Hostname: page-component-7479d7b7d-jwnkl Total loading time: 0 Render date: 2024-07-08T15:35:16.210Z Has data issue: false hasContentIssue false
  • English
  • Français

Magnetic resonance spectroscopy in anxiety disorders

Published online by Cambridge University Press:  24 June 2014

Clarissa Trzesniak ,
David Araújo  and
José Alexandre S. Crippa
Clarissa Trzesniak*
Affiliation:
Department of Neuropsychiatry and Medical Psychology, Ribeirão Preto Faculty of Medicine, University of São Paulo, São Paulo, Brazil
David Araújo
Affiliation:
Department of Neuropsychiatry and Medical Psychology, Ribeirão Preto Faculty of Medicine, University of São Paulo, São Paulo, Brazil
José Alexandre S. Crippa
Affiliation:
Department of Neuropsychiatry and Medical Psychology, Ribeirão Preto Faculty of Medicine, University of São Paulo, São Paulo, Brazil
*
Clarissa Trzesniak, Departamento de Neuropsiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Hospital das Clínicas – Terceiro Andar, Av. Bandeirantes, 3900, 14049-900 Ribeirão Preto, São Paulo, Brazil. Tel: +55 16 36022201/36022703; Fax: +55 16 36022544; E-mail: clarissaf@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Magnetic resonance spectroscopy (MRS) is a non-invasive in vivo method used to quantify metabolites that are relevant to a wide range of brain processes. This paper briefly describes neuroimaging using MRS and provides a systematic review of its application to anxiety disorders.

Method:

A literature review was performed in the PubMed, Lilacs and Scielo databases using the keywords spectroscopy and anxiety disorder. References of selected articles were also hand-searched for additional citations.

Results:

Recent studies have shown that there are significant metabolic differences between patients with anxiety disorders and healthy controls in various regions of the brain. Changes were mainly found in N-acetylaspartate, which is associated with neuronal viability, but some of them were also seen in creatine, a substance that is thought to be relatively constant among individuals with different pathological conditions.

Conclusions:

MRS is a sophisticated neuroimaging technique that has provided useful insights into the biochemical and neurobiological basis of many anxiety disorders. Nevertheless, its utilization in some anxiety disorders is still modest, particularly social phobia and generalised anxiety. Although it is an extremely useful advance in neuroimaging, further research in other brain areas and patient populations is highly advisable.

