Abstract
ObjectiveThe anterior cingulate cortex (ACC) is associated with the processing of negative emotions. Gamma-aminobutyric acid (GABA) metabolism plays an important role in the pathogenesis of mental disorders. We aimed to determine the changes in GABA levels in the ACC of perimenopausal women with depression.MethodsWe recruited 120 perimenopausal women, who were followed up for 18–24 months. After reaching menopause, the participants were divided into a control group (n = 71), an anxiety group (n = 30), and a depression group (n = 19). The participants were examined using proton magnetic resonance spectroscopy (MRS). TARQUIN software was used to calculate the GABA concentrations in the ACC before and after menopause. The relationship of the GABA levels with the patients’ scores on the 14-item Hamilton Anxiety Scale and 17-item Hamilton Depression Scale was determined.ResultsGABA decreased with time. The postmenopausal GABA levels were significantly lower in the depression group than in the anxiety group and were significantly lower in both these groups than in the normal group. The postmenopausal GABA levels were significantly lower than the premenopausal levels in the normal, anxiety, and depression groups (P = 0.014, <0.001, and <0.001, respectively). The premenopausal GABA levels did not significantly differ between the normal vs. anxiety group (P = 0.907), normal vs. depression group (P = 0.495), and anxiety vs. depression group. The postmenopausal GABA levels were significantly lower in the depression group than in the anxiety group and were significantly lower in both these groups than in the normal group, normal vs. anxiety group (P = 0.022), normal vs. depression group (P < 0.001), and anxiety vs. depression group (P = 0.047).ConclusionChanges in GABA concentrations in the anterior cingulate cortex are related with the pathophysiological mechanism and symptoms of perimenopausal depression.
Highlights
The anterior cingulate cortex (ACC) is closely related to the occurrence and development of depression
The postmenopausal GABA levels were significantly lower in the depression group than in the anxiety group and were significantly lower in both these groups than in the normal group
The postmenopausal GABA levels were significantly lower than the premenopausal levels in the normal, anxiety, and depression groups (P = 0.014,
Summary
The anterior cingulate cortex (ACC) is closely related to the occurrence and development of depression. The ACC occupies the rostral portions of Brodmann areas 24, 25, 32, and 33, and is activated by diverse tasks, ranging from emotion processing and regulation to attention and cognitive control (Ferrone et al, 2007). Many previous studies have confirmed the significant association of the ACC, especially the subgenual ACC, with the processing of negative emotions. The pregenual ACC is considered to be associated with cognitive functions such as social cognition, including theory of mind tasks and conflict monitoring (Ferrone et al, 2007; Formica et al, 2007; Ferolla et al, 2011). A meta-analysis has shown that women in the perimenopausal period were vulnerable to anxiety or depression, and had more severe symptoms than women in the premenopausal period (de Kruif et al, 2016). The pathophysiological mechanisms of perimenopausal depression are still unknown
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