Proton magnetic resonance spectroscopic imaging in pediatric major depression

Background: Neurobiologic abnormalities in dorsolateral prefrontal cortex (DLPFC) are believed to be involved in the pathophysiology of major depressive disorder (MDD). Although MDD commonly emerges during childhood and adolescence, to our knowledge, no prior study has examined the DLPFC in pediatric patients with MDD. Methods: In this study, choline compounds (Cho), N-acetylaspartate (NAA), and creatine/phosphocreatine (Cr) were measured in left and right DLPFC using a multislice proton magnetic resonance spectroscopic imaging sequence with validated phantom replacement methodology in 11 treatment-naïve MDD patients, 10-16 years of age, and 11 case-matched healthy control subjects. Results: A significant increase in Cho was observed in left but not right DLPFC in MDD patients versus control subjects (32.5% higher). No significant differences in NAA or Cr were observed between case-control pairs. Conclusions: These results provide new evidence of localized functional neurochemical marker alterations in left DLPFC in pediatric MDD. Our results must be considered preliminary, however, given the small sample size.