Keywords

anxietyMRSneurochemistryneuroimagingpsychiatryspectroscopy
Type
Review article
Information
Acta Neuropsychiatrica , Volume 20 , Issue 2 , April 2008 , pp. 56 - 71
Copyright
Copyright © 2008 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Malhi, GS, Valenzuela, M, Wen, W, Sachdev, P. Magnetic resonance spectroscopy and its applications in psychiatry. Aust N Z J Psychiatry 2002;36:31–43. CrossRefGoogle ScholarPubMed
Ross, AJ, Sachdev, PS. Magnetic resonance spectroscopy in cognitive research. Brain Res Rev 2004;44:83–102. CrossRefGoogle ScholarPubMed
Bonavita, S, Di Salle, F, Tedeschi, G. Proton MRS in neurological disorders. Eur J Radiol 1999;30:125–131. CrossRefGoogle ScholarPubMed
Marshall, I, Wardlaw, J, Cannon, J, Slattery, J, Sellar, RJ. Reproducibility of metabolite peak areas in 1H MRS of brain. Magn Reson Imag 1996;14:281–292. CrossRefGoogle ScholarPubMed
Wang, PW, Napapon, S, Chandler, RA, Ketter, TA. Magnetic resonance spectroscopic measurement of cerebral gamma-aminobutyric acid concentrations in patients with bipolar disorders. Acta Neuropsychiatr 2006;18:120–126. CrossRefGoogle ScholarPubMed
Rosenthal, R. Judgement studies. Design, analysis, and meta-analysis. Cambridge: Cambridge University Press, 1987. CrossRefGoogle Scholar
Mathew, SJ, Mao, X, Coplan, JDet al. Dorsolateral prefrontal cortical pathology in generalized anxiety disorder: a proton magnetic resonance spectroscopic imaging study. Am J Psychiatry 2004;161:1119–1121. CrossRefGoogle ScholarPubMed
Coplan, JD, Mathew, SJ, Mao, Xet al. Decreased choline and creatine concentrations in centrum semiovale in patients with generalized anxiety disorder: relationship to IQ and early trauma. Psychiatry Res 2006;147:27–39. CrossRefGoogle ScholarPubMed
Davidson, JR, Krishnan, KR, Charles, HCet al. Magnetic resonance spectroscopy in social phobia: preliminary findings. J Clin Psychiatry 1993;54:19–25. Google ScholarPubMed
Phan, KL, Fitzgerald, DA, Cortese, BM, Seraji-Bozorgzad, N, Tancer, ME, Moore, GJ. Anterior cingulate neurochemistry in social anxiety disorder: 1H-MRS at 4 Tesla. Neuroreport 2005;16:183–186. CrossRefGoogle Scholar
Tupler, LA, Davidson, JR, Smith, RD, Lazeyras, F, Charles, HC, Krishnan, KR. A repeat proton magnetic resonance spectroscopy study in social phobia. Biol Psychiatry 1997;42:419–424. CrossRefGoogle ScholarPubMed
Miner, CM, Davidson, JR, Potts, NL, Tupler, LA, Charles, HC, Krishnan, KR. Brain fluoxetine measurements using fluorine magnetic resonance spectroscopy in patients with social phobia. Biol Psychiatry 1995;38:696–698. CrossRefGoogle ScholarPubMed
Dager, SR, Marro, KI, Richards, TL, Metzger, GD. Preliminary application of magnetic resonance spectroscopy to investigate lactate-induced panic. Am J Psychiatry 1994;151:57–63. Google ScholarPubMed
Dager, SR, Richards, T, Strauss, W, Artru, A. Single-voxel 1H-MRS investigation of brain metabolic changes during lactate-induced panic. Psychiatry Res 1997;76:89–99. CrossRefGoogle ScholarPubMed
Dager, SR, Friedman, SD, Heide, Aet al. Two-dimensional proton echo-planar spectroscopic imaging of brain metabolic changes during lactate-induced panic. Arch Gen Psychiatry 1999;56:70–77. CrossRefGoogle ScholarPubMed
Friedman, SD, Dager, SR, Richards, TL, Petropoulos, H, Posse, S. Modeling brain compartmental lactate response to metabolic challenge: a feasibility study. Psychiatry Res 2000;98:55–66. CrossRefGoogle ScholarPubMed
Dager, SR, Strauss, WL, Marro, KI, Richards, TL, Metzger, GD, Artru, AA. Proton magnetic resonance spectroscopy investigation of hyperventilation in subjects with panic disorder and comparison subjects. Am J Psychiatry 1995;152:666–672. Google ScholarPubMed
Friedman, SD, Mathis, CM, Hayes, C, Renshaw, P, Dager, SR. Brain pH response to hyperventilation in panic disorder: preliminary evidence for altered acid-base regulation. Am J Psychiatry 2006;163:710–715. CrossRefGoogle Scholar
Layton, ME, Friedman, SD, Dager, SR. Brain metabolic changes during lactate-induced panic: effects of gabapentin treatment. Depress Anxiety 2001;14:251–254. CrossRefGoogle ScholarPubMed
