Tryptophan metabolite concentrations in depressed patients before and after electroconvulsive therapy.
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Authors
Ryan, Karen M
Allers, Kelly A
McLoughlin, Declan M
Harkin, Andrew
Issue Date
2019-10-10
Type
Journal Article
Research Support, Non-U.S. Gov't
Research Support, Non-U.S. Gov't
Language
en
Keywords
Depression , Electroconvulsive therapy , Kynurenine pathway , Non-psychotic , Remission , Unipolar
Alternative Title
Abstract
Tryptophan and kynurenine pathway (KP) metabolites are implicated in the pathophysiology of depression. We aimed to investigate their plasma concentrations in medicated patients with depression (n = 94) compared to age- and sex-matched healthy controls (n = 57), and in patients with depression after electroconvulsive therapy (ECT) in a real-world clinical setting, taking account of co-variables including ECT modality and heterogenous psychopathology. Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D24). Tryptophan (TRP) and kynurenine (KYN) metabolite concentrations [anthranilic acid (AA), 3-hydroxyanthranilic acid (3HAA), picolinic acid (PA), kynurenic acid (KYNA), and xanthurenic acid (XA)] and KYNA/KYN and KYNA/quinolinic acid (QUIN) ratios were lower in patients compared to controls. For the total group there was no significant change in KP metabolites post-ECT or correlations with mood ratings. However, improvements in mood score were correlated with increased KYN, 3-hydroxykynurenine (3HK), 3HAA, QUIN, and KYN/TRP in a subgroup of unipolar depressed patients. Additionally, in remitters baseline KYN, 3HK, and QUIN were associated with baseline HAM-D24 scores, and changes in 3HK and 3HAA concentrations post-ECT correlated with improvement in mood. KYN, KYNA, AA, 3HK, XA, PA, and QUIN were increased in a smaller 3-month follow-up group (n = 19) compared to pre-ECT concentrations. Overall, the results indicate that ECT mobilizes the KP, where a moderate association between selected metabolites and treatment response in unipolar depressed patients is evident.
Description
Citation
Ryan, K. M., Allers, K. A., McLoughlin, D. M., & Harkin, A. (2020). Tryptophan metabolite concentrations in depressed patients before and after electroconvulsive therapy. Brain, behavior, and immunity, 83, 153–162. https://doi.org/10.1016/j.bbi.2019.10.005
Publisher
License
Copyright © 2019 Elsevier Inc. All rights reserved.
Journal
Brain, behavior, and immunity
Volume
83
Issue
PubMed ID
ISSN
1090-2139