The abnormal choline to creatine ratio of the right anterior cingulate gyrus is linked to cognitive impairment in youth with major depressive disorder

BACKGROUND: Previous studies indicated that the notion that 20-40 % of patients with major depressive disorder (MDD) have cognitive impairments (CI). The mechanism of cognitive deficits in MDD is largely unknown. Recent evidence suggests that metabolic changes may be associated with poorer cognitive outcomes in MDD. METHOD: We recruited 105 right-handed, untreated youth with MDD patients, and 68 demographically matched healthy controls (HCs), and underwent the MATRICS Consensus Cognitive Battery (MCCB) assessment and proton magnetic resonance spectroscopy (1H-MRS) scan in the anterior cingulate gyrus (ACC) and putamen. Differential and association analysis was performed to investigate the relationship between cognitive performance and neurometabolism ratios of ACC and putamen in MDD groups. RESULTS: Thirty-nine patients defined as CI group (>1.5 SD below the normal mean of MCCB in two or more MCCB domains) and 67 patients for NCI (without CI) group. The CI group exhibited significantly higher Cho/Cr ratios in the right ACC when compared to the NCI group and HCs groups. Both CI and NCI groups showed significantly higher Cho/Cr ratios in the left putamen compared to the HCs. Meanwhile, the number of episodes were positively correlated with the Cho/Cr ratios in the left putamen (r = 0.35, p = 0.035) in CI group. CONCLUSION: Our findings suggest that both CI and NCI MDD may experience putamen dysfunction. Additionally, the frequency of depressive episodes appears to have a cumulative effect on alterations in the Cho/Cr ratios in the putamen. Concurrently, an increased Cho/Cr ratio in the ACC is linked to widespread cognitive deficits in MDD patients. These results may point to a subgroup of patients who could benefit from interventions aimed at modulating brain functional status.