA+ Levels in the Medial Prefrontal Cortex of Perimenopausal Women: A 3T 1H-MRS Study. Int J Neuropsychopharmacol 2022; 26:32-41. [PMID: 36146906 PMCID: PMC9850658 DOI: 10.1093/ijnp/pyac066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/12/2022] [Accepted: 09/21/2022] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Perimenopause is associated with an increased risk of developing a major depressive (MD) episode. A significant number of women develop their first MD episode during perimenopause, suggesting a unique pathophysiology of perimenopausal (PM) depression. Previous research has shown that depression is associated with decreased gamma-aminobutyric acid (GABA) levels in the medial prefrontal cortex (MPFC) of MD patients. The objective of this study was to compare MPFC GABA+ levels in healthy reproductive-aged (RD) and PM women. METHODS A total of 18 healthy PM and 20 RD women were included in the study. MPFC GABA+ levels, which include homocarnosine and macromolecules, were measured via magnetic resonance spectroscopy using a 3 Tesla magnet. MPFC GABA+ levels were referenced to creatine + phosphocreatine (Cr+PCr). Absence of current or past psychiatric diagnosis was confirmed via a structured interview. RD participants were scanned during the early follicular phase of the menstrual cycle. PM women were scanned outside of ovulatory cycles. RESULTS Mean MPFC GABA+ concentrations (relative to Cr+PCr) were decreased in the PM group compared with the RD group (PM mean = 0.08 ± 0.02, RD mean = 0.09 ± 0.02, t = -2.03, df = 36, P = .05) even after correcting for in percentage in gray matter (GM). Because PM women were inherently older than RD women (aged 48.8 ± 3.55 and 31.5 ± 9.66 years, respectively), the age difference between the 2 groups was statistically significant (P < .001). When age was treated as an independent covariate and included in the model, the difference in GABA+ between PM and RD women was no longer significant (P = .092). CONCLUSION Perimenopause is associated with decreased MPFC GABA+/Cr+PCr levels, which may contribute to the increased risk of experiencing a MD episode during PM.
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Affiliation(s)
- Kim H Tran
- University of Alberta, Department of Psychiatry, Edmonton, AB, Canada
| | - Jessica Luki
- University of Alberta, Department of Psychiatry, Edmonton, AB, Canada
| | - Sarah Hanstock
- University of Alberta, Department of Psychiatry, Edmonton, AB, Canada,University of Alberta, Department of Biomedical Engineering, Edmonton, AB, Canada
| | - Christopher C Hanstock
- University of Alberta, Department of Psychiatry, Edmonton, AB, Canada,University of Alberta, Department of Biomedical Engineering, Edmonton, AB, Canada
| | - Peter Seres
- University of Alberta, Department of Biomedical Engineering, Edmonton, AB, Canada
| | - Katherine Aitchison
- University of Alberta, Department of Psychiatry, Edmonton, AB, Canada,University of Alberta, Department of Medical Genetics, Edmonton, AB, Canada,University of Alberta, Neuroscience and Mental Health Institute, Edmonton, AB, Canada,Northern Ontario School of Medicine, Division of Clinical Sciences, Psychiatry Section, Thunder Bay, ON, Canada
| | - Tami Shandro
- Lois Hole Hospital for Women, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Jean-Michel Le Melledo
- Correspondence: Jean-Michel Le Melledo, MD, Department of Psychiatry, Room 1E7.14, 8440 112 Street, Walter Mackenzie Center, Edmonton, Alberta, Canada, T6G 2B7 ()
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Ghuman A, McEwen A, Tran KH, Mitchell N, Hanstock C, Seres P, Jhangri G, Burgess D, Baker G, Le Melledo JM. Prospective Investigation of Glutamate Levels and Percentage Gray Matter in the Medial Prefrontal Cortex in Females at Risk for Postpartum Depression. Curr Neuropharmacol 2022; 20:1988-2000. [PMID: 35236264 PMCID: PMC9886796 DOI: 10.2174/1570159x20666220302101115] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/19/2022] [Accepted: 02/27/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The substantial female hormone fluctuations associated with pregnancy and postpartum have been linked to a greater risk of developing depressive symptoms, particularly in high-risk women (HRW), i.e. those with histories of mood sensitivity to female hormone fluctuations. We have shown that glutamate (Glu) levels in the medial prefrontal cortex (MPFC) decrease during perimenopause, a period of increased risk of developing a major depressive episode. Our team has also demonstrated that percentage gray matter (%GM), another neural correlate of maternal brain health, decreases in the MPFC during pregnancy. OBJECTIVE To investigate MPFC Glu levels and %GM from late pregnancy up to 7 weeks postpartum in HRW and healthy pregnant women (HPW). METHODS Single-voxel spectra were acquired from the MPFC of 41 HPW and 22 HRW using 3- Tesla in vivo proton magnetic resonance spectroscopy at five different time points. RESULTS We observed a statistically significant interaction between time and group for the metabolite Glu, with Glu levels being lower for HRW during pregnancy and early postpartum (p<0.05). MPFC %GM was initially lower during pregnancy and then significantly increased over time in both groups (p<0.01). CONCLUSION This investigation suggests that the vulnerability towards PPD is associated with unique fluctuations of MPFC Glu levels during pregnancy and early postpartum period. Our results also suggest that the decline in MPFC %GM associated with pregnancy seems to progressively recover over time. Further investigations are needed to determine the specific role that female hormones play on the physiological changes in %GM during pregnancy and postpartum.