Shioiri, T, Kato, T, Murashita, J, Hamakawa, H, Inubushi, T, Takahashi, S. High-energy phosphate metabolism in the frontal lobes of patients with panic disorder detected by phase-encoded 31P-MRS. Biol Psychiatry 1996;40:785–793. CrossRefGoogle ScholarPubMed
Massana, G, Gasto, C, Junque, Cet al. Reduced levels of creatine in the right medial temporal lobe region of panic disorder patients detected with (1)H magnetic resonance spectroscopy. Neuroimage 2002;16:836–842. CrossRefGoogle ScholarPubMed
Goddard, AW, Mason, GF, Almai, Aet al. Reductions in occipital cortex GABA levels in panic disorder detected with 1h-magnetic resonance spectroscopy. Arch Gen Psychiatry 2001;58:556–561. CrossRefGoogle ScholarPubMed
Goddard, AW, Mason, GF, Appel, Met al. Impaired GABA neuronal response to acute benzodiazepine administration in panic disorder. Am J Psychiatry 2004;161:2186–2193. CrossRefGoogle ScholarPubMed
Ham, BJ, Sung, Y, Kim, Net al. Decreased GABA levels in anterior cingulate and basal ganglia in medicated subjects with panic disorder: a proton magnetic resonance spectroscopy (1H-MRS) study. Prog Neuropsychopharmacol Biol Psychiatry 2007;30:403–411. CrossRefGoogle Scholar
Schuff, N, Marmar, CR, Weiss, DS, Neylan, TC, Schoenfeld, F, Fein, G, Weiner, MW. Reduced hippocampal volume and n-acetyl aspartate in posttraumatic stress disorder. Ann N Y Acad Sci 1997;821:516–520. CrossRefGoogle ScholarPubMed
Schuff, N, Neylan, TC, Lenoci, MAet al. Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder. Biol Psychiatry 2001;50:952–959. CrossRefGoogle ScholarPubMed
Villarreal, G, Petropoulos, H, Hamilton, DAet al. Proton magnetic resonance spectroscopy of the hippocampus and occipital white matter in PTSD: preliminary results. Can J Psychiatry 2002;47:666–670. CrossRefGoogle ScholarPubMed
Neylan, TC, Schuff, N, Lenoci, M, Yehuda, R, Weiner, MW, Marmar, CR. Cortisol levels are positively correlated with hippocampal N-acetylaspartate. Biol Psychiatry 2003;54:1118–1121. CrossRefGoogle ScholarPubMed
Mohanakrishnan Menon, P, Nasrallah, HA, Lyons, JA, Scott, MF, Liberto, V. Single-voxel proton MR spectroscopy of right versus left hippocampi in PTSD. Psychiatry Res 2003;123:101–108. CrossRefGoogle ScholarPubMed
Mahmutyazicioglu, K, Konuk, N, Ozdemir, H, Atasoy, N, Atik, L, Gundogdu, S. Evaluation of the hippocampus and the anterior cingulate gyrus by proton MR spectroscopy in patients with post-traumatic stress disorder. Diagn Interven Radiol 2005;11:125–129. Google ScholarPubMed
Li, L, Chen, S, Liu, J, Zhang, J, He, Z, Lin, X. Magnetic resonance imaging and magnetic resonance spectroscopy study of deficits in hippocampal structure in fire victims with recent-onset posttraumatic stress disorder. Can J Psychiatry 2006;51:431–437. CrossRefGoogle ScholarPubMed
Ham, BJ, Chey, J, Yoon, SJet al. Decreased N-acetyl-aspartate levels in anterior cingulate and hippocampus in subjects with post-traumatic stress disorder: a proton magnetic resonance spectroscopy study. Eur J Neurosci 2007;25:324–329. CrossRefGoogle ScholarPubMed
Freeman, T, Kimbrell, T, Booe, Let al. Evidence of resilience: neuroimaging in former prisoners of war. Psychiatry Res 2006;146:59–64. CrossRefGoogle ScholarPubMed
Freeman, TW, Cardwell, D, Karson, CN, Komoroski, RA. In vivo proton magnetic resonance spectroscopy of the medial temporal lobes of subjects with combat-related posttraumatic stress disorder. Magn Reson Med 1998;40:66–71. CrossRefGoogle Scholar
Brown, S, Freeman, T, Kimbrell, T, Cardwell, D, Komoroski, R. In vivo proton magnetic resonance spectroscopy of the medial temporal lobes of former prisoners of war with and without posttraumatic stress disorder. J Neuropsychiatr and Clin Neurosci 2003;15:367–370. CrossRefGoogle ScholarPubMed
Kimbrell, T, Leulf, C, Cardwell, D, Komoroski, RA, Freeman, TW. Relationship of in vivo medial temporal lobe magnetic resonance spectroscopy to documented combat exposure in veterans with chronic posttraumatic stress disorder. Psychiatry Res 2005;140:91–94. CrossRefGoogle ScholarPubMed
De Bellis, MD, Keshavan, MS, Spencer, S, Hall, J. N-Acetylaspartate concentration in the anterior cingulate of maltreated children and adolescents with PTSD. Am J Psychiatry 2000;157:1175–1177. CrossRefGoogle ScholarPubMed
