Neurometabolic alterations in the anterior cingulate gyrus and putamen: Insights from adolescents with insomnia and depression.
TL;DR
Preliminary findings highlight the need for further investigation into the neurobiological relevance of sleep disturbances in adolescent MDD, which may be associated with altered brain neurometabolism.
Abstract
Background
Sleep disorders are common in adolescents with major depressive disorder (MDD), with an incidence rate surpassing that of low mood. Nonetheless, the effects of sleep disturbances on brain function in adolescent MDD remain unclear.
Method
97 right-handed, untreated adolescents with MDD and 63 healthy controls (HCs) underwent proton magnetic resonance spectroscopy (1H-MRS) scans of the anterior cingulate cortex (ACC) and putamen. Differential and association analysis examined the relationship between sleep quality, depression severity, and neurometabolic ratios of ACC and putamen in MDD groups.
Results
Among 97 MDD patients, 64 were categorized into the insomnia symptom (IS) group, with an insomnia item score ≥ 1 on Hamilton Depression Rating Scale (HDRS) and a Pittsburgh Sleep Quality Index score ≥ 6. IS group exhibited significantly lower choline-to-creatine (Cho/Cr) ratios in the right ACC compared with the NIS group and HCs, and a higher Cho/Cr ratio in the right putamen compared with HCs. NIS group showed lower N-acetylaspartate-to-creatine (NAA/Cr) ratios in the right putamen compared with the IS group and HCs. Within the IS group, HDRS scores showed nominal negative correlations with NAA/Cr ratios in the bilateral ACC and Cho/Cr ratios in the right ACC. Insomnia item scores were nominally correlated with Cho/Cr ratios in the left ACC. However, these correlations did not survive FDR correction.
Conclusion
A substantial proportion of adolescents with depression experience sleep disturbances, which may be associated with altered brain neurometabolism. These preliminary findings highlight the need for further investigation into the neurobiological relevance of sleep disturbances in adolescent MDD.