Neurometabolics of the anterior cingulate cortex (ACC) in major depressive disorder (MDD): A systematic review and meta-analysis

H-MRS) studies for meta-analysis. Average concentrations of eight neurometabolites were compared using a random effects model. We found that subjects with MDD had significantly decreased N-acetylaspartate (NAA; Hedges' g = -0.16, 95% CI -0.299 to -0.030, p = 0.017), and gamma-aminobutyric acid (GABA; Hedges' g = -0.26, 95% CI -0.434 to -0.082, p = 0.004), and increased levels of glutamine (Gln; Hedges' g = 0.21, 95% CI 0.105 to 0.311, p < 0.001) in the ACC. Subgroup analyses suggested significantly increased NAA detected by magnets stronger than 1.5 Tesla only, glutamate (Glu) in the dorsal ACC only and significantly increased myo-inositol (mI) and choline (Cho) in exclusively unmedicated subjects. This study provides a summative picture of the neurometabolic profile of the ACC in people with MDD and provides a foundation for the development of biomarker-based diagnostic criteria and novel pharmacological treatments.

Authors

• Ava J. White
• Jennifer L. Robinson
• Alan E. Wilson
• Meredith A. Reid

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