Left Medial Temporal Cytosolic Choline in Early Onset Depression

Objective: Previous studies have linked the choline (Cho) resonance seen in proton magnetic resonance spectroscopy (1H-MRS) to major depressive disorder (MDD). We endeavoured to clarify the possible involvement of cytosolic choline in the amygdala (anterior medial temporal region) of juvenile subjects with MDD. Method: A total of 11 age- and sex-matched MDD and control pairs aged 14 to 18 years participated in long-echo proton magnetic resonance spectroscopic imaging (1H-MRSI) of the amygdala. Compounds available include N-acetyl-aspartate (NAA), creatine–phosphocreatine (Cr) and choline-containing compounds. Results: Subjects with depression demonstrated lower left amygdala Cho–Cr ratios, compared with control subjects (paired t = 2.624, df 10, P = 0.025). Left amygdala NAA–Cr and right amygdala Cho–Cr and NAA–Cr did not differ significantly between subjects with depression and control subjects. In subjects with depression, simple regression revealed a negative trend between left amygdala Cho–Cr and Beck Depression Inventory (BDI) score (F = 3.509, P = 0.098). Right amygdala NAA–Cr and Cho–Cr did not differ significantly. Conclusion: Cytosolic choline appears to be involved in the pathophysiology of early-onset MDD, likely secondary to corticosteroid-neuroendocrine-driven changes.