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Affiliation(s)
- Arjun Ghuman
- Address correspondence to these authors at the Department of Psychiatry, Room 1E7.14, 8440 112 street Walter Mackenzie Center, Edmonton, Alberta, Canada, T6G 2B7; Tel: 780-407-6578; Fax: 780-407-6672; E-mail:
| | - Alyssa McEwen
- Address correspondence to these authors at the Department of Psychiatry, Room 1E7.14, 8440 112 street Walter Mackenzie Center, Edmonton, Alberta, Canada, T6G 2B7; Tel: 780-407-6578; Fax: 780-407-6672; E-mail:
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Tran KH, Luki J, Hanstock S, Hanstock CC, Seres P, Aitchison K, Shandro T, Le Melledo JM. A comparative magnetic resonance spectroscopy study of GABA+ and glutamate referenced to creatine and phosphocreatine in the left dorsolateral prefrontal cortex of perimenopausal women and women of reproductive age. Front Psychiatry 2022; 13:989050. [PMID: 36386999 PMCID: PMC9644378 DOI: 10.3389/fpsyt.2022.989050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The perimenopause is associated with an increased risk of developing a major depressive (MD) episode. The biological changes occurring during perimenopause responsible for this increased risk of depression remain to be elucidated. Postmortem and magnetic resonance spectroscopy (MRS) studies have revealed decreased gamma-aminobutyric acid (GABA) and glutamate (Glu) levels in the dorsolateral prefrontal cortex (DLPFC) of MD patients. The objective of this study was to compare LDLPFC GABA+ and Glu ratios (referenced to creatine and phosphocreatine) in healthy reproductive-aged (RD) and perimenopausal (PM) women. MATERIALS AND METHODS Eighteen healthy PM and 20 RD women were included in the study. Our dependent variables, LDLPFC Glu and GABA+ ratios which include homocarnosine and macromolecules, were measured via MRS, using a 3 Tesla magnet. Absence of current or past psychiatric diagnosis was confirmed via a structured interview. RD participants were scanned during the early follicular phase of the menstrual cycle (MC). PM women were scanned outside of ovulatory cycles. RESULTS Mean LDLPFC GABA+ and Glu ratios were not statistically different between the PM group and RD group (PM mean = 0.10 ± 0.06, RD mean = 0.11 ± 0.04, t = -0.383, df = 36, d = -0.13, p = 0.70) (PM mean = 0.56 ± 0.06, RD mean = 0.57 ± 0.05, t = -0.794, df = 36, d = -0.26, p = 0.43), respectively. The perimenopause demarcates the end of the reproductive life. Unsurprisingly PM women were older than RD women (PM women: 48.8 ± 3.55 years, range 41-53 years old; RD women: 31.5 ± 9.66 years, range 18-47 years old) (p < 0.001). This inherent entanglement of group and age is a limitation of our study. CONCLUSION Contrary to our previous findings of decreased GABA+ and Glu in the medial prefrontal cortex in perimenopausal women, the perimenopause is not associated with decreased GABA+ or Glu ratios in the LDLPFC. This suggests that brain areas playing a role in MD display different sensitivity to the female hormones fluctuations associated with perimenopause.
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Affiliation(s)
- Kim H Tran
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Jessica Luki
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Sarah Hanstock
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Peter Seres
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Katherine Aitchison
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada.,Women and Children's Research Institute, University of Alberta, Edmonton, AB, Canada.,Division of Clinical Sciences, Psychiatry Section, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | - Tami Shandro
- Lois Hole Hospital for Women, Royal Alexandra Hospital, Edmonton, AB, Canada
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