Seedat, S, Videen, JS, Kennedy, CM, Stein, MB. Single voxel proton magnetic resonance spectroscopy in women with and without intimate partner violence-related posttraumatic stress disorder. Psychiatry Res 2005;139:249–258. CrossRefGoogle ScholarPubMed
Lim, MK, Suh, CH, Kim, HJet al. Fire-related post-traumatic stress disorder: brain 1H-MR spectroscopic findings. Korean J Radiol 2003;4:79–84. CrossRefGoogle ScholarPubMed
Rosenberg, DR, MacMaster, FP, Keshavan, MS, Fitzgerald, KD, Stewart, CM, Moore, GJ. Decrease in caudate glutamatergic concentrations in pediatric obsessive-compulsive disorder patients taking paroxetine. J Am Acad Child Adolesc Psychiatry 2000;39:1096–1103. CrossRefGoogle ScholarPubMed
Whiteside, SP, Port, JD, Deacon, BJ, Abramowitz, JS. A magnetic resonance spectroscopy investigation of obsessive-compulsive disorder and anxiety. Psychiatry Res 2006;146:137–147. CrossRefGoogle ScholarPubMed
Bartha, R, Stein, MB, Williamson, PCet al. A short echo 1H spectroscopy and volumetric MRI study of the corpus striatum in patients with obsessive-compulsive disorder and comparison subjects. Am J Psychiatry 1998;155:1584–1591. CrossRefGoogle Scholar
Ebert, D, Speck, O, Konig, A, Berger, M, Hennig, J, Hohagen, F. 1H-magnetic resonance spectroscopy in obsessive-compulsive disorder: evidence for neuronal loss in the cingulate gyrus and the right striatum. Psychiatry Res 1997;74:173–176. CrossRefGoogle ScholarPubMed
Ohara, K, Isoda, H, Suzuki, Yet al. Proton magnetic resonance spectroscopy of lenticular nuclei in obsessive-compulsive disorder. Psychiatry Res 1999;92:83–91. CrossRefGoogle ScholarPubMed
Mirza, Y, O’Neill, J, Smith, EAet al. Increased medial thalamic creatine-phosphocreatine found by proton magnetic resonance spectroscopy in children with obsessive-compulsive disorder versus major depression and healthy controls. J Child Neurol 2006;21:106–111. CrossRefGoogle ScholarPubMed
Rosenberg, DR, Amponsah, A, Sullivan, A, MacMillan, S, Moore, GJ. Increased medial thalamic choline in pediatric obsessive-compulsive disorder as detected by quantitative in vivo spectroscopic imaging. J Child Neurol 2001;16:636–641. CrossRefGoogle ScholarPubMed
Smith, EA, Russell, A, Lorch, Eet al. Increased medial thalamic choline found in pediatric patients with obsessive-compulsive disorder versus major depression or healthy control subjects: a magnetic resonance spectroscopy study. Biol Psychiatry 2003;54:1399–1405. CrossRefGoogle ScholarPubMed
Fitzgerald, KD, Moore, GJ, Paulson, LA, Stewart, CM, Rosenberg, DR. Proton spectroscopic imaging of the thalamus in treatment-naive pediatric obsessive-compulsive disorder. Biol Psychiatry 2000;47:174–182. CrossRefGoogle ScholarPubMed
Jang, JH, Kwon, JS, Jang, DPet al. A proton MRSI study of brain N-acetylaspartate level after 12 weeks of citalopram treatment in drug-naive patients with obsessive-compulsive disorder. Am J Psychiatry 2006;163:1202–1207. CrossRefGoogle ScholarPubMed
Sumitani, S, Harada, M, Kubo, H, Ohmori, T. Proton magnetic resonance spectroscopy reveals an abnormality in the anterior cingulate of a subgroup of obsessive-compulsive disorder patients. Psychiatry Res 2007;154:85–92. CrossRefGoogle ScholarPubMed
Rosenberg, DR, Mirza, Y, Russell, Aet al. Reduced anterior cingulate glutamatergic concentrations in childhood OCD and major depression versus healthy controls. J Am Acad Child Adolesc Psychiatry 2004;43:1146–1153. CrossRefGoogle ScholarPubMed
Kitamura, H, Shioiri, T, Kimura, T, Ohkubo, M, Nakada, T, Someya, T. Parietal white matter abnormalities in obsessive-compulsive disorder: a magnetic resonance spectroscopy study at 3-Tesla. Acta Psychiatr Scand 2006;114:101–108. CrossRefGoogle ScholarPubMed
Renshaw, PF, Guimaraes, AR, Fava, Met al. Accumulation of fluoxetine and norfluoxetine in human brain during therapeutic administration. Am J Psychiatry 1992;149:1592–1594. Google ScholarPubMed
Strauss, WL, Layton, ME, Hayes, CE, Dager, SR. 19F magnetic resonance spectroscopy investigation in vivo of acute and steady-state brain fluvoxamine levels in obsessive-compulsive disorder. Am J Psychiatry 1997;154:516–522. Google ScholarPubMed
Vythilingam, M, Heim, C, Newport, Jet al. Childhood trauma associated with smaller hippocampal volume in women with major depression. Am J Psychiatry 2002;159:2072–2080. CrossRefGoogle ScholarPubMed
Bueno, CH, Zangrossi, H Jr, Nogueira, RL, Soares, VP, Viana, MB. Panicolytic-like effect induced by the stimulation of GABAA and GABAB receptors in the dorsal periaqueductal grey of rats. Eur J Pharmacol 2005;516:239–246. CrossRefGoogle ScholarPubMed
Zwanzger, P, Rupprecht, R. Selective GABAergic treatment for panic? Investigations in experimental panic induction and panic disorder. J Psychiatry Neurosci 2005;30:167–175. Google ScholarPubMed
Graeff, FG, Silveira, MC, Nogueira, RL, Audi, EA, Oliveira, RM. Role of the amygdala and periaqueductal gray in anxiety and panic. Behav Brain Res 1993;58:123–131. CrossRefGoogle ScholarPubMed
Villarreal, G, Hamilton, DA, Petropoulos, Het al. Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder. Biol Psychiatry 2002;52:119–125. CrossRefGoogle ScholarPubMed
Lindauer, RJ, Vlieger, EJ, Jalink, Met al. Smaller hippocampal volume in Dutch police officers with posttraumatic stress disorder. Biolo Psychiatry 2004;56:356–363. CrossRefGoogle ScholarPubMed
Wignall, EL, Dickson, JM, Vaughan, Pet al. Smaller hippocampal volume in patients with recent-onset posttraumatic stress disorder. Biol Psychiatry 2004;56:832–836. CrossRefGoogle ScholarPubMed
Vythilingam, M, Luckenbaugh, DA, Lam, Tet al. Smaller head of the hippocampus in Gulf War-related posttraumatic stress disorder. Psychiatry Res 2005;139:89–99. CrossRefGoogle ScholarPubMed
Devinsky, O, Morrell, MJ, Vogt, BA. Contributions of anterior cingulate cortex to behaviour. Brain 1995;118:279–306. CrossRefGoogle ScholarPubMed
Bremner, JD. Traumatic stress: effects on the brain. Dialogues Clin Neurosci 2006;8:445–461. CrossRefGoogle ScholarPubMed
Eichenbaum, H. Declarative memory: insights from cognitive neurobiology. Annu Rev Psychol 1997;48:547–572. CrossRefGoogle ScholarPubMed
Bremner, JD, Randall, P, Scott, TMet al. MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. Am J Psychiatry 1995;152:973–981. Google ScholarPubMed
Gilbertson, MW, Shenton, ME, Ciszewski, Aet al. Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nat Neurosci 2002;5:1242–1247. CrossRefGoogle ScholarPubMed
Shin, LM, Wright, CI, Cannistraro, PAet al. A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Arch Gen Psychiatry 2005;62:273–281. CrossRefGoogle ScholarPubMed
Modell, JG, Mountz, JM, Curtis, GC, Greden, JF. Neurophysiologic dysfunction in basal ganglia/limbic striatal and thalamocortical circuits as a pathogenetic mechanism of obsessive-compulsive disorder. J Neuropsychiatry Clin Neurosci 1989;1:27–36. Google ScholarPubMed
Castle, DJ, Phillips, KA. Obsessive-compulsive spectrum of disorders: a defensible construct? Aust N Z J Psychiatry 2006;40:114–120. Google Scholar
Woods, SW, Charney, DS, Silver, JM, Krystal, JH, Heninger, GR. Behavioral, biochemical, and cardiovascular responses to the benzodiazepine receptor antagonist flumazenil in panic disorder. Psychiatry Res 1991;36:115–127. CrossRefGoogle Scholar
Bernik, MA, Gorenstein, C, Vieira Filho, AH. Stressful reactions and panic attacks induced by flumazenil in chronic benzodiazepine users. J Psychopharmacol 1998;12:146–150. CrossRefGoogle ScholarPubMed
Aina, Y, Susman, JL. Understanding comorbidity with depression and anxiety disorders. J Am Osteopath Assoc 2006;106:S9–S14. Google ScholarPubMed
Yildiz-Yesiloglu, A, Ankerst, DP. Review of 1H magnetic resonance spectroscopy findings in major depressive disorder: a meta-analysis. Psychiatry Res 2006;147:1–25. CrossRefGoogle ScholarPubMed
Yildiz-Yesiloglu, A, Ankerst, DP. Neurochemical alterations of the brain in bipolar disorder and their implications for pathophysiology: a systematic review of the in vivo proton magnetic resonance spectroscopy findings. Prog Neuropsychopharmacol Biol Psychiatry 2006;30:969–995. CrossRefGoogle ScholarPubMed
Bertolino, A, Frye, M, Callicott, JHet al. Neuronal pathology in the hippocampal area of patients with bipolar disorder: a study with proton magnetic resonance spectroscopic imaging. Biol Psychiatry 2003;53:906–913. CrossRefGoogle ScholarPubMed
Miller, GA, Keller, J. Psychology and neuroscience: making peace. Curr Dir Psycho Sci 2000;9:212–215. CrossRefGoogle Scholar